Pandemic Flu Not Predictable

Dr. Lynfield

So far, Minnesota pandemic flu cases have centered on the Twin Cities, they typically have affected younger people and most cases have not been severe.

But state health officials warn that the H1N1 “swine” flu outbreak expected this fall may be different and anyone could be affected.

“We want the citizens to be motivated, but not frantic…” Health Commissioner Dr. Sanne Magnan said. “We want them to be prepared, but not panicked.”

During a two-hour Wednesday briefing, Magnan and her lieutenants said they are preparing for the worst when the pandemic flu makes its expected return this fall. But, as State Epidemiologist Dr. Ruth Lynfield said, they will have done their best work if the next flu wave never comes to pass. They emphasized the need for Minnesotans to protect themselves from the flu virus and to stay away from others if they catch it.

In the initial flu wave, April through June, about 80 percent of the cases were in the Twin Cities area. That probably is because of the higher density of population, giving each person more of a chance to contact sick people, Lynfield said.

But in an interview, Lynfield said those in other parts of the state should keep their guard up. She said the H1N1 flu is unpredictable and any area is susceptible. Since the flu spread globally so rapidly in the spring, including rural areas in parts of the world, it probably can spread quickly anywhere, she said.

Lynfield and her colleagues would not predict how many Minnesotans could be affected by the new flu later this year, but offered a serious scenario in which 30 percent were infected. That would be 1.5 million Minnesotans, with 772,000 needing doctor’s care and perhaps 3,100 deaths.

The flu’s spring outbreak was widespread around the world, but more mild in Minnesota with 263 hospitalized cases and three deaths. Health officials said that the next round could be much more severe.

The pandemic flu so far is affecting young people more than those born in 1957 or before. The theory is that those born before then were affected by a similar flu strain in their younger years and have a certain amount of immunity.

However, one of the three Minnesota deaths was an elderly person.

Health officials are targeting pregnant women and young people statewide as prime candidates for vaccinations once the serum is available, probably in October. Health care and emergency services workers also would get priority, as would older people with chronic medical conditions, the state Health Department’s Kristen Ehresmann said.

Besides the young and pregnant, those particularly susceptible to the current pandemic flu strain include those with respiratory conditions including asthma, obesity, diabetes, cardiovascular disease and neurological complications.

Pandemic flu vaccinations will be available at most of the same places people get seasonal flu inoculations, Ehresmann added, but some schools are considering offering students vaccinations.

While the federal government is paying for flu shots, private health-care providers may charge administrative costs.

Ehresmann said that it looks like two vaccinations, at different times, will be needed to fight the pandemic flu.

People also will need a separate vaccination to be protected against the seasonal flu, which is a different strain than the pandemic version.

Seasonal flu vaccinations already are becoming available, and Ehresmann said it is not too early to get the shot or nasal spray.

Health officials are emphasizing ways Minnesotans can slow the flu’s spread. Most importantly, they should stay home if they are sick and remain there until 24 hours after their fever disappears. They also suggest that household members of a sick person stay home.

People can avoid getting sick by frequent hand washing and avoiding sick people, said Magnan, who likes to tell people to wash their hands as long as it takes to sing “Happy Birthday” twice.

State homeland security official Kevin Leuer said the governor has authority to cancel public events if health officials feel that would help stem the flu’s spread, but such drastic measures are considered a last resort.

More than 200 state Health Department employees are working full time on the pandemic, with hundreds more in other state and local agencies involved.