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2009 Year in Review: Local health officials advise H1N1 preparedness

In a file photo, registered Nurse Karen Bullerman prepares to give a flu shot to 22 month old Kate Noble, Rushmore, while sitting on the lap of her mother, Sarah, during an H1N1 clinic at Prairie Elementary in Worthington. (Brian Korthals/Daily Globe)

WORTHINGTON -- By the time the first case of H1N1 novel influenza, often called "swine flu," was confirmed in Minnesota April 29, people were already worried about the virus's unusually high fatality rate and its inclination to strike young people as easily as elderly ones.

District 518 had already started preparing for the H1N1 incursion by that point, however, and encouraged people in the community to stay calm.

H1N1 then began moving across the state, and by May 2, Nobles-Rock Community Health Services Administrator Brad Meyer was warning people that it was only a matter of time before the virus made its way to Nobles County.

"We're reviewing our pandemic influenza plan, updating contact numbers and data," Meyer said. "We're keeping our hospitals and clinics updated, and we met with hospital staff this morning to talk about what we're doing and what things we should be thinking about."

Meyer encouraged people to stay home if they were sick, a statement that would soon become very familiar as public health officials continued to cope with the virus and its spread. People also started to become familiar with the virus's symptoms -- fevers of 100 degrees or higher, headaches, fatigue, weakness, chest discomfort or coughing.

People still weren't too worried, however -- when Nobles-Rock Community Health offered two forums regarding H1N1 novel influenza, only one person attended.

"We think the majority of the virus is behind us," Meyer said after the May 6 and 7 forums.

He also said health agencies had begun receiving questions about the "hype" over the H1N1 flu, but assured people the public health response was called for.

By June 11, Meyer reported to the Nobles County Board that 13,000 cases of H1N1 had been confirmed in 52 countries, with an additional 124 cases confirmed in Minnesota. By then, however, testing for the novel flu virus had already stopped.

Public health exercises involving the H1N1 flu and other possible pandemics planned for up to 40 percent of the working population becoming ill or caring for someone else in August, as a new healthcare advisory committee was formed. It included representatives from Worthington and Luverne hospitals and clinics, emergency management workers and the NRCHS sanitarian, and immediately began assessing whether the local supply of antivirals would be enough.

Also in August, Meyer reminded parents to watch for H1N1 and encouraged everyone to wash their hands, cough into their elbows, stay home if sick, and plan ahead for child care arrangements and work. Meyer also informed people the H1N1 novel influenza vaccine would likely be ready in the fall.

Agencies continued collaborating with health officials and schools as the school year began, and Meyer once again reminded everyone of the symptoms of the seasonal flu and those of the H1N1 novel influenza.

In early September, Sanford Regional Hospital Worthington was one of 15 sites to join a pandemic influenza community tabletop exercise.

Worries over H1N1 novel influenza flared up again when 120 4-H'ers were sent home early from the State Fair after some of them reported symptoms of an influenza-like illness.

Meyer and other public health officials continued to prepare for H1N1 as fall continued, visiting schools, law enforcement officials and businesses. Meyer reported to the Nobles County Board that public health officials would not be encouraging school closures unless absences reached approximately 25 to 30 percent of students or faculty.

District 518 let the public know it had not yet confirmed any cases of H1N1 in its schools Sept. 24, after cases had been confirmed in the Luverne school district. Medical officials, meanwhile, were reminding everyone to get their seasonal influenza shots, and emphasizing that those shots would not protect people against H1N1 novel influenza.

After a rumor of a confirmed H1N1 case was posted on Facebook, District 518 again told people no cases of that flu had been confirmed in its schools on Oct. 1, and only two cases of seasonal influenza had been seen in the district too.

Pork producers began to feel the backlash from people mistakenly believing the "swine flu" had something to do with pigs, and combined with high costs and low profits and the pain of the recession, experienced one of the longest economic downturns in memory.

Later in October, the swine flu actually was found in pigs -- who had caught it from humans. The virus was confirmed in six pigs from the Minnesota State Fair on Oct. 30.

Local vaccine producers Newport Labs announced they had a product they believed would guard swine against the human form of the H1N1 novel influenza virus on Oct. 21.

In December, Newport Labs challenged pork producer associations, government leaders and the American Association of Swine Veterinarians to provide free vaccine to millions of pigs around the country, offering to give away 10 million free vaccines if 10 million would be provided by others. At that point, Newport Labs had not yet been granted permission to mass market its vaccine.

Swine aside, the virus continued to spread among the human population in southwest Minnesota and northwest Iowa. Worthington reported 100 students out sick, and in Luverne, 104 students were out in a single day. Public health officials continued warning people about the virus and its effects, making presentations in daycare facilities, schools and adult basic education classrooms.

But good news was on the horizon. By early November, absentee rates had returned almost to normal, after the second wave of H1N1 novel influenza had passed.

"I haven't heard back from all the school nurses, but the ones I've talked to are saying absentee rates are around normal," Meyer said. "That doesn't mean that people are not going to get sick. We just think that the highest numbers of people that could possibly get sick have gotten sick. Now, we'll see some residual illness for the next month or so."

The area's first H1N1 novel influenza vaccination clinic was in Luverne on Nov. 30. People reportedly waited in line for two hours at the second vaccination clinic at Prairie Elementary. Almost 350 children were vaccinated against H1N1 novel influenza at the three-hour clinic in Worthington alone.