Latest Update on H1N1 Swine Flu

The number of swine flu cases has decreased in the United States during the summer months as one would expect with flu outbreaks. For some reason, however, swine flu cases have been widespread in the states of Georgia and Alaska, despite the fact that this it is summer and not the typical period when one would expect a high number of flu cases. As of August 27, 2009, the CDC reports that since the outbreak of the H1N1 swine flu in the spring, there have been confirmed cases of 8,843 hospitalizations and 556 deaths in the United States.

Most Recent Update on the H1N1 Swine Flu From the White House

On Tuesday, August 11, 2009, Dr. Richard Hatchett, White House Medical Preparedness Policy Director, spoke at a conference in Arlington, Virginia about the H1N1 swine flu epidemic. As background, he explained that the H1N1 flu has been in the U.S. for the last 30 years - but that the current strain of H1N1 swine flu is significantly different than previously existing strains. He also described how the U.S. has experienced three prior flu pandemics - the most famous being the 1918 flu epidemic, but with another occurring in 1957 and another in the mid-1960's. What we should learn from these previous flu pandemics, according to Dr. Hatchett, is that such pandemics are inevitably multi-year events with the flu increasing in the fall and spring, diminishing during the summer, and then typically returning the next fall and spring - with this continuing for two or more years. For this reason, he emphasized that the development of a vaccine for the H1N1 swine flu is important even if it is not available when the flu returns in the fall. According to Dr. Hatchett, best estimates are that thus far since the H1N1 swine flu appeared this past April, somewhere between 1.5 to 10 million people in the U.S. have been infected with the swine flu (i.e. significantly more than the actual confirmed cases). He also estimates that thus far there have been 436 deaths thus far in the U.S. Because of the wide variation on estimates of the number of people that have been infected with the swine flu, it is impossible at this point to estimate how virulent the current case of the H1N1 swine flu is in terms of mortality rate. What is exceptional about the current pandemic of the H1N1 swine flu, however, is how 50 percent of cases have been in people between age 5 and 24, with the age 25 to 49 having the next highest rate of cases. Also, 60 percent of the hospitalizations have been of young people in the 5 to 24 age group. This is in contrast with the normal flu where the highest incidence of illness is in the age 4 or younger or age 65 or older age groups. Also, normal strains of the flu infect approximately 5 percent of the population over a flu season. In a little over a month in the spring, however, it is estimated that 10 percent of the population of New York City became infected with the swine flu. Thus it is possible that the H1N1 will eventually affect a signficantly greater portion of the population than the normal flu. Coupled with the fact that the H1N1 swine flu also dramatically affects the young at a greater rate than the normal flu, this raises grave concerns about the eventual impacts of the H1N1 swine flu. Currently, the highest "intensity" of the H1N1 swine flu has been in Argentina and Chile in the southern hemisphere where they are currently in the peak of their flu season (i.e. where it is currently in the middle of their winter). Next in "intensity" have been the experiences thus far of Mexico and Canada. While the United States has a signficantly highest "intensity" of the pandemic thus far than most countries, it still has experienced a mild intensity compared with Argentina, Chile, Mexico and Canada. Thus far the H1N1 swine flu pandemic has hit the western hemisphere the hardest, with the exception of Great Britain which has also been hard hit by the swine flu. In summary, flu pandemics have caused a significant number of deaths and social disruption in the past, and there is no reason to believe that the current H1N1 swine flu pandemic will not have a similar affect as demonstrated by the experience of countries like Argentina in the southern hemisphere currently and by Mexico, Canada, and the U.S. this past spring. If the current H1N1 swine flu pandemic is like past flu pandemics, it will be a multi-year challenge for our society to respond to with the greatest challenge for the U.S. still to come this coming fall and spring flu seasons, and possibly during the flu seasons of the following year as well. What could mitigate the impact of the current H1N1 swine flu pandemic, however, is how quickly we can develop and distribute an effective vaccine.

The Front Page of the Washington Post Had A Story Today About the Return of the Swine Flu This Fall

According to the Washington Post dated August 10, there were 19,273 reported cases of the swine flu for the period April 24 thru June 3, then an additional 70,648 reported cases from the period from June 4 to July 3, and then an additional 72,459 reported cases from the period from July 4 to August 4. This demonstrates that despite the fact that the swine flu seems to have retreated from the public's consciousness, actually the number of swine flu cases has steadily increased each month. Countries with the largest number of deaths are the United States, Canada, Mexico and Britain in the Northern Hemisphere. As the swine flu has now spread to the Southern Hemisphere, a large number of deaths from the swine flu have also been reported in Argentina, Chile, Paraguay, and Australia. According to the Washington Post, a new round of the swine flu "could hit the Northern Hemisphere within weeks and lead to major disruptions in schools, workplaces and hospitals, according to U.S. and International health officials. 'The virus is still around and ready to explode,' said William Schaffner, an influenza expert at the Vanderbilt University School of Medicine. 'We're potentially looking at a very big mess.' "

5 Congressional Pages Have Developed the Swine Flu

Today it was announced that 5 Congressional pages have been determined to have the swine flu. To prevent further spreading, the remaining Congressional pages have been quarantined. This reminds us what health officials have been telling us - which is that the swine flu epidemic is not over and that, in fact, we should expect increased cases and more severe cases and deaths from the H1N1 swine flu than we have experienced thus far. In summary, we have a long road to go in dealing with the swine flu and the worst is still likely to occur with the flu season this coming fall. It is also possible that the H1N1 swine flu break will last more than one year. As Bob Woodrow of the Washington Post has commented, the H1N1 swine flu outbreak is still very possible to become the biggest news story of this year.

What is Different About the H1N1 Swine Flu From the Regular Flu

From what we presently know about the H1N1 swine flu, it does not seem to be more deadly than the regular flu. This is not necessary cause for relief, however, as already approximately half of the states report deaths from the swine flu - and a large number of deaths annually occur from the normal flu. What is different about the H1N1 swine flu, however, is how teens and young adults seem to be more susceptible to severe cases and even death than infants or the elderly as is the case with the normal flu strains. In this way, the H1N1 swine flu is more like the 1918 world-wide influenza that killed approximately 100 million people than normal seasonal flu outbreaks. Also, like the 1918 influenza, the current H1N1 swine flu is spreading very rapidly during the summer months - i.e. during what is normally a period of drop off of the spread of normal flu. This could mean that the swine flu this fall is likely to be much more severe than what has occurred thus far.

Will the Swine Flu Vaccine Be Available In Time for the Fall?

A potential vaccine for the swine flu is presently being tested for safety and efficacy. The problem is that it would then need to be manufactured and administered in huge quantities by September. The reason for the September deadline is because, even after being given a flu vaccine, it takes 6-8 weeks for the body to build up its immune system to fight the flu after being given the vaccine. Since the peak flu season is typically from November to January, one can count backwards and figure out that the flu vaccine needs to be administered by September.

Denmark Has Reported First Case of Swine Flu Resistance to Anti-Viral Drugs Such As Tamiflu

Denmark has reported a case of an individual where the swine flu has shown to have developed a resistance to anti-viral drugs such as Tamiflu. This is a significant program as we approach the fall flu season. Normally in any given flu season, about half of the population has a resistance to whatever is the current flu. This will not be the case where instead, perhaps only three percent or less of the population will have any resistance to the H1N1 swine flu. Even if the swine flu is no more virulent than any other flu outbreak, this would mean that we should expect a larger outbreak of the H1N1 swine flu simply because the population has no natural immunity or resistance to it.