It was, as Laurence Manning Academy headmaster Spencer Jordan said, "the worst phone call that anyone can ever receive."
After closing his Clarendon County school for the week Wednesday because so many children were absent with flu symptoms, Jordan learned one of his students - fifth-grader Ashlie Pipkin - had died en route to a Columbia hospital. She had been diagnosed Tuesday with pneumonia at Sumter's Tuomey Regional Medical Center, and a rapid test had indicated she had the flu.
"It was the most sickening and heartfelt sorrow I've ever felt in my life. My heart goes out to her family," Jordan said Thursday, after visiting with Ashlie's family in Sumter County.
Parents and coaches expressed shock and sadness Thursday at the death of the vibrant 11-year-old, a standout on the softball field. But medical professionals are urging parents to remain calm, stressing the H1N1 flu is not a great threat to otherwise healthy children.
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"That case (Wednesday) was very unusual. ... She did have some underlying asthma issues, and that put her at higher risk for complications," said Dr. Anna-Kathryn Rye, a pediatric infectious disease physician at Palmetto Health Richland.
An autopsy was conducted, and results may be available as soon as today, said Sumter County Coroner Harvin Bullock.
"It scares people. That's normal," Rye said. "Of course, people get anxious when you hear about an 11-year-old who dies from the flu.
"I'd like to send out a message for everybody to stay calm. We are expecting deaths in children and adults who are in higher risk categories, but normal children and normal adults seem to be handling the flu very well."
'MOST YOUNG PEOPLE ... GET BETTER'
State epidemiologist Dr. Jerry Gibson agreed.
The recent case is "very sad, but it's not at all characteristic of what's going to happen for most cases," Gibson said. "For most young people, it's just the flu. They get better.
"How a child, or an adult, does with this is a lot like how they would do with seasonal flu."
In other words, people with underlying health problems - asthma, diabetes, cystic fibrosis or HIV - are at greater risk and need to take special precautions and react immediately to any symptoms. But health experts still suggest otherwise healthy people should treat swine flu as they would seasonal flu. For most, that means treating symptoms with over-the-counter drugs and getting lots of fluids and rest.
"Unless there are signs of severe illness, you don't need to take children to emergency rooms," Gibson said. "You're not going to enjoy going there."
Patients with flu symptoms have been flooding emergency rooms and doctors' offices.
The pediatric emergency room at Palmetto Health Richland in Columbia is seeing an average of 40 children a day with influenza-like illness, spokeswoman Tammie Epps said.
The emergency room at Tuomey in Sumter, which treats children and adults, has been seeing about 200 people a day for the past several weeks with flu symptoms, "a huge number for us," said spokeswoman Brenda Chase.
Doctors' offices are as well-equipped as emergency rooms to deal with most flu cases. But Gibson also doesn't suggest rushing to doctors' offices at the first sign of flu symptoms. Call first, and you might be able to get enough advice over the phone to avoid a trip.
If a child has underlying health problems or shows one of the danger signs - trouble breathing, is unresponsive or inattentive, difficult to wake or refusing to eat - doctors can prescribe an anti-viral drug that lessens the time and symptoms of the flu. Tamiflu is the most common pill form, while Relenza is a nasal form.
Since Sept. 1, there have been 76 hospitalizations in South Carolina with lab-confirmed cases of flu and three deaths - not counting Ashlie Pipkin, according to DHEC. While the agency didn't break down whether those cases were all H1N1 flu, the Centers for Disease Control and Prevention have said the vast majority of the flu active now is the H1N1 strain.
'I JUST STARTED CRYING'
In Sumter and Manning Thursday, parents were grappling with the death of a child who seemed so healthy - even playing in a softball tournament this past Saturday and Sunday.
"She was a great athlete, a great person - always cheerful," said Dupree Cantley, who coached Ashlie on a Sumter all-star softball team this summer. "She was always willing to listen to the coaches. ... Before I coached her in all-stars, she beat my team in the championships with a home run. Just a great athlete and a great kid."
Headmaster Jordan had a similar reaction.
"As I walk around on my daily tours, I would go to the playground. ... Ashlie would be leading the charge on a football team with 95 percent boys, and she'd be holding her own if not beating them," Jordan said.
"This is such a shock to Laurence Manning Academy," he said. "We pride ourselves on being a close-knit family."
Of Laurence Manning Academy's 1,010 students, 287 were absent Monday, prompting the decision to close for the rest of the week.
Jordan said parents supported the decision to close the school. On Thursday, a professional cleaning crew came in to disinfect all of the school's surfaces with a bleach solution.
School will reopen Monday. Jordan said he has heard from several parents who want to be sure it's safe. "We've done everything we can do," he said.
Amy Marshall, who has a daughter in kindergarten at the school, said she agreed with the decision to close this week.
"When we found out Tuesday they were going to close I was kind of relieved," said Marshall, a graduate of Laurence Manning Academy.
"People are freaking out so bad about it. You hear about people dying. But I think 99 percent of cases had something other than flu-like symptoms," she said.
Wednesday night, after she heard about Ashlie's death, Marshall said her own daughter was misbehaving.
"I started to get mad, and then I said, 'You know what. The Pipkins don't have their daughter to hug.'
"I just started crying, and I held her."