Influenza A/B ("seasonal flu") is of most concern for the elderly, chronically ill and the very young. Symptoms consist of mostly high fevers ( 100 to 105 ), dry nonproductive cough and total body aches (hurting from hair to eyes to feet , feeling you are going to die). Symptoms usually last 2 to 9 days.

H1N1 is also known as Swine flu due to its similarity to the animal infection. This virus is in a pandemic; this means it is not seasonal and has been reported in New York and throughout the world for several months now. It is also a repiratory virus transmitted mostly by aerosals ( that is, breathing in the virus after cough or sneeze ). Symptoms are similar to the seasonal flu, with high fever, dry cough and aches. H1N1 is more of a concern for children and adolescents; the older pateints may carry some protection from previous flu shots or infections. This may cause NSP to see more young skiers to come to the hill sick or become ill once there.

What does this mean for us ? I would suggest several maneuvers. Signs should be posted around the lodges to warn skiers of the symptoms and advise not to "push through" the aches. Schools need to be advised to screen the kids before boarding the buses; they should stay home if there are fevers, aches and cough.

I know that Bristol has patrollers talk to the kids on the bus about rules, courtesy etc; warnings about flu should be included.

Second, many of the patrollers will be getting flu and or H1N1 vaccines; I would suggest that hill chiefs know who has vaccines to be available to care for the ill skier.

Third, areas need to be identified to sequester the ill skier; it will usually be best to be secluded with a separate air source. Office space may make some sense from my point of view to minimize the exposure to everyone else, both injured skiers and other patrolllers.

Fourth, masks need to be available to lower the virus spread from the ill skier/boarder to the patrollers and others. Masks should also be available to the patrollers, security personnel and bus drivers who may be exposed.

Fifth, plans should also involve the schools, as to whether to permit ill skiers onto the bus for the trip home. Areas and patrols don't want to be the default babysitters to these skiers/boarders, so setting a plan/agreement with the schools makes the most sense.

Sixth, discussions should be held now on what type of masks to stock and who will use them. To have the area provide masks for parents, friends or bus drivers could become a moderate to large expense.

I hope that this gives a basis for planning for the ski season if influenza "takes off", like it did in the southern hemisphere, Australia in particular.

Sincerely, Stephen Hellems, MD