Health care workers in May were on the front lines of the battle to identify patients who may have contacted the "swine flu," or H1N1 virus. Quick identification of an outbreak in the state could help prevent it from spreading.

 

"It has been shown historically with pandemics that the best way to prevent more morbidity and mortality is to intervene early," said Elizabeth Schneider, MD, a pathologist who is medical director of microbiology at Baptist Hospital in Little Rock. "We are implementing the guidelines that the health department has in place for a potential pandemic. The fact that we are intervening early is definitely a good thing."

 

At press time there had not been any confirmed cases of H1N1 in Arkansas. While the World Health Organization had listed the influenza virus as a phase 5 alert, the second highest level of concern, there was speculation that the virus might not be even as deadly as the regular seasonal flu that affects 5-20 percent of the population, killing an average of 36,000 Americans per year.

 

"We don't know how it will work out regarding morbidity and mortality," Schneider said. "It may just end being the same as our regular flu. We don't really know yet because the information we are getting from Mexico regarding deaths and cases may just be the tip of iceberg."

 

Schneider said they have been giving advice to clinics around the state on how to collect and transport samples of suspected H1N1 virus. Some people think they need viral transport media to get samples to the health department.

 

"All you need is a culture swab that is a Dacron, Rayon or polyester—it is important that it is not cotton," Schneider said. "Use sterile saline to keep it moist, and store it in the refrigerator until it is transported to the health department."

 

Schneider echoed the advice from the Centers for Disease Control and Prevention (CDC) about not traveling to Mexico unless it is absolutely necessary.

 

Arkansas Sen. Mark Pryor, who chairs the Ad Hoc Subcommittee on State, Local, and Private Sector Preparedness and Integration that has held pandemic hearings, said it may be "counterintuitive" to close the Mexican border.

 

 "It seems logical we would want to close the border so it won't spread into the U.S.," Pryor said. "But all experts agree there is no scientific or medical reason to close the border. Most people think that is a logical response to this, but the health professionals tell us it would not have any effect. Apparently it is spreading with airplane travel. For all we know, the flu could be leaving Mexico and entering other countries, and then coming into the U.S."

 

Pryor said the outbreak highlights the importance of doing more coordinating preparedness through all layers of government and the private sector.

 

"We need to make sure we are all working together with federal, state and local government, plus the health care community, to solve this," Pryor said.

 

He added it is also important that the U.S. work with the Mexican government to focus on determining the origins of the unusual flu that is a combination of swine, bird and human flu viruses. New Scientist has reported the flu had its origins at a large-scale pork production operation in the U.S. a decade ago.

 

Schools in some states have closed after having an outbreak of the H1N1 virus, and the Arkansas Department of Health (ADH) will recommended school closings if the virus shows up in the state.

 

"We will be taking appropriate measures to slow the spread of disease in our state," said William Mason, MD, branch chief for Preparedness and Response at the Arkansas Department of Health (ADH). "If the first case is in a school, we will recommend that the school be closed for seven consecutive days. Those decisions will need to be made on a case-by-case basis and may change based upon the latest data available to us at the time."

 

ADH will only be closing schools with probable or confirmed cases, and will not be recommending closure for other schools in the district that are not affected.

 

"Arkansas is taking a very aggressive stance in its response to the news that the threat of a pandemic is imminent," Mason said.

 

The Arkansas Public Health Laboratory recently received a new diagnostic test from the CDC that will allow faster identification of the H1N1 virus. The test shortens the time between testing and confirmation that the case is actually the H1N1 virus, which will allow faster response to protect the public.