One In 3 St. Francis Prep Students Had Flu-Like Symptoms
The Health Department today updated the flu situation in New York City, reporting five more probable cases of infection with the newly identified flu virus known as H1N1 (SO). The agency has sent specimens from the five affected people to the Centers for Disease Control and Prevention (CDC) for confirmatory testing. The agency is now awaiting confirmatory results for 33 probable cases. To date, nearly all confirmed and probable cases have been mild, and all of the affected people have recovered or are recovering. No deaths have been associated with the illness in New York City.
Until now, every case in New York City had been linked to a known area of high transmission – either Mexico or the St. Francis Preparatory school in Queens – but the probable infections now include at least one patient not known to be associated with outbreaks. The St. Francis-associated probable cases include five from Public School Q177 in Queens, a school nearby St. Francis, where roughly a dozen students reported flu-like illness earlier this week. The school has been closed since Wednesday. While the school has been closed, Health Department personnel have visited homes of affected students and collected nasal swabs for analysis.
The testing completed this week has not found any probable cases of H1N1 (SO) flu at Manhattan’s Ascension School, where several students became ill this week. Some tested positive for seasonal influenza, but the tests ruled out the virus associated with H1N1 (SO) flu. Additional testing also showed that a 20-year-old Pace University student who was briefly hospitalized with mild illness this week had seasonal influenza, and not the new H1N1 strain. The Health Department had classified the student as a probable case yesterday, after conducting preliminary tests. The student was discharged yesterday and is recovering at home.
“Working together we can better understand H1N1 (SO) flu and find the most appropriate and effective ways to reduce its impact,” said Dr. Thomas R. Frieden, New York City Health Commissioner. “As we search for these answers, everyone can help stop the spread of flu by taking simple steps. Cover your mouths when you cough or sneeze, wash your hands regularly and thoroughly, and stay home if you come down with fever and a cough.”
As part of its effort to understand, and interrupt, the spread of H1N1 (SO) flu in New York City, the Health Department created an online questionnaire to survey students, parents and staff at the St. Francis Preparatory school. The agency reported the findings in a monograph sent to the school community and a report published Thursday night by the CDC.
In the survey, which drew a 75% response rate, more than 1,000 St. Francis students, parents and faculty members reported that they had experienced flu-like symptoms since early April. A third of students developed symptoms, and the number of affected people surged on Wednesday, April 22 (see chart). In addition, nearly a third of the affected students reported that at least one additional household member developed a fever and either cough or sore throat.
Six of the affected students, and one faculty member, had a connection to Mexico, where the illness was first reported. Nationwide, many cases of H1N1 (SO) flu have been linked to Mexico in recent days, but other findings indicate that spread is occurring within the United States.
The symptoms of H1N1 (SO) flu seem to resemble those of seasonal flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting as well. New Yorkers experiencing severe symptoms, such as difficulty breathing, should seek health care and treatment. Otherwise, the Health Department recommends at-home care.
The Health Department is advising physicians not to over-prescribe Tamiflu for patients with mild symptoms. Antiviral medications should only be used for people with severe illness and to treat H1N1 (SO) flu (or prevent it in those exposed to confirmed or likely cases) among those at risk of complications from flu, such as young children, the elderly and people with chronic medical conditions. The Health Department will continue to work with medical providers to test flu patients who develop severe illness or are associated with clusters, but does not currently recommend testing for all flu patients.
In recent days, some businesses have mistakenly reported confirmed cases of H1N1 (SO) flu in their workplaces. H1N1 (SO) flu cannot be diagnosed by local doctors or hospitals. At present, only the Health Department’s Public Health Laboratory can determine if a case is probable, and only CDC can confirm it. In fact, in recent days the Department’s Public Health Laboratory has confirmed many cases of seasonal flu, which is indistinguishable from H1N1 (SO) by testing in doctor or hospital laboratories.
Eating pork or pork products cannot spread H1N1 (SO) flu. The most effective way to lower the risk is for people with fever and either cough or sore throat to stay home.
* All New Yorkers should cover their mouths when they cough with their sleeve or a tissue or handkerchief.
* Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
* Try to avoid close contact with sick people.
* Stay home at least 7 days if you have fever accompanied by cough or sore throat. Do not return until a day or two after your illness resolves.
* Stay away from clinics and hospitals unless you have severe symptoms.
School and day care administrators, employers and managers of group living facilities should make sure to do the following to avoid the spread of illness:
* Keep shared spaces clean and well ventilated.
* Group living facilities should separate people who are sick
* Schools and employers should encourage those who are sick to stay at home, but should not require doctors’ notices to let healthy people return.
Flu epidemics evolve in unpredictable ways; it is impossible to know whether this one will dwindle, remain the same, or surge in coming weeks, and whether the illness will remain mild. Some severe cases are likely in people with underlying risk factors – such as young children, the elderly, and people with chronic medical conditions –the Health Department is watching closely for signs of increased virulence. For facts about influenza, and more information about H1N1 (SO) flu, please visit the Health Department and CDC websites.