County officials plan for flu season, possible pandemic

November 30, 1999|By CANDICE BOSELY

In October 1918, a young American Indian woman in Washington, D.C., volunteered to help care for the people suffering from the world's most severe flu pandemic.

In a seven-page letter written to a friend in Kansas, the nurse, who signed her name as "Lutiant," described what she saw.

"As many as 90 people die every day here with the 'Flu.' Soldiers, too, are dying by the dozens," she wrote.

Later in the letter, she recounted of her nursing: "Our chief duties were to give medicines to the patients, take temperatures, fix ice packs, feed them at 'eating time,' rub their back or chest with camphorated sweet oil, make egg-nogs, and a whole string of other things I can't begin to name. ...


"When I was in the Officer's barracks, four of the officers of whom I had charge, died. Two of them were married and called for their wife nearly all the time. It was sure pitiful to see them die. I was right in the wards alone with them each time, and Oh! The first one that died sure unnerved me ? I had to go to the nurses' quarters and cry it out. ... Orderlies carried the dead soldiers out on stretchers at the rate of two every three hours for the first two days (we) were there."

A copy of Lutiant's letter is kept at the Washington County Health Department, where officials are preparing for the possibility of another flu pandemic.

"If you look back in history, we are overdue for a pandemic," said Elizabeth Nuckles, the Health Department's Community Health Nursing program manager for the Communicable Disease Program. "It would behoove us not to dismiss that possibility."

Washington County Hospital officials agree.

"It's not a matter of if it will happen, it's a matter of when it will happen," Kathy Morrisey, director of Infection Control at the hospital and a registered nurse, said of a flu pandemic. "We want to get across that, really, every family, every citizen, every business, every work group needs to plan for what they're going to do in the event of a pandemic."

In that vein, officials with several agencies, including the hospital and Health Department, are holding a roundtable discussion Oct. 12 at Robinwood Medical Center. The preparations that are in place for dealing with a pandemic will be discussed, and audience members can ask questions.

To be considered a pandemic, a flu virus must be virulent and easily transmitted from one person to another.

Given the current transportation situation, it's estimated that if a pandemic started in another country, it could spread to the United States in a matter of hours.

The most infamous flu pandemic in history was the "Spanish flu," which from 1918-1919 killed an estimated 40 million to 50 million people worldwide. In 1957, "Asian flu" killed an estimated 2 million people, according to information from the World Health Organization.

Maureen Theriault remembers 1968 well.

Not only was it the year she graduated from college, it was the year she spent New Year's in bed, miserable with the flu.

Theriault, a spokeswoman for Washington County Hospital, wasn't the only person that year to spend several days in misery, given that 1968 was the last time a flu pandemic hit the United States.

As many as 1 million people died in that pandemic, called the "Hong Kong flu."

Numbers have been compiled on the likely effects of a flu pandemic in Washington County. Should it be similar to the less serious 1957 pandemic, it's estimated that 42,570 people would be sick, 21,285 would require outpatient care, 410 would need to be hospitalized and 100 would die.

A more serious 1918-like pandemic would result in the same number of people falling ill and needing outpatient care, but it's estimated that 4,680 people would need to be hospitalized and 900 would die, according to information from the Health Department.

When many think of an international flu outbreak, they think of avian flu.

"People confuse avian and pandemic flu, and there really is a difference," Theriault said.

A pandemic flu could consist of an avian virus.

"But it could just be a new flu virus that wipes us out," Morrisey said.

In such a case, it likely would be up to six months or more before a vaccine would be available. Control measures would have to be implemented, which might include postponing community events and encouraging people to work from home if possible.

It's estimated that a pandemic would leave 40 percent of the work force either ill or caring for an ill family member, Morrisey said.

One flu strain being closely watched is known as H5N1, with cases reported in several countries, including China, Indonesia, Thailand and Vietnam. No cases have been reported in North or South America.

Of 250 reported cases, 147 people have died ? a mortality rate of nearly 59 percent. That specific flu strain, which has been in existence for about three years, is not easily transmitted from person to person, Nuckles said.

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