Swine flu precautions start with the young

Charlie Houley spent the day before his birthday getting stuck with a needle, but it was for a good cause.

Charlie, now 8, was among the 24 children signed up for trials of the H1N1, or swine flu, vaccine. Through a partnership with Annapolis Pediatrics, the University of Maryland School of Medicine began administering doses there last week. The testing is being done to determine the best dose of the vaccine, as well as document any reactions.

So the Houleys signed up Charlie and his two brothers - Jack, 10 and Ethan, 11. The free trial requires five visits to the pediatric office and each time, the participating child will be given a $40 gift certificate. Trials are also being conducted in Frederick and Baltimore.

"Our pediatrician offered us the opportunity and we thought this might be a good opportunity for them to feel like they're making a difference," said mom Kate Houley of Annapolis.

She said she wasn't overly concerned when the illness hit this year, but wants to make sure her family is protected.

"We really didn't feel like it was any more deadly than the seasonal flu, but it hasn't gone away," she said. "...We don't want to get the kids sick when we can get the vaccine."

Across the country, health officials are turning a wary eye toward young people and the possibility of a swine flu outbreak. The virus first appeared in Mexico in the spring and then spread to the United States where 522 people have died from it, including seven in Maryland, according to the Centers for Disease Control and Prevention.

More than 30 cases have been confirmed in Anne Arundel County and it also led to the brief closure of an elementary school last school year. The symptoms, similar to seasonal flu, include fever, cough, sore throat and a runny or stuffy nose.

Children older than 6 months and young adults up to 24 years old are in one of the highest-risk brackets for catching the virus.

Bracing for the flu

Schools are at extra risk for an outbreak because children spread illnesses so easily, said Gene Saderholm, deputy director of clinic and school health for the county Department of Health. Her office plans to offer the swine flu vaccine to county public-school students once it's available from the federal government. But she said she doesn't yet know when - school officials are guessing mid-October - or how many doses the county will receive.

"We're targeting students because schools are reservoirs for many diseases, like flu, that are communicable," Saderholm said. "It's been proven by other outbreaks. If we immunize them, we have the opportunity to not have them carry it home and get their families sick."

What county health officials know is parents will have to sign a permission slip for their child to receive the vaccine. It will be administered through an injection, unlike the regular seasonal flu vaccine that county children can receive through a nasal spray when it's offered at their schools during the first two weeks of October.

For now, school nurses are concentrating on teaching children ways to contain the illness, like coughing into tissues or their shirt sleeves instead of their hands, washing their hands often and using alcohol-based hand sanitizers.

Officials also are telling parents to follow guidelines set by the CDC, which is recommending any children showing flu-like symptoms be kept home until 24 hours after their fever has disappeared.

Last year, officials closed Folger McKinsey Elementary School for two days after suspecting a student had the virus. County schools likely will remain open this year, even as children get sick.

"The CDC has issued new guidance... suggesting we keep schools open and use good public-health measures, like washing hands and doing some social distancing and also teaching kids how to sneeze into their sleeve," Saderholm said.

Parents seemed to have greater worries last school year, when some families kept healthy children home for fear they'd catch swine flu. So far this year, few have called with concerns, said Bob Mosier, a county schools spokesman.

Test trials

During the University of Maryland trials, the young participants are placed in three categories based on age: 6 months to 35 months, 3 years to 9 years and 10 to 17 years. The children are randomly placed into two groups, based on the strength of their dosage - either 15 or 30 micrograms.

Blood samples are given to measure how well the vaccine is working. Families complete a one-week diary after each dose, noting any changes, such as fever, pain or swelling at the injection site. The oldest children - in the 10 to 17 year group - are required to give five blood samples, while the younger ones give three samples.

Nurse Linda Wadsworth expected to wrap up in Annapolis this week and still had 11 more patients to see. The challenge has been getting participants in the youngest age category.

"There are so many vaccinations that it's difficult to fit in (the vaccine) and the parents are a little bit more nervous," said Wadsworth, with the University of Maryland. "The whole idea is to get the whole population immunized. We're not going to have people go unimmunized."

On the first day of school last week, the public schools sent information about the virus home with students advising parents to keep sick children at home if they register a fever greater than 100 degrees and have a cough or sore throat. Saderholm said the same rules apply to teachers.

Private schools in the area also are preparing for a possible outbreak. At St. Anne's School of Annapolis, Head of School Fran Lukens said school leaders are staying apprised of federal guidelines and relaying information to parents.

"We've taken measures," she said. "Normally students have a handshake at the door; that's a hand wave now."

At the Naval Academy, which saw some cases of the virus last year, officials said they're monitoring the midshipmen for symptoms and working on a plan to administer the vaccine. Separately, shots for the regular seasonal flu will be available to the 4,300-member brigade of midshipmen beginning next week.

At St. John's College in Annapolis, student health director Nancy Calabrese said her office worked all summer on a plan to combat swine flu that includes, if necessary, turning the gym into a quarantine facility with cots from the Red Cross.

"We have all kinds of documents for students and recommendations to avoid transmission," she said. "We have masks, we have sanitizing solutions, and we are awaiting the arrival of the vaccine through the county Health Department."

The University of Maryland School of Medicine is still seeking more babies for their vaccine trials. Call 410-706-6156 to enroll.