I'd left for a conference in Manhattan at 6:00 the morning of April 25, 2009, and was well out of the media loop. But the fact that over 100 students at my sons' school, St. Francis Preparatory High School in Queens, had gone home ill on Thursday and Friday hadn't escaped my notice. Rumor was that food poisoning or a gas leak had sickened them. International Night festivities had been cancelled Friday night. The school nurse, Mary Pappas, RN, BSN, had sounded the alert, and appropriate measures were taken.
At 5:00 p.m. my son called me complaining of "burning up," body aches and chills, begging for "drugs." No one could find the thermometer, but concerned, I directed him to take a shower and two ibuprofen. My 16-year-old son, who also attends Prep, got on the phone. "He has swine flu."
"Don't be ridiculous," I said. "Swine flu is in Mexico."
"No," Adam said. "It's all over the Web, and it's at Prep."
By the time I got home, Nick’s fever was gone, and by the next day, though still coughing, he was in teenage self-isolation, instant messaging his friends. Testing for H1N1 at Prep had ceased, but the school had e-mailed a questionnaire to track symptoms in pupils, contacts, and family members. All the Prep students who developed symptoms that we had contact with also recovered quickly. During the week off, they flocked to the movies, the malls and each other's houses, in between doing the lessons and homework assignments posted online.
On Monday, April 27, H1N1 management and control efforts at Montefiore Hospital in the Bronx were well under way. Multiple e-mail updates from the DOH, as well as Montefiore's infectious disease specialists, came on a daily basis. At the high school health center I run for the School Health Program, the illnesses I evaluated for the next two weeks were mainly asthma exacerbations from the record high temperatures and soaring pollen counts. A mild upper respiratory and gastrointestinal virus circulated during the weeks of May 4 and May 11, but no one was febrile. Prep students went back to school, other affected schools closed, emergency rooms were flooded with the worried well or quickly recovering, fueled by the media frenzy.
Parents, teachers, principals, and clinic staff are concerned, but not alarmed. The deaths have been saddening, but details that have been released, limited by HIPAA, show that all had underlying medical conditions.
The Department of Health is accessible, their guidelines continually updated as the outbreak spreads like spokes on a wheel throughout the five boroughs and the tri-state area. The press has pulled back on the sensationalized reporting to provide updates the general public needs to stay informed. Hospitals, clinics and school administrators are swamped, but receiving needed support and assistance from the DOHMH, our own experts, and our occupational health services. Coordinated, effective public health activities are as dynamic and fast moving as H1N1 in New York City.
Reported by Carole Ann Moleti, CNM, FNP-BC, MPH, MS, caroleannmoleti@yahoo.com.