Moore County organizations are taking proactive and aggressive measures to protect residents against the spread of H1N1 influenza.

H1N1 -- also known as swine flu -- is expected to spread rapidly in the coming months.

While the flu may be unpredictable, Moore County health officials say they expect a large number of county residents to fall ill with the virus before a vaccine becomes available sometime this fall.

The Moore County Health Depart-ment is the lead agency locally for the H1N1 outbreak, and is working closely with local organizations to coordinate response.

"The Health Department continues to actively monitor the H1N1 flu situation and is working closely with the hospital, schools and health-care providers on prevention and treatment of the flu, along with planning for vaccinations," a statement re-leased Friday read.

The local health department is following the guidance of the Centers for Disease Con-trol and Preven-tion (CDC) and the N.C. Department of Health and Hu-man Services.

H1N1 originated in Mexico earlier this year but has since spread around the world as a full-blown pandemic. According to the CDC, all 50 states and the District of Columbia have confirmed cases. The spread of the virus has resulted in 8,843 hospitalizations and 556 deaths in the United States. The CDC reports on its Web site that most of those hospitalizations have been people with underlying health problems.

So far, the virus has caused mild to moderate illness in most individuals.

North Carolina is one of 13 states experiencing "regional" activity, the second-highest activity rate the CDC is listing. Georgia and Alaska are reporting "widespread" flu activity, which is unusual for this time of year. Activity in the southeastern United States appears to be increasing.

According to the Health Depart-ment, the virus is easily spread from person to person and can be found in every county in the state.

FirstHealth Moore Regional Hospital has been working in tandem with the health department and the CDC on the issue.

"We have developed a high-census contingency plan," said Jayne Lee, director of infection control and patient safety, "and we are working with our emergency department physicians to address increased visits to the emergency department."

FirstHealth is also strongly encouraging its employees to get the H1N1 vaccine when it becomes available, and the hospital will follow established isolation precautions when dealing with infected patients.

The public school system isn't taking the situation lightly, either, because of the close contact students have with one another.

The system will keep a close eye on students, faculty and staff, and will remove sick individuals from the school setting as soon as possible, spokesman Tim Lussier said. They will not be allowed to return until seven days have passed since the diagnosis or until they are fever free for at least 24 hours, whichever is longer.

The school system continues to work with the Health Department on its flu plan. It promotes good hygiene and hand washing across the district, and will distribute alcohol-based hand sanitizers.

The system is sending out information packets to parents, and a series of ConnectED phone messages is forthcoming. A podcast is also available on the school system's Web site.

"Our main focus is to keep parents informed," Lussier said. "We want parents to work with us in monitoring their child's health."

Sandhills Community College finds itself in a similar boat. It has been working on its "pandemic flu plan" -- much like a business contingency plan -- since this summer. Like the school district, it will be vigilant of its community and send sick individuals home.

"We're educating faculty and staff as well as the students about how to stay well and not spread the flu," said Susanne Adams, vice president of student services. "We're doing a lot of education and a lot of preventive measures. We've been very proactive about this."

College officials have been working with faculty about making attendance policies as flexible as possible, and are exploring ways to keep students up to speed on class material while at home. It is considering a "flu study buddy" program where students can team up and stay in contact about class work if one is out sick.

Because it is a commuter campus, SCC isn't presented with the challenges that colleges and universities with dormitories have.

"That makes it a little better," Adams said.

Just Like Seasonal Flu

While a global disease pandemic is always a cause for alarm, local pediatrician Christoph Diasio is urging residents to keep the spread of virus in perspective. About 200,000 Americans are hospitalized each year with the seasonal flu. About 36,000 die from it every year.

"For the individual person who has H1N1," he said, "it is no worse than the seasonal flu. Except for pregnant women, it's like the flu before. But because its new, more people will get it."

It is estimated that between 40 and 50 percent of Americans could end up contracting the virus. That creates a numbers game, Diasio said, and because more people will be infected, naturally more people will be hospitalized and die.

Diasio said that the fact the virus appears to have more success infecting younger people -- the opposite of seasonal flu, which usually strikes the elderly -- it seems to have created panic across the country.

But while it is hard to anticipate how the virus will behave in the coming months, it does not appear to have the characteristics of the 1918 "Spanish flu" virus that killed millions of people globally.

At the same time, Diasio said, it's still important for everyone to be aware of the disease and to do what they can to prevent its spread. There's still the chance that the virus could mutate into something deadlier.

"No one knows how exactly this is going to go," Diasio said.

Preventive Measures

H1N1 is spread through respiratory droplets that are projected by coughing and sneezing, and individuals can become infected by coming in contact with contaminated surfaces. CDC studies show the virus can infect a person from two to eight hours after being deposited.

Sneezing and coughing into the elbow, frequent hand washing with soap and water or an alcohol-based sanitizer, avoiding touching the eyes, nose or mouth and staying home when feeling ill are the best ways to curb the spread of the disease.

The CDC expects that most people will recover from the disease without medical care. But those who are experiencing severe flu symptoms or are at high-risk for complication -- pregnancy, diabetes, heart disease, asthma and kidney disease -- are advised to seek medical attention.

Diasio recommends treating H1N1 as you would the normal flu. Getting lots of rest, drinking plenty of fluids and staying away from others is a good policy.

"Most people are doing just fine without treatment," he added.

Over-the-counter medications containing acetaminophen and ibuprofen can be used to treat aches and fevers. Children and teenagers should not be given aspirin, and children under the age of 4 shouldn't be given over-the-counter medications unless a medical professional is consulted.

Tamiflu is a brand of antiviral medication that is used to relieve flu symptoms and can shorten the length of the illness, but it is being reserved for those who are at high-risk for complications or who have severe symptoms.

There are concerns that overuse of the medication in healthy individuals with routine flu symptoms could make the virus resistant and render the medication ineffective -- a dangerous proposition if the virus mutates.

Vaccination Priority List

"Antivirals should not be used for healthy people in an attempt to prevent becoming sick," the health department statement said. "Medical providers know the proper use of antivirals and will administer their use on a case by case basis utilizing the CDC recommendations."

Drug companies are hard at work developing a vaccine for the new flu strain, which is expected to be comprised of two separate doses. The vaccine will not be available until October, and early doses will also be reserved for those who are at a higher risk.

The CDC's vaccine priority list includes pregnant women, those who care for children younger than 6 months old, health-care and emergency medical personnel who have direct patient contact, people between 6 months and 24 years old, and people between 25 and 64 years old who are at a higher risk because of chronic health disorders or compromised immune systems.

Once demand for the priority list is met, vaccines for all up to 64 years of age will be made available. Those over 65 appear to be less at risk for infection, and will be vaccinated as demand for the younger age groups are met.

The H1N1 vaccine should be available to everyone by midwinter. Individual states are developing vaccine delivery plans.

"It is important for people to get the vaccine," Diasio said.

Final prioritization will be determined by the CDC as the vaccine is shipped to the states and in turn to the counties.

In Moore County, the decision has been made to vaccinate the children in the schools and through local health-care providers.

Vaccinations for other priority groups will be provided by local health-care providers, participating pharmacies and the health department as the vaccine becomes available.

The seasonal flu vaccine will not protect individuals from H1N1, but the CDC is still recommending individuals to get it as soon as it is available.

No shortages of the seasonal flu vaccine are expected.

Contact John Krahnert III at 693-2473 or by e-mail at jkrahnert@thepilot.com.