Get your flu shot

Kansas has confirmed 240 cases of the H1N1 flu virus in the state, but officials estimate there may be as many as 10,000 cases in 41 counties. And with reported cases all around Clay County, there still has been no confirmed case here, according to Pat Roedig with the Clay County Health Department.

Kansas has confirmed 240 cases of the H1N1 flu virus in the state, but officials estimate there may be as many as 10,000 cases in 41 counties.

And with reported cases all around Clay County, there still has been no confirmed case here, according to Pat Roedig with the Clay County Health Department.

"We can't explain it, but were very happy," Roedig said this morning.

She said the department tested two people, one turned out to be a standard flu variety, the other was not flu.

Clay County Emergency Management director Pam Kemp told county commissioners this morning that health and school officials have been working together in ancitipation of more H1NI flu cases after school starts.

Health officials across Kansas expect the flu season that begins this fall to be unusually intense after watching swine flu cases pop up and spread for several months.

They're anticipating thousands - perhaps even a few million - shots by hospitals, clinics, doctors and pharmacists to help ward off the H1N1 virus, on top of normal annual flu vaccinations.

Local officials have been on telephone conference calls weekly with officials at the Kansas Department of Health and Environment.

Roedig said officials are planning who will receive the initial doses of the H1N1 vaccine. Most likely will be the highest risk group, school age children with respiratory diseases.

She said no decision will be made until trials currently underway by four manufacturers of the vaccine are over and officials know whether there are any ill effects and have determined whether one or two doses will be required.

Officials don't know when the vaccine will be available but could be as early as October. By then officials will decide whether all children in the school system will be vaccinated. School children have the highest incidents of the vaccine and children four and under have the highest rate of hospitalization for the virus.

Incidents of the H1N1 variety is higher than regular flu for persons up to 49 years of age, Roedig said.

She said the vaccine will be available for everyone and that it will arrive at the county health department weekly once shipments start.

State health officials don't have many specifics yet on when new vaccines will arrive or how they'll be distributed around the state - and can't be entirely sure they'll come at all. And they worry about schoolchildren being more vulnerable as a group to swine flu than to other strains.

"It's a beehive of activity in every county health department across this state," said Jason Eberhart-Phillips, the state health director. "Together with them, we have to anticipate immunization of the entire population."

The Kansas Department of Health and Environment has reported 247 confirmed cases of swine flu in 41 counties. The agency also reported 23 hospitalizations and a death last week in which the H1N1 virus may have been a contributing factor in a victim who already suffered from a chronic medical condition.

But state officials say the case count is low, because the health department has moved away from counting individual cases in favor of focusing on trends. The state is not even accepting medical specimens for testing from some counties.

For the coming flu season, a big question involves the vaccine against swine flu. As of last week, three manufacturers had begun clinical trials. Health officials in Kansas hope doses will begin arriving by mid-October.

Making it convenient for people to get the shots is a key issue. Claudia Blackburn, director of the Sedgwick County Health Department, said she anticipates discussions about schools and work sites.

"Any place that has the capability of administering the vaccine to a population in a convenient way, we'll be working with those people," she said.

A committee advising the federal Centers for Disease Control recommends swine flu vaccinations for everyone from 6 months through 24 years old and anyone from 25 through 64 with chronic conditions, such as diabetes or respiratory problems, where flu could cause complications.

Also on the list are pregnant women, health care and emergency services workers and people who have regular contact with children under 6 months. Eberhart-Phillips said about half the U.S. population is covered.

Nancy Tausz, the Johnson County Health Department's director of disease containment, said if enough vaccine is available, officials will try to persuade everyone to get the shots. Health officials expect swine flu vaccinations to require two doses, several weeks apart.

If clinical trials for the new vaccines prove unsuccessful, then health officials expect to fall back on education tactics they used after the first swine flu cases were reported in late April. Those include stressing the importance of regular hand washing and staying home when sick.

They're also likely to encourage people with mild cases to stay home from work or school - and avoid hospitals if they don't face complications.

"During the usual flu season, with just the winter infections that hospitals are dealing with, they're usually at full capacity or close to it anyway," Eberhart-Phillips said. "There isn't room now to just suddenly put a spike of a new patients into hospitals or into emergency rooms."

In 2007, the last year for which data was available, the state reported about 2,100 deaths in which pneumonia or influenza were at least a contributing factor and 51 in which flu was the direct cause.

Eberhart-Phillips expects that the H1N1 virus will cause deaths even though it seems stable and results in mostly mild cases, because of how widespread it could become.

"The virus is pretty easily transmissible, and none of us have an innate immunity without the vaccine," he said. "We would anticipate that the mortality of this of this is going to be probably on the order of double."