Posts Tagged ‘death rate’

The H1N1 Pandemic: Is a Second Wave Possible?

The H1N1 Pandemic: Is a Second Wave Possible?

Since early November, cases of H1N1 have continued to decline nationwide, and scientists keeping track of the numbers say that as pandemics go, 2009 H1N1 may turn out to be a mild one — at least for the time being.

The question now on health officials’ minds is: Will there be a second wave of cases in the new year? The answer depends on whom you ask. "We took an informal poll of about a dozen of some of the world’s leading experts in influenza," Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention (CDC), told reporters recently. "About half of them said, Yes, we think it’s likely that we’ll have another surge in cases. About half said, No, we think it’s not likely. And one said, Flip a coin."

It is an accurate reflection of how unpredictable the influenza virus can be. Although flu activity has been waning for the third week in a row, health officials warn that there are still four to five months left in the official influenza season, plenty of time for the virus to make its rounds and find new hosts. "The story of pandemics, and the story of H1N1 in general, is the story of persistent uncertainty where we never quite know what we are going to get or when," says Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at the Columbia University Mailman School of Public Health.

How severe the current H1N1 pandemic seems depends on what you use as a measuring stick. Compared with previous pandemics, like the 1918 Spanish flu, which killed 20 million people and infected up to 40% of the world’s population, or even the far less deadly 1957 and 1968 bouts with a strain of H1N1 influenza similar to the 2009 strain, things don’t seem as bad this time around. Fewer people are getting severely ill when infected, and fewer have died or required hospitalization from the flu than in previous pandemics.

Marc Lipsitch, an epidemiologist at the Harvard School of Public Health, and his colleagues studied the course of the 2009 H1N1 pandemic last spring in two cities — New York and Minneapolis — and determined that 0.048% of people who developed symptoms of H1N1 died, and 1.44% required hospitalization. Based…
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H1N1 Flu Perspective

H1N1 Flu Perspective

By Ilene at Phil’s Stock World

Below are excerpts from a number of articles regarding the H1N1 flu pandemic in the Ukraine and the Norway mutation.  The "Norway" mutation was found in three cases in Norway, and throughout other countries as well. Due to its ability to bind to receptors deeper in the respiratory tract, it is speculated that it may confer greater virulence to the H1N1 virus.  It has not been proven to be spreading wildly throughout the Ukraine and other regions – it may be endemic however, as part of the mixture of circulating flu.  More research needs to be done to learn the extensiveness, communicability of, and significance of this form of the H1N1 virus.

First, for perspective, here’s a entry in Wikipedia about deaths in the 1918 flu pandemic:

The global mortality rate from the 1918/1919 pandemic is not known, but it is estimated that 10% to 20% of those who were infected died. With about a third of the world population infected, this case-fatality ratio means that 3% to 6% of the entire global population died. Influenza may have killed as many as 25 million in its first 25 weeks. Older estimates say it killed 40–50 million people while current estimates say 50—100 million people worldwide were killed. This pandemic has been described as "the greatest medical holocaust in history" and may have killed more people than the Black Death.

As many as 17 million died in India, about 5% of India’s population at the time. In Japan, 23 million people were affected, and 390,000 died. In the U.S., about 28% of the population suffered, and 500,000 to 675,000 died. In Britain as many as 250,000 died; in France more than 400,000.[18] In Canada approximately 50,000 died. Entire villages perished in Alaska and southern Africa.[which?] Tafari Makonnen (the future Haile Selassie) was one of the first Ethiopians who contracted influenza but survived, although many of his subjects did not; estimates for the fatalities in the capital city, Addis Ababa, range from 5,000 to 10,000, with some experts opining that the number was even higher, while in British Somaliland one official there estimated that 7% of the native population died from influenza. In Dutch East Indies (now Indonesia), around 1.5 million assumed died from 30 million inhabitants. In Australia an estimated 12,000 people died and in the Fiji Islands, 14% of the population died during only two weeks,


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Swine Flu News

Swine Flu News

By Ilene

The good news is that the number of new cases appears to be dropping off in most of the United States. More good news is that the swine flu vaccine appears to be reasonably safe, with no increases in serious events, including death, above the expected baseline rate. The not-so-good news is that a currently noted "peak," in flu language, is temporary. Additional waves of increasing illness are expected.  Other bad news is that pediatric deaths from the swine flu are already considerably higher than in seasonal flues, and the numbers are expected to continue rising. In addition, viruses with specific mutations, D222G or D225G, and a mutation resulting in tamiflu resistance, are being isolated from cases in multiple locations. 

Estimated Statistics:

Update from the CDC, Weekly 2009 H1N1 Flu Media Briefing, Anne Schuchat, director of vaccination and respiratory disease at the C.D.C

these estimates will give a single number and then a range, a lower and upper estimate around each number….  So for April through October 17th, we estimate the 22 million people have become ill from pandemic influenza.  We estimate 98,000 people have been hospitalized so far through October 17th.  And the upper and lower estimates on hospitalizations are from 63,000 to 153,000. We estimate that 3,900 people have died so far in the first six months of the pandemic from this virus.  And the estimates there are from 2,500 up through 6,100 people having died so far.  We’ve been talking a lot about this pandemic being a younger person’s disease, that it’s disproportionately affecting children and young adults and relatively sparing the elderly, very different from seasonal flu… [In] children under 18, we estimate 8 million children have been ill with influenza, 36,000 hospitalized, and 540 children have died…

I do believe that the pediatric death toll from this pandemic will be extensive and much greater than what we see with seasonal flu…The numbers I’m giving are through the first six months through October. We have had a lot of disease since then and we’ll probably have a lot of disease going forward…

What does this look like compared to previous pandemics.  The estimates I’m giving you are the first six months.  This is April through the middle of October.  We have a long flu season ahead of us.  In typical seasonal flu we see disease from


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Double-Edged Sword: Swine Flu and Vaccines

By guest author Terry Doherty and Ilene, your editor

Terry Doherty is the Research Program Coordinator in the Depts of Biomedical Sciences and Academic Affairs at Cedar Sinai in Los Angeles, California.

Double-Edged Sword: Swine Flu and Vaccines

There’s plenty that is unknown about the swine flu and the swine flu vaccine.  If searches on the internet are any indication, deciding whether or not to be vaccinated may be a tough, emotionally charged decision for many people.  So how – without having the background to write a swine flu grant proposal, conduct the research, and get the thing published in the New England Journal of Medicine – do we decide whether or not to get a swine flu shot?  

One way is to attempt to evaluate and weigh the risks of the vaccine against the risks of the flu.  That is how I approach the subject, but it’s easier said than done.  As is often the case with medical interventions, the risks are not fully known. And even if we could carefully assess the risks, our underlying assumptions may be wrong.  Percent risks are averages collected by studying large populations.  We may not be one of the statistical average.  Then there are the gaps in the available data, and own biases and belief systems.  Our view of the world affects our analysis and often we are not even aware of how large of an effect those biases may play.   

In Vaccine War: Autism, Flu and Science, TIME, Maia Szalavitz discusses how emotion and biases play a large part in our risk-benefit assessments:

Just in time for the national roll-out of the new H1N1 flu vaccine, Wired Magazine and the Atlantic have weighed in on the ongoing vaccine war: Wired has a profile of Paul Offit, a vaccine researcher and pediatrician who has consistently spoken out in favor of vaccination and pointed to the lack of evidence linking vaccines and autism; the Atlantic checks in with a piece questioning the science suggesting that flu vaccines and antiviral drugs prevent people from dying.

Both articles have elicited heated debate all over the Web: Amy Wallace, who wrote Wired’s piece, excerpted below, has received vitriolic criticism and attacks from vaccine opponents, setting records for page views…

This debate over vaccination doesn’t seem likely to end any time soon. For critics, vaccines…
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Swine Flu Chart

I found this at Barry Ritholtz’s The Big Picture’s "H1N1 (swine flu) Fatality Rates: Overreaction?" and had a few comments:

1.  The chart compares death rates in persons infected (or known to be infected) with various pathogens. The total numbers of people who are or will be infected with these diseases are different.  For example, in the U.S., the percentage of people infected with HIV is much smaller than the percentage of people who contract the flu each year; i.e., the chart shows the death rate per infected person, not death rate per person in the population.

2. The death rate reflects virulence, but is not a measure of transmissibility – or contagiousness.

3. The course of the swine flu hasn’t played out yet, so we don’t know what’s in store.  Hence, to answer the question, "overreaction?" – perhaps "we’ll see" is the best answer. – Ilene

flu chart

A couple more swine flu vaccines stories:  here and here.

 


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U.S., Other Nations Stop Counting Flu Cases

Looking for detailed statistics on the prevalence and death rate for swine flu? Forget it. – Ilene

U.S., Other Nations Stop Counting Flu Cases

swine fluBy AP / MIKE STOBBE, courtesy of TIME

(ATLANTA) — U.S. health officials have lost track of how many illnesses and deaths have been caused by the first global flu epidemic in 40 years.

And they did it on purpose.

Government doctors stopped counting swine flu cases in July, when they estimated more than 1 million were infected in this country. The number of deaths has been sitting at more than 600 since early September.

Other nations have stopped relying on lab-confirmed cases, too, and health officials say the current monitoring system is adequate. But not having specific, accurate counts of swine flu means the government doesn’t have a clear picture of how hard the infection is hitting some groups of people, said Andrew Pekosz, a flu expert at Johns Hopkins University.

The novel H1N1 flu seems to be more dangerous for children, young adults, pregnant women and even the obese, according to studies based on small numbers of patients. But exactly how much more at risk those people are is hard to gauge if the overall numbers are fuzzy.

"This wasn’t as critical early on, when case numbers were low," said Pekosz. But now, it’s hard to say exactly how swine flu’s dangers vary from group to group, he said.

The Centers for Disease Control and Prevention is relying on a patchwork system of gathering death and hospitalization numbers. Some states are reporting lab-confirmed cases. Others report illnesses that could be the new swine flu, seasonal flu or some other respiratory disease.

Some say that’s a more sensible approach than only counting lab-confirmed cases. Many people who got sick never get tested, so the tally of swine flu cases was off almost from the very beginning, they say.

"It was a vast underestimate," said Dr. Zack Moore, a respiratory disease expert for the North Carolina Department of Health and Human Services.

What’s more, as the initial panic of the new virus ebbed, fewer people were fully tested, so the results weren’t as accurate or comprehensive. "The kinds of numbers you were getting later in the summer were different from the numbers early on," said Dr. Daniel Jernigan, deputy director of the CDC’s influenza division.

That’s why the CDC shifted…
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