FAIRHOPE, Ala. — We’re not yet out of the woods when it comes to the H1N1 influenza virus, according to health officials. Perhaps better known as swine flu, the illness has infected around 60 million Americans so far, with 265,000 hospitalizations. Nearly 12,000 of those have died from H1N1 complications.

U.S. Surgeon General Dr. Regina Benjamin, a Spanish Fort resident, said Monday that H1N1 has made the 2009-2010 flu season “one of the most challenging in recent memory.” She pointed out that it has been persistent in the Southeast, and now Alabama, Georgia and South Carolina are the three states with the most local and regional activity.

“We’re at a critical moment in our national response to this virus, and we need to continue to urge Americans to get vaccinated, especially people at high risk from complications from H1N1,” Benjamin said. ”There still seems to be a lot of misinformation out there. We’re seeing higher rates of disease in adults who have chronic conditions like diabetes, cancer, heart disease, asthma, COPD and other lung illnesses.”

Benjamin also noted that minority groups such as African Americans and Hispanics are more at risk because they seem to have a higher instance rate of the chronic illnesses she mentioned, but are among those less likely to be vaccinated.

The nation’s supply of H1N1 vaccine last week reached around 124 million doses shipped, yet many Americans remain unvaccinated. Benjamin said, “The H1N1 response continues to be an incredible effort by state and local officials, manufacturers, scientists and health care workers. The H1N1 vaccine is very safe, it's effective, and it prevents death.”

Dr. Anne Schuchat, assistant surgeon general and director of the National Center for Immunization and Respiratory Diseases, agrees. She said, “Disease rates are much lower on average around the country than last fall, but the H1N1 virus is still circulating and people continue to become ill, be hospitalized and die from this virus. H1N1 has been causing more disease recently in the Southeast where several states are reporting regional (or local) activity.”

With Alabama being one of those states reporting regional activity, it is especially important to be vigilant, Schuchat added.

The activity seen in the Centers for Disease Control and Prevention’s (CDC) influenza surveillance is consistent with flu activity in college campuses in the Southeast that was reported by the American College Health Association. Nearly all the influenza viruses currently circulating are the H1N1 pandemic virus.

“We have not seen seasonal flu in substantial numbers at all, even to this week, in late March,” Schuchat said.

Asked about numbers of H1N1 infections versus seasonal flu in Baldwin County, Teresa Porter R.N., emergency preparedness coordinator for the Alabama Department of Public Health’s Area Nine (consisting of eight south Alabama counties, excluding Mobile), said, “We’re not tracking individual cases anymore. We’re looking at it from the regional component. We’re broken down into 11 public health areas (in Alabama). and less than 50 percent of those areas are affected.”

Things are a little more tense in Georgia right now, however, thanks to a reported spike in the number of flu cases there.

Schuchat pointed out that for the past several weeks, the Georgia Department of Community Health has reported an increase in flu-related hospitalization. Earlier this month, Georgia health officials requested a team from CDC to help them conduct a more in-depth investigation. The CDC staff is working closely with officials there to analyze those cases, hospitalizations and deaths reported recently in the winter months and compare them to previous flu activity reported in the summer and fall.

Georgia has recently seen more laboratory-confirmed influenza hospitalizations each week than they’ve seen at any time since October. Around 40 patients have been hospitalized there in the past week.

Schuchat said, “The data suggests that the increase in hospitalizations were required because of the H1N1 strain, not by other seasonal influenza viruses, and the agency doesn’t have any evidence that the H1N1 virus has changed in Georgia. Does that mean we’re going to see that in other states? I really don't know. But a couple of the Southeastern states are seeing more activity right now than the rest of the country.”

Because the virus has apparently remained much the same as it was a year ago when first reported, the U.S. fall vaccine supply will be a single shot that will include the current pandemic H1N1 vaccine strain, and also an influenza-B strain and influenza-A (H3N2) strain.

“We think it’s important for people to get the trivalent vaccine,” Schuchat said. ”And getting vaccinated now, is critical to protect you in the months ahead. We don’t know if the H1N1 will continue to circulate in the summer the way it did last year. Right now we're recommending vaccine to protect people over the several months ahead until the new trivalent vaccine becomes available and people can protect themselves from the three different kinds of flu at this point.”

Porter said both the current seasonal vaccine and the H1N1 immunization can be taken at the same time if both contain inactive viruses. She said most doctors, as well as the Baldwin County Health Department, have plenty of both vaccines and can give them on a walk-in basis. Everyone should make sure they have received both, she added.

Although around 12,000 people have died from the H1N1 virus, 90 percent of those people, about 11,000, are people under 65. Schuchat said that’s many more deaths in a particular year among younger people than what is typically seen with seasonal flu.

The CDC estimates that the rate of death in young people is probably five times higher than what would typically be seen with seasonal influenza.

“Now the very good news is that the elderly, while not completely immune, have been relatively spared and the number of deaths we estimate from the elderly from the H1N1 virus is much lower than what we would typically see with seasonal influenza,” Schuchat said.

”There’s a shift to younger people in terms of serious illness, hospitalization and death. And that does make it different. Of course, we think it’s important to prevent seasonal influenza as well and recommend vaccines against both each year. This year, we had the new virus to contend with.”