H1N1 (Swine Flu) What Does it Mean This Winter?

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ECDC_logoThe European Centre for Disease Prevention and Control recently surveyed H1N1 (Swine Flu) epidemiological 2009 data for 28 countries, finding that 51% of all deaths have been among people aged 20-49 years, and only 12% were among people over 60 years of age.

This is striking, as it is a near-perfect reverse of normal flu trends, and mirrors what was seen, demographically, in 1918. While the  President’s Council of Advisors on Science and Technology have tried to factor in such trends, it is extremely difficult to know how influenza dynamics, illnesses and death rates may vary if transmission and illness is primarily among young adults.

Officials with the Centers for Disease Control and Prevention have already signaled quiet dispute, insisting to reporters this week that the numbers of hospitalized and dead will be far smaller that the White House reckons, possibly well below seasonal normal flu levels.

A French study of infection and death due to H1N1 in New Caledonia and Mauritius offers stark contrast to the CDC’s optimism. Based on careful assessment of 30,000 reported infections in New Caledonia, and 70,000 in Mauritius, the French find that Acute Respiratory Distress Syndrome (ARDS) occurs far more commonly with the “swine flu” than normal seasonal influenza.

Moreover, the researchers conclude that, “lethality due to H1N1pdm to be 1 per 10,000 infections, about 100 times more than regular seasonal influenza.” The researchers acknowledged that most of these ARDS cases and deaths were due to secondary bacterial infections, but warned that such profound lethality could be the norm for H1N1 in poor countries.

Further data can be collected from the Public Library of Science data base.

Comment:

The natural progression of seasonal influenza, in terms of increased numbers will likely start in Sept, with a potential peak occurring from Oct forward. The current vaccination programmes may miss this timing as it takes 2-4 weeks post vaccination to obtain adequate immunity. Prevention and reduction of risk remain key factors in the management of risk of contagion. These areas have already been explored in earlier news releases.

The use of Vit D as a prophylactic is gaining support from international scientific laboratories, with Canada already running experiments. The risk to benefit of the mucosal optimisation programme makes compelling justifications on application. The use of effective viral exclusuionary masks will also add a powerful prevention component.

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