Flu season has come earlier than usual for Butler County and the rest of the nation this year.

And it's already hitting the population hard.

Dr. Tom McGill, Butler Memorial Hospital vice president of quality and safety and an infectious disease control specialist, said the hospital had 38 laboratory confirmed influenza cases for September.

For the first six days of October, the hospital had confirmed 79 cases.

McGill said anyone who shows up at the hospital with flu-like symptoms is given a one-hour test for the presence of influenza A.

Anyone with those symptoms who also is being admitted to the hospital for some other reason will be given a two-day test that includes culturing of the patient's germs. This test is to determine whether the patient has H1N1 flu and needs to be isolated.

McGill said the hospital is testing patients for the presence of influenza A with a one-hour test. If that patient is being admitted to the hospital, a two-day test is conducted that includes culturing of the patient's germs.

The hospital is not, however, specifically testing for H1N1 flu because McGill said it costs $500 per test and takes a week to get the results back.

"The thing is that 98 percent of all influenza A cases are H1N1," he said, adding that it is just as effective to go ahead and treat signs and symptoms of the flu.

As for vaccines, McGill said the hospital has ordered enough for its staff and an estimated number of admitted patients.

The hospital is not acting as an outreach such as the Visiting Nurses of Western Pennsylvania, or the VNA, that sets up flu shot clinics.

McGill expects the vaccine to reach the hospital and Butler county doctors the week of Oct. 19.

He also said people should continue to follow the guidelines set out by the Centers for Disease Control and Prevention in Atlanta: hand washing, covering mouths during coughs and sneezes, and staying at home when sick.

But, McGill warned, if at anytime someone who is sick with the flu has trouble breathing, that person should call a doctor immediately.

"Some people who are sick are taking a turn for the worse about day four or five of the illness, finding they are short of breath, and some are going into respiratory failure," he said.

County school districts

School districts in the county have reported two confirmed cases of H1N1 flu.

In a case in the Seneca Valley School District, the student has since fully recovered. The other case was in the South Butler School District in the 2008-09 school year. District officials would not divulge any more about the case because of confidentiality rules.

What district officials have said is that they encourage parents to have their children inoculated for the seasonal flu and for their children to practice good personal hygiene to reduce the chances of contracting the flu.

Butler School District Superintendent Ed Fink said the district is working closely with the Visiting Nurses Association, which has applied to receive the H1N1 nasal mist inoculations and vaccine.

"We would work then with their expertise on how (vaccinations) would be administered," Fink said.

In the Seneca Valley district, no flu vaccines will be administered. District spokeswoman Linda Andreassi said the decision came after the district conferred with its doctors.

"Because the (H1N1) vaccine is now available to primary care providers, we were told that also providing it at the district level will cause an overlap of services and potentially create confusion," Andreassi said.

"We have reviewed hand washing practices with special presentation videos and demonstrations, and hand sanitizer stations are set up all over our buildings," she said.

The district's Web site, www.svsd.net, outlines a "pandemic plan" to answer parents' questions about what to do if their child is sick and what precautions to take when their child is well.

Since influenza attacks the lungs and is complicated by secondary, bacterial infections, all of the school letters state that children with chronic health problems such as asthma, diabetes or metabolic conditions should seek medical attention immediately if they appear or feel sick.

In the Slippery Rock School District, students who exhibit flu-like symptoms will be sent to the nurse's office and then home, after parents are notified. These students will not be allowed back into school until they have been fever-free for at least 24 hours without the help of fever-reducing drugs such as Motrin or Tylenol, according to information on the district's Web site.

Impact on colleges

Rita Abent, executive director of public relations at Slippery Rock University, said the college had a "baptism by fire" in the spring when it became a focus of the regional swine flu scare after some students came home from Mexico. Graduating students who attended the trip were required to attend a separate ceremony.

While SRU has been notified that it will be a distribution location for the H1N1 vaccine, Abent said she does not know when the shipments will arrive. Abent said the university has been preparing for pandemic for two to three years.

"Part of what we have done this fall is try to have crisis avoidance, and you do that by educating people," Abent said. "We have had an aggressive campaign led by the wellness center."

When students returned to campus this year, health educators held workshops in residence halls to help students understand their hygiene responsibilities to prevent the spread of the H1N1 virus.

"We have had a series of both in-person training sessions and electronic e-mail reminders to people on what to do if they feel ill and signs of the flu to keep people informed," Abent said.

"Student health services handed out hand sanitizer so people would have them, and there are campaigns in the offices so when visitors come in we can practice good hygiene."

Abent also said the college is focusing on using large amounts of hand sanitizer and Lysol throughout the rest of the year. It continues to work with the National College Health Association and the state Public Health Department.

While SRU waits for the H1N1 vaccine, the number of students registered for the seasonal flu shot has doubled since last year.

"People are aware of that importance," Abent said.

SRU has had one confirmed case of H1N1 in the past few months while 22 students have presented symptoms. Those students are treated as cases of H1N1 although they have not been confirmed, and follow the guidelines set by the Centers for Disease Control.

"The awareness level is pretty high," Abent said.

John Kearney, vice president of student services at Butler County Community College, attended a workshop in Harrisburg where the colleges in the state learned to prepare for the virus. When the school year started, Kearney sent e-mails to the faculty, staff and students to share the guidelines for avoiding an H1N1 outbreak.

"I told them about the symptoms, which are similar to seasonal flu, and warning signs of serious complications, then told them about where to find more information on their own," he said.

There are signs on campus advising students to wash their hands as much as possible, along with a sanitizing program for doorknobs and frequently touched areas.

There are three confirmed cases of H1N1 at BC3.

"They are all recovering and doing well, and we told them to stay away from school until they are fever-free without the use of medicine," Kearney said. "We are making arrangements for them to finish their work and it is going well."

He does not think community colleges will be administering the vaccine.

Rebecca Miller, communications associate at Grove City College, said students there are urged to visit different Web sites should they come down with any symptoms.

Students also are encouraged to prepare a cold and flu kit, which has a thermometer, sanitizer, surgical mask, cough syrup, bottled water and soups.

"Our emergency response team is meeting regularly to stay updated on the latest developments," Miller said.

The only confirmed case of the H1N1 virus at Grove City College occurred in May, Miller said. The college applied to be a distribution center for the vaccine but has not heard back yet from the state.

Eagle staff writers Ed Biller, Kelly B. Garrett and Stephanie Rex contributed to this report.