Preparing for this week's Thanksgiving break, Principal Terry Crum liked what he saw as he walked hallways at St. James/Seton Catholic School: full classrooms.
That wasn't the case earlier this fall when his Omaha school had as many as 100 students — or 14 percent — out at a time.
“It's a relief,” he said. “Hopefully we don't get hit with another bout of it.”
Prevalence of H1N1 flu has dropped in Nebraska and Iowa, and not just in classrooms. Doctor visits and hospitalizations for flu also have fallen from peaks last month. Cases appear to be declining through most of the United States.
Health officials say we are entering a pivotal period with the flu.
Even though H1N1 cases have declined, it could roar back when cold weather hits and overlap with the seasonal flu, making more people sick and burdening doctors and hospitals.
Or H1N1 could replace the seasonal flu and remain the relatively mild virus that it has been so far, and then start to fade.
Doctors, however, warn against becoming complacent. People should continue to take precautions. Those include getting vaccinated, although doses remain limited and people have faced long waits at some public clinics.
“(This) doesn't mean that it is over,'' said Dr. Patricia Quinlisk of the Iowa Department of Public Health. “It could just come right back again.”
Health officials in Nebraska and Iowa point out that even though flu levels have dropped, the flu is more common than it normally is this time of year.
Flu-like illnesses accounted for more than 11 percent of hospitalizations in Nebraska in late October. By the middle of this month, the figure had dropped to about 5 percent, but that was still significantly higher than the 1 percent of a year ago.
More than 30 people have died from H1N1 in Nebraska and Iowa, and hundreds have been hospitalized because of complications. So far, H1N1 has been the only flu strain circulating.
Seasonal flu cases can hit in early fall but usually don't start to grow in numbers until December and January.
Flu viruses grow and spread more easily in cold weather, which is why some doctors believe there is a good chance H1N1 cases could start to rise again this winter.
Quinlisk said it's possible that H1N1 flu and seasonal flu could overlap, with both flu strains hitting communities. A person could get H1N1 and, after he's recovered, get hit with the seasonal flu. Having both viruses at the same time would be unlikely.
Flu viruses temporarily damage nasal membranes. That could make a person who's recovered from the flu more at risk for another respiratory illness, including another flu strain, she said.
Dr. Tom Safranek, a Nebraska public health official, agreed that H1N1 and the seasonal flu could overlap. But he also said H1N1 could replace the seasonal flu. He said history indicates that often when a new flu strain appears, it will replace existing strains.
Dr. Gregory Gray, an infectious disease specialist at the University of Iowa, agreed. He said H1N1, because it is now the prevalent strain, would simply “outcompete” the seasonal flu.
It's too early to know what that means for the public, Safranek said. The H1N1 flu strain could mutate and become more severe, or it could become like the seasonal flu, which he said generally has been mild in recent years.
Dr. Anne O'Keefe of the Douglas County Health Department said the problem with H1N1 flu is that many people still have not been vaccinated for it, which could help it spread more easily than the seasonal flu.
Safranek said it's essential that the public continue to take precautions.
Crum, the school principal, said absences have returned to normal levels for fall, with about a dozen, or less than 2 percent, of his 720 students out recently.
But he said staff members at his school near 90th Street and Ames Avenue have not let up. They continue to wipe down desks and door knobs and remind students to wash their hands and cover their coughs.
“We sure are not letting our guard down,” he said.
Contact the writer:
444-1122, michael.oconnor@owh.com
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