This year's virulent strain of flu has killed a patient in Blair County, according to the latest information from the state Department of Health.
Widespread in Pennsylvania and most of the country, the flu has also killed three patients in Centre and one in Bedford County, according to the department's website.
The outbreak has led one local nursing home to quarantine a building and hospitals and other facilities to restrict visitation.
Mirror photo by Patrick Waksmunski
HeathSouth Rehabilitation Hospital of Altoona has posted a no entry sign for people suffering from the flu in its main entrance vestibule near Valley View Boulevard.
It has also raised the possibility that if things get much worse, facilities could put into practice the more radical elements of their disaster plans.
The Mirror was unable to obtain any specific demographic information about the Blair and Centre county deaths Tuesday afternoon from the state or local hospitals.
But the Bedford County victim was an elderly woman who lived in a nursing home and developed complications of pneumonia, dying Jan. 7, according to Beth Hullihen, infection control specialist with UPMC Bedford Memorial.
Statewide, the flu has killed 40 people since the season began Oct. 2, with all but six at least 65 years old and none were younger than 25, the state said.
The number of cases confirmed by lab tests continues to rise week-by-week in Pennsylvania, with a total of 16,500 case reported so far this season. That's actually just "the tip of the iceberg," as most diagnoses are "presumptive," without testing, according to the website.
Hollidaysburg Veterans Home on Friday quarantined Arnold Hall on its complex, after four residents there tested positive for flu, said Joan Nissley, spokeswoman for the state Department of Military and Veterans Affairs.
The home is allowing no visitors and no new admissions at Arnold. It is also not taking those residents on activity trips, Nissley said. The home has reduced resident and staff movement from unit to unit and building to building to deter the spread of the illness, Nissley said.
The home is offering residents and staff the anti-viral medication Tamiflu, beginning Monday, she said.
And the home, along with the other five state veterans homes, is conducting two sessions to retrain staff on the use of masks and gloves to prevent the spread of flu, Nissley said.
Altoona Regional Health System on Tuesday tightened visitation rules to protect patients, staff and the public.
Until further notice, every visitor must be at least 18 and a member of the patient's immediate family or a caregiver, according to a hospital news release. Only two visitors at a time can be at a patient's bedside.
Visitors to maternity patients must wear surgical masks, which the hospital will provide.
As always, anyone feeling ill, especially those with cold or flu symptoms, should not visit, according to the news release.
The hospital can make exceptions for critical cases, according to Dr. Linnane Batzel, chief medical officer.
The hospital has been reminding doctors' offices to provide masks to patients they send to the hospital or at least encourage them to ask for masks when they arrive, Batzel said.
Mount Nittany Medical Center in State College, which has handled about 40 cases per week over the last three weeks, has not restricted visitation, but is asking those who feel sick not to visit, spokeswoman Elle Morgan said.
The hospital is providing masks, tissues and hand sanitizers at its kiosks, Morgan said.
Some care facilities are monitoring employees for signs of sickness and asking those who are sick to go home, said Shannon Calluori, director of the state Bureau of Public Health Preparedness.
"Maybe a nurse would greet employees at the employee entrance door," she said.
It would help stem the outbreak if everyone who gets sick would stay home, she said.
A few hospitals statewide have activated medical surge plans, Health Department spokeswoman Holli Senior said.
One of those is Lehigh Valley Hospital in Allentown, which set up tents outside to handle an influx of patients with the flu.
Hospitals can use such fully equipped tents or separate buildings on their campuses to "triage" patients exhibiting flu symptoms.
They can treat the non-acute patients, give them a prescription and send them home, for example, Calluori said. They can send the ones who need testing or admission in to the hospital, she said.
The tents or other triage centers reduce the risk of spreading the contagion and take the pressure off emergency rooms, she said.
Altoona Regional's disaster plan allows for transformation of its observation floor into a quarantine area, Batzel said.
The hospital can isolate the air flow to that floor, she said.
The plan doesn't call for setting up a tent outside, but the hospital has a tent available, if necessary, Batzel said.
The disaster plan sets specific triggers for activation, Batzel said.
"We're nowhere near that level," she said.
But officials are watching, she said.
If things get worse at Mount Nittany, there's space in the newly expanded emergency room to create a quarantine area, Morgan said.
It helps that all emergency room patients and all flu patients admitted to the hospital get private rooms, Morgan said.
Activation triggers depend on the nature of an outbreak, the number, age and acuity of patients, the available space, the number of critical employees, and the number of employees who have called in sick, Calluori and Morgan said.
Meanwhile, individuals can help prevent the flu from spreading by taking care of themselves and practicing courtesy, health officials emphasized.
The U.S. Centers for Disease Control and Prevention recommends vaccinations for everyone older than six months. This season's vaccine is about 62 percent effective, according to the CDC.
Altoona Regional also offered some common-sense advice similar to the urgings parents give their children.
"Cover your nose and mouth with a tissue when you cough or sneeze. Throw your tissue in the trash. Perform hand hygiene afterward," the news release said.
Mirror Staff Writer William Kibler is at 949-7038.