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County fears delay in getting H1N1 flu vaccine

The H1N1 virus has arrived but it's unclear how long Brainerd lakes area residents will have to wait for the H1N1 flu vaccine.

Joyce Mueller, nurse manager at Crow Wing County Public Health, said the three mass immunization clinics planned in early November at Forestview Middle School in Baxter as well as Pequot Lakes and Crosby-Ironton high schools have been temporarily postponed because the county likely will not receive enough vaccine by that time. There is also a shortage of the seasonal flu vaccine. She said the county is expected to receive about 420 doses of the seasonal flu vaccine within the month.

"The amount of vaccine for seasonal influenza and H1N1 is beyond our control," noted Dr. Peter Henry, medical consultant for Crow Wing County Public Health and medical director of the emergency room at St. Joseph's Medical Center in Brainerd. "It isn't a matter of being prepared for it, we don't have the vaccine and can't get it. That's the way it is."

Mueller said the county is monitoring the types of vaccine shipments, either injections or FluMist, that will be available and that will determine who will be able to get the vaccines first. Mueller said there will be more of the FluMist available in about a month, so the county will use the nasal spray vaccine to target healthy 2-4-year-olds and the parents, family members and caregivers who have no chronic health conditions of infants 6 months and younger.

"We want to provide a cocoon around that infant, for anyone spending time with that infant, to get them vaccinated to protect that baby," Mueller explained.

The FluMist vaccine cannot be used on children younger than 2.

The smaller shipment of injectable vaccine the county may initially receive within a month will be used for pregnant women and medically fragile children, those who cannot get the FluMist vaccine.

Mueller said Public Health will notify the public when it receives those shipments and is ready to begin H1N1 vaccinations.

Henry said St. Joseph's emergency room experienced an increase in patients last weekend with more than 110 patients on Saturday and more than 100 on Sunday, an estimated 30-40 percent exhibited flu-like symptoms.

"I think we're going to see a significant surge over the next few weeks," said Henry. "This isn't an unexpected thing. It would have been nice to have the immunization from the vaccine manufacturers but we don't have that."

Henry said St. Joseph's has sent 15 tests from patients hospitalized with suspected H1N1 virus to the Minnesota Department of Health and so far two cases, both children, were confirmed to have the H1N1 virus. Six of those tests are still pending and seven tests were negative for H1N1, more than likely it was another type of viral illness, said Henry.

Henry said Brainerd Lakes Health officials have discussed extending hours at its clinics, Conveient Care and Urgent Care because of the increased cases of flu-like illnesses and to take some of the load off of the emergency room, but have decided to hold off at this point.

Brian Blom, director of occupational health and safety at Cuyuna Regional Medical Center in Crosby, said the hospital experienced heavier than normal ER use over the weekend but not all cases were influenza-related.

"We are seeing a little increase in the number of patients presenting with influenza-type illnesses but we're able to handle the amount of cases we're seeing," said Debra Anderson, director of nursing at Central Lakes Medical Clinic in Crosby.

Medical staff in Crosby and Brainerd, along with Crow Wing Public Health, have been meeting regularly and working collaboratively to plan for a major surge in influenza cases. If this happens, either hours at any of their medical facilities will be expanded or the last option is to open flu centers that deal with influenza-related illnesses only.

Dr. Troy Couture, a pediatrician at Brainerd Medical Center, said there are other viral illnesses going around right now, but the majority of the cases likely are caused by the H1N1 virus.

"We're definitely seeing an uptick in the amount of patients with a fever and cough, it's more like what we see in January," said Couture.

Couture said most of his patients seem to be tolerating the flu well. He recommends that parents treat their children's symptoms, making sure they're comfortable, well hydrated, that they get plenty of rest and stay home from school. He said parents are welcome to call the clinic to find out if their child needs to be seen by a doctor or receive anti-viral treatments like Tamiflu. Children under 2 likely may need to be seen because they're at an increased risk for serious complications. Children with chronic health conditions, such as asthma, should be seen by a doctor, said Couture.

"We would prefer if people would contact us, it would help to keep the burden off the ER a little bit," said Couture.

Couture said he and his colleagues had hoped that the school break Thursday and Friday would have helped alleviate the spread of the flu, but Monday was one of the busiest days in the clinic, he said.