Schools are open, the aches and pains are gone and the vaccine is on the shelves, but state health officials say Wisconsin might not have seen the last of swine flu.
The state Department of Health Services confirmed more than 2,600 cases in November and December, but the outbreak has faded since, with only 112 cases confirmed between January and mid-March. Still, pandemics historically come in three waves, experts say, and a third has yet to strike.
"It appears to be waning from the public eye, but we want to be sure people keep their guard up," said Tom Haupt, state influenza coordinator. "It's still around. A third wave is still in the realm of possibility."
The 2009 H1N1 virus first hit the U.S. in April, followed by a second wave of infections in the fall. Wisconsin health officials have confirmed 9,670 cases since last April. More than 1,300 people have been hospitalized in the state and 55 have died.
The virus surprised state health officials when it appeared last April, Haupt said. Everyone was expecting a bird flu pandemic, not swine flu, he said.
"Things just took off very, very quickly," he said.
Gathering reliable data on the extent of the problem was a challenge, he said. State officials wanted doctors to beef up tests for swine flu and send them to the state hygiene lab for confirmation, but many didn't get the message and continued to send tests to out-of-state labs.
"Sometimes it really fell through the cracks," Haupt said. "We basically lost control of it."
Fear of the virus upended the state's schools last fall as districts canceled classes and administered standardized tests earlier to get ahead of anticipated widespread absences. Ashwaubenon High School canceled all of its athletic events on one October weekend, forfeiting its varsity football and boys' soccer games and its cross country meets.
The state Assembly in September passed a resolution to officially refer to the virus as 2009 H1N1 Influenza rather than swine flu out of sensitivity to the pork industry.
The federal government shipped $24.6 million to Wisconsin to help with the response. Still, the vaccine was slow to arrive, forcing rationing. Haupt said the state didn't receive adequate supplies until late November.
Much of the delay stemmed from the vaccine-making process, Haupt said. Manufacturers must grow the vaccine in eggs, which takes weeks.
Now, though, Wisconsin has so much vaccine state health officials aren't counting doses any longer, said state Department of Health Services spokesman Seth Boffeli.
State Health Officer Seth Foldy told the state Homeland Security Council last week that DHS has started working on a plan to dispose of expired vaccines safely.
"We've basically got vaccine everywhere," Boffeli said. "Hospitals, clinics, at private pharmacies, at Walgreens, at Targets. That is the one good thing we have."
Brown County Health Department Director Judy Friederichs said 51 people from her county ended up in the hospital during the fall outbreak, but her agency hasn't heard of a case since early February. Her county has 1,500 to 2,000 vaccine doses available, she said.
"Right now we are overstocked," she said. "Probably right now, there's a lot of people who think that it's over."
Health officials nationwide are reviewing their response thus far, with an eye toward improving communication, developing new methods of growing the vaccine faster and keeping a national tally of flu-related hospitalizations, he said.
"Realistically," he said, "we have to keep our guard up and make sure we continue to monitor this."