Swine flu: Round 2 arrives

Connecticut may be starting to catch up to the rest of the country, and that's not a good thing.

"The second wave of the pandemic has started," William Gerrish, spokesman for the state Department of Public Health, said Friday. "Many schools are experiencing outbreaks of influenza-like illness, and most of it will be due to the H1N1 virus."

According to the Centers for Disease Control, flu-like illness has been widespread across the country for the past few weeks, with the exception of the New England states and a handful of others. Now, however, Connecticut is moving into the "widespread" category, too. Virtually all the flu identified this fall is H1N1, or swine flu, the CDC said. It behaves differently than seasonal flu because it attacks mostly children and young adults and is causing high levels of illness several months earlier than the usual peak.

Both Lawrence & Memorial Hospital in New London and Day Kimball Hospital in Putnam reported an influx of patients with flu symptoms coming to their emergency rooms Friday. Those two hospitals and The William W. Backus Hospital in Norwich have all imposed restrictions on visitors younger than 18.

Among schools in Eastern Connecticut, Plainfield Central School has been hardest hit thus far, with half of its 570 students out sick on Friday, Principal Jerry Davis said. Schools in Pomfret and Brooklyn have also had high absenteeism due to flu-like illness, according to the Northeast District Department of Health.

At St. Bernard High School in Montville, the absentee rate this week was about double what it normally is, with many of the ill students experiencing fever, cough, sore throat and other flu symptoms, Headmaster William McKenna said Friday. On Thursday, 27 students were absent and another 14 were sent home after going to the nurse's office. The school was closed Friday for a previously scheduled staff development day.

At Guilford High School, 40 percent of 1,115 students were absent Friday, leading to the decision by administrators to close the school through Tuesday. The town's health director said six students had symptoms of H1N1 flu, also called swine flu, as confirmed by their individual doctors.

Dennis Johnson, the health director, said he could not determine how many of the other absent students also have H1N1 flu, and how many are staying home to avoid getting sick.

Most recover at home

Dr. Douglas Waite, director of infectious diseases at Day Kimball, said nearly all the flu patients seen at the hospital at its satellite facilities have been children and adolescents. The hospital is considering setting up a tent or other area separate from the main hospital to treat flu patients. None of the patients seen at Day Kimball required admission to the hospital, though two who went to L&M developed confirmed H1N1 cases that were severe enough to require it, said L&M spokesman Kelly Anthony. One is an older person with a chronic health condition, and the other is a child.

Waite stressed that most children and others who get the virus can recover at home without treatment by a physician or at the emergency room. He recommended rest, plenty of fluids and ibuprofen or acetaminophen.

At the hospital, he said, "we've seen a variety of types of cases, some who did need a bit of treatment to others who simply needed reassurance," he said.

The most common symptoms are fever and cough. Sore throat and body aches are also common. Waite said parents should seek medical care for their child if they become very lethargic, have frequent bouts of vomiting or diarrhea, are not taking fluids, are short of breath or if their fever goes up suddenly after three to four days after first improving, "especially if there's a cough that worsens."

Over the next week, Dr. Waite said he expects the virus will continue to spread rapidly in the local area. Along with the influx of flu patients, the hospital and its affiliate offices are also fielding dozens of calls from parents asking about the virus and when the vaccine will be available for their child's age group. Thus far, vaccine has been available mainly to children younger than school age.

"It is stressing the system," said Waite, who is also the vice president of medical affairs and quality at Day Kimball, and medical adviser to the Northeast health district. "Unfortunately, it'll get worse before it gets better. That's the nature of the pandemic."

Schools advised to stay open

Patrick McCormack, director of the Uncas Health District in Norwich and interim director of the Northeast District, said local school superintendents have been notified about the outbreaks and asked to have their school staffs monitor the types of symptoms being reported by students or their parents.

School officials are being advised to keep schools open even if absentee levels are high, he said. Schools are in turn advising parents to keep children home if they are sick, and not to let their children return to school until at least 24 hours after their temperature returns to normal.

At Plainfield Central School, Principal Davis said, the virus swept through the student population quickly. Thursday morning began with 100 students absent due to illness.

"As soon as the buses came in and dropped them off, they started coming down with symptoms," he said. About 180 students went to the nurses' office Thursday and were sent home. Two staff members were also sent home sick.

On Friday, with half the student body out, the school was "very quiet," Davis said.

"Some of the classes that normally have 25 kids have five kids in them," he said.

A school dance scheduled for Friday evening was postponed.

Waite said the scenario at Plainfield Central is typical for swine flu.

"The attack rates are very high in children, and the incubation phase is only a day or two," he said. "When it hits you, it hits you hard."

At Day Kimball, anyone younger than 18 is restricted from maternity and pediatric units, and further restrictions are being considered, Waite said.

Both Backus and L&M imposed restrictions Friday on visitors younger than 18 from all areas. Anyone with a cough, sore throat and a fever over 100 degrees is also asked to stay away.

Limiting visitors to curb spread

In addition, Dr. Joseph Gadbaw, chairman of infection control at L&M, said only adult family members, including grandparents, will be allowed into the maternity area.

"With vaccine not readily available," he said, "limiting visitors is the best way to prevent the possible spread of the flu."

He encouraged the public to limit hospital visits to further reduce the risk of exposing patients to H1N1. Hospital staff will also be required to wear masks when appropriate, he said, and they may ask visitors and patients to also wear them.

Visitors may also be asked questions by staff to screen them for flu symptoms.

"School-aged children are known to be contagious with the flu for longer periods of time and aren't always able to tell others they have been developing respiratory symptoms," Gadbaw said. "We discourage adults from bringing children to our emergency- or urgent-care facilities whenever possible."

Gerrish, of the state Department of Public Health, said vaccine continues to arrive in the state and is being distributed to local health districts running vaccine clinics. Thus far about 127,000 doses have been received, although about 500,000 had been originally expected from the federal government by this time.

"We're asking people to be patient," he said. "We're working as hard as we can, and we will continue to expand the target groups (eligible for vaccine). Eventually, everyone who wants to get a flu shot will be able to get one."

j.benson@theday.com

Fay Abrahamsson of The Guilford Courier contributed to this article.