It's here?

Reports of cases of H1N1 are beginning to circulate here at Reid Hall. To my knowledge, there has only been one confirmed case to date here, but a number of people are reporting symptoms that are compatible with (though not definitive) H1N1.
Here in the Smith program, five students are sufficiently ill to have contacted me with their concerns. One of them saw a doctor, who diagnosed a possible case of bronchitis and prescribed antibiotics. Viruses, like H1N1, DO NOT respond to antibiotics. She feels better, which can mean that she had a bacterial infection, or simply that she improved over time, and happened to be taking antibiotics concurrently.
The others are reporting a variety of symptoms, including vomiting, diarrhea, fever, and general malaise. No way to know what this is, or if these are related cases.
I will update as I get more information. And I would be grateful, of course, if others could post the status of their programs on the site.

The early days

The current situation:
The school year has begun in France, and the close contact that takes place in schools has -- not surprisingly-- led to an increase in the reported cases of H1N1. As of today, the estimates of the numbers of new cases in France (over the last 2 weeks of August) ranges from 5,000 (Ministere de Sante) to 23,000 (Groupes regionaux d'observation de la grippe).
These estimates may seem wildly divergent, but they reflect the difficulties inherent in obtaining accurate estimates, even in a country with a well-developed reporting network, as well as the differing criteria used by different groups for diagnosis. Nevertheless, these numbers do suggest that we are seeing the expected uptick in flu cases that marks the the beginning of the flu season.

Perhaps more subtly, we are beginning to see a marked increase in the numbers of clustered outbreaks, where multiple individuals at a single location present with H1N1. 17 such clusters have been reported throughout France, and they underscore the ability of this virus to break out in high-density settings (e.g. schools, nursing homes, etc...). Epidemiologists, incidentally, pay a great deal of attention to such clusters as early warnings of potential, more severe outbreaks.

Prevention and control:

The French government continues to develop its overall recommendations concerning vaccination. It has ordered some 100,000,000 doses of vaccine (France's population is apx. 65,000,000), and will likely be deploying them beginning in late September. Obviously, the vaccinations will not all be available at once, nor will they be administered at once. Instead, the government foresees a rational triage that will give priority to emergency and health workers, the very young and the elderly, and those at high risk for H1N1. Interestingly, high-school and college students are among the highest priority groups. This decision reflects both the fact that classrooms are high transmission environments and the curious ability of this strain to target healthy young adults.

Thinking about epidemics:

Disease is both an empirical condition and a cultural construct. Here in France, a good deal of attention is being paid to H1N1 as a metaphor and a mirror for a series of cultural anxieties, and as yet another window into the levers of power and the complicated relationship between the individual and the state. We have these types of discussions in the US as well, but they tend to be confined to the pointy-heads in ivory towers. Here, in contrast, the cultural and political implications of H1N1 are front page issues. Two particularly interesting discussions can be found here:

http://www.liberation.fr/societe/0101589691-je-ne-prends-pas-mes-decisions-seule
http://abonnes.lemonde.fr/opinions/article/2009/09/09/liberte-grippee_1237918_3232.html#ens_id=1185166

French Government announces tentative vaccination plan

The French ministry of health announced yesterday that a massive, voluntary vaccination program could be in place by the end of September.
The link to this story can be followed here.

The purpose of this blog

This blog is being set up as a clearing house for H1N1 information. Our objectives are:
1) to provide accurate and up to date information to Program Directors/Associate Directors/Staff about the H1N1 threat:
2) to provide a straightforward mechanism for all Reid Hall personnel to communicate about this situation;
3) to act as a rumor control mechanism, substituting data and facts for rumors and fears.

As of now, all staff listed in the master directory of Reid Hall (kindly supplied by Susannah Mowris) can contribute to this blog-- you will be getting an email with instructions shortly.
As with many matters concerning H1N1, the utility of this blog depends entirely on our collective willingness to contribute to it.

Et maintenant, aux barricades,
Rob