Update on A (H1N1) Influenza (Swine Influenza) - May 22, 2009

According to the Centers for Disease Control (CDC), as of May 22, 2009 there are 6552 U.S. human cases of A (H1N1) influenza infection, which include 9 deaths.

The state by state breakdown is:

Alabama 66 cases 0 deaths
Arkansas 3 cases 0 deaths
Arizona 520 cases 2 deaths
California 553 cases 0 deaths
Colorado 59 cases 0 deaths
Connecticut 81 cases 0 deaths
Delaware 94 cases 0 deaths
Florida 129 cases 0 deaths
Georgia 27 cases 0 deaths
Hawaii 33 cases 0 deaths
Idaho 18 cases 0 deaths
Illinois 877 cases 0 deaths
Indiana 106 cases 0 deaths
Iowa 71 cases 0 deaths
Kansas 34 cases 0 deaths
Kentucky 22 cases 0 deaths
Louisiana 86 cases 0 deaths
Maine 9 cases 0 deaths
Maryland 41 cases 0 deaths
Massachusetts 197 cases 0 deaths
Michigan 176 cases 0 deaths
Minnesota 39 cases 0 deaths
Mississippi 7 cases 0 deaths
Missouri 24 cases 1 deaths
Montana 10 cases 0 deaths
Nebraska 29 cases 0 deaths
Nevada 32 cases 0 deaths
New Hampshire 23 cases 0 deaths
New Jersey 47 cases 0 deaths
New Mexico 97 cases 0 deaths
New York 327 cases 1 deaths
North Carolina 12 cases 0 deaths
North Dakota 5 cases 0 deaths
Ohio 14 cases 0 deaths
Oklahoma 50 cases 0 deaths
Oregon 101 cases 0 deaths
Pennsylvania 73 cases 0 deaths
Rhode Island 9 cases 0 deaths
South Carolina 36 cases 0 deaths
South Dakota 4 cases 0 deaths
Tennessee 89 cases 0 deaths
Texas 900 cases 3 deaths
Utah 122 cases 1 deaths
Vermont 2 cases 0 deaths
Virginia 25 cases 0 deaths
Washington 494 cases 1 death
Washington, D.C. 13 cases 0 deaths
Wisconsin 766 cases 0 deaths

International human cases of swine flu infection as reported by the World Health Organization (WHO) are:

42 countries have officially reported 11,168 cases of influenza A(H1N1) infection, including 86 deaths.

The breakdown of the number of laboratory-confirmed cases by country is:

Argentina 1
Australia 7
Austria 1
Belgium 5
Brazil 8
Canada 719
Chile 24
China 11
Colombia 12
Costa Rica 20
Cuba 4
Denmark 1
Ecuador 8
El Salvador 6
Finland 2
France 16
Germany 14
Greece 1
Guatemala 4
India 1
Ireland 1
Israel 7
Italy 10
Japan 294
Korea 3
Malaysia 2
Mexico 3892
Netherlands 3
New Zealand 9
Norway 3
Panama 73
Peru 5
Philippines 1
Poland 2
Portugal 1
Spain 113
Sweden 3
Switzerland 1
Thailand 2
Turkey 2
United Kingdom 112
USA 5764
Grand Total 11168

There are many questions about whether or not there will be a vaccine developed against A (H1N1) influenza, and in particular, if it will be ready in time for the upcoming fall "flu season." The U.S. Secretary of Health and Human Services, Kathleen Sebelius, announced today that HHS will take the steps necessary to prepare for potential commercial-scale production of a candidate vaccine. She is directing that approximately one billion dollars be available for clinical studies that will take place over the summer and for commercial-scale production of two potential vaccine ingredients (vaccine antigen and adjuvant) for the pre-pandemic influenza stockpile. These funds will be used to place new orders on existing contracts with companies that hold U.S. licenses for flu vaccines.

From the Center for Biosecurity at the University of Pittsburgh Medical Center, we learn that as the number of affected patients grows, doctors and researchers are beginning to detect patterns reflecting important clinical details about the more severely affected patients. This information is important for clinicians and can also serve to inform policymakers about what scenarios to expect and the resources that are likely to be needed should this pandemic continue to expand.

As of May 17, 2009, 30 patients infected with 2009 influenza A (H1N1) have been hospitalized in California. The Centers for Disease Control and Prevention (CDC) released a report detailing the clinical characteristics of those patients.

For patients admitted to the hospital, pneumonia and dehydration were the most common admission diagnoses. Underlying medical conditions were present in 64% of the patients. These included chronic lung diseases, conditions requiring immunosuppression (e.g., chemotherapy), heart disease, diabetes, and obesity. Common symptoms of influenza were fever, coughing, vomiting, and shortness of breath. Pneumonia was common.

It is interesting to note that diagnosis of influenza was made by rapid antigen testing, viral culture, and direct immunofluorescent antibody tests. Rapid tests were positive in three quarters of persons with influenza and negative in one quarter of persons with influenza. The negative tests are thus considered to be "false negative" tests.

Another interesting finding is that the antiviral therapy of oseltamivir was used in only half of the patients.

Tags: A(H1N1) influenza, S-OIV, influenza, swine flu, flu, swine influenza, wilderness medicine, outdoor medicine, healthline

Labels: A (H1N1) influenza, influenza, swine flu, swine influenza

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