September 8, 2009

H1N1 Invades: Gannett Diagnoses 291 Students With Flu-Like Illness

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Correction Appended
Cornell witnessed a surge of students experiencing flu-like symptoms over the holiday weekend, bringing the total number of students diagnosed by Gannett Health Services with probable H1N1 influenza to 291 as of last night.
Since individuals are not required to report having the flu and may choose to seek medical attention from other healthcare providers, this number only reflects those actually diagnosed at Gannett.
“We have no way of knowing how many people [in total] have H1N1 in our community of students, faculty and staff,” said Sharon Dittman, associate director of community relations at Gannett Health Services.
“H1N1 will have an impact on many individuals in our community, but also on the community as a whole.  Cornell students — and the faculty and staff members who work with them — need to know that the highest number of cases of 2009 H1N1 flu have been confirmed among people five to 24 years old and [need to] prepare for the impact on our lives together,” Dittman said.
A Cornell student wishing to remain anonymous was diagnosed with probable swine flu on Sunday at Cayuga Medical Center. She suspects that she contracted the flu by drinking out of the wrong cup at a party.
“I got all the symptoms within a two-hour frame,” the student said.
Complaining of a sore throat, bad cough and fever, she sought medical attention at CMC, where an entire waiting room was devoted to patients experiencing flu-like symptoms.
“We are working closely with the CMC emergency department and convenient care center, and we refer patients who need in person assessment and/or treatment to those facilities whenever we are closed. We also send those who need a higher level of care than we are able to provide [to] our ambulatory clinic,” Dittman said.
According to the Centers for Disease Control and Prevention, from mid-April to Aug. 30, a total of 9,079 hospitalizations and 593 deaths associated with the H1N1 virus were reported. However, the CDC discontinued individual reporting of probable cases of the 2009 H1N1 flu in late July.
The Seattle Times reported last week that Washington State University has documented over 2,000 cases of probable swine flu. Predictions suggest that 15 to 40 percent of the population may get H1N1 flu, as opposed to the seasonal flu attack rate of 5 to 20 percent.
More than half of the 165 colleges providing information to the American College Health Association reported instances of the H1N1 virus on their campus, according to the association. The ACHA reported 1,600 cases at institutions of higher education, or about 7.9 per 10,000 students, with instances highest in the Southeast and far Northwest.
As advised by the New York State Department of Health and the CDC, students are diagnosed with probable H1N1 without actual testing. A student is evaluated based on clinical assessment of symptoms, health history and knowledge about the presence of the virus in the community rather than a laboratory test.
“In New York State, only public health laboratories can perform the testing needed to confirm Novel H1N1 Influenza, and we are able to submit specimens for testing only when authorized by the Tompkins County Health Department. Testing is done primarily for epidemiological reasons and for people who are hospitalized with more severe disease,” Dittman said.
Dittman added that the CDC determined that the current quick tests for the flu, such as a nasal swab, only range in accuracy from 40 to 69 percent and may take several days before returning a positive or negative result.
Symptoms of H1N1 typically appear to be sudden onset and usually include fever and one of the following: cough, sore throat, body aches/chills and occasionally diarrhea and/or vomiting. If a student has these symptoms, Dittman suggests to review the Gannett website first for guidance and then call Gannett.
“When [students] call anytime of day or night, they will speak with one of our very experienced nurses who will ask them questions about their symptoms, any underlying conditions and living situation, and then make recommendations for self-care and/or further medical evaluation at Gannett or Cayuga Medical Center,” Dittman said.
Since the illness is causing mild flu symptoms for most, students can practice self-care and consult with a Gannett nurse over the phone. Individuals can also receive a flu kit that includes a thermometer, Tylenol or ibuprofen, facemasks, tissues, hand sanitizer and information.
Students not comfortable with self-care, have severe symptoms or have an underlying health condition can seek treatment at Gannett. With accordance to CDC recommendation, anti-viral medication is not likely to be prescribed due to side effects, supply concern and future disease resistance. Wait times may also be longer than previously experienced due to a mass influx of calls and appointments.
All students that are diagnosed with probable H1N1 will receive follow-up calls from Gannett until the isolation period is over.
“We want to make sure that people are getting better and not worse; we also urge everybody who has been in touch with us to call us immediately if they have any worsening symptoms,” Dittman said.
Gannett will not be taking less-urgent appointments, such as physicals, due to increased clinical demand. Students will still be able to receive care for pressing concerns.
Doctors are urging students to take a full week off or not return to classes until a fever has subsided for at least 24 hours. Cornell has been working with faculty to make sure that students recovering from the flu be able to stay at home and not endanger the rest of the community.
Professor David Levitsky, nutrition, announced to NS 1150: Nutrition, Health and Society last week that a student in the class likely contracted swine flu. Levitsky said that the University has been in contact with faculty to make sure that students have proper time to recover without worrying about being penalized for absences.
“As a professor, I must have received maybe four or five different e-mails coming from various levels of the administration informing [the faculty] of what to do and to be aware of [the flu],” Levitsky said.
This past Friday, Janet Corson-Rikert, M.D., executive director of Gannett Health Services, sent out an e-mail to the student body reminding students to seek help if suddenly experiencing flu-like symptoms.
Travis Apgar, associate dean of students for fraternity and sorority affairs, also sent out an e-mail last Friday to members of the Greek community warning of the spread of H1N1 in social situations and close quarters.
“… I would strongly suggest that as you socialize, you keep in mind that some of the more popular ways in which to enjoy a beverage, including games like pong, should be avoided as close contact, sharing cups and other utensils and devices are prime points for transmission,” Apgar stated in the e-mail.
According to the CDC website, the 2009 H1N1 vaccine is expected to be available in the fall. It is expected that the seasonal flu and the H1N1 vaccine may be given the same day, as the seasonal flu is still expected to cause illness. As the H1N1 vaccine is expected to become available later than the seasonal vaccine, individuals are encouraged to get the seasonal flu vaccine as soon as it is available.
According to Simeon Moss ’73, director of Cornell University Press Relations, and Dittman, Cornell has contingency plans that will continually be reevaluated as the situation evolves. Currently, the symptoms are not severe enough to warrant the implementation of any of the contingency plans, which were originally developed to handle the more severe avian flu. Possible tactics include short-term housing for students who are sick or for the roommates of those who are sick, transportation and a triage clinic on other parts of campus.
“We aren’t sure yet what we’re dealing with and we’re working hard to shift our resources and identify supplemental staffing. The leadership of the University is active right now in assuring Cornell’s response and support for Gannett in contingency planning,” Dittman said.
The original headline of this article stated that 291 students are likely infected with the H1N1 virus. 291 is in fact the number of students seen and diagnosed with flu-like illness by Gannett Health Services.