From staff reports

DURHAM AND RALEIGH -- Duke University Health System on Friday requested that patient visitation in all its inpatient and outpatient facilities be limited to adult members of the patient's immediate family or designated caregivers in order to minimize potential patient exposure to the H1N1 influenza virus.

The request also applies to Duke Health outpatient treatment centers and clinics.

Supervisors in certain areas of each facility may impose additional restrictions depending upon the need of specific patient populations.

Duke Health hospitals include Duke University Hospital, Durham Regional Hospital and Duke Raleigh Hospital.

Duke Health said anyone who has a fever or respiratory illness should not visit hospitalized patients.

"We believe this is another common sense precaution we can take to try to limit any inadvertent patient exposure to H1N1 flu," said William Fulkerson, senior vice president for clinical affairs at DUHS. "We recognize and appreciate the interest people have in supporting friends who are in the hospital, and we hope that everyone understands that this is simply a pro-active measure to provide optimal safety for our patients during this flu season."

Duke's restrictions came on the day the state reported its first child death from flu since the 2009 H1N1 strain was first reported in the U.S. in the spring.

The unidentified child died Sept. 19, of complications from an influenza infection, according to state health officials Friday.

The state reported that while the dead child's influenza test was not specific for 2009 H1N1, the strain accounts for more than 99 percent of all flu circulating in the state and the country and so the child's death was likely due to that strain. The child was at risk for complications from the flu because of underlying medical conditions.

"This is always a difficult announcement to make," State Health Director Jeffrey Engel said. "We hope that making people aware of this tragic case will remind others to be vigilant about protecting themselves and their children."

Most healthy children and adults who get the flu will recover without needing to see a doctor, but it is important that people contact their doctor right away if they are ill and at high risk for flu complications or have more severe flu symptoms.

People at high risk for H1N1 and seasonal flu complications are:

n Children younger than 5 -- particularly children younger than 2.

n Adults 65 and older.

n Pregnant women.

n And people with the following conditions:

-- Chronic diseases of the lungs (including asthma), heart (except hypertension), kidney, liver, blood (including sickle cell disease), brain or nervous system, muscles (particularly those that cause difficulty with swallowing) or metabolism (including diabetes mellitus).

-- Immunosuppression (weakened immune system) including that caused by medications or by HIV.

-- Children younger than 19 who are receiving long-term aspirin therapy.

Engel stressed that vaccination is the best way to prevent the flu. Seasonal flu vaccine is already available and H1N1 is expected to be available next month. Engel urged everyone to watch for announcements by state and local health officials alerting them when 2009 H1N1 vaccine becomes available.

"Flu shots help prevent people from becoming ill and from spreading flu to others," he said. "This year they are even more important because of H1N1. And if you do get sick, remember to stay home from work or school, cover coughs and sneezes and wash your hands."

For more information about influenza in North Carolina, go to www.flu.nc.gov.