H1N1 Cases Continue To Be Mild In NYC
Intensive investigation of the newly identified H1N1 virus shows that the illness continues to be mild in New York City so far. “We have looked daily at every hospital and every intensive care unit in the city within the past 10 days,” said Dr. Thomas R. Frieden, New York City Health Department Commissioner, “and we have yet to find a single patient with severe illness from H1N1 (SO).” The Health Department also reported that testing at the Centers for Disease Control and Prevention (CDC) have confirmed 11 more cases of H1N1 (SO) infection in New York City. The new results bring the number of confirmed cases to 73. The CDC is currently testing six more probable cases from New York City.
Dr. Frieden cautioned that the Health Department’s case counts do not reflect the city-wide infections since the Health Department is not recommending or offering H1N1 testing for people with mild flu symptoms. Confirming an H1N1 infection is not necessary except for those who have more severe illness since most people will recover on their own and do not need to take medicine for flu. In addition, not all people with influenza infection have symptoms – as many as a third may not. It is possible that hundreds, perhaps thousands, of New Yorkers have already encountered the new virus but experienced only mild symptoms. In a survey released last Friday, the agency identified more than 1,000 likely cases among students, staff and household members associated with the St. Francis Preparatory School in Queens.
The Health Department is now collaborating with the CDC to further assess the St. Francis outbreak. Besides surveying affected households, the two agencies will collect and analyze blood samples from a small subset of households to determine the actual rate of infection. St. Francis closed on Monday, April 27, and reopened today, May 4. Students with fever and a cough or sore throat – there or at any other school – should stay home until they have recovered and been symptom-free for at least 24 hours.
Among the newly confirmed cases are several from Public School Q177, in Queens, where roughly a dozen students reported flu-like illness last week. The school has been closed since Wednesday, April 29, and plans to reopen on Wednesday, May 6. The new tally also includes two confirmed cases and one probable case, all in adults, who are not associated with places where spread of the virus has been established (Mexico or the St. Francis Preparatory School). This is further evidence that the H1N1 (SO) is not confined to a particular group but is spreading more widely, as human flu viruses generally do.
Although H1N1 (SO) is likely spreading, it does not appear to have caused more severe illness than seasonal flu. But seasonal flu can be serious, especially among infants, the elderly, and people with underlying health conditions. While searching for new probable cases of H1N1 (SO) flu, the Health Department has linked several cases of serious illness – and at least two clusters, one of them at a school – to human H3N2 seasonal flu viruses. “Any kind of flu can be serious, especially for infants, the elderly, and people with underlying health conditions,” Dr. Frieden said. “That’s why covering coughs and sneezes, hand-washing, and staying home when you’re sick are so important.”
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.
Antiviral medications are particularly important for people with severe illness and to treat both H1N1 (SO) flu and seasonal 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 patients who develop severe illness or are associated with clusters, but does not currently recommend testing for patients with mild illness.
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.
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.
* If you are sick with fever and either a cough or sore throat, stay home for at least 24 hours after all of your symptoms are gone.
* Stay away from clinics and hospitals unless you have severe symptoms, and notify your doctor or the clinic before, or as soon as you arrive, that you have a fever and respiratory systems so that you can be appropriately isolated from others.
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.
* Encourage hand washing and the covering of mouths when coughing.
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 may occur 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.