Swine flu still widespread

Local health districts are getting more H1N1 swine-flu vaccine, and the state Health Department expects to get an additional 6,000 treatment courses of liquid pediatric Tamiflu to make available to uninsured people.

Describing the H1N1 flu as a "younger people's flu," Centers for Disease Control and Prevention Director Thomas Frieden said yesterday that flu was still widespread and plans are being made to distribute to states all 234,000 doses of liquid pediatric Tamiflu left in the federal emergency stockpiles.

In addition, vaccine shipments are continuing -- as of yesterday, 26.6 million vaccine doses had been made available for states.

"What we have today is essentially more virus, more vaccine and more treatment," Frieden said yesterday.

"In a usual flu season, 90 percent of the deaths are among people over the age of 65," said Frieden, a physician. "In H1N1, 90 percent of the deaths are in people under the age of 65."

Nationally, 114 children have died from H1N1 swine flu, and most had underlying health conditions, Frieden said.

In Virginia, of 13 deaths confirmed as H1N1-related, two have been children, including 6-year-old Amelia County resident Heaven Wilson, who died last week. Heaven apparently didn't have any medical conditions that would raise her risk for severe flu complications.

Though flu-like illness seems to be decreasing in some parts of the country, Frieden said there is no reason to believe it's a trend that will continue. Flu season typically runs from October through spring.

"The numbers around here are as high as ever, around 14 percent of visits," said Dr. Danny Avula, Richmond City Health District deputy director. State data show visits to hospital emergency departments and urgent-care centers for flu-like illness are a record high 14 percent of all visits.

Frieden said yesterday that some of the activity may be people who would not normally seek care but who are responding to media attention to the outbreak. However, he said recent survey data show that many who should seek medical care when they get fever, cough and sore throat are not.

"One of the things that we have been surprised to see is that even among people who have an underlying condition, such as asthma or heart disease or lung disease, only half sought care for influenza-like illness," Frieden said.

Dr. Kay Rankin, director of the Tri-Cities-area Crater Health District, said that is possible.

"There is a subset of people who are very proactive about getting health care and appropriate health care," Rankin said. "And there are others who need it and should be getting it, but for a multitude of reasons are not accessing the health-care system the way we would like them to. Sometimes that might have to do with education or transportation or financial reasons. I don't think there is one simple answer."

Groups prioritized to get H1N1 vaccine are pregnant women, caregivers of infants less than 6 months old, children and young adults ages 6 months to 24 years, people ages 25 to 64 who have medical conditions that put them at risk for severe flu complications, and health-care and emergency medical service workers.

People are showing up for flu shots who don't fall into those groups, Avula said. Most are agreeing to wait when asked.

"We are having to make impassioned pleas. . . . 'If you get this vaccine, you are getting it in lieu of someone who is high risk,'" Avula said. "People are very willing to step aside and wait until there is more vaccine."

Frieden said the liquid Tamiflu formula for children was being provided to states to deal with spot shortages.

"It's now clear that with disease throughout the country, it makes sense to release what we have and get more from the manufacturer as soon as they can provide it," Frieden said.

Virginia has already made about 9,000 courses of liquid pediatric Tamiflu available across the state to deal with spotty shortages of the flu-fighting drug.

Contact Tammie Smith at (804) 649-6572 or .