Flu season

Uptick of confirmed flu cases reported in the area


North Big Horn Hospital Clinic receptionist Barbara Mitchell models the type of mask that may, in some situations, provide the wearer with some protection from airborne droplets that may contain the flu virus.  Patti Carpenter photo
North Big Horn Hospital Clinic receptionist Barbara Mitchell models the type of mask that may, in some situations, provide the wearer with some protection from airborne droplets that may contain the flu virus.
Patti Carpenter photo

According to official reports, a bad, icky, swine-like flu virus is just beginning to rear its ugly head in Big Horn County. North Big Horn Hospital and Clinic medical provider Dr. Richard Jay concurs, noting that hospital staff has seen a steady increase in individuals with symptoms in the past few weeks. The first case tested positive in October, but few cases followed. Medical providers at the clinic breathed a sign of relief until four additional confirmed cases were reported in the past two weeks. 

A hospital spokesperson confirmed the lab at NBHH has received four test results that tested positive for Influenza A, which includes a subtype H1N1, sometimes called the swine flu virus.

The Wyoming Dept. of Health (WDH) website defines influenza as a “contagious respiratory disease that can be prevented by immunization, a virus that attacks the nose, throat, and lungs. It can cause mild to severe illness and at times can lead to death.”

The cold and flu are both respiratory illnesses, but the similarity ends there, said Dr. Jay. Each illness is caused by a different type of virus, with cold symptoms far less severe than flu symptoms.

Influenza symptoms can include fever, dry cough, sore throat, headache, fatigue, runny or stuffy nose and body aches.  About 25 percent of children may also experience vomiting and diarrhea, according to the WDH. Vomiting and diarrhea is less common in adults.

The WHD tracks confirmed cases of influenza in the state, using medical providers throughout the state as “sentinels,” to test and report positive results obtained through laboratory tests. The latest survey ending on Jan. 11, 2014, reported 1,286 cases in the state, as compared to 3,931 confirmed cases reported last year at the end of flu season. The highest concentration of confirmed cases by county so far includes 334 cases in Laramie County, 325 in Campbell County and 200 cases in Natrona County, as compared to 11 confirmed cases in Big Horn County, where the virus appears to be in the early stages of spreading.

Jay said the staff at the clinic is seeing Influenza A in the community including cases of the subtype H1N1, which has particularly severe symptoms. According to Jay, this type of virus is very dangerous to patients with compromised immune systems like those receiving chemotherapy or immune suppressing drugs.

“The H1N1 in the immunized individual (someone who got the flu shot recently) can produce something like a mild cold to a moderate cold. That is, those people who had the shot in October, November or December,” said Jay.

He said the hospital tests people for suspicious symptoms and sends the results to the state, which in turn provides statewide statistics tracking the spread of the virus.

Jay said those who did not get their flu shot are more at risk than those who received a flu shot in the fall months leading up to flu season.

“Generally, in the unimmunized adult, the H1N1 is a big deal,” said Jay. “It is a big deal for adults and it is particularly unpredictable in infants who are unimmunized.”

Jay said he had a conversation recently with an infectious disease internal medicine specialist in Billings, where he learned that, in Billings hospitals, providers are already seeing hospitalizations involving “previously healthy individuals,” who just ignored their illness, thinking they would get over it like the always do.

“That’s for regular people who are not immunized who have chosen not to be treated. There are cases already where individuals have developed significant respiratory distress and that’s right in Billings, and we all go over there to shop or whatever, so we could easily pick up the virus while we are there.”

The Centers for Disease Control (CDC) states on its website that 40 states have reported widespread influenza activity during the week ending Jan 11, an increase of 35 states over the previous weekly report.

It is of significant note that the cases in official reports only include cases where the individual was tested positive for the virus in a laboratory. Officials at every level caution that there are most likely many more unreported cases.

Jay said after talking with other local providers, he estimates that around 100 individuals have been seen (October through January) who may have had the virus but were not tested, which he said is not uncommon in the early stages of an epidemic.

He said there have not been any local hospitalizations yet, but he is carefully monitoring a case of one individual.

“We have been watching one individual who has been horribly sick for the last couple of weeks,” said Jay. “This is someone in an otherwise normal healthy group who exercises regularly, eats right and is normally a picture of health. He has been miserably ill for the last two and a half weeks and is actually being treated. Once people have this for a week, they pretty much run out of gas and need our help. It’s a pretty bad virus.”

Jay said it doesn’t matter if you’ve had the virus before because the virus changes or mutates. He explained that this is why it is important to get the flu shot every year.

“Every time it hits a person, there is a minimal change to the RNA structure,” said Jay. “This type of virus replicates and changes every time it hits.”

Jay said he saw the first case in October, which presented itself in an individual who recently traveled on an airplane. The person tested positive for the virus.

“We sent that positive confirmation to the state and then we all kind of held our breath for a few weeks but didn’t really see any other cases at that time,” said Jay. “We are starting to see positives again just within the last two weeks.”

by Patti Carpenter