WESTERN SAN JUANS – Regional households have not been immune to the influenza outbreaks currently sweeping the nation, as the annual virus makes its rounds throughout Ouray, Montrose and San Miguel counties.
The Centers for Disease Control report that flu activity was elevated across the United States for the first week of 2013, with Colorado reporting high levels of influenza-like-illnesses (ILI.) This winter has seen an earlier start to the flu season than normal, nationwide, with many health professionals reporting an especially fierce flu strain sickening the population this year, as well as a surge in norovirus (the “stomach flu”) and the worst whooping cough outbreak in 60 years.
Yet while the rest of the country and state are on the frontlines of what could be an intense season for winter ills, local trends haven’t alarmed health care professionals – yet. Regional health officials report that while Southwest Colorado is certainly in the grip of cold and flu season, so far virus outbreaks have not caught the medical community unawares in Montrose or Ouray counties.
Peg Mewes, director of Montrose County’s Health and Human Services department, says that while influenza activity has continued to increase since the beginning of December throughout Colorado, the rates of infection in Montrose County – while elevated – are still lower than in other parts of the state. At Montrose Memorial Hospital Emergency Department, the percentage of patients diagnosed with influenza-like illness in the first week of January was at 23 percent. Montrose’s pediatric population has seen an increase since December, when the average was 13.75 percent, to the current January rate of 18 percent. “But these rates are lower than those seen in other parts of the state, who are experiencing consistent rates of 28 percent in the month of December,” Mewes said.
Montrose Memorial Hospital said this week it is imposing temporarily restrictions on visitors who are 12 and under, and on anyone who is ill, in an effort to protect patients and staff from the seasonal flu.
In Ouray County, schools are reporting near-normal levels of absence due to illness, with 16 students who missed school last week due to cold or flu-related sickness, out of a total population of 192, while Ridgway Schools did not report any students out with flu symptoms, said Ouray County Public Health Director Cheryl Roberts.
“We have seen many viruses, but only two have actually had positive test results, both testing positive for influenza A,” said Sarah Lauderdale, family nurse practitioner at Mountain Medical Center in Ridgway. “We have seen a recent increase in patients flulike symptoms over the past two weeks, however.”
In Telluride, however, community-wide, illness is prevalent. Local schools and daycares are noting a high incidence of illness among students, and cases of both influenza and norovirus have been on the rise throughout the community since the Christmas holiday.
Gordon Reichard, executive director of the Telluride Medical Center, says the medical facility was relatively quiet until the Christmas break visitors arrived, bringing with them germs from all over the country.
“All was going well until we started to see an influx from the states where the flu was raging” for the holidays, Reichard said, noting that prior to December 21, TMC had seen less than five cases of influenza.
Now that’s changed. “Since the first of the year, our phones have been ringing off the hook, our waiting rooms have been full and our providers are double- if not triple-booked throughout the day. We are doing all we can to try to accommodate patients.
“In a very few cases,” he added, “people have received care in our Emergency Department or had to drive to Norwood or Montrose,” Reichard said.
Elevated levels of norovirus have complicated things further, he added, as more patients are requiring medical attention for the virus, which causes diarrhea and vomiting and is highly contagious. The Colorado Department of Health and Human Services released a health advisory earlier this month, alerting schools, daycare centers and other group settings to a substantial increase in reports of gastrointestinal illnesses like norovirus across the state.
Betsy Muennich is the state-required nurse consultant for several Telluride-area preschools, many of which have struggled to keep their young students and staff symptom-free in recent weeks. “There definitely seems to be an increased incidence [of illnesses,] especially the norovirus illness,” she said, noting that the post-holiday spike is fairly normal for Telluride. “We always seem to have a bad flu season over the holidays, because we have so many tourists coming in,” said Muennich, who also works in the ER at TMC.
While the regional influenza numbers haven’t yet raised significant concerns within the medical community, public health officials overwhelmingly agree that it isn’t too late to be immunized with this year’s flu vaccine – and that those who haven’t yet gotten the vaccine should do so as soon as possible. The CDC reported this week that this season’s vaccine has been proven to reduce the risk of flu sufferers’ having to visit the doctor 60 percent, which is consistent with the efficacy of most season’s flu vaccines.
Finding providers who still have the vaccine in stock may be challenging, however. Ouray County’s Roberts reports that the Ouray County Public Health Department has less than ten doses left for infants, and all other flu vaccinations were used up, as of last week.
As of last Friday, Walgreens, Target, and Montrose County Health and Human Services still had the vaccine, and City Market expects to have a new order at the end of this week. Safeway Pharmacy had vaccines available, as of Wednesday. In San Miguel County, the San Miguel County Nursing office is the only provider still offering the vaccine.
Medical providers recommend that flu sufferers consider taking Tamiflu, which can ease symptoms if taken within 48 hours of infection, and then, if the infection is suspected, that sufferers do not risk spreading the virus, by avoiding public places and using good hygiene practices. Muennich recommends washing hands with soap and water for as long as it takes to sing “Happy Birthday,” or using one teaspoon of alcohol-based hand sanitizer and rubbing until hands are completely dry, five times a day or more.
“People could probably avoid 95 percent of sicknesses, if they just followed those rules,” she said.
The CDC has also reported that the United States is in the midst of its biggest outbreak of pertussis, or whooping cough, in 60 years; there were about 42,000 confirmed cases in 2012, the highest total since 1955. The disease is unrelated to flu, but causes a hacking, constant cough and breathlessness, and can prove fatal in unimmunized infants.
Cases of whooping cough were actually below the five-year average for December in Colorado, with a total of 40 cases reported across the state last month. Montrose County had five cases of pertussis (whooping cough) in all of 2012. Ouray is not reporting any cases of the disease, but TMC’s Reichard says the facility has recently seen “a tremendous amount of Pertussis,” in addition to a high incidence of strep throat.
Children are routinely immunized for pertussis, however research has found that the vaccine loses its efficacy over time, and that parents and other household members are responsible for about 80 pertussis of infant pertussis infections. (DTaP boosters are available for adults and recommended for those who care for or come into close contacts with infants and small children.)