By John Woodrow Cox
Valley News Staff Writer
Concern over a new strain of swine flu that experts believe originated nearly 2,000 miles from the Upper Valley has prompted area hospitals to tighten protocols, caused Vermont and New Hampshire health agencies to stockpile antiviral drugs and left Upper Valley communities to re-emphasize traditional hygienic standards -- shield coughs and sneezes, stay away from people with symptoms, and keep hands clean with soap or hand sanitizer.
“Since this is a new virus, there is no vaccine available at this time, which is why these preventative steps are so important,” said Dr. Jose Montero, director of public health at the New Hampshire Department of Health and Human Services. “We understand that people may be concerned, but I want to emphasize that these precautionary measures will go a long way toward limiting disease, that there are antiviral medications available to treat anyone who may become ill, and that there have been no cases identified in New Hampshire so far.”
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Dr. Kathy Kirkland, a Dartmouth-Hitchcock Medical Center infectious disease expert and epidemiologist, said the hospital had begun accumulating extra Tamiflu and Relenza, two drugs that could treat and shorten -- but not cure -- the illness.
For now, if patients admit to flu-like symptoms and acknowledge that they've traveled to or been in contact with people who visited either Mexico, California's San Diego or Imperial Counties or Texas’ Guadalupe County in the last seven days, doctors will ask that they wear hygienic masks and test them for the illness.
She said doctors would take a nasal swab that would be analyzed on-site, and then sent to a state lab. State health officials could determine if a sample matched any other known flu strain in about six hours, Kirkland said, but federal officials in Atlanta would have to confirm it as the swine flu, a process she estimated could take another day to complete.
“They would get treated like somebody who has the flu basically. If they're very sick, they get admitted to the hospital,” she said of those who were diagnosed with the swine flu strain. “If they have a mild case, which so far most of the U.S. cases have been, they would be most likely discharged to their homes and be kept in volunteer isolation.”
In what one official here called the “perfect storm” of bad timing, thousands of Upper Valley students have just returned to the area from spring break trips, possibly to popular spring break destinations in Mexico.
School Principal Bruce Williams said officials at Hanover's Bernice A. Ray Elementary School had already started asking parents, teachers and staff to be vigilant of the health concerns.
“We try to do it in a way that doesn't cause panic,” Williams said of their hygienic reminders. At the same time, “if we're not doing anything, then that obviously will cause concern.”
In Lebanon, Superintendent Mike Harris said school officials would ask staff and students if they'd traveled, just to keep tabs on people who might have visited areas where the illness is prevalent.
“Is it worrisome? Sure,” he said. “Schools tend to be contagious-prone areas.”
Yesterday morning, Hartford Superintendent Don LaPlante said his district had an applicable emergency plan, and he would encourage good hygiene among students. He intended to bring the issue up at an afternoon staff meeting, but other than keeping watch for students displaying flu-like symptoms, LaPlante didn't plan to take further action until state officials advised him to.
“I'm not going to jump the gun and start polling people on where they've traveled until we're told that we need to do that,” he said.
Superintendent Meg Gallagher, who heads the Windsor Central Supervisory Union, said her staff already encourages students to practice proper hygiene, and she also hadn't proposed an additional response to the flu scare.
Lebanon Fire Chief Chris Christopoulos, who also leads a regional emergency group that encompasses 14 Upper Valley New Hampshire towns, has advised the Lebanon School District and others. In the last five years, the regional group has developed a plan for health crises, like meningitis or hepatitis outbreaks, that officials could also apply to a flu epidemic or pandemic. Emergency efforts would be coordinated between the state and the 14 municipalities and their hospitals, schools, businesses and community organizations.
If needed, Christopoulos said, they would disseminate information to the public and perhaps establish temporary care centers, staffed with doctors and nurses, for people who needed treatment.
“We're certainly watching what's going on at the national level, and we feel we have a lot of things in place to manage this,” he said. “I don't want to say we’re panicking. We’re just in that preparedness mode.”
U.S. Border Patrol officials refused to say if they were changing their practices for screening drivers entering from Canada, and officials with the Centers for Disease Control and Prevention in Atlanta didn't return a phone message yesterday afternoon.
Officials at Dartmouth and at area municipalities and senior centers said they were monitoring news on the issue and would adhere to whatever state officials told them.
For at least one Upper Valley company, the spreading health problem has already impacted business.
About a dozen people scheduled for business trips in Mexico City have cancelled their flights booked through West Lebanon-based Milne Travel, manager Scott Milne said, adding that a wedding that included 30 guests moved their ceremony from a hotel near Cancun to the Dominican Republican.
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