In region, response to outbreaks decided locally
One school will close. Another will remain open. A third - the only school with confirmed new cases of swine flu yesterday - not only will hold classes, but also has stopped testing for H1N1 influenza.
One school will close. Another will remain open. A third - the only school with confirmed new cases of swine flu yesterday - not only will hold classes, but also has stopped testing for H1N1 influenza.
The decisions, made in Delaware, are confusing at first blush. But they illustrate the evolving nature of both the outbreak and the response, which experts say must be shaped by local conditions.
They also show how, just one week after swine flu roared into the public consciousness, the daily count is already becoming obsolete. With the University of Delaware, home to all 10 of the state's confirmed cases, no longer testing, it is impossible to know how many people have been infected in Delaware and, by extension, nationwide.
The university, in consultation with the state Division of Public Health, decided to stop sending swabs to a lab, because it is clear that H1N1 - the swine flu - is on campus. The symptoms and treatment are nearly identical to seasonal flu, and more than 500 students with flulike symptoms have already been treated, many with the antiviral drug Tamiflu. Knowing who has the new variety would neither aid in their recovery nor prevent its spread, health officials said.
But testing will continue, and is encouraged, because the results serve as an early warning to identify and try to limit outbreaks in areas that have yet to be hard-hit.
Indeed, a new probable case involving a student from the Red Clay Consolidated School District led officials yesterday to cancel classes tomorrow at Austin D. Baltz Elementary School in Wilmington. The closing, which is intended to halt or slow the spread of infection, could be extended for a week or more, officials said in an afternoon teleconference with reporters.
A second probable case prompted the same district officials to continue instruction at the First State School. Located on the Wilmington Hospital campus, it provides kindergarten through high school education to children with chronic illnesses so severe they cannot attend regular school.
The children are vulnerable even in normal times, and officials said about half the 15 or so students had flulike symptoms recently, although not necessarily the H1N1 influenza or even the seasonal flu. Students receive medical care at the school and will be given antivirals, which can slightly reduce the severity and duration of the flu, and limit its spread to others.
Those two students were among 16 cases in the state still listed as probable, meaning a local lab had identified a Type A influenza, the state lab had determined it was not one of several varieties of Type A seasonal flu, and the U.S. Centers for Disease Control and Prevention had not yet performed the additional tests required to confirm it as H1N1. The 14 others, all University of Delaware students, were identified from nose and throat swabs taken before the university stopped sending them to the state lab.
In Philadelphia yesterday, Health Commissioner Donald F. Schwarz announced that the probable case of a 2-year-old had come back from the CDC as negative for swine flu. A confirmation would have been significant because the boy's flu, which city health workers uncovered through a review of lab reports stored in a database, appeared March 23 - earlier than any known case in the United States.
Philadelphia is awaiting results for three more probable cases, Montgomery County is waiting for two, and New Jersey is waiting for one. No H1N1 cases have been confirmed in Pennsylvania, but there are seven in New Jersey.
