Swine flu cases increase on campus

It's six months after the outbreak of the H1N1 virus in the U.S. and university campuses across the country are littered with graphic posters reminding students to cover their noses when they sneeze and wash their hands regularly as confirmed cases of H1N1 increase. But no one seems to know exactly which way the pandemic is swinging.

Despite extensive H1N1 awareness campaigns, university campuses in Missouri particularly have taken a knock from the pandemic, with the University of Missouri-Columbia reporting that at least 50 students have consulted health officials with suspected symptoms of swine flu.

Earlier this week Truman's department of student health services confirmed that it had recorded nine cases of swine flu, and the state laboratory has since stopped taking specimens from the University for testing. But there are no indications on whether the flu is receding or still on the offensive.

"We are no longer sending in specimens to the state laboratory since it is now evident that we do have the H1N1 on campus," said Brenda Higgins, director of the Student Health Center.

At least 1,640 swine flu cases have been reported from 165 colleges, according to a recent survey by the American College Health Association. 

Truman has spent between $10,000 and $12,000 on publicity and sanitation  to prevent the spread of H1N1, according to figures gathered from different departments,  and campus awareness campaigns have gone into overdrive. Still, flu cases have climbed from one to nine during the past two weeks.

"It appears that the majority of our students are doing what they've been encouraged to do," Higgins said. "That is to self-isolate at home until they have no fever for 24 hours. 

"I think this has really been helping to keep the numbers down. The students who have had the H1N1 have recuperated without incident."

There are some unreported cases involving students who have not checked into the health center, but instead opted to seek medical attention at home in line with response procedures recommended by the institution.  

Higgins said unreported cases have made it difficult for health officials to know how many cases there are, as many students are attempting self-care at home without reporting to the health center. 

When the south sneezes...

The flu so far has breached the best contingency measures put in place to curb its spread, mainly because of the high mobility of people, especially by air travel. New cases mostly have been reported after long weekends like the Labor Day holiday, which saw millions of people travelling across states. A combination of travel and the onset of the winter season is expected to have the effect of gasoline on fire.

Kirksville family medicine physician Justin Puckett said he thinks Truman and the broader Kirksville community have been particularly lucky to have a relatively low number of cases, a trend he attributes to the awareness campaigns. But he said winter is likely to bring a resurgence of the flu.

"For a university of [Truman's] size, the numbers are relatively low comparatively," Puckett said. "Overall, we have been lucky.  It appears much of our public education has worked here. We are staying home when we are sick.  We are washing our hands.  Truman students have implemented the recommendations of public health officials to prevent spread of the virus."

Puckett said countries in the southern hemisphere already have had their winter, enabling medical professionals  to have a glimpse into the behavior of the virus. He said observations were that H1N1 didn't seem to make people sicker than the seasonal flu. However, viral infection rates for both H1N1 and seasonal flus are expected to increase in winter as more people are pushed inside by colder weather.

"The big difference is that, especially for the younger groups with less antigen (virus) exposure, the virus is just passing to others more easily, and so more people are getting sick," Puckett said. "If more people are infected with the flu in a flu season, more are going to have complications, and more people are going to die.  Even if the fractions are the same, the raw numbers are expected to be higher this year."

Is Truman prepared?

From the onset, the presence of sound contingency measures has been the key factor in determining the rate at which flu cases spread, as well as the speed at which infected individuals seek medical attention. Kirksville's health system has an ongoing plan for outbreaks of disease, which would be activated in case of a flu outbreak. Until now, officials have put their faith in awareness, which Puckett said will allow health officials to focus their efforts on individuals with the most serious complications. 

None of the cases reported at Truman have ended in hospitalization, according to the health center, and most students recover with just symptomatic treatment for coughs, sore throats and fevers. Higgins said the health center prescribed Tamiflu only a couple of times to patients who had underlying chronic health conditions that elevated them to a high-risk category.

Truman departments so far have stocked up on antibacterial hand cleaners and cleaning and antiseptic supplies in a bid to restrict the spread of H1N1, but there doesn't seem to be a surefire strategy in place to curb a possible outbreak.