The death on Feb. 10 of Center for Alaskan Coastal Studies Director Terry Shepherd from complications of the H1N1 flu does not show a resurgence of the pandemic that first hit Alaska and Homer last June. Shepherd, 45, died at Providence Alaska Medical Center in Anchorage. Hers is the 13th H1N1 death in Alaska and the first laboratory-confirmed H1N1 death in the state since Nov. 28.
"As the poor family down in Homer realized, each death is a personal tragedy," said Greg Wilkinson, a spokesperson for the Alaska Department of Health and Social Services in Anchorage. "It still has the possibility of being fatal," he said of the H1N1 virus.
The Alaska Virology Lab in Fairbanks last week confirmed that a middle-aged Homer woman had died of complications from H1N1. Because of medical privacy laws, DHSS could not identify Shepherd by name. Her family said last week that Shepherd had died from H1N1.
Wilkinson said the Homer woman did not have any pre-existing conditions. Shepherd's family and friends described her as physically active and said she liked to hike, swim, ski and snowshoe.
Alaska has entered the peak of its historical flu season. Although hospitalizations for flu-like symptoms and pneumonia have averaged about 50 cases weekly statewide since Nov. 3, when DHSS changed how it counted cases, seasonal flu has not shown up in Alaska.
"Do we expect it?" Wilkinson said. "You bet. It would be very odd if we get out of flu season without seeing the seasonal flu in Alaska."
Sometimes called swine flu, the H1N1 virus first hit the United States in April. By June, Homer had its first case of H1N1, a 20-year-old man. By October, H1N1 was considered widespread in Alaska. The CDC estimated that from April to January, 57 million Americans got H1N1, 257,000 had been hospitalized and 11,690 people had died.
Most of the victims were ages 18-64, with only 5 million cases for age 65 or older. The CDC said that seniors had been exposed earlier to viruses similar to H1N1 and had some prior immunity. Seasonal flu causes about an average of 30,000 deaths in the U.S. annually, and generally affects the over-65 age group worse.
A rapid diagnostic test done at health clinics and hospitals can identify suspect flu viruses as influenza A and influenza B. Influenza A includes H1N1 and influenza B includes seasonal flu, the strain of flu that commonly hits the United States each winter. Confirmation that a type A or type B flu is H1N1 or seasonal flu requires further testing at the state lab. The majority of specimens tested have been H1N1. State and national tests show these results:
* No lab-confirmed seasonal flu in Alaska;
* 814 lab-confirmed H1N1 cases in Alaska since Aug. 30;
* Nine lab-confirmed H1N1 cases in Alaska this year; and
* About 250 lab-confirmed seasonal flu cases in the U.S. since Aug. 30.
Almost half the flus reported elsewhere in the world by the World Health Organization are seasonal flu.
Significantly, while DHSS reports fewer doctor visits for flu-like symp toms, hospitalizations remain steady.
"We're seeing a good number of people hospitalized," Wilkinson said.
Wilkinson noted, however, that those numbers come from hospitals reporting, and not every hospital asked to report does so each week.
In Homer, South Peninsula Hospital is seeing average to below-average numbers of people visiting the emergency room for flu-like symptoms, said Derotha Ferraro, SPH director of public affairs. Visits per week since November have ranged from three to five.
"As far as visits to the emergency room, we are average to below average of people presenting at the ER with flu-like symptoms," Ferraro said.
Dr. Bill Bell at Homer Medical Clinic said the clinic has not seen any seasonal flu. In October and November the clinic saw about five or six cases of H1N1 a week, but -- except for Shepherd -- no cases after the end of November.
Patients getting the H1N1 vaccine at the Homer Public Health Center doubled last week after the news of Shepherd's death.
Usually, about 25 people a week get vaccinated at the twice weekly clinics, but with the extra clinic on Friday and the heightened concern, that number doubled to 50 last week.
"The virus has been in our area all this time, and it just kind of hit it home a little bit," Public Health Nurse Leslie Callaway said of Shepherd's death.
People have been getting vaccinated not just to protect themselves, but so as to not infect others, Callaway said.
Homer Public Health has given about 1,000 H1N1 vaccines since the vaccine became available last November. Initially, vaccines were recommended for high-risk groups. The CDC now recommends everyone get the H1N1 vaccine, including seniors. DHSS strongly encouraged people to get the H1N1 vaccine.
"We're absolutely recommending people get vaccinated," Wilkinson said. "We'd much rather see you get a poke in the arm than get sick in bed."
Callaway said Homer Public Health has done risk assessments for businesses. Nurses visit businesses to review procedures for minimizing spread of H1N1 or seasonal flu, such as encouraging frequent handwashing and disinfecting surfaces like door knobs or light switches.
CACS staff got H1N1 vaccines after Shepherd got sick, said Beth Trowbridge, acting director. CACS also did a deep cleaning at its Smokey Bay Way offices. No one at CACS has reported flu symptoms.
H1N1 in Alaska
* 814 lab-confirmed H1N1 cases since Aug. 30
* Nine lab-confirmed H1N1 cases in 2010
* 13 H1N1 deaths since April; 11 since Aug. 30.
Seasonal flu in Alaska
* Six suspected seasonal cases since Aug. 30, (not lab confirmed)
Average Peak Months
2009-2010 yet to begin
* About 250 lab-confirmed seasonal flu cases in the U.S. since Aug. 30
Michael Armstrong can be reached at michael.armstrong.@homernews.com.
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