The Department of Health and Environmental Control’s latest by-county report showed Newberry County holding steady at 21 cases. Locally, cases of the virus stemmed from a Newberry Academy senior class trip to Cancun.
The state’s numbers have crept to 41, according to the latest CDC report.
You can thank area healthcare workers and citizen cooperation, which played a big part in the H1N1 containment in South Carolina, says DHEC Commissioner Earl Hunter.
“In some other states, we’re seeing it move pretty rapidly,” says Hunter.
Illinois alone has 1,002 confirmed cases and even mini-state Maryland has 48, says a CDC report.
But neither Newberry nor anywhere else is clear just yet.
“In the past few weeks, we’ve seen a definite drop in the number of new or suspected cases of the H1N1 virus (swine flu) in South Carolina,” DHEC reports. “We suspect that the worst of our state’s H1N1 outbreak is over, although the virus might resurface in the fall.”
A return of a meaner, nastier swine flu is possible.
But it could also return in a milder form, or not at all, says Hunter.
In the meantime, here’s a look at DHEC’s behind-the-scenes swine flu work and some facts to understand the “novel strain” that demanded so much attention last month:
How DHEC tracks H1N1 cases:
DHEC divides the state into eight areas, each with an epidemiology teams or “Epi team.”
Epi teams are made up of nurses, social workers and medical directors among others.
Once DHEC is notified of any infectious or contagious disease, be it tuberculosis or swine flu, it investigates.
DHEC studies a patient’s symptoms, test results, travel history and how much contact they’ve had with others.
After monitoring the patient and sometimes requesting their isolation or quarantine, DHEC then sees where the illness has spread.
While awaiting test results, DHEC may request isolation or quarantine of hundreds, says Hunter, to “ensure that they didn’t remain infectious or become infectious and then spread it to other people.”
“That’s the kind of work that goes on all the time,” he says.
Swine flu or not? The process:
At first, DHEC studied nose-swabs to see if the virus strains fit other common strains that “had normally circled the globe during flu season,” says Hunter.
“Novel” strains that didn’t match familiar strains were called “unsubtypeable” and “probable” swine flu cases.
DHEC sent these “probable” swabs to Atlanta to match with the Center for Disease Control and Prevention’s confirmed H1N1 samples they had on hand.
Early on in the April outbreak, the CDC was the only center that had some the virus from Mexico for comparison, says Hunter.
But soon, CDC sent kits to DHEC and other state health centers to confirm H1N1 for themselves.
CDC asked states to send their first five swine flu finds back to CDC to ensure accuracy.
CDC approved each of DHEC’s confirmed cases.
“Our public health laboratory, which I think is one of the best in the country, is very wonderful about taking samples through our Epi teams and the regional office and doing further analysis to confirm what we suspect is true,” says Hunter. “In the case of influenza, (it’s) able to subtype it and determine, in this case, whether we got H1N1 swine variety.”
DHEC does this to understand how severe the illness is and see if patients get the needed treatment and don’t spread it to others. DHEC will also ask schools to close to keep the infection from spreading.
What’s the worst swine flu scenario?
“So far, the strength or virility of the virus seems to mirror a typical seasonal flu at this point in time,” says Hunter.
In some cases, H1N1 symptoms went away without medicine or a doctor’s visit “just like a seasonal flu does,” says Hunter.
Early on though, Hunter says DHEC was concerned about reports from Mexico, thinking it could be a lot more deadly strain.
“We really had to be on tremendous guard for that,” says Hunter, noting the 1918 avian flu pandemic that killed 20 percent of some countries’ population.
“You have to be on guard and be very quick in your response,” says Hunter. “Then if it turns out to be like this one has—less of a problem and more like the seasonal flu—you just breathe a big sigh of relief this time.”
Isolation and quarantine can be bothersome, but it’s better than widespread hospitalizations, event closings and even death, says Hunter.
“We always try to stay one step ahead of theses things if we can,” Hunter says.
Could we see a swine flu resurgence?
Usually, over the last 300 years in world history, there has been on average, a pandemic about every 30 years, says Hunter.
The last true pandemic in the United State was in 1968.
“So it’s been about 41 years since we’ve had one,” says Hunter.
Some are concerned about the not-so-mild H5N1 bird flu which began in southeast Asia and spread to other places.
“We’ve been on guard about for the last three or four years,” says Hunter. But most were sick with the bird flu after direct bird contact. It hasn’t spread much from human to human.
But the last three or four various pandemics had a second wave where “the virus was much stronger with much worse symptoms and led to more deaths and hospitalizations,” says Hunter.
Now DHEC, the CDC and the World Health Organization are all watching for a second swine-flu run.
If the virus spreads southward, those in the southern hemisphere are going into their winter months and staying in close quarters, so there is more of a chance for it to spread and mutate, or change.
A virus’ ambition: “A virus is always trying to do one thing and that is survive,” says Hunter. “It will mutate and go to whatever means it needs to continue to survive.”
DHEC expects the H1N1 to mutate, but hopes it changes into a milder form.
But it could grow stronger.
Or it could become a more recognizable strain seen in the past.
Or it could die off.
“It could just fizzle out,” says Hunter. “We just really at this point don’t know.”
The good news for those who had the swine:
If you’ve had it, you’ve built up a bit of immunity to it and your chances for getting it again are slim.
“That’s the silver lining in this. People who have already been exposed to this will have some level of immunity even if the strain were to come back around in a slightly mutated form,” says Hunter. “They’d probably have some layer of protection, if not good immunity to it.”
If Newberry only had 21 confirmed cases, why were stores out of Tamiflu?
We know that not everyone who comes in contact with influenza will get it, says Hunter.
“But to err on the conservative side, you presume that all the people that have come in contact will get the virus so we go ahead and give them the treatment to try to stop symptoms,” says Hunter. “Like in the case of Tamiflu.”
Tamiflu can lessen the symptoms after you have the flu, stopping the virus in its tracks.
Or, if you have the flu in your body but haven’t started showing symptoms, Tamiflu can stop the virus even before symptoms show.
However, taking Tamiflu before even being exposed to the virus, doesn’t help, says Hunter.
Tamiflu isn’t “preventative” medicine and can’t keep you from contracting swine flu.
So if you take if for five days without ever being exposed to the virus, after those five days, you’re not protected anymore than others.
“It’s not like a flu shot that causes your body to build up immunity that will protect your body against a certain strain of influenza,” says Hunter.
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