Swine Flu Rhode IslandIn the basement of the Health Department, a couple of dozen people hunch over laptops or cluster in conversation, each wearing a different color vest to identify his role, such as the yellow “communications,” the navy-blue “epidemiology” and the red “operations.”
This is the Operations Center on the swine flu, and it is bustling –– even though not a single case of swine flu has been identified in Rhode Island.
Health Director David R. Gifford says he expects to see a case eventually, and he wants to be sure to catch it early and respond swiftly.
The swine flu from Mexico worries public health officials, because it has two characteristics that could lead to a pandemic: it is a strain derived from pig influenza, and thus is unfamiliar to the human immune system, and it can be transmitted from person to person. The avian influenza that occurred in Asia a few years ago was deadly –– but didn’t pass from person to person.
With the outbreak in Mexico, which has spread to 40 Americans, “We are further along than we’ve ever been,” Gifford says. “Are we going to have a pandemic? I don’t know.”
Meanwhile, the goal for state health officials is readiness –– and communication.
And that’s not as easy as it sounds.
On Friday, Gifford activated the incident command structure, which creates defined roles and lines of command for people dealing with an incident or emergency, and Monday morning they donned their vests and set up shop in the basement. In between, they worked through the weekend.
“We wanted to get the message out to all physicians, hospitals and emergency rooms,” Gifford says. That meant faxing and e-mailing more than 3,000 licensed doctors, as well as conference calls with all the emergency departments and contacts with all the hospitals –– on a weekend.
The health-care providers were asked to notify the Health Department of any case of a traveler from Mexico coming down with a flu-like illness. So far, they’ve found only one person who fit the profile –– Journal reporter Steve Peoples, who went to the Miriam Hospital emergency room on Saturday. On Sunday, he got a call from the Health Department instructing him to go back for further testing and to stay home until the results were in. He learned on Monday that he does not have swine flu.
Also over the weekend, the Health Department set up a Web page devoted to the swine flu ( http://www.health.ri.gov/pandemicflu/swineflu/swineflu.php), opened a Twitter account ( http://www.tiwtter.com/rideptofhealth), and established an information line ( (401) 222-8020, Monday through Friday 8:30 a.m. to 4:30 p.m.).
The most important public message? Well, it’s one you’ve heard before. “We know how influenza spreads. We know how to prevent it,” Gifford said. Prevention involves three simple measures: wash your hands often and use alcohol-based hand-sanitizing gels; cough into your elbow instead of your hands; and stay home when you’re sick.
The state has already stockpiled 12,000 treatment courses of Tamiflu, an antiviral drug that reduces the duration and severity of flu infections. Gifford also expects to receive some –– he’s not sure how many –– of the 11 million doses of Tamiflu that the U.S. Centers for Disease Control and Prevention is releasing to the states.
(The CVS, RiteAid and Walgreens drugstore chains also said they were ready to meet a growing demand for Tamiflu prescriptions and face masks.)
Gifford compares this effort to preparing for a hurricane. You never know exactly where and how hard you’ll get hit. In this case, no one knows whether a few cases will show up in Rhode Island, and then die out, or whether a global pandemic will explode.
Nothing will change in the Health Department’s approach when the first case appears, Gifford said. But if many Rhode Islanders are at risk of serious illness, other measures will be implemented, such as closing schools or urging people to avoid large gatherings.
To keep track of how the virus is spreading, Gifford holds a conference call every morning with the health directors of the five other New England states plus New York and New Jersey, and a second briefing with the CDC in the afternoon.
“I’m hoping,” he says, “that this all turns into an exercise.”
The symptoms of swine flu are similar to those of the seasonal flu that sweeps through every winter: fever, cough, headaches, aches and fatigue. It lasts 7 to 14 days. The swine flu cases seen in the United States so far have been mild, involving only one hospitalization and no deaths. But that could change.
Colleges in Rhode Island say that students who traveled to Mexico for spring break in March likely missed the swine flu outbreak, and they know of no known cases of the illness on their campuses.
Nevertheless, some colleges are advising students to take precautions.
Brown University, for example, is telling students who are experiencing flu-like symptoms and who have traveled to places that have reported cases within the past 7 to 10 days to stay at home and call the university health service. The university is advising Brown faculty and staff who feel sick and have traveled to those places recently to call their primary care physician. Brown officials also reported that there are two Brown students studying in Mexico City, but both are fine.
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