Flu worries arrived in force this week, with a deluge of ER patients triggering pandemic staffing plans at all three local children's hospitals.
Most of the patients almost certainly had swine flu. Tests have found very few cases of seasonal flu, which normally doesn't arrive until later in the year.
Still, most cases were mild, doctors said, and youngsters ended up in the emergency room largely because parents were anxious and confused.
"At one point last night we had 12 to 15 people just waiting to give their names," Christopher J. Haines, emergency department director at St. Christopher's Hospital for Children, said yesterday.
"These are kids who need to stay home, get fluids, get rest, take Tylenol," he said.
"For a well child that's above 2 years of age that doesn't have an underlying medical problem, we're not going to test and we're not going to treat," said Haines, adding that his staff was patiently explaining the reasons to parents:
"You just don't need to. It is a pretty mild illness."
Hospitals that mainly serve adults reported slight increases in ER volume.
Neither Philadelphia nor archdiocesan schools have recorded any spikes in school absenteeism, spokesmen for both said yesterday.
Yet there was no question that the flu is here.
More than 21 percent of specimens sent to labs in the extended Philadelphia region - from Reading, east to Ocean City, north to Trenton, and south to Dover, Del. - during the week that ended Saturday tested positive for influenza, reported SDI Health L.L.C. of Plymouth Meeting, which tracks health statistics nationwide.
That matches the week ending March 7 - the peak for flu last season - and SDI said its analysis indicated that the numbers were continuing to rise.
Reports of flulike illness varied widely around the country, with the Philadelphia region reporting more than the national average for the first time. But Cincinnati had twice as much.
The Pennsylvania Department of Health also reported a statewide surge in laboratory-confirmed influenza last week - to triple the highest positive percentages in the spring, when swine flu first surfaced, and well above any week since at least the 2003-04 season.
Laboratory test results by themselves are a very rough estimate of flu activity, although the state also reported a smaller increase in emergency-room visits for flulike illness.
The New Jersey Department of Health and Senior Services for the first time this season recorded an increase in emergency-room visits for flulike illness for the week ending Oct. 10, but last week's update was not available.
No deaths have been reported this fall in either state.
Meanwhile, shipments of swine flu vaccine continued to trickle in, with most directed toward health-care workers, pediatricians, and schools. Vaccination with FluMist began yesterday in archdiocesan elementary schools, with eight buildings expected to receive it by tomorrow.
The city's Department of Public Health will then focus on public schools - every school is scheduled to receive the nasal spray, which is approved only for healthy people, at a series of clinics beginning Monday - and return to parochial schools next month.
More than 400 patients were seen for flulike symptoms Tuesday in Children's Hospital of Philadelphia's emergency room, according to a memo e-mailed to physicians, and some other units were at or near capacity.
The hospital has implemented a pandemic staffing plan to enable full coverage in the ER, ICU, and other areas, the hospital said in a statement last night.
At St. Christopher's, emergency-room visits began to spike Sunday and Monday, said Haines, the ER director, and were approaching 300 a day. That is at least 40 percent more than a typical day, he said. Regular flu season normally prompts an increase of no more than 10 percent. The hospital implemented its pandemic staffing plan Tuesday.
Most of the patients "have fever, they have cough, they have a sore throat, they have a runny nose, and moderate-to-high fevers, 103-104-105 fevers," Haines said. "They're ill, but they don't need to get admitted to the hospital."
Children without underlying medical conditions are not likely to have a problem, he said. Hospital visits would be called for if a child has breathing problems, seizures, unusual lethargy, and signs of dehydration such as excessive vomiting or diarrhea in combination with decreased intake of fluids and output of urine, he said.
The third pediatric hospital in the region, Alfred I. duPont Hospital for Children in Wilmington, also is on alert status after emergency department visits began to spike - they are now about one-third higher than in a typical flu season - two weeks ago, a spokesman said yesterday.
There, too, most cases have been mild and most of the handful of patients who were serious have preexisting conditions.
Pediatricians' offices are jammed with worried parents "and the overflow patients are coming to the ED," public relations director Jim Lardear said. Most do turn out to have mild cases of swine flu, Lardear said.
"Some parents cry when they learn their child has H1N1."
Check for updates on swine and seasonal flu vaccine throughout the region: http://go.philly.com/swineflu
Contact staff writer Don Sapatkin at 215-854-2617 or firstname.lastname@example.org.