Anchorage Daily News

Officials temporarily closed a village school Friday after as many as half of the roughly 90 students stayed home sick. It's the first emergency school closure of the year in Alaska, and comes as rural health care providers battle swine flu -- or at least fear of the flu -- across the state.

"Right now if you have the flu, you have swine flu," said Department of Health and Social Services spokesman Greg Wilkinson.

Officials with the North Slope Borough School District decided to close the Nunamiut School in Anaktuvuk Pass through Tuesday because so many kids were absent this past week.

Doctors say the swine flu, or the H1N1 virus, has proven no more dangerous than regular flu. It's a relatively mild virus and is now so widespread that the state has stopped trying to track every case. But with the virus linked to three deaths so far in Alaska and vaccinations weeks away, rural school and health officials are taking extra precautions to prevent the spread.

The Bethel hospital saw a spike in emergency room visits Thursday and Friday morning, with more than a third of the patients -- or about 75 people -- reporting flu-like symptoms, said Donna Bach, spokeswoman for the Yukon Kuskokwim Health Corp. On Monday, the hospital plans to open a "flu table" where people can pick up fever-reducing medicine, face masks and hand sanitizer.

In the village of Chevak on the Yukon-Kuskokwim Delta, the health clinic canceled scheduled appointments to focus on flu patients and avoid exposing healthy people to the virus. Flu reports have since subsided in the village, Bach said.

The North Slope school district is cleaning buses with bleach twice a day, said school superintendent Peggy Cowan. In some schools, the district closed open gym to stop the spread of germs.

"Slope-wide the incidence of illnesses -- and there's been a diversity of illnesses -- seemed to have peaked last week," Cowan said Friday.

That didn't hold true, though, in the village of Anaktuvuk Pass, a community of about 290 people in the Brooks Range. As many as half the roughly 90 students didn't show up this week, Cowan said.

"Yesterday absenteeism rose sharply and had been at a high level all week. To give students time to recuperate and to prevent the spread of illness, we decided to close the school," she said.

Cowan doesn't know if swine flu is to blame. The local clinic reports more than one illnesses is spreading around town, she said. But the district followed the Centers for Disease Control and Prevention guidelines for H1N1 emergency closures, shutting the school down for five calendar days beginning Friday.

The H1N1 virus spreads like any seasonal flu -- traveling in sneezes and coughs, said Dr. Beth Funk, a medical epidemiologist for the state Public Health Division. Hand-washing and hygiene can counter the spread, but in rural Alaska not all villages have running water.

There are roughly 50 communities across the state where half the households still have no indoor plumbing, according to the state Department of Environmental Conservation. Last year, a CDC study concluded such towns have higher rates of pneumonia and other serious respiratory tract infections.

Alaska is one of 11 states where swine flu is widespread, the CDC reported Friday.

The Bering Strait School District in Northwest Alaska saw attendance drop by about 5 percent this fall as schools and clinics tell people to stay home if they're sick, said curriculum director Greg Johnson.

"I'd say it's either attributable to flu or fear of the flu," he said.

Johnson's 8-year-old daughter missed the first day of school with a high fever. A health aide figured she probably had swine flu, he said.

THREE DEATHS IN ALASKA

The H1N1 virus first appeared in the United States in the spring. By late May, it'd hit Alaska.

Three people who had swine flu in the state have died: a Fairbanks woman with underlying health problems; a middle-aged woman from Seward with multiple pre-existing conditions; and 10-year-old Fairbanks boy who Funk has said was likely overwhelmed by a secondary bacterial infection.

The Public Health Division is holding workshops across Alaska this month to prepare for distributing an H1N1 vaccine. The first batch of vaccine should arrive in Anchorage around the second week of October, Wilkinson said.

Estimates for that first shipment have ranged from 30,000 to 140,000 doses, Wilkinson said. Shipments of 35,000 to 40,000 doses will follow each week until there's enough to vaccinate everyone who wants a shot, he said.

Those most vulnerable to the virus would be prioritized for the first shots. "If we have 100,000 people in the state, maybe, who are high risk and we get 30,000 doses, we're going to have to make some hard decision on a limited resource," Funk said.

The amount of vaccine shipped to each community will be based on population, rather than region. It'll arrive in rural communities directly from Anchorage or could reach villages from hub cities on regional airlines -- or could be carried by public health nurses, said immunization program manager Laurel Wood.

"It's exactly the way that we distribute all vaccine now. This is something that we do a lot," she said.

The vaccination isn't mandatory, though Wood recommends people get both the swine flu vaccination -- once it becomes available -- and seasonal flu shots.

The Associated Press contributed to this report. Read The Village, the ADN's blog about rural Alaska, at adn.com/thevillage. Twitter updates: twitter.com/adnvillage. Call Kyle Hopkins at 257-4334.

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