Most of San Diego County's school children this week began an academic year that will pose the challenge of dealing with swine flu.
Kids who attend San Diego's Language Academy Elementary School chattered excitedly outside the school building after the first day of classes came to an end. Parents waited to pick them up in a line of cars that slowly snaked along 64th street. One mom, Christa Carey, said she's not worried about swine flu.
"Is the swine flu in San Diego that big of an issue right now? Probably not," she said. "But no, I don't regularly inoculate her for even the flu. And I don't deem it necessary at this point."
Another Mom, Ginger Shoulders, said flu shots are on her agenda.
"Definitely. I have a 3-month-old and so it's been recommended that we do. The whole family."
Shoulders added that if they offer flu shots at school, it's all the better.
"It's hard to get into our doctor sometimes. So it it's quicker to get it here, I would do it at the school," she said.
Arun Ramanathan is the chief student services officer for San Diego Unified School District. He says his district will focus on protecting vulnerable populations; pre-schoolers, pregnant teens, and kids with diabetes. Members of those groups who get swine flu will be required to stay home for at least a week and they'll get first dibs on any medication. Ramanathan said school officials won't be as quick to close down schools with cases of swine flu as they were last spring.
"The threshold for closing a school was very low," he said. "You could had one student, or one suspected case, in a comprehensive high school and then you would have to close the school."
Now, schools will wait until they have a 30 percent absentee rate before they consider closing down. San Diego Unified is one local school district that is working with the county health department to provide flu vaccinations at school sites. Shots would be given for both seasonal flu and swine flu. Ramanathan said the biggest challenge might be getting parental consent.
"We'd have to find a way to get the consent form to the parents. The parents would have to sign off on the consent form and that would be a challenge because there are two shots associated with the flu vaccine," he said.
Swine flu first appeared at the spring of this year. In fact, a San Diego ten-year-old was the very first person to be confirmed as having the novel virus that's become pandemic. The H1N1 virus is expected to sicken a very large part of the world population since humans have no natural immunity to it. The good news, so far, is the swine flu has not changed genetically. Brian Plew, head of public health at Life Technologies, a San Diego-based biotech company, said, "It is very important for public health agencies around the globe to understand that we still have the same virus circulating the globe," said Plew. "It has not yet changed from its initial identification earlier this year."
So, the H1N1 virus is the same relatively mild form of flu we've known from the beginning. Anne Schuchat, of the CDC, said the stability of swine flu also means the vaccine, expected to be available in October, should actually work.
"That doesn't mean that a couple months from now, or a couple weeks from now, the virus won't change," said Schuchat. "And that's one of the really frustrating things about influenza. It can change."
The swine flu could mutate into something more virulent. Plew said it could also genetically cross with an avian flu, which has not yet been able to pass from one person to the next.
"Worst case scenario would be a cross with avian influenza H5N1, producing a new virus that maintains the virulence and lethality of H5N1, combined with the ease of transmission of the novel pandemic strain H1N1," he said.
All of the existing plans for school closures, use of anti-viral medication and vaccines depend on swine flu remaining the creature we've come to know. Ideally, human immunity will build up over time and greatly reduce the flu's ability to spread. But if the virus becomes more virulent sometime soon, it'll be a whole new contest.
