H1N1 flu shot clinics will begin next week

Minnesota will be gearing up for county-by-county H1N1 vaccine clinics next week -- just as the outbreak seems to have passed its peak.

At least for now.

Flu cases reported by Minnesota schools, clinics and hospitals dropped sharply for the second consecutive week in early November, the Health Department reported Thursday.

Still, state health officials urged people not to become complacent about the outbreak as the vaccine becomes more widely available in coming weeks. The epidemic could pick up steam again -- or there could be a third wave of H1N1 later in the winter, a common pattern in previous flu epidemics.

"We want to prevent that third wave," said Dr. Ruth Lynfield, Minnesota state epidemiologist. The flu first appeared last spring, then seemed to ebb over the summer.

The number of flu-related deaths, meanwhile, increased from four to seven last week, bringing the total since the outbreak began last spring to 23. Of those 21, were confirmed to be H1N1, and two were likely to be H1N1, but could not be verified.

But the number of schools reporting outbreaks plummeted to 40, down by more than two-thirds compared with the previous week. Those are schools at which more than 5 percent of students were out sick, or more than three elementary schoolchildren were absent from the same class.

Hospitalizations also declined, dropping from 182 to 134, and the "sentinel'' medical clinics that report flu activity to the Minnesota Department of Health said that only 1.3 percent of patients came in for flu-like symptoms, down by two-thirds compared with the previous week.

"For the second week in a row we do have some promising indicators," Lynfield said.

The epidemic appears to be waning just as the vaccine is becoming more widely available.

Kris Ehresmann, director of the state's vaccine program, said that by the end of this week nearly 700,000 doses will have been distributed to 604 pediatric clinics and 281 clinics that care for pregnant women.

But the vaccine is still arriving at a trickle, she said. This week, manufacturers provided only 4 million more doses nationwide, not the 8 million that federal health authorities had expected, she said. The vaccine is distributed to states based on population.

Nevertheless, public health agencies across Minnesota are gearing up for vaccine clinics at schools, child care centers and other locations on the assumption that they will receive more supplies.

The clinics, authorities emphasized, are still intended primarily for the highest-risk people -- children younger than 4, children up to age 18 with underlying health problems, pregnant women, and those who care for infants younger than 6 months.

However, healthy children younger than 10 will be able to get the nasal vaccine at many of the upcoming clinics. Because that vaccine contains a live virus, it is not recommended for pregnant women or very young children. It is recommended for children 10 and younger, who are next on the list of high risk people.

Each county or city is organizing clinics a bit differently. For example, the Minnesota Visiting Nurse Agency will hold clinics at six day-care centers in Minneapolis today. Parents from about 78 day-care centers can attend with their children. They are being notified about the clinics by their day-care centers.

Next week, there will be after-school clinics at seven elementary schools in Minneapolis aimed at children 9 and younger, said Gretchen Musicant, director of public health for Minneapolis. Early next week officials at those schools will notify parents of the clinics.

The schools were chosen because they are in low-income neighborhoods with families that might not have health insurance or access to medical care, she said. They also have higher rates of the kinds of conditions that increase risk from flu, primarily asthma.

"We know there are issues for kids in low-income neighborhoods," Musicant said.

Josephine Marcotty • 612-673-7394