Prevention the best way to deal with H1N1, advises chief medical health officer

Author:  Bernadette Friedmann-Conrad,
Sage Writer,
REGINA
Saskatchewan Sage
Volume:  13 Issue:  10
Year:  2009

The number of H1N1 Human Swine Flu cases increased substantially in Saskatchewan over the last month, and the World Health Organization declared the outbreak a pandemic. But the province's health officials say the best thing to do is not to panic, and to follow simple preventative measures to keep the disease from spreading.

"For this virus, the single best thing is to wash hands and wipe down surfaces that are used by many people, such as door knobs and computers," said Saskatchewan's Chief Medical Health Officer, Dr. Moira McKinnon.

"If you do get a cough or a cold see the health care worker quickly, and make sure you cough into your elbow not into your hand. This is basic infection control, but I know that can be difficult for some northern communities if they don't have running water," she said, adding that even though there has been a lot of media coverage about the H1N1 virus, most people experience only mild symptoms and fully recover.

And while there are stories of increased severity, the World Health Organization did not decide to raise the pandemic to level 6 because of the severity of cases, but more than anything because of the geographic spread.

There have been very few severe cases in the southern part of Saskatchewan and there is no indication that Aboriginal people are affected more severely, said Karen Hill, Media Relations Officer at the Saskatchewan Ministry of Health. "But the agency is keeping a close eye on the north."

"To the best of our knowledge, as of today, it is not affecting First Nations populations any differently. Of course we're increasing surveillance amongst northern communities specifically because of what's happening in Manitoba," she
added.

At the beginning of June, in the remote northern First Nation of St. Theresa Point, a number of residents were diagnosed with influenza-like illness and had to be evacuated to Winnipeg hospitals where they were put in intensive care and on respirators. Half of those in hospital were Aboriginal, said McKinnon.

"We know people from Saskatchewan have been visiting northern communities in Manitoba, and they are returning. What we need to do is look if Aboriginal people are more severely affected by the flu virus. Once we sort that out, we might need to change our policies in regard to treatment."

Saskatchewan's health officials were having difficulty assessing the situation because of the unclear data from Manitoba. Of the 55 cases in intensive care, only two were definitively confirmed as H1N1. Some of the patients, who had been in ICU for a month, could not be accurately tested because the virus might no longer have been present in the body. So it was hard to determine if these cases, in fact, were the serious form of H1N1 Human Swine Flu.

McKinnon said although most cases in Saskatchewan have been mild, "if the communities in the north experience a different clinical picture, where they're getting much more ill more quickly, than we need to treat them earlier."

The isolation of northern communities may not help matters, she said. Crowded living conditions, high levels of diabetes, and inadequate nutrition could be contributing factors.

"Peoples' ability to fight off illness is always reduced with poor nutrition and poor living standards, and it spreads always much more quickly," she said.

For that reason, many First Nations communities across the province have developed pandemic plans, and the World Health Organization agrees that planning ahead to regulate communications, surveillance, vaccination, health care services, infection control, and anti-viral drugs has "immediate and lasting benefits, increasing overall response capacity for all threats to public health."

Meanwhile, on June 19 the Saskatchewan Ministry of Health advised that physicians, health clinics, and hospitals will only test patients for the H1N1 flu virus if severe flu-like symptoms are evident or if there are other clear medical reasons for testing.

According to the advisory, the growing number of confirmed cases in the province "reflect the unusually high number of specimens being submitted by physicians' offices, particularly in Regina. Changes in the numbers are not an indication of an increase in the severity ofÝflu symptoms in the community."

Testing patients with mild flu symptoms for H1N1, said the Ministry, is unlikely to affect the treatment. Therefore, patients should not be concerned if their health professional decides not to test for H1N1.

At the same time, the Ministry also changed its policy with regard to reporting confirmed cases of H1N1 in recent weeks. It no longer provides specific information on which Health Care Region new patients tested positive for the virus, but is now providing only the provincial total for confirmed cases.

"The H1N1 flu virus is present in Saskatchewan communities," stated the advisory. "Residents are encouraged to continue taking precautions against infection through frequent hand washing, coughing and sneezing into the arm, and staying home if feeling unwell."