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H1N1: likely here, but without dramatic effect—yet

November 18, 2009
BERLIN — While the H1N1 virus is affecting other parts of the state, it has yet to affect Berlin or the surrounding towns in a significant way.

From the schools to the county nursing home to the hospital and the state prison, healthcare workers and officials are reporting very few cases.

Only a limited number doses of the H1N1 vaccine have made it to the area. Officials credit a high level of awareness and strict observance of infection control precautions for the low incidence of the virus.

Judy Collins, the school nurse at the Milan Village Elementary School said they have yet to see any confirmed cases.

"Our attendance has been wonderful," she said. "Our kids have been very good about infection control. I'm hoping they keep this up all year long."

Fewer students are calling out sick than normal, she said, most likely because the kids are washing their hands more and practicing proper sneeze and cough technique. Every classroom has a sink with soap and water and bottles of hand sanitizer, she said, and people are using them.

"The kids are learning good lessons," she said.

About 50 percent of the students are immunized, she said, so she is hopeful even if there is an H1N1 outbreak it won't have drastically curb attendance.

At Androscoggin Valley Hospital there are early signs of such an outbreak.

"We've started to see an increase of people with flu-like symptoms," said James Patry, public relations and marketing director for AVH.

So they have taken precautions. The hospital is asking anyone under the age of 18 to please refrain from visiting people in the hospital, because the virus is most prevalent among younger people.

"It works both ways," Mr. Patry said: the hospital doesn't want young people bringing the virus in, and they also don't want young people getting infected when they come to see someone.

They are also asking people exhibiting flu-like symptoms over the age of 18 to wait until their symptoms are gone to visit people.

"A lot of people are cautious, and we certainly have been," he said. "It's not uncommon seeing visitors wearing masks."

The masks are one more precaution to contain possible spread of the virus. Not all of the staff at AVH have been vaccinated because they have yet to receive enough doses, Mr. Patry said.

"What we do get, we're prioritizing," he said, meaning it goes to healthcare workers with direct patient contact, young children, pregnant women and people with compromised immune systems. Right now, he said, they're out of doses, and he doesn't know when they'll get more.

The Berlin Public Health Department is also out of H1N1 vaccine, but didn't get any to begin with. Laura Viger, the director of BPH, said they received 500 seasonal flu vaccine doses, which they gave away already, and they should have 60 more by the end of the month. Their role has been mostly a supporting one with the H1N1 vaccination efforts, she said.

"We're trying to stay abreast of what's new and be a good partner," she said.

They are partnering with Coös County Family Health Services, which has dispersed about 800 H1N1 vaccine doses.

"It's all gone," said Patty Couture, chief operating officer for CCFHS.

The initial doses went quickly, she said, but they have more on order. They requested 1,000 more doses, she said, but they will likely get around 200. The state is sending out all of it they have, she said, but "everyone is receiving limited doses."

CCFHS has seen a rise in the number of cases of flu, Ms. Couture said, but they aren't testing to find out if it is H1N1. Regardless of whether it is H1N1, everyone is taking precautions, she said. Patients with symptoms are wearing masks and using hand sanitizer, "which is really helpful," she said.

AVH helped in the effort by donating boxes of hand sanitizer to the local schools. Gorham Middle High School Principal Keith Parent said it was a welcome addition, one that complimented spray disinfectant to keep the germs at bay. He said students had also been advised not to share water bottles, sneeze into their elbows, wash their hands and stay home if they are sick.

"We have been fortunate in that our numbers out daily have been less than 10," he said in an email. "We have been lucky so far."

GMHS School Nurse Bruce Fike said the steps have been helpful at keeping absences low. One aspect has been the school's position on absences.

"We have stressed that sick students will not be penalized for staying home when they are sick," he said, "and all staff members have been instructed to give returning students ample opportunity to make up any missed work."

Students aren't the only ones that might be missing work, however. Mrs. Viger said she took an informal survey of the department heads around the city last week.

"There were seven people that has something like the flu," she said. None of them came to work, which is exactly what they're supposed to do to keep the virus from spreading.

In places where people live in close proximity H1N1 can spread rapidly, like it did in many colleges around the state. At White Mountains Community College, however, they haven't seen much impact. Martha Laflamme, vice-president of student and community affairs, said they have been taking similar steps as other schools, with disinfectant wipes and hand sanitizer, and they haven't seen many absences.

"We are keeping our fingers crossed that it doesn't change," she said.

WMCC doesn't have dorms, which reduces the risk. At the state prison, however, where people live in bunk style accommodations, the risk of an H1N1 outbreak is much higher.

"We have had some flu cases among inmates and staff," said Warden Larry Blaisdell, but the impact has been minimal.

The prison has good infection control practices, he said, and that has kept H1N1 from running rampant.

"Basic precautions are what's holding off the worst of the worst of it," he said.

Those precautions are also key in the Coös County Nursing Home. Though older adults have shown some resistance to the H1N1 virus, it is still a concern for the staff.

"I've had no confirmed cases so far," said Sue Hickey, infection control nurse at CCNH.

Infection control practices are a key part of the every day routine at CCNH, she said, so it is rare to see an outbreak of the flu. Maybe one or two people a year get it, she said, despite the close living quarters. H1N1 has not been an issue for the residents so far, she said.

The staff, on the other hand, have been encouraged to get the vaccine.

"The 20 people that wanted it got it," she said.

They got it because they are healthcare workers, the first line of defense against outbreaks. The short supply of vaccine has kept the general population from getting it, but around the area people are hoping they can slow the spread of H1N1 through other means. At this point it's unclear if the efforts are working, or if the virus just hasn't showed up yet. The only thing to do now is wait and see.

Martin Lord & Osman
Salmon Press
Town of Alexandria
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