In Westminster, emergency room nurses have been working double shifts. In Hagerstown, the hospital has made up extra beds and canceled elective surgeries. In Randallstown, a Catholic school had to send so many children home that it closed for a day.
Flu season is hitting Maryland later and harder than usual this year.
Over the past three weeks, the flu has taxed nursing home services, emptied seats in classrooms and sent coughing and wheezing patients to hospitals across the state.
"We've been squeezing them in with shoehorns," said Dr. Michael Kerr, an emergency room physician at Carroll County General Hospital. "We've been calling in extra nurses, opening up units. There are no empty beds, and all the hospitals around us are equally busy."
Nationwide, the flu season has been relatively mild. Maryland health officials say the state got off to a late start and is now experiencing a moderate outbreak of influenza cases and other viral illnesses that mimic flu symptoms. But they agree with emergency room doctors, who see evidence that it is more severe than in the past few years.
Emergency room visits are up 35 percent to 50 percent daily in areas from Baltimore to Western Maryland. Hospitals, including the Greater Baltimore Medical Center in Towson, Johns Hopkins Hospital in Baltimore and Anne Arundel Medical Center in Annapolis, are seeing an influx of patients suffering from flu and related complications.
As of this weekend, 20 nursing homes had reported flu outbreaks, compared to just four in mid-January, according to Maryland health officials. The state keeps track of the disease in nursing homes, where patients are especially vulnerable because they live in close quarters and have weakened immune systems.
Because doctors are not required to report flu cases -- in contrast to diseases such as meningitis, measles and tuberculosis -- the state Health Department has little more than anecdotal evidence of the problem.
"We know there are a lot of people sick. Most people's impression, which is probably right, is that this year is worse than last year," said Dr. Georges Benjamin, the state's deputy director for public health services. "We're watching it very carefully."
The encouraging news, Benjamin said, is that the dominant flu virus appears to be Type A, a broad category that can be treated fairly quickly with anti-viral drugs. Such drugs are usually given to the elderly or those with health problems who are at a high risk of serious complications.
Flu shots are the best prevention, Benjamin said. Still, even those who have been vaccinated -- and all who have not -- should do their best to avoid contact with people who have the flu, he said. Once sick, people should stay home, rest and drink plenty of fluids.
While hospitals are filling up, some schools are emptying out. Holy Family School, a small Catholic elementary in Randallstown, had 63 students absent Thursday -- and had to send home another 27 because of flu and cold symptoms. On Friday, the school closed, leaving a taped message: "The faculty is cleaning the classrooms and disinfecting the building, so we are unable to answer our phones at this time."
Reports of high absenteeism in schools are occurring elsewhere.
In Howard County, for example, Swansfield Elementary and Bryant Woods Elementary reported earlier this month that at least 10 percent of their students were absent for as long as three days. School officials aren't certain but believe it's flu-related, said school spokeswoman Patti P. Caplan.
Hospitals are treating patients with high fevers, dehydration, extreme weakness and flu-related infections, including pneumonia and bronchitis. Patients are being admitted when they are at risk of complications or require intravenous antibiotics and fluids.
At Washington County Hospital in Hagerstown, flu sufferers have taken up all the spare beds. The hospital had to put off some nonemergency operations last week to free up beds. Today, the hospital plans to resume a normal surgery schedule, though that could change if more people come in, said Beth Kirkpatrick, a hospital spokeswoman.
Howard County General Hospital recorded its highest occupancy in more than 18 months because of the influx of flu patients. All but five of its 163 beds were filled, and just about every department was busier than average, said spokesman F. John Walker Jr.
Some hospitals, including Carroll County General and GBMC, have put patients in beds normally reserved for more temporary uses, such as for post-operative recovery. GBMC, which has been seeing 150 to 200 patients a day in its emergency room compared to the usual 110, also has used empty beds on its surgical floors.
As of yesterday, several hospitals appeared to be recovering from the flu bout. At GBMC, Maureen Morton, the nursing supervisor, said: "It's starting to be like a normal weekend."
At Carroll County General, Kerr was treating three patients with pneumonia. All of the cases, he said, were most likely brought on by the flu.
Sun staff writer Kris Antonelli contributed to this article.
Pub Date: 2/22/99