H1N1 still contagious even after symptoms disappear

The U.S. Air Force Academy in Colorado Springs found itself in an unusual position earlier this year — professors had the chance to study the H1N1 virus up close after a large-scale outbreak quarantined hundreds of cadets.

Scientists from the Air Force School of Aerospace Medicine Epidemiology Consult Service worked with academy staff and discovered that the virus sheds longer than first thought.

Nasal washes indicated the presence of viable virus shedding — meaning the patient was still contagious — a week after the onset of the disease. In fact, 19 percent of those who reported being symptom-free for more than 24 hours were still found to have viable virus shedding, indicating that the virus might persist even after the patient is feeling well and has returned to work.

The results of the study, published in the American Journal of Preventive Medicine, could help public health planners to develop protocols for isolation in high-risk settings if the scale or severity of the flu increases.

The outbreak at the academy represented one of the largest recognized clusters at a U.S. college.

Investigators believe this is the only study to examine how long the virus exists after onset of the symptoms.

The outbreak started between July 6 and 7, after 1,376 new basic cadet trainees arrived at the academy to start a six-week military training program. As more cadets became ill — overall there were 134 confirmed cases of the virus and 33 suspected cases — treatment and containment efforts started.

A total of 228 cadets were quarantined during the outbreak, with no cases among health care workers who treated them.

Investigators determined the outbreak was started by a social mixing event, which has implications for colleges and universities across the country.

The academy credits quick isolation of the infected cadets to keeping the outbreak from spreading.

“Novel H1N1 is now endemic in all 50 U.S. states. University and college-based outbreaks of H1N1 have occurred and more can be expected this fall as students gather from diverse geographic areas, reside in dorm settings and attend mass gatherings such as football games, pep rallies and student assemblies,” the study says. “The combination of aggressive separation of ill BCTs (basic cadet trainees), public health education and prompt implementation of health care infection control practices limited the duration and scope of the H1N1 infection at USFA. Comprehensive plans and rapid implementation are critical.”

The authors admit that isolating patients at other colleges and universities might not be feasible, but they recommend both planning for an outbreak and implementing other infection control practices.

Web instead of doctor visits

State public health officials are encouraging people who are sick to visit AMAfluhelp.org, a flu health assessment Web site that is intended to help alleviate the long wait times in doctors’ offices and emergency rooms.

The Web tool — accessible through www.colorado.gov/nofluforyou – will help patients determine the severity of their flu symptoms and allow them to share that information with their doctors. The programs give patients the ability to talk with their doctors via the Internet and receive advice about when to return to work or school — without visiting their doctors’ office.

Colorado doctors’ offices, clinics and emergency rooms — like those nationwide — are busier this year dealing with seasonal flu and H1N1. About 580 H1N1 cases have been confirmed in Colorado.

Public clinics rescheduled

The El Paso County Department of Health and Environment has tentatively rescheduled its public clinics to vaccinate people against the H1N1 flu virus.

Earlier clinics had to be canceled because of lack of vaccine. Public health officials hope the vaccinations will be available by Nov. 11.

Clinics are scheduled for:

10 a.m., Nov. 11 at Coronado High School, 1590 W. Fillmore St.

8:30 a.m., Nov. 13 at New Life Church, 11025 Voyager Parkway

4 p.m., Nov. 17 at Harrison High School, 2755 Janitell Road

10 a.m., Nov. 19 at The Hangar, 6436 S. Hwy 87, Suite R

Because of limited supplies, and the difficulty in receiving the vaccination, the following high-risk groups are recommended to be vaccinated first:

Preschool children ages 6 months through 4 years.

School-age children and young adults ages 5 to 18 with chronic health conditions.

Health care workers with direct patient contact.

Pregnant women.

Parents and caretakers for children younger than 6 months.

Health officials warn that the availability of the vaccination is subject to change, and are asking that participants visit www.elpasocounthealth.org before visiting the clinics to make sure they are still scheduled.

For additional information about the flu, call the Pikes Peak United Way’s health and human services help line at 211.

Amy Gillentine covers health care for the Colorado Springs Business Journal.