Nation prepares swine flu defense

Schools and health facilities serving Dinétah are making preparations for the probability that the H1N1 virus, better known as "swine flu," will reach this area.

The federal Centers for Disease Control is already reporting cases of swine flu in California, Texas and several other states. Arizona reported its first case late Wednesday, reportedly in an 8-year-old boy in Maricopa County.

Navajo Nation health officials, meanwhile, are advising tribal members to follow the same basic precautions they would to avoid any other type of flu - only it's more important now because the H1N1 virus doesn't seem to respond to medicine.

To prevent illness, wash your hands often. If there is no water or soap available, use a hand sanitizer.

If you cough, use a tissue or tuck your nose into your elbow. Don't cough into your hand because hand contact is one of the best ways to spread the virus, including touching inanimate objects such as doorknobs.

Some other tips to protect yourself from catching the flu - or to minimize its effects if you do get sick - include getting plenty of sleep and exercise, drinking a lot of fluids, eating healthy and managing stress.

On Wednesday, the CDC reported that a 23-month-old toddler in Texas has become the first casualty of the disease in the U.S.

Health officials said the youngster contracted the disease on a trip to Mexico and was hospitalized in Brownsville, Texas. He died April 27.

Hardest hit is Mexico, where more than 2,000 cases and some 150 deaths have been reported in the last two weeks.

Usually flu targets the very young and the elderly, although the H1N1 virus has been hitting mainly people in young adulthood. Nevertheless, school districts on the reservation are making preparations in case it reaches this area.

On Tuesday, Tom Horne, director of the Arizona Department of Education, sent out a memo urging school districts to ready themselves.

"I want every one to be on high alert in the event that one of our students has been identified with the swine flu," he said. "In the event that we do have an identified case at a school, I would recommend closure of that campus in order to stop the spread of the virus."

In Window Rock, Superintendent Thomas Jackson said a number of steps have been taken.

Curtailing travel

First, travel is being curtailed.

Some students were planning to make field trips in the coming weeks to California and these have been cancelled, he said. Travel by staff to states where the disease is already present also is being curtailed.

The virus entered the U.S. via U.S. citizens who were returning from trips to Mexico, including a student group from New York City that presently accounts for most of the U.S. cases of the flu.

"We don't want to be in a position where we will go somewhere and bring the disease back here to affect members of our community," Jackson said, adding that he realizes there will be people who travel to areas where the virus has spread and may bring it back to this area.

As of Wednesday morning, the number of confirmed cases in the U.S. was at 66 with most of these cases - 45 - in New York. California had 11, Texas six, Kansas two and one each in Indiana and Ohio. Arizona health officials late Wednesday morning confirmed one case - some reports say it's an 8-year-old boy - in Maricopa County.

In almost every case, the illness can be traced back to individuals who traveled recently to Mexico, where the outbreak has prompted sweeping public health measures to reduce the chances of exposure.

Jackson said the Window Rock district will be prepared to close schools if a case shows up here although the hope is that this will not happen before school lets out for the summer in a couple more weeks.

However, if a case is diagnosed here, school will definitely be called off for days and possibly weeks, he said, noting that such an occurrence could cause problems if it happens during finals. It may also require school districts to postpone or even call off graduation ceremonies.

Since swine flu has many of the same symptoms as an ordinary flu, districts may find themselves trying to determine whether to wait until swine flu is diagnosed or treat any flu as a possible swine flu case and close school.

Jackson said a check of the schools in the Window Rock district shows no one with any flu symptoms - it's well past the usual flu season.

Over at the Navajo Nation Division of Health, officials are holding daily meetings to shape a tribal response to the threat.

Ironically, tribal officials just completed a training exercise to handle a flu pandemic, which was funded under a federal bio-terrorism grant. So far no one's claiming the swine flu outbreak is a terrorist plot.

"Things are changing daily and sometimes hourly," said Anselm Roanhorse, division director.

A number of departments within the health division, including its bio-terrorism department, are on alert and are monitoring conditions across the reservation.

"Right now we are concentrating on prevention and education," Roanhorse said. No cares have been reported within 400 miles of the reservation but expectations are that the disease, as it spreads, will get closer and closer over the next few days or weeks.

Prevention & education

The health division has already given briefings to the council's Health and Social Services Committee as well as to the president's office.

The big question - and one that still hasn't been addressed as yet - is whether the Navajo government will go the same way as the schools - closing down for a few days in the event someone in this area comes down with the disease.

Employees who have the disease or think they have it will definitely be asked not to come to work, but a complete shutdown of the tribal government may depend on what state governments do and how many cases occur here.

Navajo Area IHS officials have also been meeting almost on a daily basis to keep up-to-date on the issue.

Jennie Notah, press officer for the Navajo Area IHS, said the unit developed a response plan in 2006, so service units know what they should do in case a lot of cases arise here.

"Fortunately, a vast majority of the cases in the United States have been mild," she said.

If the disease hits this area hard, only severe cases will be admitted to the hospitals here and others will be asked to go home and treat the disease there.

The important thing, said Notah, is for people to take precautions themselves.

Besides the preventive measures listed above, people who develop flu symptoms should do the right thing - stay home.

Symptoms would include a temperature above 101.7, coughing, sore throat, nausea and vomiting. The sick person should isolate him- or herself in one bedroom and use one bathroom in order to reduce exposure by other family members.

Stay home - don't try to go to work, school or run errands. Concentrate on resting and getting well.

On the question of wearing masks, Notah said IHS staff members plan to follow CDC guidelines and use a "N95 respirator" when treating patients who are confirmed to have the swine flu. Although many people are wearing surgical masks in hard-hit parts of Mexico, they are ineffectual, health authorities here say.

There is no vaccination available for this type of flu.

Health officials have taken samples from those in Mexico who have the disease and are now engineering a vaccine - a weakened strain of the virus that triggers the body's immune build-up without causing the actual disease.

But health officials said that development of a vaccine is still a couple of months away and there will have to be human testing and then another couple of months to get batches manufactured. That means it won't be ready until late summer or early fall - not quick enough to meet the current emergency.

Health officials expect H1N1 will move rapidly throughout the world during the next couple of months, then die down and re-emerge this fall.

The federal government is shipping 11 million doses of anti-flu medication to the states but this is for general flu prevention and won't help with swine flu.

Health officials also stressed that despite the name "swine flu," the disease is not transmitted by eating pork or pork products.

It got the name because it's similar to a virus that pigs can catch, but people cannot.

In a speech Wednesday, President Barack Obama stressed that people should not take the current situation lightly and strongly recommended to school officials that they close down if any student comes into contact with the disease.

"If the situation becomes more serious and we have to take more extensive steps, then parents should also think about contingencies if schools in their areas do temporarily shut down, figuring out and planning what their child care situation would be," Obama advised.

Federal officials are worried that if schools close down, working parents will put their children in day care centers that would then become a path for the disease to spread.

A number of Web sites have been set up to provide people with up-to-date information and advice, including www.cdc.gov, www.ihs.gov, and www.hhs.gov.

People can also call the CDC's toll-free number, 1-800-CDC-INFO.