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 Local Health Officials and Physicians Share H1N1 Information

As the health care community and people around the world continue to learn about H1N1 virus, Miami County health officials and medical experts want local residents to be aware of what is known, and what remains to be determined.

“There are some things we know, but there’s a whole lot we don’t know at this point. It is going to shake out over the next month or so,” said James Burkhardt, D.O., medical director of the Miami County Health District.

In the meantime, Health District and hospital representatives and physicians are discussing the facts, and focusing on what people can do to try to avoid the virus, also known as swine flu.

“The severity of the flu season will be largely based on choices people make,” said Chris Cook, Health District emergency preparedness coordinator. “Are people going to make that choice to stay home when they are sick, to cough in their sleeve? I am putting the responsibility back on people,” Cook said. “We are going to have cases; people are going to be sick. We are going to immunize, but I think people need to be responsible for themselves because it affects everyone else.”

Miami County Health Commissioner Jim Luken said the Health District will be giving the H1N1 vaccine at no charge.  At this time, the county is scheduled to receive 13,000 doses of vaccine in mid-October, then more every two weeks until year’s end. Public clinics will be scheduled and announced once the vaccine is in the local Health District’s refrigerators, Luken said.

Local pharmacies and physician offices may request vaccine to give patients, which would help in getting those targeted for vaccinations seen in a timely manner. Those targeted include: pregnant women, children 6 months through age 4, people who live with/care for children under 6 months, children 5-18 years with chronic medical conditions, and health care and emergency services workers who provide direct patient care. Physician offices and pharmacies may charge an administration fee for the vaccinations, depending on their individual policies.

“Our purpose isn’t to do it all ourselves (give vaccinations). It is to make sure it gets done,” Luken said.

Still under discussion is the best way to get vaccinations to school-age children. In the meantime, the Health District is in contact with school superintendents about what is and is not known at this time, Luken said.
The vaccine is optional, and at this time still being tested to determine how much vaccine is needed to boost the immune system. For example, two shots -- a shot and a booster one month later – may be viewed as most effective for certain recipients.
Those with questions about the safety of the vaccine, particularly pregnant woman, are urged to review as much information as possible (see accompanying article “Practical Advice for H1N1”), and to discuss any questions with their physician.
“An ongoing relationship with a primary care doctor is especially important at times such as this,” said Barbara Evert, M.D., UVMC Vice President and Chief Medical officer.  “Anyone who doesn’t already have a physician is urged to get one, she stressed, adding that the CareFinders free physician referral service is available to help at 1-866-608-3463.
In Miami County, 25,000 people fall within the vaccination target group set by the Centers for Disease Control. That is more than the average year for seasonal flu vaccinations, but Luken said he believes the system is in place to handle those seeking the H1N1 vaccine.
Medical experts said they expect some confusion between the annual seasonal flu vaccine and the H1N1.  The annual seasonal flu shots at the Health District will begin the week of Oct. 5.
“I would hope that people don’t get so focused on H1N1 that they forget the seasonal flu,” said Sondra Christian, Director of Public Health Nursing for the Health District. Other places, such as pharmacies, may start giving them earlier.

The recommendation is that those over 65 not receive the H1N1 vaccine because that age group has a very low likelihood of getting sick. With seasonal flu, however, the older age group is the vaccination target.

Scott Swabb, D.O., Medical Director of the Piqua Health Department, said he has a simple answer for those over 60 who may ask why they are not targeted for the H1N1 vaccine.
“My explanation to them is there is some cross reactivity protection from the influenza virus (that hit) early in the 1950s. So they have some immunity while younger people don’t,” Dr. Swabb said.

If there is extra vaccine after the risk groups have been immunized, the vaccine then will be administered to those outside the identified risk group who want the vaccine, Luken said.
No one knows how bad the H1N1 season will be.
Ronal Manis, M.D., Medical Director of Infection Control at Upper Valley Medical Center, said pandemics happen randomly every so many years. In the past century, they have included the pandemics of 1918, 1957 and 1968.
“It appears this is more common with some of the less virulent things we have seen in ’68 and ’57. The only concern about it is whether it will change its strength, so to speak, and assume a more virulent form,” Dr. Manis said.

However, he and other local experts agreed the situation cannot be taken lightly.
With information on H1N1 everywhere – from nightly updates on the television news to headlines in national newspapers and magazines – Dr. Manis said it is wise to focus on the information available, not the volume of information.
“My recommendation to people would be to listen to the facts and not the repetition. I would also advise them to turn to the authorities, the county health personnel, for any questions they would have as this evolves,” Dr. Manis said.

Read H1N1 Tips.