Health Alerts > 5/7/09 - Flu Update
Date: May 7, 2009
Global Updates: World Health Organization phase:
Worldwide, laboratories now have officially reported 2099 cases 1490 human cases of the new swine flu in 23 countries.
No change in WHO pandemic phases of 5
National Updates:
National data (to date) includes:
o U.S. 642 confirmed cases, 43 hospitalized (4% slightly higher than seasonal) 8,000 suspect cases, and two deaths.
o While the large majority of U.S. cases of H1N1 continue to be mild, those who are hospitalized with more severe disease appear to be atypically young, federal health officials said Wednesday.The median age of hospitalized individuals with swine flu is 15, which is younger than occurs with regular seasonal flu, Dr. Richard Besser, acting director of the U.S. Centers for Disease Control and Prevention, said during an afternoon news conference. We are seeing the same distribution in hospitalized patients as we are in milder cases in the community, and that’s younger than what you would see in seasonal flu,” Besser said. “In seasonal flu you tend to see a predominance of burden of disease in the elderly and in the very young, and here we are seeing it more in the younger population.”
“That is something we are keeping our eye on. That is something that raises concern,” he added. Overall, the age spread for hospitalized patients ranges from 8 months to 53 years of age, Besser said. Why the more severe cases are skewing young remains unclear, he said, but it could be that younger people are getting sicker sooner, or older people may have some kind of built-in immunity. In any case, the U.S. outbreak of H1N1 swine flu is continuing and, although most cases are still mild, more deaths are expected, Besser said. “We remain concerned,” he said. “We are seeing continued spread around the country. We are seeing increases in numbers of patients.” The death earlier this week of a woman in Texas, the first U.S. resident to die from the swine flu, “reminds us that influenza can be a very serious infection, and it’s one we need to continue to take very seriously,” Besser added.
CDC has issued new guidance on Antivirals: (http://cdc.gov/h1n1flu/recommendations.htm) This guidance can be adapted according to local epidemiologic data and antiviral supply considerations.
High-risk groups: A person who is at high-risk for complications of novel influenza (H1N1) virus infection is defined as the same for seasonal influenza at this time. As more epidemiologic and clinical data become available, these risk groups might be revised.
o Children younger than 5 years old. The risk for severe complications from seasonal influenza is highest among children younger than 2 years old.
o Adults 65 years of age and older. Persons with the following conditions:
¨ Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), neurologic, neuromuscular, or metabolic disorders (including diabetes mellitus);
¨ Immunosuppression, including that caused by medications or by HIV;
¨ Pregnant women;
¨ Persons younger than 19 years of age who are receiving long-term aspirin therapy;
¨ Residents of nursing homes and other chronic-care facilities.
State/Local
No new cases as of now in Allen County, Indiana has 28 confirmed cases – 14 in Marion County and 7 in Lake county.
Dr. Buchanan has passed on the following informational sites:
American Family Physician
· Basic Rules of Influenza: How to Combat the H1N1 Influenza (Swine Flu) Virus
· Telephone Triage of Patients with Influenza
By Jonathan L. Temte, MD, PhD, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; AAFP Liaison to the Advisory Committee on Immunization Practices
Family Practice Management
· Preparing Your Office for an Infectious Disease Epidemic
By Charles W. Mackett III, MD, associate professor and executive vice chairman of the Department of Family Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pa.
Please feel free to call with any questions. Deb McMahan, MD
