Swine flu symptoms hit Georgia schools hard

Georgia continues to be among states hit hardest by the ongoing flu pandemic even as public health officials urge otherwise healthy children and adults to forgo anti-viral treatment as a means of extending the supply to those most at risk from complications and to prevent cultivating resistance to the drugs.

In a teleconference Tuesday with reporters, Anne Schuchat of the Centers for Disease Control and Prevention said that 25 school systems and about 25,000 students were dismissed Friday because of the flu. Those schools were in Georgia, Tennessee, Indiana and Missouri, she said.

That list likely included Glascock County schools, which were closed Friday because of an increased number of kids showing up with flulike and gastrointestinal illness and in hopes the four-day weekend would help break the viral cycle. CDC has been recommending that schools close as a last resort.

Georgia universities are also hard-hit, according to the American College Health Association. For the week ending Aug. 28, participating schools reported 2,028 cases of flulike illness, including 283 in Georgia, the group said. The report does not break down the cases by school. Georgia's attack rate, or spread, of flulike illness was second only to that of Washington state. Georgia had a rate of 80.9 infections per 10,000 students.

South Carolina universities report relatively low numbers of 21 cases and an attack rate of 5.1 cases per 10,000, according to the school health group.

The Southeast has seen the most activity for the past couple of weeks, and the reason is unknown, but it is probably because children went back to school earlier than those in Northern states and because many of the states had relatively little flu activity from the novel influenza A H1N1 virus in the spring, so "they may just be getting their spring wave now," Dr. Schuchat said.

The CDC is also reiterating and refining its recommendations to clinicians on the use of anti-viral medications. It is two-fold: otherwise healthy people don't need them and probably do not need to make a trip to the doctor or emergency room. Dr. Schuchat said.

But those with underlying illnesses should receive the drugs promptly at the first signs of fever and illness because the drugs are most effective in the first 48 hours, she said. Those at serious risk may want to get a prescription for an anti-viral medication in advance so at the first sign of illness and after a telephone consultation with the provider they can get the drug, Dr. Schuchat said.

Children younger than 2 should be seen if developing flulike illness, and children should be taken in if they develop the following complications:

- Trouble breathing or fast breathing

- A bluish or grayish color

- Vomiting that won't stop or trouble taking in fluids

- Difficulty waking up

- Irritability to the point that they don't want to be held

- Appearance of getting better, then taking a turn for the worse

The CDC is still recommending that children get the novel H1N1 vaccine when it becomes available, which is expected to begin in October. So far, the virus has not changed from the strains on which the vaccine is based so there should be a good match, Dr. Schuchat said. Others who should get the novel H1N1 vaccine are:

- Pregnant women

- Young adults up to 24

- Adults ages 25-64 with chronic health conditions such as asthma or diabetes

- People who live with an infant under 6 months old