H1N1 flu in 48 states, tribal death reported

Death reported at Gila River Indian Tribe 

By Terri Hansen
Environment and Science Reporter (NFIC) UPDATED May 21

The H1N1 “swine flu” virus has claimed the lives of 10 Americans and infected at least 5,764 victims in 48 U.S. states, but confirmed cases in Indian Country remain low. Dr. John Redd, an Indian Health Service epidemiologist said that as of May 20 there were 35 confirmed cases in Indian Country, and 13 probable cases. The Arizona Pima County Health Department reported the death of a Gila River Indian Tribe 57-year-old woman May 19. The woman had pre-existing medical conditions.

Officials report that most people infected and hospitalized in the U.S. are young adults, teens, and older children. The Center for Disease Control released results of blood sampling that indicate the current flu vaccine “is unlikely to provide protection against the (H1N1) virus,” but that adults over age 60 may have immunity against the virus due to having been previously exposed to or vaccinated against a similar strain, and people born before 1957 likely carry some degree of pre-existing immunity to the virus.

Check with tribal and local websites to learn what actions you should take if you suspect the flu. Healthy practices, such as staying home if you are ill to keep from infecting others and  frequent hand washing to keep from infecting yourself can keep you and your family well. If you haven’t already done so, make a plan for staying in touch with your family and local community resources.

MAY 6 -- Whether you call it swine flu, or the more scientific influenza A/H1N1, the official word is -- this has the potential for a pandemic.

The World Health Organization announced they may raise their alert to a Phase 6, the highest level on the pandemic alert scale. They are warning against overconfidence, even though health officials are reporting most cases of the H1N1 virus have been mild.

The U.S. has declared a public health emergency, which federal officials say is a precaution. By May 6, 41 states were reporting confirmed cases of influenza A-H1N1 infection, and 23 countries were reporting 1750 cases. The U.S. Centers for Disease Control and Prevention is ramping up the numbers of people tested, and expect the virus to soon spread to all 50 states.

Most cases of the flu have been mild. School closure policies are changing from school closures, to personal responsibility: keeping your children home if they show signs of illness, to prevent the virus from spreading.

No new cases have developed in Indian Country over the last 36 hours, according to Indian Health Service sources. The IHS is reporting four confirmed cases on the Tohono O’odham Nation in Pima County, Ariz. A case at the Confederated Tribes of Grand Ronde in Oregon, which closed a school campus, turned out not to be A/H1N1 but another flu strain. There is a strong likelihood of more cases. Dr. John Redd, director of the IHS Division of Epidemiology, said that without a shadow of a doubt “if a case is confirmed in a community, there are more cases.” As was the CDC policy, the IHS is more concerned with knowing where the virus has spread than the case count.


The IHS activated its emergency coordination center to assist the tribes in responding to any new outbreak, and Redd said all the tribes have activated their emergency response plans. “We feel the response so far as gone extremely well,” he said.

Non-IHS medical providers are also gearing up. “We’ve had calls from worried patients, but we haven’t seen any signs of disease,” reports Dr. Julia Wong, a physician with the Portland, Ore., Native American Rehabilitation Association. “We’ve got protocols arranged with the (local government) that provide a safety net for the clinic’s patients.”

This virus is unlike other viruses that have emerged in the past. “We have a new influenza virus, it’s spreading, we don’t know as much as we’d like to about the way it’s going to behave in our communities,” the CDC said. If the outbreak turned into a very severe pandemic, schools could be dismissed for months, she said.  The Education Department said school closures have affected well over 500,000 children. 

It’s a difficult call for health officials. During the swine flu threat of 1976, a government program vaccinated nearly 25 percent of the population. While only 200 people came down with the flu virus, over 500 developed Guillain-Barre syndrome, a rare neurological disorder that causes temporary paralysis; 25 died. It cost the government millions in damages, and it cost them credibility.

There’s also the specter of the 1918 Spanish flu, a human-to-human transmissible swine flu that turned into the most deadly human plague of the twentieth century. This new flu virus lacks genes that made the 1918 pandemic so deadly, the CDC told the public May 1.

This new flu virus lacks genes that made the 1918 pandemic so deadly, the CDC told the public May 1.

The CDC is asking communities, businesses, churches, schools and individuals to all take action to slow the spread of this outbreak. People who feel sick are asked to stay home from work or school and to avoid contact with others, except to seek medical care. This action alone can avoid spreading illness further. Obama, the states and many organizations are urging employers to let infected workers take all the sick days they need.

There is no vaccine yet for this novel virus but two antiviral medications, Tamiflu and Relenza, are effective treatments for those with serious illness if used early in the course of the disease.

The U.S. shipped one-fourth of the nation’s 50 million treatment courses of anti-viral drugs from the Strategic National Stockpile to the states, and are replenishing their supplies with millions more treatment courses. Redd said the IHS supply center has their own stockpile. If those supplies are used up, then the anti-virals are distributed through the states to medical facilities, both tribal and non-tribal, he said.

The symptoms this flu produces are usually fever, cough, sore throat, headaches, muscle aches, fatigue, and occasionally vomiting and diarrhea. It’s not a particularly virulent flu, CDC spokesperson Karen Hunter said. “It’s just that it’s a new strain, and the human population hasn’t built up a resistance.” She said the flu causes 36,000 deaths worldwide in any given year, and the CDC does not expect this flu to exceed that. If it turns out that the H1N1 continues to be relatively mild now, it could come back in a more virulent form during the actual flu season.

There is confusion about whether this new strain of virus, originally said to be of swine, bird, and human origin, is only swine. Latest reports are it is two different strains of swine, plus bird, plus human, or quadruple. The newest data also confirms is that this strain spreads by human-to-human contact. And whether or not this is a pig virus, eating pork won’t give it to you.

Flu is caused by airborne spread of droplets, and everyday actions such as staying away from someone with the disease, can keep you from catching it. Seek medical care if you or someone in your family shows symptoms of the flu. Young children may not have typical symptoms, but may show signs of low activity and have difficulty breathing.

To protect the public stay home if you are sick. To protect yourself the CDC recommends frequent hand washing with soap or detergents, social distancing – keeping a distance between you and people who may be sick, and using tissues or sneezing into the crook your elbow to keep from sending it airborne.

For worried families the Red Cross website is counseling that “knowing what to expect, how to prepare and where to find needed information and support can increase your resilience, decrease your stress and minimize the impact on you and your loved ones.” For more information on pandemic preparedness, visit www.pandemicfluandyou.org.

The CDC (www.cdc.gov/swineflu) and the federal government’s consolidated pandemic influenza web site (www.pandemicflu.gov) are good sources of information about pandemic flu.

Those without access to a computer can call the CDC’s toll-free hotline: 1-800-CDC-INFO (1-800-232-4636). The number for the hearing impaired is 1-888-232-6348.

Good advise for parents on talking to children, see: http://bit.ly/7NNCU.

Story Updated May 6, 1 pm PDT. For updates on the H1N1 swine flu, stay tuned to www.IndianCountryNews.com, and www.IndianCountryTV.com and the Native News Update daily news feed (M-F) and if needed, special reports.