To the Orcas Island Community:

The emergence of a new and likely pandemic strain of influenza, the H1N1 Influenza A or swine flu, has been of great concern worldwide. This virus has been confirmed in 36 states at the time of this writing, and there are multiple likely cases in Washington State. Schools around the country, and some in Washington State, are closing as a precaution to limit the spread of the influenza virus. Of particular concern to our community is the outbreak at camp Orkila, which was very likely swine flu in a group of children from King County.

Aside from the cases at Orkila, we are seeing some cases of fever with cough and/or sore throat in our community, which could be influenza. At the moment we don’t know whether there are cases on the island, but it is likely that if the swine flu isn’t already here, we are likely to see it soon.

That’s the bad news- the good news is that as we are learning more about this new flu, we are feeling reassured that it may be far more mild than we had originally thought. The swine flu presents with all of the classic flu symptoms, including fever with or without chills, cough, sore throat, body aches, headache, chills and fatigue. Some people have also reported diarrhea and vomiting. The question is how severe these symptoms will be, and the answer so far is that it seems to present much like a normal flu.

That being said, the normal flu can make you feel pretty sick, and can be dangerous for very young children, older people and immune-compromised people. In pandemic flu, it is often young and healthy people who have the most severe cases. Since this is a new virus and we still don’t know have adequate information about what it will look like, we are trying first and foremost to minimize the number of people who get exposed and infected.

These are the recommendations from the Centers for Disease Control in Atlanta for community measures to minimize the spread of the virus:

• Wash your hands often with soap or alcohol-based hand wash.

• The virus is spread by droplets, so cover your cough or sneeze.

• People who develop influenza-like-illness (fever with either cough or sore throat) should be strongly encouraged to self-isolate in their home for 7 days after the onset of illness, or at least 24 hours after symptoms have resolved, whichever is longer. If you are sick, please stay at home. If your children are sick, please don’t send them to school.

• Call your doctor’s office before coming in.

• Anyone who has difficulty breathing or shortness of breath or are believed to be severely ill should seek immediate medical attention. The Orcas Island Fire Department have been great, but are a limited resource, and should be called only when there is truly a medical emergency.

• If an ill person must go into the community (for example, to seek medical care), they should wear a face mask or use a handkerchief or tissues to cover any coughing.

Household contacts who are well should:

o remain home at the earliest sign of illness;

o minimize contact in the community to the extent possible;

o designate a single household family member as the ill person’s caregiver to minimize interactions with asymptomatic people.

We are well prepared on the island for a possible outbreak, even if it is worse than we currently expect. There is enough anti-viral medicine for even a high number of infected individuals, but there are not unlimited supplies. There is no need for healthy people to get any anti-viral medicines unless they get sick, at which time we can prescribe them appropriately, as well as treat family members.

So the bottom line is this: swine flu is likely here, it’s likely not as severe as we had thought initially, but to be safe, we should make every effort to minimize its spread in the community. In short, wash your hands, cover your cough, and stay at home if you’re sick.

Thank you and be well,

The medical community on Orcas Island:

Evan Buxbaum MD, Treehouse Pediatrics

Tony Geifer MD and Thomas Frazer MD, Orcas Island Medical Center

David C. Shinstrom MD, Orcas Family Health Center

David Russell MD, Orcas Island Family Medicine