As flu's swath widens, vaccine is rationed

By Seattle Times news services

	GREG GILBERT / THE SEATTLE TIMES The Snohomish Health District's lobby was packed yesterday afternoon as people waited to get a flu shot. Stephanie Langlois, foreground, of Lake Stevens, goes over paperwork before getting her shot.
	E-mail this article Print this article Search archive Related stories Over-the-counter relief: Flu remedies selling swiftly Other links CDC Director Dr. Julie Gerberding discusses the outbreak

The number of infections has not reached epidemic proportions, said Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention (CDC), but "the flu season is far from over."

Healthy children and adults who live with people at higher risk for flu, people between the ages of 50 and 65, and health-care and nursing-home workers no longer are being urged to get shots if they live in Washington state and other areas with vaccine shortages, the CDC said.

That leaves 83 million people at the top of the priority list for a rapidly diminishing supply of shots. They include people with chronic illnesses, people 65 and older, infants between 6 and 23 months, and women who are more than three months pregnant.

Other groups should receive shots only "where there is vaccine available," Gerberding said.

Healthy people ages 5 to 49 should consider using FluMist, a new nasal-spray vaccine made by MedImmune of Gaithersburg, Md. There are about 4 million doses of that vaccine available, although at $75 it is much more expensive than traditional shots.

Federal officials reported yesterday that they had scrounged up 250,000 vaccine doses to add to the 83 million already mostly dispensed. Health and Human Services Secretary Tommy Thompson announced that the federal government had paid $2 million for 150,000 children's doses and 100,000 adult doses, stocks that Aventis Pasteur of Swiftwater, Pa., had set aside for the government when it became clear supplies were running low.

Those doses will be given to states based on population.

The CDC is exploring the importation of an additional 500,000 doses of vaccine manufactured by Chiron for European distribution. But bringing those doses into the United States requires approval from the Food and Drug Administration. Other European flu vaccines are available, but none have been licensed for sale in the U.S.

To get a flu shot Public Health — Seattle & King County Limited vaccines available only for children and adults at high risk for complications. Hotline: 206-296-4949. For children's appointments, call any Public Health clinic. Locations on hotline or at www.metrokc.gov/health/sts_svs/ immuniz.htm. For adults at high risk for complications, call a clinic at Federal Way, Eastgate or North Seattle. Group Health Cooperative Vaccine available for high-risk children of members. Call your child's physician. GetAFluShot.com Vaccine available for anyone age 12 and older. Two clinics this weekend. 888-536-6900 or www.getaflushot.com Snohomish Health District For vaccine availability: 425-339-5224 or www.snohd.org — Seattle Times staff

"We are very appreciative to have some extra flu doses so we can prioritize those that need it the most," Gerberding said.

Washington State Department of Health officials said yesterday they already have received 2,900 additional doses of vaccine from the CDC. All of it is earmarked for children, including about 1,000 doses to be distributed by Public Health — Seattle & King County. The state also expects to receive an additional, limited amount of vaccine next month.

State and King County officials also said they are following the updated CDC priority list.

New figures from the week ending Dec. 5 showed that the number of states with widespread flu outbreaks grew from 13 to 24. Most states reporting widespread flu activity are in the West, but the worst of the flu season appeared to be moving eastward.

New states with widespread flu were Missouri, North Carolina, Mississippi, Indiana, Arizona, Iowa, Montana, Oklahoma, Oregon, Rhode Island and Virginia. Last week, only Alaska, Arkansas, Colorado, Idaho, Nebraska, Nevada, New Mexico, Pennsylvania, Tennessee, Texas, Utah, Washington and Wyoming were listed.

Federal health officials are concerned that the nation could be facing one of the nastiest flu seasons in years because the disease has hit several states, most notably Texas and Colorado, unusually early and hard. In addition, most flu sufferers have been struck by a new, unanticipated strain of the virus. The Fujian strain comes from a family of viruses that typically are more virulent.

Concern has been heightened by the deaths of babies, school-age children and teenagers. At least nine — and possibly as many as 11 — children have died of flu in Colorado alone.

In at least three deaths — an infant, a 20-month-old and a 22-month-old — the children also were infected with drug-resistant strains of staph bacteria, the CDC said. Although staph infections are common in flu patients, this is the first year that resistant strains have been detected.

	GENE J. PUSKAR / AP In Pennsylvania, Quinlan Dugan, 6, gets a flu shot at the Allegheny Health Department while his dad, Tom Dugan, holds him. The boy received one of the last 1,000 doses of flu vaccine available in Allegheny County.

Federal officials cautioned, however, that it was too early to tell whether there would be more deaths overall this year, or among young people or children, than in previous years.

"We're really concerned about this because we don't know if there is going to be a bigger impact on children this year," said Scott Harper, a CDC flu expert. "We're taking steps to try to examine this issue."

One of the hardest-hit communities is Malad, Idaho, a town of about 2,000 people near the Utah state line that virtually shut down in the past week because so many people were ill. Church services and Christmas programs were canceled, as was a wrestling match and drill-team show.

Malad students returned to class yesterday, but 15 percent of the 860 kids were still out sick.

"It's the worst I've seen in many years," School Superintendent Lynn Schow said. "We think we're OK here, and it hit us hard."

The flu typically kills about 36,000 Americans each year, and some experts are predicting the toll could top 60,000 this year.

By comparison, about 16,000 Americans died of AIDS last year. About 53,000 die from Alzheimer's each year, about 71,000 from diabetes, about 100,000 in accidents, and about 550,000 of cancer.

The United States is not suffering alone. According to the World Health Organization, Finland, France, Norway, Spain and Portugal have undergone similar outbreaks. In parts of Canada and the United Kingdom, where influenza was first noted this season, the number of cases apparently has started to decline.

While the outbreak is serious, it's not bad enough that people should change their routines or don masks, Gerberding said.

If people can't get vaccines, they should wash their hands after sneezing or wiping their noses, avoid people who are sick and "practice good respiratory etiquette" by covering their mouths and noses when sneezing, Gerberding said.

Compiled from reports by Knight Ridder Newspapers, The Washington Post, the Los Angeles Times, The Associated Press and Seattle Times medical reporter Warren King.

Copyright © 2003 The Seattle Times Company