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Orange County mirrors state in increase of swine flu cases

The virus has become so widespread that officials are stepping away from tracking individual cases, instead mustering resources to deal with the illness overall.

July 30, 2009|Tami Abdollah

Orange County is experiencing a rise in swine flu cases -- a third of its 12 reported deaths were in the last two weeks -- a trend that mirrors much of the state. The virus has become so widespread that officials are stepping away from tracking individual cases, instead mustering resources to deal with the illness.

As of July 16, health officials throughout the state stopped monitoring individuals who contract the H1N1 virus because doing so was sapping too many resources.

"At this point, it's present throughout the country, it's outside of flu season," said Ralph Montano of the state Department of Public Health. "So it's a fair assumption that if someone has the flu right now, they have swine flu."

Orange County currently has 132 hospitalizations and 12 deaths attributed to the H1N1 virus. As of July 17, the county had reported 531 confirmed or probable cases. On June 2, there were 67.

Dr. Hildy Meyers, medical director of epidemiology for the Orange County Health Care Agency, said there are "hundreds, maybe thousands" of actual cases. "Transmission is widespread, and many people with mild cases are not being tested," she said. "We're focusing on the hospitalized cases."

With a much larger population, Los Angeles County has 135 hospitalizations and 17 deaths -- though the state is reporting eight deaths in the county. That's up from 62 hospitalizations and three deaths as of July 11, said Dr. Laurene Mascola, chief of the acute communicable disease control program of the county Department of Public Health.

As of July 23, there were 583 hospitalizations and 61 deaths statewide -- up from 142 hospitalizations and 17 deaths as of June 25. Part of the reason the numbers seem so high is the increased testing, Mascola said.

"No one has ever tested for flu before in such vast amounts," she said. "In the past you couldn't get doctors to test for flu, and now they're testing anything that moves."

But the numbers themselves are difficult to track.

There is great variation in when cases are reported to the state by counties and hospitals. For example, L.A. County, which gets data from 100 hospitals, said it had not sent 20 to 30 cases to the state. There are also delays in receiving reports and lab confirmation. And each locality releases its updates at different times: the state on Thursdays, Orange County daily, San Diego County on Wednesdays, some areas almost haphazardly.

"It's a moving target, depending on what day of the week they collect their data," said Dr. Eugene Spiritus, UC Irvine Healthcare's chief medical officer. "Think of this as trending. The trend is up, and the trend is going to continue to go up."

From April 27 through July 7, UC Irvine Medical Center saw 54 cases. In just the next two weeks there were 51 cases, said Linda Dickey, a registered nurse and assistant director for infection prevention at the hospital. Most of the cases have been relatively mild, Spiritus said.

He said a group made up of the University of California's five medical centers and different campuses conducts a monthly conference call to keep up on the spread of the virus.

The Centers for Disease Control and Prevention estimates that more than 1 million Americans have been infected with swine flu. What makes the virus different from seasonal influenza is that many infected with H1N1 are younger than 25, said Ken August of the California Public Health Department.

The swine flu is essentially "considered a new strain for humans," said Meyers, but it does not seem to greatly affect those over 60, many of whom have immunity from a similar strain that appeared decades ago.

Spiritus said most in the medical community were "bracing for a significant outbreak" and expected a continued rise in cases, especially once regular flu season hits in the fall. The federal government is trying to produce a vaccine before flu season begins.

"The best prevention would be a vaccine when it's available," Meyers said. "The other things people can do are practice good hygiene: Cover a cough and a sneeze, wash your hands. And stay home when you're sick."

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tami.abdollah@latimes.com

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