SWINE INFLUENZA

Health officials across the region are meeting on a nearly weekly basis to discuss how to prepare for the H1N1 influenza virus that has become a widespread threat in New Jersey.

Health officials also said Monday that New Jersey will receive $10 million in federal funds to help it prepare for a possible pandemic.

Gov. Jon S. Corzine said the state Department of Health and Human Services will get $7.4 million for local, county and state preparedness for the virus. An additional $2.6 million will be used to prepare a response to any surge of flu patients.

The U.S. Department of Health and Human Services is providing the funding as part of $350 million in grants to help fight the flu nationwide.

Strategies to fight the flu include everything from vaccinating pregnant women first to administering vaccines to children in classrooms across the region.

Last week, the U.S. Centers for Disease Control and Prevention recommended pregnant women should be among the first people to get vaccinated. Government researchers said pregnant women could account for 13 percent of deaths related to swine flu, even though they only make up about 1 percent of the total U.S. population.

A pregnant woman's physiology changes while she's carrying a fetus, meaning her body doesn't fight off diseases and viruses the same way as when she is not pregnant. Viruses also have the potential to cause harm to the unborn baby.

"Clearly, there's a benefit for pregnant women at all stages (of pregnancy) to be vaccinated," said Dr. Daniel Morgan, an obstetrician and gynecologist associated with Shore Memorial Hospital in Somers Point.

While pregnant women need to be concerned about the virus, Morgan said British and Swiss health officials who are recommending women not get pregnant until the pandemic has passed are on the extreme side, and that he wouldn't recommend that to his patients.

Vaccinating early, often

In addition to expectant mothers, all children from 6 months to 24 years old should be among the first to get the H1N1 vaccine, according to the CDC.

The original recommendation went up to 18 years of age, but the new recommendations are forcing places such as Atlantic County to plan differently. For example, the students of the Richard Stockton College of New Jersey in Galloway Township are now a part of the recommended group, according to Atlantic County Health Office Patricia Diamond.

The health departments in Atlantic, Cape May, Cumberland and Ocean counties have all been meeting with school districts to figure out how to distribute the vaccine to the students and what the schools can do to monitor the process.

In addition to schools administering the vaccine, school nurses might be enlisted by the state to help administer them out elsewhere.

The region is preparing for an earlier seasonal-flu vaccination period, according to Leslie Terjesen, a spokeswoman for the Ocean County Health Department.

Seasonal-flu vaccinations could begin in September in parts of southern New Jersey if a vaccine for seasonal flu is ready. The seasonal-flu vaccine is separate from the H1N1 vaccine, and county health officials are recommending that those at risk receive both.

"We're going to move up the period for seasonal-flu (vaccinations) just to get used to the flow," Terjesen said. The H1N1 vaccines are expected to be in late October if the current tests go as planned.

The most at-risk groups include personnel in the health care and emergency medical service and people between the ages of 25 and 64 who have underlying medical conditions that put them at risk for complications of the virus.

'More intense in the city'

Preparing for more cases of swine flu also means understanding local populations. In Cape May county, higher populations of seasonal visitors and senior citizens means the county has to be prepared to handle swine flu differently.

Seasonal visitors have to be able to have the same access that locals have to the vaccine, and senior citizens need to be educated on what to do in the event of more widespread swine flu, according to Cape May County Health Officer Kevin Thomas.

There are also areas where the population is highly concentrated, such as Atlantic City, Bridgeton and Vineland. While the same groups of people need to be vaccinated in these cities, the potential for the virus to spread faster is greater because of people living in close quarters with one another.

"Atlantic City is a vulnerable population," said Ron Cash, the Atlantic City health officer. "It's not any different, it's just more intense in the city."

Cash said many of the casino employees also live in Atlantic City. He has asked the casinos to make sure their health care workers are available to give out vaccinations, since the city's health department will have to handle the rest of the city's residents.

Because of the increased need for vaccinations, county health departments are also enlisting the help of the Medical Reserve Corps. The counties are offering classes on how to give vaccinations for those who are qualified.

Forming a plan

A vaccine for the virus is being tested this month in sites across the country, but the nearest testing site to New Jersey is in Baltimore. The H1N1 vaccine comes in two doses that are administered 28 days apart.

The CDC predicted that as much as 40 percent of the country's population could get sick from the virus over the next two years if no vaccine was being developed and no other preventative measures were taken.

"It's all going to be predicated on what the virus does between now and the fall," said Vineland Health Officer George Sartorio.

Health officials already know the virus is widespread in New Jersey, with hospitalized cases confirmed in all 21 counties. As of Wednesday, 960 hospitalized cases were confirmed by the state's Department of Health and Senior Services, or DHSS, with 15 deaths related to the swine flu virus.

The actual number of cases in New Jersey is much higher, according to Dr. Susan Walsh, deputy commissioner of public health services for the state's DHSS, since not all people with cases of swine flu are hospitalized. The hospitalized cases receive blood tests that confirm the presence of the H1N1 virus.

A computerized approach

New Jersey's DHSS is trying to determine the best way to make sure everyone who gets vaccinated receives both doses of the vaccine. A computerized system is being considered so that patients wouldn't have to return to exactly the same location to receive the two vaccinations.

"We're going to be as flexible as we can," Walsh said.

Some local health officials are questioning the computerized approach. A system crash could result in longer waiting times for those receiving the vaccine, according to Herb Roeschke, public health coordinator for the Cumberland County Public Health Department.

"I'm not sure it's going to be as much of an asset as the state might envision," Roeschke said.

New Jersey will hold a statewide Influenza Pandemic Preparedness Summit for health officials Aug. 20 and 21.