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Swine Flu is being under-reported because the milder cases aren't driving people to the emergency room.|
Hits the young harder than the old, so outbreaks are seen in schools, not nursing homes.
Hospitals report that flu cases equal peak season numbers, when they should be almost zero.
Areas most active now are the Pacific Northwest of America and the USA-Mexico border.
Swine flu should eventually become a new but average, seasonal flu strain.
May 16, 2009
Mild U.S. Flu Cases May Exceed Official Tally
By DONALD G. McNEIL Jr.
The real number of swine flu cases in the United States could be “upwards of 100,000,” a top public health official estimated on Friday — far higher than the official count of 7,415 cases confirmed by laboratories.
The official, Dr. Daniel Jernigan, head of flu epidemiology for the Centers for Disease Control and Prevention, said at a news conference that the official number gave an inaccurate picture of the outbreak because so few mildly sick people were being tested.
He added that flu was more prevalent than usual, “something we would not normally expect at this time of year.” But he emphasized that most cases were mild. There have been 173 hospitalizations and 5 deaths reported to the agency.
The latest death, added Friday, was that of a 33-year-old man in Corpus Christi, Tex. The Associated Press reported that he died May 6 of viral pneumonia and had several health problems, including morbid obesity, an enlarged heart and an underactive thyroid.
At the same news conference, another C.D.C. official announced that the agency planned to lower its alert on travel to Mexico soon. Mexico’s outbreak has not proved as dangerous as it originally seemed.
The agency will no longer suggest that Americans avoid nonessential travel, said Dr. Martin S. Cetron, its director of global migration and quarantine. Instead, it will suggest that anyone with underlying conditions that might make the flu more severe consult a doctor before traveling. Those conditions, previous reports suggest, include pregnancy, asthma, diabetes or cardiovascular disease.
The shifting case figures show how different a new flu can be from a typical seasonal one. Seasonal flu is estimated to kill 36,000 Americans a year, usually as the last blow for the aged and infirm, and outbreaks in nursing homes are the norm. This year’s swine flu is concentrated in those ages 5 to 24, Dr. Jernigan said, and school outbreaks like those under way in New York and Houston are the norm.
New pandemic flu often mutates to become the milder seasonal flu; the seasonal H1N1 is a distant descendant of the 1918 Spanish flu, and the seasonal H3N2 is related to the H3N2 of the Hong Kong flu pandemic of 1968.
The agency has a network of 4,500 emergency rooms, clinics and doctors who report weekly how many patients with flu symptoms they see. Normally, Dr. Jernigan said, their counts would now be dropping toward zero as the flu season ends; instead, some are reporting numbers they see at the season’s peak.
Flu prevalence varies around the country, he said, but has been heaviest in the Pacific Northwest and in the Southwest, along the Mexican border.
Also on Friday, GlaxoSmithKline became the first company to announce plans to make a vaccine against the new strain of swine flu.
The World Health Organization has not yet made a recommendation on whether to go ahead with a new vaccine, but the company said it already had orders for 128 million doses from Britain, France, Belgium and Finland, roughly enough for the populations of all four countries if a single dose turns out to be protective. It will also donate 50 million doses to the World Health Organization for poor countries, the company said.
Glaxo and its customers are essentially betting that the virus will not mutate so far that the vaccine will not protect against the strain circulating when it is ready. That should be in four to six months after it gets viral “seed stock” from the C.D.C.
Glaxo will add an adjuvant, a chemical compound that jolts the immune system into a stronger reaction than the seed stock virus alone does. Glaxo said it would not have to interrupt its run of seasonal flu vaccine, which is scheduled to finish in July.
http://www.nytimes.com/2009/05/1 ... mp;pagewanted=print