By Laura Raines , Pulse editor
“Georgia is overachieving when it comes to the H1N1 virus — and that’s not a good thing. It’s truly a pandemic here, because of the widespread outbreaks,” said Dr. Rhonda Medows, commissioner of the Georgia Department of Community Health (DCH).
“Most of our schools started on Aug. 10,” Medows said. “By the first week, we were starting to see absenteeism of students with flu-like symptoms, and by the second and third weeks, the percentages were really starting to pick up.”
Many schools in Georgia have had a 10 percent absenteeism rate, while some schools have hit 30 percent.
“Three to 4 percent is the normal rate for this time of year, so these numbers are significant,” Medows said.
While most flu cases have been mild to moderate, emergency rooms are seeing at least a 10 percent increase in influenza. As of Oct. 13, 539 hospitalizations and 27 deaths were attributed to the virus in Georgia, the Georgia Department of Community Health reported.
“We’ve projected that 20 to 30 percent of the state’s population will be impacted,” Medows said.
Health care workers need to brace themselves for a tough flu season.
“Nurses will be on the frontline of care, so they need to stay healthy, get their seasonal flu shot and the H1N1 flu shot, and have a contingency plan for caring for their own children or elderly family members who become sick,” Medows said.
Medows offered some guidelines for health care workers to consider when caring for patients.
1. Be prepared to answer questions about the illness and the vaccine, which first became available in October.
“You’ll want to have a level of confidence in discussing who is at risk for greater complications of the illness,” Medows said.
Patients who have underlying diseases — such as asthma or heart disease — and develop flu-like symptoms are being advised to call their physicians and to start taking an antiviral medication within 48 hours to avoid severe complications.
DCH program manager Michelle Conner, RN, MSA, expects patients to have as many questions about the safety of the vaccine as about the disease itself. Nurses can tell their patients that the vaccine has been recommended by the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists and other medical associations, as well as the Centers for Disease Control and Prevention.
“Be familiar with the difference between the nasal spray and [the] shot form of the vaccine, because patients will ask,” Medows said.
The H1N1 FluMist nasal spray, a weakened live-virus vaccine, is recommended for healthy people ages 2 to 49, but not for pregnant women, people with certain allergies or children receiving aspirin therapy. The H1N1 FluZone shot, which has an inactive virus, can be given to people ages 6 months and older.
2. Discuss openly the facts about seasonal flu vaccines.
“Some patients may remember the connection made between Guillian-Barre syndrome and the 1976 flu vaccine,” Medows said. “Changes have been made since then. Post-1976 vaccines have shown a less than 1 in a million incidence of Guillian-Barre.”
3. Be frank about what is and what is not known about the H1N1 vaccine, and advise patients based on your knowledge of their medical histories and conditions.
“We know that one dose in adults and two doses in children (9 and under) produce the immune system response to provide protection, but we don’t know how long the immunity will last and whether there will be any long-term side effects, or for whom,” Medows said.
4. Be prepared to address the initial limited supply.
“You’ll need diplomatic skills to ask healthy adults to wait, so that high-priority patients (children and pregnant women) can be vaccinated first,” Medows said.
Efforts have been made to provide the vaccine to as many Georgians as possible, Conner said. “We have done a good job of maximizing the allowable number of providers in Georgia.”
5. Know that health care providers have been given priority to receive the vaccine. They should get the shot for their own health and well-being, and to protect them as part of a critically needed work force.
“If you develop flu-like symptoms, please stay home,” Medow said. “You don’t want to be the source of giving already-sick patients the H1N1 virus.”