People with the flu likely have H1N1, officials say

Anyone hit with flulike symptoms this summer has likely had a case of the H1N1 virus, or swine flu, health officials said yesterday.

But don't panic, they cautioned.

The vast majority of people who get the virus will not experience more than a moderate case of the flu, and will only be sick two to seven days.

Still, H1N1 flu is spreading throughout the Triad and is likely to linger.

That includes through the start of school next month, which has education and health-care officials bracing for another wave of cases this fall.

"It's the only flu going around now," said Dr. Christopher Ohl, an infectious-disease specialist at Wake Forest University Baptist Medical Center.

Unlike most flu strains that tend to not survive hot and humid weather, the H1N1 strain has been hardier. Which is why some youths have come down with cases while at or after summer camp.

It's also why health-care officials, from local and state to global, don't feel the need to count the number of confirmed cases anymore. The last number reported by the Forsyth County Health Department was 18 last week.

"The infection is considered to be established and being transmitted within all our communities," said Dr. Tim Monroe, the director of the health department. "Continual focus on confirmed cases is not informative, and can even be misleading and create unwarranted alarm."

As of July 22, there were 483 confirmed cases in North Carolina, including 89 in the 14 counties that make up the Triad and Northwest North Carolina, according to the N.C. Division of Public Health. Ohl said that the number who have had the swine flu but not been confirmed easily could be several times higher.

The symptoms include a mild fever, aches and pains, a runny nose and a headache. A person who develops more severe symptoms -- difficulty breathing, severe nausea, vomiting, diarrhea, abdominal pain or chest pain -- should get medical attention, said Dr. Jeff Engel, the state medical director.

Five deaths have been linked to swine flu, including two in Guilford County. All who died had previous health complications.

Students and teachers are being urged to take extra precautions as they re-enter classrooms next month. That means washing hands frequently and covering mouths during coughs and sneezes.

"No one really has built up an immunity to the H1N1 virus," Ohl said. "That will change over the next two years, but that's why there's a need for a vaccine and the need for people to take it once it's available."

Winston-Salem/Forsyth County Schools is taking its lead from the county health department, spokesman Theo Helm said.

"We treat it just like normal influenza," Helm said. "The health department has directed us to clean as we normally do and teach kids hygiene as we normally do.

"In the case of an outbreak, county health officials would also decide whether to close the schools," he said.

The local numbers don't include three suspected cases involving part-time aquatic workers Sunday at the West Forsyth Family YMCA in Clemmons. Staff members and parents have been sent a notification letter this week, said Amy McNeil, the communications director for the YMCA of Northwest North Carolina.

"We haven't had any more cases of staff or members falling ill in a similar way," McNeil said. "We have sanitized the appropriate areas."

The federal Centers for Disease Control and Prevention said Friday that 40 percent of Americans could get swine flu over the next year, particularly from being in crowded places, such as schools.

The CDC is expected to release its priority list detailing who should get a swine-flu vaccine first. The vaccine is expected to begin being administered in early fall. Two vaccinations are being prepared -- one for regular seasonal flu, the other for the H1N1 virus.

The groups likely to get the vaccine first are health-care workers; those with compromised health and immunity issues, such as asthma, diabetes, heart disease and cancer; pregnant women; and students ages 5 to 18 "since they tend to be the most exposed group to the flu," Engel said.

Pregnant women account for 6 percent of U.S. swine-flu deaths since the pandemic began in April, even though they make up just 1 percent of the U.S. population. Pregnant women are considered as unusually vulnerable -- especially in the third trimester -- because of changes in the lungs and immune system that make it harder for them to shake off respiratory infections.

Novant Health Inc. has set up a Web site -- www.noflu.org -- to provide updated information and preventative measures on the virus. The site has had more than 10,000 page views since debuting Jan. 1.

"We've had three months worth of experience, education and information, so we're not as agitated by the virus as we were last spring," said Dr. Jim Lederer, an infectious-disease specialist for Novant Health. "Health-care providers are getting more comfortable in managing the virus even though there still isn't a test for it."

Monroe said that his department does not anticipate making any changes to recommendations.

"Individuals with fever and respiratory symptoms should stay home from school, work or other social settings for seven full days after onset of symptoms or 24 hours after the end of symptoms, which ever is longer," Monroe said.

■ Richard Craver can be reached at 727-7376 or at rcraver@wsjournal.com.

■ The Associated Press contributed to this article.

Swine flu in N.C.

North Carolina has had 483 confirmed cases of the H1N1 virus, or swine flu, as of last Wednesday. Here are the counties with the most cases, along with the counties in the Triad and Northwest North Carolina with confirmed cases:

County - Cases

Wake - 82

Guilford, Onslow - 36

Orange - 22

Forsyth - 18

New Hanover - 16

Johnston, Wilson - 15

Chatham - 14

Alamance - 12

Cumberland, Mecklenburg - 11

Duplin, Durham, Pitt - 10

Rockingham - 8