County has prepared for flu

by Derek Farr

In Mexico, schools are closed. Public venues are locked tight, and soccer games at Mexico City’s 110,000-capacity Azteca Stadium are played in front of empty bleachers.

The drastic actions are in response to a new derivative of the H1N1 swine flu.

More than 1,700 miles north, Sublette County seems like a world away, but local health officials aren’t taking any chances.

The county is taking the swine flu very seriously.

“Right now I would say we are in an anticipatory mode,” said Sublette County Health Officer Dr. Thomas Johnston. “We don’t really know what’s going to happen, but we’re getting ready.”

For more than two years, county health officials have been conducting meetings and holding tabletop exercises as a way to prepare for the inevitable.

When the next pandemic arises, local officials want to be ready.

“We already have the superstructure set up,” Johnston said. “We have supplies on tap. We have pharmaceuticals deposited in depots around the state and there is already a modus set up to have those delivered.”

Thus far none of it’s needed.

As of Wednesday morning, the Wyoming Department of Heath said there are no confirmed or suspected cases of swine flu in the state.

But that’s not to say it won’t get here. State epidemiologist Dr. Tracy Murphy says it’s realistic it will turn up here in low levels. State Health Director Dr. Brent Sherard had a similar prognosis saying, “I would be surprised if we don’t have any cases. It’s just a matter of time.”

Johnston agrees. He believes the county’s isolation is not a firewall against the greater epidemiological world.

“We are very much in the mainstream,” he said.

That fact has local health services ready to act.

At the ready

Dr. James Quirk reports local health officials have been in touch with Johnston daily. He also says they “have implemented isolation and testing protocols at both county clinics for people whom meet certain criteria.” In addition, both staffs have been instructed on what to look for and what precautions to take with a high-risk patient.

For the layperson, swine flu symptoms are high fever, severe body aches, headaches, coughing, sore throat, diarrhea, vomiting, extreme fatigue and chills.

As of Tuesday, those symptoms have led to more than 90 confirmed cases and one death, among 10 states, in the U.S. Further south, Mexico has seen nearly 150 fatal cases.

And those deaths are at the heart of the concern. While the regular seasonal H1N1 flu, kills an average of 30,000 Americans a year, those individuals tend to be elderly or have compromised immune systems. In Mexico, the new H1N1 flu derivative has killed a disproportionate number of young, healthy people.

That harkens back the pandemic of 1918 that killed 100 million people, many of whom were in the prime of their lives.

Just such a catastrophe has prompted local health officials to participate in preparedness drills.

“I think for the public a lot of people know that there has been planning that has been going on,” said Mary Lynn Worl, Sublette County coordinator of the pandemic influenza task force. “The county has been taking steps to prepare for these emergencies.”

The last training was in April.

Common sense things

Those preparations are in stark contrast to the 1918 pandemic where health officials were virtually ignorant of what precautions to take. Sweeping through army barracks of closely housed soldiers destined for European battlefields, the 1918 flu took a heavy toll on tens of thousands of doughboys.

Those conditions are in stark contrast to today’s instructions.

“At this point we’re using common sense things,” said Sublette County Public Health Nurse Manager Dareth Gehlhausen. “Good hand washing. If you’re ill, don’t go to work. If somebody shows up to work ill, they should go home.”

She advised to use tissue and cover your mouth when you sneeze or cough and throw the tissue into the trash. If you don’t have tissue, it’s best to sneeze in the crook of your elbow and not on your hands.

Gehlhausen also suggests people relax and not panic. She says the U.S. flu cases are mild compared to the ones in Mexico, and affected patients are responding to TAMIFLU.

The virulence of the virus strain is elementary to a pandemic. Few realize the H1N1 seasonal flu is the same as the H1N1 “Spanish flu” of 1918. The difference is its ferocity. The new H1N1 flu derivative has struck hard in places like Oaxaca, Mexico. Other flu strains such as the H5N1 bird flu usually strikes its victim even harder, but at this point H1N1 is far more menacing.

While H5N1 delivers a vicious blow, it is most typically transferred from bird to human, the new swine flu is transmitted from person to person, and that’s a prerequisite for a pandemic.

The flu virus is typically spread by mucus and salvia. Coughing and sneezing helps the virus spread. Once free of its host, most viruses survive a surprisingly long time on virtually any surface such as doorknobs, desktops, phones and computers. And just like previous human-to-human virus, the new H1N1 flu appears to be extremely contagious.

That is on the mind of Sublette County EMS supervisor Will Gay. His emlpoyees are beholden to serve the community even when faced with a potential pandemic illness.

But Gay is optimistic that the training his staff completed in April will keep his people one step ahead of danger.

“Basically we’re going to try to protect our crews,” he said. “It will be interesting to see if or when it comes here.”

And if it does come here, there are protocols.

Johnston said a person with flu symptoms would receive a nasal swab at the clinic. From there an in-house test will determine if it’s influenza. If it tests positive, another nasal swab will be sent to a state testing facility that will determine the viruses’ strain.

If it is swine flu, those years of preparation will come into play.

As of Wednesday morning, the state tested four nasal swabs with none showing N1H1.

Will it or won’t it?

While it is possible the new N1H1 flu will miss Sublette County, our community’s transient population makes that unlikely.

Just as the community makes preparations for a pandemic, residents can do the same.

Most agencies suggest stockpiling two weeks worth of food and medication.

Johnston strongly advocates yearly flu shots.

More information including home, business, school and community planning can be found at http://www.pandemicflu.gov.

While governments around the world prepare to take action, Johnston calls this latest flu outbreak a wake up call.

Now comes the anxious task of watching and waiting.

“We’re not at the ‘here it comes’ point yet,” Johnston said. Instead he described it as “looking over the neighbor’s fence.” And one afflicted traveler could breach that fence. It’s possible he wouldn’t even know he was infected.

A person typically becomes contagious before the first symptoms set in.

For Sublette County health workers, the anxiety of anticipation is tempered by years of preparation and thoughtful deliberation. Community leaders across the nation strongly advocate a similar level of preparedness for individuals and families. Unfortunately, pandemics are as much of a certainty as blizzards are in the Upper Green River Valley: eventually it will happen.

And when it does, being educated and prepared is the best defense.