Swine flu may be peaking in Va.

State health officials say the H1N1 flu may be peaking in Virginia and could now start to decline.

Swine-flu vaccine continues in short supply, emergency rooms are being flooded with sick and worried people, hospitals are restricting visitation, and school absenteeism is running well above normal in the state.

The proportion of visits to emergency rooms and urgent-care centers attributed to suspected influenza reached 14.2 percent in Virginia this week, the state health commissioner said, a record high rate and double that of the past two flu seasons.

"We're hoping that we may be approaching the top of the curve," Dr. Karen Remley said yesterday during a media teleconference.

After reaching 14 percent to 15 percent of emergency-care visits, officials said, the potentially deadly H1N1 virus's impact appears to be abating in states that saw an earlier onset of the disease than Virginia.

"We have a peak now," Remley cautioned. "We don't know how many peaks there may be."

The U.S. Centers for Disease Control and Prevention said H1N1 influenza is as prevalent now as during the winter peak of regular flu seasons. Swine flu has resulted in more than 1,000 deaths so far, the CDC said yesterday. Nearly 100 pediatric swine-flu deaths have been reported.

Each year in the U.S., an average of 36,000 people die from flu-related complications and more than 200,000 people are hospitalized from flu-related causes.

Virginia's supply of swine-flu vaccine is far smaller than needed to inoculate high-risk individuals, much less the entire population, officials said.

More than 3.5 million people fit in the groups with the highest need for the vaccine, the health commissioner said, while the state has received fewer than 400,000 doses.

"There's such a mismatch right now," Remley said.

The Richmond City Health District's immunization clinic boomed to overflowing this week, said district spokesman George Jones, and the clinic was almost out of H1N1 vaccine by its close yesterday. Staff members expect to round up enough vaccine for pregnant women and front-line health-care workers at Monday's immunization clinic, he said.

No vaccination site in the state has received all the vaccine it asked for, Remley said, "and many have not received any."

Unlike the other nine people who have died of H1N1-related causes in Virginia, 6-year-old Heaven Wilson of Amelia County had no underlying complications that put her at high risk from the disease, officials said.

However, Remley said, "the virus has not demonstrated any change in its infectivity or severity."

Young people are especially susceptible to the H1N1 virus. Though not all caused by illness, public school absenteeism rates reported in central Virginia were running at 5 percent to 8 percent, state figures show, and Amelia County's was 16.4 percent for the week ending Oct. 17.

Influenza is a respiratory infection caused by a variety of flu viruses. Symptoms of 2009 H1N1 flu include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people have vomiting and diarrhea.

The infection produces inflammation of the lungs and respiratory tract, leading to viral pneumonia. Pneumonia builds up fluid in the lungs that makes breathing harder, blood pressure can drop and, robbed of oxygen, other organs start to fail.

Secondary infections, such as bacterial pneumonia, can occur.

"A lot of the time, it's the secondary infection that gets you," said Dr. Marsh Cuttino with HCA Virginia Health Systems. "Everything starts going wrong. . . . That's when you die."

"Prevention isn't just about preventing disease, it's about preventing complications," said Dr. Mark Levine, Virginia's deputy health commissioner. "It's about acting when you're really sick."

Contact Peter Bacqué at (804) 649-6813 or .

Staff writer Holly Prestidge and The Associated Press contributed to this report.