top stories : : : :

If you've got the flu, chances are you have the H1N1 viral strain.

"What we've been told from the state is close to 100 percent of all influenza A viruses have been H1N1 2009," said Dr. Mark Netherda, Sonoma County deputy public health officer. While shipments of the H1N1 vaccine are slowly trickling in, they will not be widely disseminated to the general public for some time.

The vaccine is arriving "in relatively small amounts right now so they're being reserved for the five target groups," Netherda said. "We've ordered more, we just don't know when it's coming." Influenza A is a common genus of viruses that covers several strains, including the H1N1 virus. When a sample tests positive for Influenza A, it is sent to the state public health lab to subtype the sample to see whether or not it's the H1N1 virus. Netherda said of the flu cases detected this year, the vast majority are positive for H1N1. Influenza A is also common with the seasonal flu, which has represented a very small portion of cases.

"It's still early for seasonal flu and we're not really seeing it," Netherda said. "That (seasonal flu) usually peaks in January."

When the H1N1 virus was first detected last spring, every person who came into a hospital or doctor's office with flu-like symptoms had a sample taken and sent to the state lab to determine how widespread the virus was in California. Once the overwhelming majority was found to be positive for H1N1, the state stopped testing every case and instead only sub-typed samples from patients who were hospitalized or had died from the flu. Netherda explained that state health officials are looking for trends to determine what risk factors make a person susceptible to complications from this virus. "Once we got a sense of how infectious this thing is, we stopped testing. Now we're looking for trends, such as high body mass index or obesity," Netherda said, adding that 51 percent of people who died from the disease were obese. "We want to know the biggest risk factors."

Netherda said the Sonoma County Department of Public Health received 8,000 doses of H1N1 injection vaccines this week, with more to come. Previously, Public Health had been administering a nasal spray version of the vaccine, which was prioritized to children, as those under 10 will be required to get two vaccinations to be fully protected from the disease.

"We want them to get their first dose now," Netherda said, adding that the second dose could be given three weeks after the first.

The injectable vaccine will be distributed as quickly as possible to the highest risk "target" groups, including families with children under 6 months, youths between the ages of 6 months and 24 years, adults ages 25 to 64 with chronic illness, pregnant women and health care workers. Sutter Medical Center and Kaiser Hospital also received shipments of the vaccine, but are prioritizing those to their own patients. A majority of primary care physicians also requested the vaccine to distribute to their patients, but many shipments have arrived with incomplete numbers.

"We only got 200 doses. That's all they're sending us," said Noelia DeTorres, medical assistant at Sonoma Plaza Pediatrics, which ordered 600 doses of the vaccine. As most children will require two doses, DeTorres said, "basically, we can immunize our 100 sickest patients."

DeTorres said medical providers are in the unenviable position of having to determine who gets the H1N1 vaccine first. She said they are searching medical records to find the children with underlying medical conditions who will be more likely to have complications from the virus. "If someone can't fight this thing off, that's our priority," DeTorres said.

Netherda said Public Health will be holding two public H1N1 flu shot clinics this Saturday, Oct. 24, at Casa Grande High School in Petaluma and Windsor High School from 9:30 a.m. to 3:30 p.m. However, he said, only those in the prioritized groups will receive the shot. "If you're not in one of our target groups, expect to be turned away," he said, adding that people should first contact their primary care physician to inquire about the vaccine before heading to a public-health clinic. "We'd like people to have some patience and make sure those who have no other way can get it," he said.

Health officials said manufacturing the vaccine is a long, time-consuming process, which has delayed shipments. While there is an ample supply of seasonal flu vaccines available, many manufacturers switched to producing the H1N1 vaccine this year, which has disrupted shipment of the seasonal flu vaccine. Sonoma Valley Hospital ran out of seasonal flu shots several weeks ago, but has ordered more. But most primary care physicians and Safeway Pharmacy in Sonoma offer seasonal flu shots with an appointment.

"There's plenty of supply" for the seasonal vaccine Netherda said, adding that some orders have not been shipped yet.

While health officials recommend everyone obtain both the seasonal and H1N1 flu vaccines, it is still unclear when the H1N1 vaccine will be widely available to the public. According to Dr. Mark Horton, director of California Department of Public Health, 12,000 heath-care providers across the state have ordered the H1N1 vaccine, but there have been delays in the manufacturing.

"We fully expect that, in time, enough vaccine will be available for everyone who wants to get vaccinated," said Horton in a written statement. "Meanwhile, continue to fight the flu by using common sense-washing hands, covering coughs and sneezes and staying home when sick until 24 hours after symptoms and fever pass."

Netherda said the injectable vaccine available now does contain the preservative thermasil, which has long been suspected as a contributing factor in the development of neurological disorders such as autism, although medical studies have been inconclusive on the subject. Nonetheless a handful of states, including California, have banned vaccines that contain thermasil for pregnant women or children. But because children and pregnant women are among the high-risk groups for flu complications, the state has created an exception that gives pregnant women and parents the right to decide if they want to utilize the H1N1 vaccines containing thermasil.

"We do expect the preservative-free vaccine to come, we just don't know when or in what supply," Netherda said, adding that the level of thermasil in the current vaccine is "well below federal standards."

Health officials hope to get as many people vaccinated as quickly as possible as the national incidence rate for the H1N1 flu has continued to rise every week for the past six weeks. DeTorres said her office has seen an increase in the number of flu cases this year, but with all the talk of H1N1, she worries other illness are being overlooked.

"We can't assume everything is swine flu," she said.

Please log in to comment:

*Member ID:
*Password:
	Forgot Your Password?

Not registered yet? Sign up here! (registration is free)

Note: All fields are required

Personal Information

First Name:

Last Name:

Address:

City:

State:

ZIP code:

Phone:

Email: (this will serve as your username)

Desired password:

Re-type password: