Local facilities strained by rush of flu patients

Local hospitals and doctors' offices are reporting a steep increase of feverish patients this week, a sign that the swine flu is in full swing.

"We've all been hearing a lot about it, and now it's here - there's no question about it," said Dr. Arno Zaritsky, executive medical director at Children's Hospital of The King's Daughters.

The region that includes Hampton Roads reported one of the highest rates of people with flu-like illnesses visiting emergency rooms and urgent care centers in the state last week, reaching almost 15 percent of all patients, three times the peak of the previous flu season.

The state had a rate of about 14 percent. Only the area that includes Lynchburg had a higher rate than the Hampton Roads area.

The rates more than doubled during the past two weeks both statewide and in Hampton Roads.

Only those flu patients who are seen by surveillance doctors across the state and those who are hospitalized are tested for the specific strain of flu. The vast majority of those tested have had H1N1, so it's presumed the uptick in flu cases is attributable to the swine flu.

Zaritsky said patient volume in CHKD's emergency department has been 50 percent higher than usual, a load that has caused the hospital to bring in extra health care providers and use space in the hospital that is not normally used for emergency care.

"It's overtaxing our usual way of doing things," Zaritsky said.

The percentage of those needing to be admitted is below normal, an indicator that "the worried well" are among those seeking emergency care.

Zaritsky said most of the patients with H1N1 did not need emergency care. He is concerned that parents who bring children with mild and moderate symptoms could delay treatment to those who really need it.

Other local hospitals also are reporting increases in their emergency departments. Lynne Zultanky, spokeswoman for Bon Secours Hampton Roads, said that system's hospitals are seeing a 30 to 40 percent increase in volume.

Bon Secours Mary Immaculate Hospital in Newport News saw 51 patients with flu symptoms in its emergency room in one recent day, which is unusual. Sentara spokeswoman Kim Van Sickel said that system's hospitals also are reporting increases.

Both hospital spokeswomen said the rate of admissions has been low and that doctors are seeing many patients who could be treated in doctors' offices or with rest and fluids at home.

CHKD's emergency department has seen a high of 245 patients in a day this week, when a normal rate is 140. At one point, 50 children were in the waiting room.

Zaritsky said CHKD-affiliated pediatric offices are also seeing a flood of patients, and many scheduling phone lines have been overwhelmed. He said one CHKD practice saw 70 unscheduled patients recently, which is unusual.

Zaritsky said that many families who bring their children to pediatric practices want them to be prescribed Tamiflu, the anti-viral medication that eases flu symptoms.

However, he said the medication should be used only for patients who are at high risk of developing complications, or who need to be admitted to the hospital. The medication does have side effects, such as vomiting, so it's best reserved for serious illness, he said.

Typically the flu season doesn't begin until December in Hampton Roads. The H1N1 flu began surfacing in April, and it continued through most of the summer. Rates went down in August but began rising again with the start of school in September.

The state Health Department has also been tracking school absenteeism as a way to monitor H1N1 activity.

Statewide, schools had a 7.6 percent rate of absenteeism last week. The local rates ranged from 5.6 percent in Chesapeake and Norfolk last week to 7.5 percent in Suffolk.

Those rates include absences for all reasons, not just illness.

Elizabeth Simpson, (757) 446-2635, elizabeth.simpson@pilotonline.com