There are four confirmed cases of H1N1 flu in San Juan County as of this morning, county Health and Community Services Director John Manning reported today.

However, county health officials are considering H1N1 flu “widespread” on San Juan Island because of school-absence rates; nearly one-third of the students at Friday Harbor High School were reported absent at the end of last week and the absence rate at the middle school in Friday Harbor remained above 20 percent all week.

The absence rate at Orcas High School climbed from less than 10 percent to 18.5 percent during that same period.

There have been no reported deaths or hospitalizations of San Juan County residents associated with the disease. A 6-month-old baby was hospitalized last week, but it was not related to H1N1, the county communications office reported. Incidence of flu are reportedly increasing on Orcas Island. Health officials characterize flu cases on Lopez and Shaw so far as “sporadic.”

County health nurses continue to call the families of all of the county’s students reported absent with flu-like symptoms to gather information and provide advice. Those efforts have produced results. Orcas Island physician Dr. David Russell reported last week that information provided to a parent by a county health nurse enabled him to catch and treat a probable case of pneumonia. Without early treatment, that infection could have become serious enough to require hospitalization.

As of Friday afternoon, the county Health and Community Services Department had received and distributed about 1,000 doses of H1N1 vaccine, the county communications office reported.

Because the initial shipments of vaccine have been small, health officials have not been able to expand the group receiving the vaccine beyond its highest priority groups:

— Pregnant women.

— Caregivers of children less than six months.

— Children 6 months through 4 years (pre-school population).

— Children 5 years through 24 years with chronic illness (school-age children).

— Health care workers and EMTs with direct patient care.

This week, Health and Community Services will be vaccinating school children in areas where it appears the vaccine can be most effective at preventing the spread of the disease.

“We are having to make very careful use of the limited amount of vaccine we have,” County Health Officer Dr. Frank James said in a press release. “Among the things we have to take into consideration is that it takes about eight days for the vaccine to begin providing protection, so people who are already infected will not benefit.”

According to reports at the national level, additional supplies of vaccine are supposed to become available soon, but thus far there is no indication when larger quantities might arrive here.

In many parts of the county, the rapid spread of flu has increased demands on health care providers, and health officials are asking residents to avoid unnecessary calls or visits.

“It is usually not necessary to see your physician for diagnosis or testing since in most cases recovery occurs without complications,” Dr. Dale Hessinger said. “Because it is likely that the number of cases of H1N1 flu will peak very quickly, medical providers will need to concentrate their time and resources on cases that are more serious than most people will experience.”

However, county health officials are emphasizing that people in high-risk groups — including anyone with a chronic underlying medical condition such as obesity, diabetes, asthma and heart disease — should contact their health care provider early to discuss antiviral treatment. Treatment with anti-viral drugs must be started within 48 hours of the onset of flu symptoms to be effective.

Health officials emphasize that medical care should be sought in cases where the following symptoms develop:

1. Fever over 100.3 for a child less than 12 weeks old.

2. Dehydration — no tears, little urine, not drinking.

3. Labored breathing, i.e., grunting, wheezing, skin between the ribs sink in with each breath, flaring of the nostrils with each breath.

Medical care should also be sought if there is difficulty breathing or shortness of breath, pain in the chest, dizziness and/or confusion, severe vomiting, or the return or worsening of illness following an initial improvement.

Dr. James continues to emphasize the need to slow the spread of H1N1 until enough vaccine is available to protect a larger percentage of the population. He says his advice is as simple as it is important:

1. Wash your hands.

2. Cover your cough.

3. Stay home if you are sick.

4. Call your doctor before going to the office if you have cough and fever or sore throat.