By Amanda McGregor
SALEM — North Shore Children's Hospital is beefing up emergency room staff and keeping more waiting-room space available to cope with an influx of hundreds of apparent swine flu cases — a trend pediatricians are seeing across the North Shore.
When Dr. James Higgins arrived at his office at Pediatric Associates of Greater Salem on Monday morning, he had more than 60 voice mails, illustrating the spread of the virus, as well as a growing concern among parents.
"A lot of kids have this," said Dr. Edward Bailey, chairman of pediatrics at North Shore Children's Hospital in Salem, "but what we're finding is that it's no different — other than the numbers — in terms of the severity of the flu virus we see every year."
"We are seeing many, many cases, but most of them are not serious," said Higgins, whose pediatric practice has more than a dozen doctors and 24,000 patients.
"The two kids I know of personally who have been hospitalized have underlying health issues," he said. "If anything, most of the kids are less sick than with the average seasonal flu."
The best way to prevent swine flu (2009 H1N1 virus) is to get vaccinated, but there is a vaccine shortage. In its absence, health officials are urging people to protect themselves and others through hand washing and covering coughs and sneezes.
The scarce doses of vaccine are being administered to the highest-risk groups, including pregnant women, children under 2 and health care workers, according to the Centers for Disease Control and Prevention, which is reporting widespread H1N1 in 48 states.
The shortage has been a source of frustration and worry for medical professionals and parents.
The Beverly Health Department has received only 200 doses of the swine flu vaccine so far, not enough to offer them to the general public, said Pat Zingariello, the city's public health nurse.
Zingariello administered 100 doses to pregnant women at the North Shore Birth Center on Monday. She plans to start using the other 100 doses for school nurses and health care workers.
Zingariello said the health department has been getting calls from people worried about swine flu.
"Somebody needs to be the voice of reason," she said. "This is not smallpox. Too many people are panicking."
At Pediatric Associates of Greater Salem, Higgins estimated they have been able to inoculate between 700 and 800 children, out of some 5,000 in the practice who fall into the high-risk tier.
"The threat has been oversold," Higgins said, "and the treatment has been oversold because they have not been able to deliver the amount of vaccination they said they were going to. And that's what makes people crazy."
Beverly Hospital is also seeing an increase in patients with flulike illnesses in its emergency department, inpatient units and physicians' practices.
"We started planning for this early," said Dorothy Egan, the hospital's infection control nurse. "We're prepared as this unfolds to manage individuals. ... We're preparing today for next month."
Most children who contract H1N1 show the same symptoms as for the seasonal flu: fever, cough, aches and pain. When this occurs, parents should call their pediatrician, Bailey said.
"As with any illness, there will be a very small percentage of kids whose symptoms will get worse and worse when they should be getting better," Bailey said. "After five to seven days, if there is suddenly chest pain, a higher fever, rapid breathing, dehydration and failure to take in fluids and urinate, lack of awareness of time and place, they should call their doctor."
Bailey said there have been no North Shore swine flu deaths that he knows of.
He also advised people to get the seasonal flu vaccine.
"Soon we're going to have the arrival of seasonal flu, and it may be mixing in with this," Bailey said. "Just because you have one of these flus doesn't mean you can't get the other."
Swine flu vaccine supply is expected to improve over the next month or so, according to the American Academy of Pediatrics, which recommends vaccinating young people between the ages of 6 months and 24 years, as well as people with chronic medical conditions who are at an increased risk of complications from influenza.
"Realize that most children are going to be well," Higgins said. "Most are going to be sick and get better before they are going to be immunized."
Staff writer Paul Leighton contributed to this report.
Staff writer Amanda McGregor can be reached at amcgregor@salemnews.com.
Who should be vaccinated first?
Pregnant women and mothers with newborns.
Household members and caregivers for children under 6 months of age.
Health care and emergency medical services personnel.
All people from 6 months through 24 years of age.
People ages 25 to 64 who have health conditions associated with higher risk of medical complications from influenza, including asthma, diabetes, cardiovascular disease, HIV, neurological and neurodevelopmental conditions, and cancer.
Source: Centers for Disease Control and Prevention
The following Web sites have more information about the flu:
The Centers for Disease Control and Prevention: www.cdc.gov
A federal flu Web site managed by the U.S. Department of Health and Human Services: www.flu.gov
The American Academy of Pediatrics: www.aap.org
Salem
The Salem Board of Health is offering the H1N1 vaccine to "highest risk" individuals: pregnant women, people who live with pregnant women and people who live with or care for an infant under 6 months. Those Salem residents may call 978-741-1800 to reserve the vaccine on a first-come, first-served basis.
Peabody
The Peabody Health Department will offer the vaccine to Peabody residents who are: pregnant, immediate household members of pregnant women and immediate household members of children under 6 months. Supplies are limited and are available on a first-come, first-served basis. Call 978-538-5926 to register.
Danvers
The Board of Health will provide vaccine to young children through grade three on Wednesday, Nov. 11, from 1 to 5 p.m. at the Senior Center, by appointment only. To schedule an appointment, Danvers residents should call the Senior Center at 978-762-0208 between 5 and 7 p.m. on Monday and Tuesday. You must speak to a representative; appointments cannot be made by leaving a message.
Ipswich
The Ipswich Board of Health has a limited amount of vaccine available to pregnant women on a first-come, first-served basis. Call the Health Office on Monday, Nov. 9, to register, at 978-356-6606, ext. 4.
Boxford, Middleton, Topsfield
There is a Tri-Town H1N1 vaccination clinic for pregnant women, who may call 978-887-1520 and leave a message with their name, telephone number and how far along they are in their pregnancy.
Q&A with Dorothy Egan, infection control nurse at Beverly Hospital
How can you distinguish H1N1 swine flu from a common cold?
We know the symptoms are sudden. The suddenness of it makes it more likely to be flu.
What are the symptoms?
A fever greater than 100 (degrees) most of the time, not all of the time.
Aching joints, muscles hurt.
You might have a dry cough; you might have a sore throat.
Headache.
Nasal congestion might be there.
Given that one has those symptoms, most healthy people recover with absolutely no complications.
Additional symptoms more likely to occur in children?
You might have diarrhea, which is unusual with the flu.
You might have vomiting, which is again unusual with flu, but children are presenting that.
What should parents do if they think their child may have H1N1?
When you have the flu and you're under the age of 18, you should call your doctor. People who are infectious are discouraged from spreading the infection to others and should try to stay as isolated as possible, but that doesn't mean not communicating with your primary care provider.
What should adults do?
(Pregnant women and people with pre-existing health conditions including asthma and diabetes) should seek medical evaluation immediately by calling the doctor. Most healthy people with the flu do not need to make contact. Healthy people do fine.
When should adults be concerned?
If people think they're doing OK, but they get a higher fever or chest pain or coughing that produces mucus. ... If they feel weak, faint, confused or begin to vomit ... or if they felt better for two days and then get a fever again, they need to go to the emergency room immediately.
Why?
What happens is that they recover from the flu, but they get pneumonia or bacterial infections. Half the people who have died have died because they thought they recovered.
If you have swine flu, what activities should you avoid?
The CDC recommends that people don't go to hospitals or schools, places of employment, malls, or anywhere while they have fever or symptoms of flu.
When is it safe to begin interacting with the public?
The CDC feels that 24 hours after your fever goes away, as long as you're not taking medications to reduce your fever, you can go back to school or back to work without posing a great risk to others. That's as long as you're feeling better.
What can parents do to prepare?
Parents need to stay informed. (Visit www.flu.gov).
How can people get vaccinated?
The topic of vaccination should be managed and directed by primary care physicians, given that it's difficult for the public to understand the shortage of supply.
Key to staying safe and healthy?
I think people need to communicate and follow the primary care physicians' and pediatricians' advice.
