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Cases of both seasonal and H1N1 flu have decreased steadily since mid-September, said MIT Medical Chief of Internal Medicine Howard M. Heller yesterday. H1N1 vaccinations have begun to arrive on campus, but will be distributed first to top-priority candidates, a group that, for the time being, only includes health care workers.

MIT Medical will announce the dates of H1N1 vaccine clinics for other priority vaccine recipients during the next two weeks.

Most cases of the flu have been mild so far, with only six students admitted to the MIT infirmary and one student hospitalized for flu over the past two months. All patients have recovered.

MIT Medical bases its estimate of flu incidence on the number of people coming into urgent care with upper respiratory illnesses. Last month, urgent care received about 60 to 80 patients daily, a third to a half of whom suffered from respiratory infections or influenza-like illnesses (ILIs).

Last week, Heller said, only 15 percent of patients at urgent care had come in for respiratory infections or ILIs.

Calls from MIT Medical to Student Support Services excusing sick students have also decreased; in September, MIT Medical made between 10 to 26 such calls per day, while in the past week they only made fewer than half a dozen calls a day.

Over the past month, 45 students took advantage of the meal delivery service provided by MIT Campus Dining, according to Richard D. Berlin, director of campus dining. Most students have ordered just one or two meals, mostly dinner, before finding meals elsewhere, he said. While the meal delivery service is still available to sick students, how long it will continue is yet to be determined, said Berlin.

Heller explained that the reported decrease in ILIs does not necessarily indicate a decline of actual illness around the campus, because of unaccounted-for students who do not go to MIT Medical. “Word has gotten out about how to take care of yourself,” said Heller. Students know to stay at home if they are mildly ill instead of coming in to MIT Medical, as promoted by fliers and announcements around campus. “We know there are a lot of students out there who have influenza and other respiratory infections but aren’t necessarily coming in here.”

Still, by monitoring the campus activities, MIT Medical is confident that the actual incidence of flu is decreasing.

MIT Medical is no longer performing rapid flu testing to confirm flu diagnoses, except in high-risk cases, so the exact number of flu cases is unknown. Medical stopped testing partly because Massachusetts state government stopped mandating testing and because the test is only 70 percent accurate anyway.

Doctors now simply use clinical judgement to gauge patients’ treatment, Heller said.

Doctors estimate that while a minority of patients with flu symptoms have the flu, 95 percent of people who have contracted the flu at this point in the flu season have the H1N1 strain, said Heller.

Although cases decreased since last month, MIT Medical does not know whether H1N1 cases peaked in September or will spike up again. The incidence of regular flu generally peaks in January, said Heller, but predicting the course H1N1 will take is difficult.

Some H1N1 Vaccines Arrive, Slowly

MIT Medical received its first shipment of 500 H1N1 vaccines last Friday, but they are not yet available for the whole MIT community. Health care workers will be vaccinated first, as required by Massachusetts state government, which is distributing the vaccinations for free.

As more vaccines come in, MIT Medical plans on distributing vaccinations based on the Center for Disease Control (CDC) recommendations, which prioritize pregnant women and people with other medical conditions, such as asthma and diabetes. H1N1 vaccine clinic dates should be announced by the first week of November.

MIT Medical requested vaccinations for 30,000 people, but it does not know when the next shipment will come. “We are totally at the mercy of the state,” Heller said, and although the CDC reports that there should not be a shortage, it published on its website that “availability and demand can be unpredictable.”

Heller described how the H1N1 clinic will be conducted, whenever it occurs: “It is a military type operation,” running such large-scale clinics, said Heller, “first of all, finding a space that’s big enough to accommodate thousands of people, and then getting the doctors, nurses, and MIT EMTs, requires a lot of planning.” Having trained for such a scenario in years past, MIT Medical is ready for the task; “We’ve got it all planned, but we don’t have a date.”

Demand for regular flu vaccinations increased this year, but MIT Medical is suffering from a shortage of vaccines and is not expecting another shipment. Only those at high risk of complications from the flu will be allowed to make appointments for the remaining vaccinations. Last year MIT Medical administered 7,200 regular flu vaccines, while in the first two months of this year alone it administered between 5,500 and 6,000 vaccines, including 1,035 at last Thursday’s student clinic.

Regular flu vaccinations do not protect a person from the H1N1 strain, so Heller suggests that people receive the H1N1 vaccine when it becomes available. Even if a person was diagnosed with flu earlier this year, because MIT Medical did not test specifically for which strain it was, Heller recommends people receive both vaccinations as a precautionary measure.

Heller praised the MIT community for doing what it can to limit flu infections: “I think the fact that so many different parts of MIT work really hard and really well together to get the word out” has helped slow the spread. “No one thought we’d be preventing H1N1 at MIT, what we were hoping was that we’d slow it down.”