UK: 607 confirmed fatalities due to influenza

[tetano]

Re: UK: 254 confirmed fatalities due to influenza

Pregnant woman hit by swine flu fighting for life

A PREGNANT woman was today fighting for her life after contracting swine flu, the Evening Express can reveal.

The woman, who is understood to be several months into her pregnancy, has the potentially-lethal H1N1 strain of the swine flu virus.

The mum-to-be is being treated with one of two life-saving ECMO (extracorporeal membrane oxygenation) machines in Aberdeen Royal Infirmary?s intensive care unit.

Read more: http://www.eveningexpress.co.uk/Arti...#ixzz1Bl8Vdr1u

[SusanC]

Re: UK: 254 confirmed fatalities due to influenza

Total deaths (England and Wales) from all causes has now been running at 669 deaths per week above the 5 year average over the last 5 weeks. That's 6.4% above the 5 year average.

See http://www.statistics.gov.uk/StatBas...eets/D6157.xls



And http://www.hpa.org.uk/web/HPAweb&HPA.../1287147913271

The excess mortality data need to be interpreted in the context of the flu season, which causes a peak of mortality every year. You can find more useful chart on pages 46-47 in this link http://www.hpa.org.uk/webc/HPAwebFil.../1284475036543

(would appreciate if someone will post those charts, thanks!! )

Also the RCGP ILI charts do show the peak reached on week 51, ie the drop around xmas and new year was probably real, and not just due to reduced number of consultation days.

[Hogweed]

Re: UK: 254 confirmed fatalities due to influenza

Susan,

I'm not sure what you mean when you say they have to be interpreted in context of the flu season as the figures I quoted are directly from government figures and show the deaths in Weeks 49-1 of current season compared to the same weeks averaged over the last five years. Therefore they automatically take the seasonality into account.

I agree the deaths have hopefully peaked as the wave subsides though. If you take the spike down week (52) then total deaths were 9689. The 5 year average for week 52 is 8825. So even that spike down was still 864 deaths more than would be expected based on the last 5 years.

If what you are saying is that compared to a really bad flu season it's still not too bad then I agree. But the only winter in the last 10+ years that has had a significantly higher death spike in weeks 49-1 is 1999/2000 with 2008/2009 about equal and both of these were also due to flu. I Note that the chart you refer to (below) is not a chart of just the most recent years as it includes 1999/2000 (a very bad year) for context.




Excess winter deaths, England and Wales, 1999/2000?2009/2010

Here's a report from December 2008 for some more context

http://www.guardian.co.uk/society/2008/dec/24/health-flu-outbreak

Flu outbreak is worst for eight years

* Sarah Boseley, health editor
* The Guardian, Wednesday 24 December 2008
* Article history

Britain is in the grip of a flu outbreak greater than anything seen in the last eight years, with soaring numbers of people falling ill, new figures show.

The last big flu outbreak occurred in 1999/2000, when 22,000 people died, which is 10 times the average for a winter flu season.

So all I was really pointing out in my post was that the current wave is likely showing up in deaths from all causes just as it did in 1999/2000 and 2008/2009. What continues to be unusual is that most of the reported deaths in the UK recent outbreak are in the under 65s and many previously fit and healthy people have died - which gets noticed more of course.

[SusanC]

Re: UK: 254 confirmed fatalities due to influenza

What I meant was that the chart you were showing before uses a 'prediction' curve with rather shallow slopes, whereas when you look at actual excess deaths charts, almost every flu season, the spike during the flu season is more acute than the prediction curve. Which makes this chart (that you are showing now) more useful as a visual reference than the previous one. That's all I'm saying.

Sorry to be brief, not able to type for any length of time without putting all my rehab efforts out.

Thanks.

[SusanC]

Re: UK: 254 confirmed fatalities due to influenza

However, the deaths may or may not have peaked yet. I'd wait a couple more weeks to be able to see that properly.

[cartski]

Re: UK: 254 confirmed fatalities due to influenza

However, the deaths may or may not have peaked yet. I'd wait a couple more weeks to be able to see that properly.

Sorry, but remind me again why there would be a decline at all?

Yes, I know its morbid. But why would the virus burn itself out, and not just keep infecting over time? Why should we expect a peak in an outbreak at all?

Surely any personal transmission safeguards were well in place before the out break began after last year's scare. And antivirals are not that effective.

While examining the peaks is interesting, isn't there a lot of observations to be made from the full distributions as they change from season to season?

J.

[SusanC]

Re: UK: 254 confirmed fatalities due to influenza

Sorry, but remind me again why there would be a decline at all?

Yes, I know its morbid. But why would the virus burn itself out, and not just keep infecting over time? Why should we expect a peak in an outbreak at all?

Surely any personal transmission safeguards were well in place before the out break began after last year's scare. And antivirals are not that effective.

While examining the peaks is interesting, isn't there a lot of observations to be made from the full distributions as they change from season to season?

J.

The precise mechanisms for 'waves' (whether in pandemic or seasonal flu) are not fully understood. It's likely to be a combination of number of susceptible subjects declining over time, plus weather-related factors.

As for personal transmission safeguards, I'd say on a population level, the effect is minimal (ie the vast majority of the public have not taken any precautions). There may be localized effects eg in institutions, if stringent safeguards were present, but overall, I'd not expect any such effects to show up at the population level.

Don't know what you mean by 'full distribution'. The ILI charts, for example, will show the full trends year-round, from season to season. And they do show, quite clearly, that flu outbreaks tend to cause waves that peak and then subside to a low level in 'off' seasons

[SusanC]

Re: UK: 254 confirmed fatalities due to influenza

Note that the seasonal pattern is more distinct in temperate than in tropical climates.

Here's some food for thoughts, for those interested. http://www.newfluwiki2.com/showDiary.do?diaryId=2390

[sharon sanders]

Re: UK: 254 confirmed fatalities due to influenza

Thanks SusanC, very informative but I think the books on virology and genetics are being re-written as we learn more about the pandemic process.

[cartski]

Re: UK: 254 confirmed fatalities due to influenza

The precise mechanisms for 'waves' (whether in pandemic or seasonal flu) are not fully understood. It's likely to be a combination of number of susceptible subjects declining over time, plus weather-related factors.

Don't know what you mean by 'full distribution'. The ILI charts, for example, will show the full trends year-round, from season to season. And they do show, quite clearly, that flu outbreaks tend to cause waves that peak and then subside to a low level in 'off' seasons

What I meant was that the chart from the Guardian posted by Hogweed about the peak of deaths was not as informative as the ILI charts you mentioned (pages 46 and 47 in the HPA document). The mean, median and mode are changing from season to season, changing the skew of the distributions. So the rapid rise and fall of 99/00 seems differnt than the rapid rise but slower fall in 08/09 and 09/10. I just wondered why the peaks weren't even flatter - why is there a decline at all.

I guess the papers about genetic diversity and bottlenecks go to susceptability, in lay person's terms. As the virus' genetic diversity declines at the end of the season, people are less susceptable to the virus; hence, the ILI charts show a similar decline in deaths. Something like that?

Very difficult stuff for lay persons, I think.

J.

[SusanC]

Re: UK: 254 confirmed fatalities due to influenza

I guess the papers about genetic diversity and bottlenecks go to susceptability, in lay person's terms. As the virus' genetic diversity declines at the end of the season, people are less susceptable to the virus; hence, the ILI charts show a similar decline in deaths. Something like that?

J.

It could also work the other way round - as virus fitness declines, for whatever reason eg weather, less people are infected and thus some of the circulating strains die off through failure to transmit continuously.

[tetano]

Re: UK: 254 confirmed fatalities due to influenza

A MUM-to-be was fighting for life in hospital

The woman is thought to be several months into her pregnancy and has the potentially deadly H1N1 strain of the virus.

She was admitted to Aberdeen Royal Infirmary and has been hooked up to a special ECMO machine to help her beat the illness.

It is understood doctors are poised to deliver the unborn baby in a bid to save it if the patient's condition deteriorates.

Infections expert Hugh Pennington said: "It is very serious. Once you get to the stage where ECMO machines are involved it's high-risk."

Since the start of the flu season 145 people have been treated in intensive care in Scotland and 40 have died.

The majority were suffering from swine flu.

Read more: http://www.thesun.co.uk/scotsol/home...#ixzz1C1q3DyLP

[Hogweed]

Re: UK: 254 confirmed fatalities due to influenza

However, the deaths may or may not have peaked yet. I'd wait a couple more weeks to be able to see that properly.

Total deaths from all causes for Week 2 have now been posted.

Total Deaths Week 2: 13,133
Average Week 2 deaths last 5 years: 12,540
Week 2 deaths at 593 above 5 year average (4.7&#37.

Week 1 deaths were 12,644 so we have increased by 489.

Although the figures are out updated graphs from the weekly Influenza report won't be available for a couple of days yet.

Details at http://www.statistics.gov.uk/StatBas...eets/D6157.xls

[sharon sanders]

Re: UK: 254 confirmed fatalities due to influenza

Thanks Hogweed.

"Week 2 deaths at 593 above 5 year average (4.7%)."

[cartski]

Re: UK: 254 confirmed fatalities due to influenza

Total deaths from all causes for Week 2 have now been posted.

Total Deaths Week 2: 13,133
Average Week 2 deaths last 5 years: 12,540
Week 2 deaths at 593 above 5 year average (4.7%).

Week 1 deaths were 12,644 so we have increased by 489.

Although the figures are out updated graphs from the weekly Influenza report won't be available for a couple of days yet.

Details at http://www.statistics.gov.uk/StatBas...eets/D6157.xls

Of the very many things I don't understand, one is why the calendar date is important for outbreak analysis. It's convenient, for an administration, of course, but is it really informative to correlate the severity of an outbreak with the calendar date?

Knowing that there's been a 489/12644=3.87% increase over 7 days tells us that, contrary to some reports, the situation is still worsening.

However, I'm not sure what it tells us when the comparison is to the prior year or average of the prior year in the same week number. Perhaps the comparison should be from the outset of the outbreak and the epi curves shifted over to align for comparison among different seasons, or correlated with an index of local weather if that's a major determinant of the virus' genetic "fitness".

I wonder if there's a gapminder app for outbreak analysis.

J.