The flu is here, and it is making its presence known. With the spreading of the H1N1 virus (swine flu), along with seasonal influenza type A and cold season hitting, it seems like people are getting sick all over the place.
Ken Ferbrache MPAS, PA-C spoke to the Lovell Area Chamber of Commerce Monday, Oct. 19, about the different viruses going around this season, steps that can be taken to reduce contracting them, and how North Big Horn Hospital is dealing with the influx of H1N1 flu cases.
Ferbrache said there are active cases of H1N1 in the Lovell area, with two positive cases confirmed at NBHH within the last month. It is unclear exactly how many patients are suffering from H1N1, however, because the state is only testing hospitalized patients at this point, he said.

Because of the high rate in which H1N1 is present in patients who show symptoms of influenza A, NBHH is assuming those patients have H1N1, and prescribing Tamiflu for treatment. Tamiflu is a new prescription drug that kills the virus, Ferbrache said, and is effective against H1N1 and Influenza A. Tamiflu works best within the first 48 hours of symptoms, but it still helps patients who are past the 48-hour mark, he said.
Families of people who have the flu are also being treated with a smaller, preventative dose of Tamiflu over an extended period of time, Ferbrache said. While patients showing symptoms are typically given 75 mg of Tamiflu twice a day for five days, family members of infected people can be given a preventative dose of 75 mg once a day for 10 days, he said.
A prescription of Tamiflu costs $95 to $105 per prescription, Ferbrache said. There is currently no shortage of the drug in the local area, but NBHH has been using the amount ordered.
In addition to the flu, NBHH is still seeing a normal number of patients with other viral syndromes that cannot be treated with Tamiflu, Ferbrache said, including strep throat and mono.
Ferbrache said immunization can help prevent a full-blown case of the flu, but vaccinations vary in effectiveness, because they are designed to address a mutating version of the virus and scientists must predict how the virus will change when formulating the vaccines. The effectiveness of vaccinations varies from year to year, he said.
Because the H1N1 vaccine was made quickly and scientists don’t have historical data of the virus’ behavior, the vaccine is a bit worrisome, Ferbrache said, but it should provide some protection. While the goal of being vaccinated is to avoid a full case of the flu, receiving the vaccination can give a person some symptoms.
NBHH has the live nasal spray version of the immunization as well as the non-live vaccination in injectable form, Ferbrache said.
There are many things that can help prevent the spread of the virus. At NBHH, patients with flu-like symptoms are asked to put on masks and use hand sanitizer when entering the facility to prevent spreading germs to caregivers or other patients. It is especially crucial to keep the virus away from other patients in the hospital who already have compromised immune systems, Ferbrache said, such as people with AIDS, COPD or diabetes.
“That could be the straw that broke the camel’s back for that person,” he said.
Ferbrache said people with the virus can be contagious for up to five days before showing any symptoms. He pointed out that many students might already have been spreading the virus at school for days before they knew they were sick. The virus can be spread for three days after a patient’s fever subsides, Ferbrache said.
Ferbrache said anyone with flu-like symptoms and a fever should stay home from work or school. People with mild symptoms should stay at home and treat the flu with ibuprofen or Tylenol, rest and liquids. If a patient decides to come to the hospital clinic for care, the hospital staff asks they use a mask and hand sanitizer upon entering the facility. Anyone under 14 years of age is currently not allowed to enter the hospital, because of the high probability that they could be carrying the virus, he said.

Schools have been hit by the spreading of the flu in recent weeks, but some fear the worst could be yet to come.
At Big Horn County School District No. 2, students have been sent home sick increasingly in the past week, according to Superintendent of Schools Dan Coe. Lovell Elementary School has been averaging 60 to 70 students absent, Lovell Middle School has averaged about 30 students and Lovell High School has averaged 35 to 40 students, Coe said. LES usually has a 5 percent absence rate during this time of the year, and now the school is missing about 20 percent of students, Coe said.
The schools are taking preventative measures such as making masks and antibacterial foam dispensers available to students and staff, Coe said. Facilities Director Ron Massine recently held an in-service with custodians to stress the importance of disinfecting in all district facilities.
Closing school won’t help matters either, Coe said, because the flu will come back around in a different form, and there will probably be several waves of sick students.
“As long as we have staff, we’ll keep school open,” he said, adding that staff had not been greatly impacted by the flu as of Tuesday.
Big Horn County School District No. 1 Superintendent of Schools Shon Hocker said a total of 88 students were absent Monday out of the district total of 613 for 14.3 percent. He said 30 percent of students were absent from Rocky Mountain Middle School last Thursday, and by Monday there were only 13 percent missing. He said the number includes 4 to 6 percent of students who are hunting, on vacation or absent for another reason, but a good chunk of them are from sick students.
“As the CDC predicted, it’s hitting our middle school aged kids first. We’ll see where it goes from there,” Hocker said.
He said some parents have been extra cautious and have pulled their children out of school for several days to avoid catching the flu.
District staff has been affected less severely than the students so far, Hocker said, though some adult employees have been home sick with the flu and others are indirectly affected, such as having to stay home to care for their kids.
Hocker said the district is taking a number of precautions to reduce spreading of the flu, such as offering hand sanitizer dispensers, cleaning busses, cleaning classroom desks after each class meeting and teaching students better sanitary tactics like sneezing into their elbow instead of their hands and washing hands frequently.
“The custodians are working their tails off keeping the schools clean,” Hocker added.
The district maintains an absence policy, but students will not lose credits for any time missed because of a sickness accompanied with a doctor’s note. Hocker said he has been talking with Rick Schroeder of NBHH to work on the best way for students to receive notes for missing school.
Hocker thanked all of the district patrons who are helping to curtail the situation and thanked parents for keeping their children at home when they are sick.
“It certainly is appreciated and I think it benefits the whole plan to keep as many people as we can from getting sick,” Hocker said.
Students and staff in both districts are advised to stay home if they have a fever, and to come back to school once the fever breaks and they are feeling better.