The Alabama Department of Public Health is cautiously optimistic that the worst of the swine flu pandemic is over.

“It appears by all the indicators that we look at that H1N1 is tailing off,” said Dr. Jim McVay, department spokesman.

Health department officials are cautious about the prediction because even if the worst is over, Alabama is one of the 25 states still reporting widespread H1N1 activity. They hope Alabama’s residents will also be cautious, saying the worst thing people can do is not get the H1N1 inoculations that have finally become available to everyone because of indications that the worst of the pandemic may be over. And despite their caution, they admit the indicators are there. One indicator is the number of swine flu-related deaths.

“The deaths reached their high in October,” he said, adding that they dropped notably in November and December.

The first of Alabama’s 39 swine flu-related deaths occurred in July. After the one death in July, there were four in August, 11 in September and 14 in October.

But in November, the number of deaths dropped to five, and there were only four in December.

“So far, there appears to be a clear pyramid,” McVay said.

But his hope that Alabama may have seen the worst of the swine flu and be in a recovery phase isn’t just based on the number of deaths connected to swine flu.

He said the health department monitors information from hospitals, and those records are showing that the number of people coming into emergency rooms with influenza-like illnesses “has dropped considerably.”

“At one point it was as high as 20 percent of all the people who were reporting to emergency rooms,” he said. “That has been going down the past several weeks.”

Currently, H1N1 accounts for about 7 percent of all the people reporting to state emergency rooms.

“That’s still above average for a period that is not a traditional flu season. Usually the number now would be around 2 to 3 percent, but it is certainly nothing like the 20 percent that it reached in September,” McVay said.

As of last week, there had only been four swine flu-related deaths throughout the tri-county since the onset of the epidemic — three in Montgomery County and one in Elmore County.

The first three deaths in the tri-county occurred in Montgomery County. A female infant died in August, followed by a 61-year-old male in September and a 33-year-old female in October. The most recent death reported was in Elmore County, where a 37-year-old male died in November.

While McVay said the health department is cautiously optimistic, he said the key word is “cautiously.”

He is urging people to continue to view the disease as a serious threat and to act accordingly.

In the 1918 and 1957 pandemics, a third wave of the disease spread in January. He said health experts are split about whether that could happen with the current pandemic and that the simple truth is that at this point no one knows.

He said the best way for people to make sure that H1N1 remains on the downswing is to make sure they get immunizations and that their children get the second round of immunizations.

And he said people need to keep doing the things that have helped combat the epidemic already.

“One reason I believe things may have turned around is that people have taken this flu very seriously and responded to it appropriately,” he said. “Parents have been keeping their children home if they show flu-like symptoms, (and) schools have taken a very proactive approach to make sure parents keep children with these symptoms home until they’ve gone at least 24 hours without an elevated temperature.

“Many work places have taken the same approach. People have taken trying to protect others much more seriously than usual. They have also been using sanitizers, washing hands and taking other efforts to try and protect themselves, their family members and others. And they need to continue to do all these things.”

During the past three weeks, the health department reported that every case of flu-related illnesses that has been tested has been H1N1 instead of traditional flu.

The absence of traditional flu is also a pleasant surprise. Prime months for traditional flu are between December and February. One reason for the dearth of traditional flu cases may be because we aren’t deep into the season yet. But McVay said there is another possible explanation, which is more hopeful.

He said that when fears about H1N1 were at their height, there was no H1N1 vaccine. So people came in to get regular flu vaccinations in higher numbers.

He said it is too early to tell, but he is hoping that all these vaccinations for regular flu will keep cases of regular flu down this year.

-montgomeryadvertiser-