Perth County has been prudent in getting vaccinated against the H1N1 flu — but, as evidenced in other municipalities, getting the vaccine may become more difficult due to shortages.
“We’re very pleased with how many people have had vaccinations — it’s pretty unprecedented,” says Dr. Miriam Klassen, acting medical officer of health for Perth County.
As of Friday afternoon, almost 5,500 had been vaccinated at Perth District Health Unit-ran clinics, and, with clinics taking place on Monday on Stratford and Tuesday in Mitchell, the number of those immunized will likely creep toward about 7,000 — or roughly 10 per cent of the total population of Perth County  being vaccinated.
That’s if there is enough vaccine available to continue the priority clinics.
Last week, GlaxoSmithKline, producers of the H1N1 vaccine in Canada, interrupted production to begin producing a different version of the vaccine, intended for pregnant women. This switch lead to a shortage of the traditional vaccine — and could lead to cancellation of priority group clinics this week.
The priority groups include: those under 64 with chronic conditions, pregnant women over 20 weeks, or women who have recently had a baby; healthy children age six months to five years; health care workers and those who care for or live in the same house as someone who cannot be immunized.
The Perth District Health Unit received three deliveries of the vaccine, containing 12,000 shots. With half being used already, “I can see getting through most of the week,” Klassen says.
For clinics later in the week — including the one scheduled for St. Marys this Thursday, Nov. 5 from 11:30 a.m. to 7:30 p.m. at the Pyramid Centre, Klassen says that “we will let people know as soon as we know” if the clinic has to be delayed, via the health unit’s website (www.pdhu.on.ca), or on local radio.
“It is possible we may have to cancel some,” she adds.
This is why, she says, only the priority groups will receive the shot this week — and more intensive screening will take place at this week’s clinics to ensure that all who attend are in one of the priority groups. 

“In Perth County, people have been great,” in following the priority group guidelines, Klassen notes. She adds that health unit staff has been very prudent in planning clinics on shorter notice than in normal flu seasons.
Even though H1N1 is circulating, “it is still advised to get the shot — it won’t hurt you,” Klassen says. “If someone had a lab-confirmed case, you don’t need to get it,” she says — otherwise, it is difficult to know if a person actually had H1N1 and is now immune to it.
“We don’t want vaccine sitting in (storage) fridges; we want it in arms,” she says.
And this vaccine “seems to be really effective,” Klassen says. At the research level, it was above 90 per cent in creating antibodies. Even for children who have only received one of two shots (all first-time vaccines given to children must be given in two doses as their immune systems aren’t as developed), the response has been good, Klassen says.
One of the more confusing aspects of the priority groups is that those over the age of 65 aren’t part of it. Early monitoring of the H1N1 virus indicates that those born prior to 1957 are less likely to acquire it.
But youth are more susceptible to it; the death of a 13-year-old Etobicoke boy highlights the refrain that “this is a different flu season.”
And, with many parents in the area already caring for children with what’s likely H1N1, Klassen says that the best sign to bring children in to the emergency room is “if your child is getting better, then gets worse.” It could be a sign of a secondary infection, such as pneumonia, complicating the flu.
Dehydration, a bluish tinge to the skin or lips, and shortness of breath are all signs that a child is taking a turn for the worse and should seek immediate emergency care.
As for non-severe cases, Klassen says that “for the most part, it seems to be a mild flu,” noting that since more people are susceptible to it means more people will get it. During the course of a traditional flu season in Ontario, 300 will die from it, either directly or indirectly.
Improved monitoring
Klassen says that because cases aren’t being confirmed in labs doesn’t mean that the Health Unit isn’t monitoring the H1N1 virus now that it is widespread.
She explains that many lab tests are done at the outset of a breakout, to confirm it is happening.
Right now, few lab tests are being done, she says, ‘because we all know that it’s circulating, and that it’s the prominent strain.”
Lab tests are done in cases where complications have come into play; as well, in cases of death, to confirm what caused the death. But lab-testing everyone who suspects they have H1N1 would prove costly — not to mention time consuming.
The health unit has always performed surveillance at schools, but in light of the H1N1 pandemic, it has been increased, she says. Schools are reporting number of absentees due to illness to the health unit on a daily basis, and, while not all absent students have H1N1, “it’s a good harbinger of the flu.”
Both the Avon Maitland and Huron-Perth Catholic school boards continue to monitor the situation. Daily  updates are being posted by the Avon Maitland board at www.yourschools.ca.
On Monday, the public board reported 12 elementary schools and one secondary school had at least a 10 per cent student absence due to illness. Arthur Meighen and South Perth Centennial were the only schools in the area to hit 10 per cent.
On Friday, Oct. 30, Arthur Meighen, South Perth Centennial, as well as St. Marys Central, were all over the threshold.
As for Holy Name of Mary school, secretary Judy Greason said the school has had over 10 per cent absence, however, it was not due solely to student illness, but other factors such as student appointments, etc.
Steve Howe, communications manager for the AMDSB, says the number of schools reaching a 10 per cent absentee rate fluctuates each day. He adds that it’s been predominantly Huron County schools on the list over the last couple of days, while when the board first began monitoring, it was mostly Perth County schools.
The safety precautions that school boards continue to stress to students is also being emphasized to staff, Howe says, noting some schools have reported at least a 10 per cent faculty absent rate.
“Staff have been impacted, but not to the point where it’s created any problems,” he adds. “They’ve been able to find replacements through our supply list.”
Howe says the staff absent rate can be deceiving, noting a 10 per cent faculty absent rate could mean a few as one (for a smaller school), or six (for a larger school).
There are three sentinel physicians who are monitoring patients for “influenza-like illness” in area hospitals, as well as providing statistics for those with any respiratory illnesses.
So the 22 lab-confirmed cases of Influenza A in Perth County (of which H1N1 is a subset) are “just the tip of the iceberg,” Klassen says. Of those 22, 13 have been confirmed as H1N1 “and the others probably are.” There have also been two lab-confirmed cases of  Influenza B, “unusual,” says Klassen, as Influenza B tends to be more rare.
Klassen isn’t making  predictions on how long H1N1 will circulate in the community. She notes that, in an annual flu season, “one wave tends to last around eight weeks, or two months. It may be that we have an early (flu) season this year — but I’m not going to guarantee it.”
She will, say, however, that “the more people who have had the flu — or, more importantly, have had the vaccine, the less likely it is to take hold (in the community).”