By Rebecca Hertz

Killeen Daily Herald

Four Texas children died this week from complications resulting from the H1N1 flu virus (swine flu). But health officials say the public should not be alarmed and should continue to follow precautions.

A 16-year-old Richardson girl and a 6-year-old boy from Texarkana, both with underlying health problems, and a 14-year-old Fort Worth girl and a 12-year-old Corpus Christi girl who had no underlying health issues died after contracting the H1N1 flu virus.

Earlier in September, an 11-year-old girl from Garland, with no apparent health issues, also died from the virus.

According to the Texas Department of State Health Services flu surveillance update of Sept. 28, there have been "18 confirmed flu-associated pediatric deaths in Texas from the start of the 2008-2009 flu season last fall till now."

Dr. John Carpenter, director of infectious disease with Scott & White, said the facility's emergency room saw 100 more patients per day last weekend over the previous weekend. All of the diagnosed flu cases were H1N1.

Carpenter advises taking a child who is ill to the doctor right away. The child's fever distinguishes flu from the common cold.

According to the Centers for Disease Control and Prevention Web site, "These viruses remain similar to the viruses chosen for the 2009 H1N1 vaccine, and remain susceptible to the antiviral drugs oseltamivir and zanamivir with rare exception."

Bonnie Scurzi, director of nurses at the Bell County Public Health District, said the health district is gearing up to open offices in Killeen and Temple specifically to provide H1N1 vaccines to the underinsured and uninsured.

Once the vaccine becomes available in mid- to late October, the department will provide the service at its regular clinics in Killeen all day Tuesday, and in Temple all day Wednesday until the new offices are operational.

Scurzi said most people should plan to go to their private providers for the vaccine.

Most people, especially those under 25, have little or no immunity to the H1N1 virus. The CDC suggests that people alive in 1957 to 1962 were exposed to a similar strain of flu, the 1957 pandemic flu.

The H1N1 strain is thought to be a distant relative of that influenza virus, so older people have full or partial immunity. Even if a person has had the flu in the past, there is no way to predict how severe the case will be, said Artealia Gilliard, CDC spokesperson.

"We have always been concerned that the virus could create a lot of illness especially in young people," Gilliard said. "This is why people under age 25 are recommended to be the first to receive the H1N1 vaccine."

Because some of the children had no underlying health issues, the public has raised concerns about whether the virus is changing and if the vaccine will be effective.

"There has always been concern that the bug will mutate," Carpenter said. "But to my knowledge, that has not been documented yet."

Vaccines are built from the strains that were circulating in late spring. If the virus were to mutate, the vaccine development process would have to start over, he said.

Gilliard said states are submitting orders for the vaccine. Initially, the plan was to ship 45 million doses in mid-October. That has been revised and the plan is to distribute each lot of the vaccine as soon as it is ready.

The gradual roll-out will start with 6 million to 7 million doses and be distributed based on each state's percentage of the total U.S. population.

The community distribution process will be determined at the state level.

Gilliard said that the vaccine is safe and eventually there will be more than enough for the 159 million people in the recommended groups.

"Most people who become ill with the flu get better on their own," Gilliard said. "Parents of young children should look for signs of severe illness … and seek immediate medical assistance."

The Associated Press contributed to this article.

Contact Rebecca Hertz at or (254) 501-7469.

What to watch for

In children, emergency warning signs that need urgent medical attention include:

Fast breathing or trouble breathing.

Bluish or gray skin color.

Not drinking enough fluids.

Severe or persistent vomiting.

Not waking up or not interacting.

Being so irritable that the child does not want to be held.

Flu-like symptoms improve but then return with fever and worse cough.

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