Unnecessary visits discouraged

Family doctors are extending prescriptions and encouraging Manitobans who aren't sick to stay away from clinic waiting rooms that could soon fill up with flu patients in need of antivirals.

Across the country, family doctors are bracing to see three times as many patients sick with influenza than they normally would in a typical year.

Dr. Fran Berard, president of the Manitoba College of Family Physicians, said that's why physicians across the province are telling their patients not to come in unless they really need to. She said many family doctors are writing extra doses of prescriptions over the phone or have asked patients to phone their pharmacy to extend prescriptions, as long as they aren't narcotics.

Many clinics encourage people with flu symptoms to put on a mask, Berard said, and keep a one- to two-metre distance from others.

"If you're not well, fine, come in. But if you're well, we're trying to avoid unnecessary visits," Berard said.

Health officials expect the number of people sick with H1N1 to increase in the coming weeks as the second wave of influenza enters its peak. People who are at high risk of severe illness with any ordinary symptoms of influenza -- including fever, cough, muscle aches, fatigue, and nausea -- should see a family doctor within 24 to 48 hours to receive antivirals that can prevent symptoms from worsening.

Tamiflu and other antivirals are only available with a doctor's prescription, so high-risk Manitobans will need to visit their family doctor or a walk-in clinic for the medication.

"You should go early to get assessed because you may need Tamiflu or another antiviral to prevent a more serious illness," said Dr. Sande Harlos, the Winnipeg Regional Health Authority's medical officer of health.

Harlos said the second wave of H1N1 hasn't reached its peak yet, and there are contingency plans should there be an increased demand for antivirals. She said clinics will extend hours and family doctors will take on extra patients with flu symptoms in the event there is a flood of patients at walk-ins.

If the situation worsens, primary health centres will set up areas designated for patients with flu symptoms to see a doctor and get the antivirals.

No one knows for certain when the number of H1N1 cases could reach its peak, which is why health officials urge people at high risk of severe illness to get the vaccine as soon as possible.

On Thursday, provincial officials confirmed the first suspected flu death this season is under review, and that the number of cases of severe respiratory illnesses in intensive care units is on the rise. Since Oct. 8, 20 people have been hospitalized for severe respiratory illness, including one lab-confirmed case of severe H1N1.

Health officials expect most, if not all, of the severe cases will turn out to be H1N1. Officials are still trying to determine how many severely ill patients received the H1N1 vaccine.

It can take between a week and two weeks for body to build up immunity to the flu, but Harlos said it's hard to say whether the peak will hit before people are able to build up an immunity to H1N1. However, she said the body starts to build antibodies to ward off influenza after a couple of days, so it's never too late to get the vaccine.

jen.skerritt@freepress.mb.ca

Clinics reopen Nov. 12

Twelve city vaccination clinics are closed until Thursday, Nov. 12. The province expects another shipment of vaccine doses Wednesday, and clinics will reopen the next morning to vaccinate those on the priority list against H1N1.

On Friday, 4,763 people received the H1N1 vaccination at Winnipeg Regional Health Authority clinics, raising the cumulative total to 99,136 since the start of the campaign.

Meanwhile, Winnipeggers are asked to avoid unnecessary visits to emergency rooms.

On Friday, Children's Hospital ER saw a large number of children present with flu-like illnesses -- more than half of all patients. Everyone who goes into Children's emergency will be offered a mask to protect themselves or prevent them from spreading an infection to others.

Republished from the Winnipeg Free Press print edition November 7, 2009 A4