...and this is as of July 24,2009. As of this date, 43,771 cases are confirmed as laboratory identified cases of the new H1N1 virus. There has been 302 deaths reported in the United States with more expected as the season runs into the fall and the winter. The CDC thinks that there have been over a million cases of swine flu thus far, with 20 states having reported widespread or regional activity. This H1N1 is here to stay for a while folks.
From http://www.cdc.gov/media/transcripts/2009/t090724.htm
But as we've been saying, that's really just the tip of the iceberg, so we're no
longer going to expect the states will continue this individual reporting
and we're going to transition to other ways of describing the illness and
the pattern. On our website you can see something called "FluView,"
which goes through much more detail about what's happening in different
parts of the country. We believe there have been well over a million
cases of the new H1N1 virus so far in The United States. As I said, it's
very unusual for that kind of illness to be occurring at this time of the
year. The Novel H1N1 viruses are making up 98% of all the subtyped
viruses we have, subtype influenza A viruses, and we're seeing them dominate
here in the U.S.
Yesterday we provided a little update about the clinical patterns that we were
seeing with the H1N1 virus. There was a report about four children who
had severe neurologic complications. Fortunately, most of these
children have done well. But it's just a reminder that seizure,
encephalitis and other neurologic complications can occur in
influenza. This is reported in the literature -- quite a bit for
seasonal influenza -- and now it's also occurring with this new H1N1
virus. We don't know whether neurologic problems will be more common
with this virus, but we want clinicians to be on the lookout for that and to
think about testing and treating for influenza in such circumstances.
We know that neurologic problems like seizures are very concerning for
parents and we want them to have this conversation that that is one more
thing to be on the lookout for in conjunction with influenza. And
another reason that we're taking this new H1N1 virus so seriously, in terms
of what we're working on and the things that we're busy preparing for,
there's a lot of work going on at CDC, HHS and across the government to be
ready for the fall.
All of this info was provided at a CDC press conference, which also had a little question and answer session. Following are a couple of the questions and answers.
Miriam Falco: Hi. Dr. Schuchat, thanks for taking the questions.
Would you say that, especially given the information we got from NOWR on the
neurological problems, would you still characterize this strain of flu being
mild, causing mild and moderate illness, or is it more severe than that?
Anne Schuchat: I don't like to use the word "mild" for the new H1N1
influenza virus. I actually think this is a virus that's capable of
causing a spectrum of illness that includes severe complications and
death. Each person is different and each person experiencing this virus
has a slightly different scenario. We've seen people with high fever and
cough and respiratory illness and really not able to do much more than four or
five days. Then we've seen people who have difficulty breathing, severe
respiratory failure and need to be in intensive care unit for weeks. So I
think there's really a spectrum. The neurologic features that we heard
about in the NOWR yesterday are just the reminder of the many ways influenza can
cause disease. Of course this new strain of influenza is causing some of
the complex presentations as well, encephalitis, high fever and seizure.
So I think, you know, it's very important we take this virus seriously.
Maggie Fox: Hi, Dr. Schuchat. I'm sorry to ask you to do this because
you say you don't like to say how many but the million number is getting kind of
old at this point. We're trying to explain to people all around the world
how many might truly be affected so we can get away from the count thing.
Is there a better estimate how widespread this is likely to be, given that we
have 500,000 deaths every year from seasonal flu which suggests many tens of
millions are affected.
Anne Schuchat: For The United States for
seasonal flu we have about 36,000 deaths and about 200,000
hospitalizations. And we think that millions and millions of people are
affected. Probably 20 million or more people are infected every year with
seasonal influenza viruses. What I can tell you that we know right now is
that in communities where this particular virus has circulated, we saw community
attack rates of 6% to 8%. But this virus didn't circulate everywhere this
past spring. We had the 6% to 8% attack rate just during the spring
months. So we think in a longer winter season, attack rates would probably
reach higher levels than that, that we would see quite a bit more than
that. Maybe more two or three times as high as that. So I think that
when people are trying to really get their arms around just how bad this will
be, what I like to say is that we need to be ready for it to be
challenging. We have lots of ways that we can limit the impact that it
has, but it's going to take us working together. We know that our
emergency rooms are often crowded in the regular year, and particularly in the
winter season they can be crowded. This particular virus might crowd the
emergency department season more. So one of our goals is to work with the
medical community and the population to help people know when you don't really
need to go to the emergency department and when you do so we can free those up
for the most relevant cases, the cases that really need management there.
And so unfortunately with influenza we just can't put numbers down to
this. I suspect years after next year we'll have a good idea exactly how
large the impact was and how much we prevented through the efforts that we work.
Get your vaccine people, this is going to get ugly. If you are a diabetic, as much as I hate to say this, go and get your shot. You will be glad that you did.
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