The Student Health Center has seen record numbers of patients for August and September over the past week, Dr. Louise Hanson said, with about 30 cases each day of influenza-like illnesses.
In response to the increased demand, the Student Health Center will open another flu clinic on Sunday from 2-5 p.m. intended for those who develop flu-like symptoms or who have been in close contact with a person with a diagnosed case of the flu over the weekend. Last weekend, the clinic saw 30 patients during the special Sunday clinic.
Most days the center sees over 200 patients, a record for this time of year, said Hanson, the medical director for student health services. ILIs give the best indicator of how ill the Vanderbilt community is, Hanson said, although the Centers for Disease Control and Prevention criteria for an ILI include generic symptoms, like a fever over 100 degrees or a cough, that could be any number of other similar illnesses. And Hanson said yesterday morning that Student Health is still seeing many of these, like mono, strep throat and end-of-summer colds.
Student Health is continuing to send in cases to state testing centers, from where confirmation of specific illnesses, including seasonal and H1N1 influenza, come. At the Tennessee Department of Health’s request, Hanson said, Student Health only sends in cases for testing on Mondays, meaning only people who go to Student Health on that day have the possibility of having their case confirmed or disproved as a specific illness. Other clinics that are also part of the state’s Sentinel Provider Network send samples on other days. This routine goes on year-round, regardless of what illnesses may be most popular in a community.
As confirmation can take up to two weeks, “treatment should be based on clinical presentation,” the TDOH state laboratory testing policy for H1N1 influenza says, meaning clinics like Student Health have to evaluate a case based on symptoms and exposure.
Hanson said yesterday that since the confirmation of the first case of seasonal flu in the community in late August, no more confirmations of seasonal flu have come back from state testing centers.
“Most of the ILIs we're sending to the state are coming back as positive for H1N1, so we still believe that most patients who have flu-like illnesses do have H1N1,” Hanson wrote in an e-mail yesterday.
And because cases are only sent on Monday, confirmations don’t give an accurate picture of what’s going on in the community, Hanson said.
“The purpose of these confirmations, the swabs, is not to individually care for students or any patient or individually care for a community,” Hanson said in an earlier interview. “The purpose … is looking for infections, looking for resistance, looking for new mutations, looking for what else is out there. … So to use those numbers as a marker of a community's wellness or un-wellness is not good because it's a very biased, unrepresentative sample of what may be going on in our community.”
While many universities, including Vanderbilt, have had hundreds of ILI cases, most of which are suspected to be H1N1, no college is planning on canceling class, according to university Web sites. Even universities reporting thousands of cases expect to continue operations as usual.
Student Health does, however, stress that students isolate themselves as much as possible, including from the classroom, while they have a fever and for at least 24 hours after their fever leaves. Students can take preventative measures such as washing their hands or using an alcohol-based sanitizer to hinder the virus’s spread.
Student Health is giving out Tamiflu on a case-by-case basis to some patients who have flu-like symptoms, said Liz Latt, the assistant vice chancellor for news and communications. Tamiflu is effective if initiated within 48 hours of symptom onset, an e-mail from Student Health said yesterday. Antibiotics are only being given to students with other illnesses that are suspected to be bacterial.
Additionally, a vaccine for the seasonal flu arrived on campus earlier in the month and was available this week to those who are at a “high risk” for acquiring the virus, as defined in an e-mail sent to the student body. Many in the community who were qualified took advantage of the opportunity to be immunized.
“Out of the original 800 shots we got into stock with this first shipment, we only have 70 left,” Hanson wrote in yesterday’s e-mail. “ We're hoping to get more starting next week. We still have another 3,200 coming to us over these next few weeks and will notify students of that availability as soon as we know more.”
Previously, the American College Health Association data showed that colleges in the Southeast, notably Mississippi State University, had the highest number of cases, but The Associated Press reported yesterday afternoon that Washington University in Spokane, Wash., was reporting as many as 2,500 cases of H1N1 among students. Mississippi State’s flu watch Web site said there had been 467 probable cases of H1N1 as of yesterday, of which only 57 were still ill.
H1N1 is a strain of influenza A that is commonly referred to as swine flu. Clinically it is no different than seasonal influenza, Hanson said in an earlier interview, meaning symptoms and recovery times are similar. The H1N1 flu does not last any longer than the regular flu, Latt said.
