Discussion thread: USA - Texas: H1N1pdm09 December 17, 2013+

Vibrant62 · Dec 22, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

The 1918 virus continued to cause problems until at least 1933.

It would not be surprising if there has been some antigenic drift or similar modifications to pH1N1, and its a nasty virus. This might just be the new 'normal' for the flu season hereafter, and especially when it is the predominant strain.

gsgs · Dec 23, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

Europe hopes for H1 this season ... better than H3
usually one of them "kills" the other - well, last season there were both

Ronan Kelly · Dec 23, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

Flu deaths go unreported
By Lora Hines
December 23, 2013

Even with three recently confirmed deaths, the number of flu-related fatalities in the Houston region this season will remain unknown.

Texas is among many states that only monitor children's flu deaths, following the federal mandate. Health experts say flu is so widespread that it would be impractical and expensive to try to test and report every suspected case or death.

"What would be gained by it?" asked Catherine Troisi, an epidemiologist and assistant professor at the University of Texas School of Public Health in Houston. "People do die from flu-like symptoms because of bacterial infections and underlying conditions. A lot of it isn't diagnosed."

Typically, only small percentage of people seek treatment and testing isn't always performed, so the numbers wouldn't accurately represent the extent of disease, they said.
...
The Centers for Disease Control and Prevention in Atlanta estimates between 3,300 and 49,000 people die annually from flu-like symptoms. State officials estimate Texans make up between 8 and 10 percent of that total.
...
http://www.houstonchronicle.com/news/health/article/Flu-deaths-go-unreported-5086975.php?cmpid=btfpm

morningperson · Dec 23, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

Questions I would love to have answered, but really don't see how they can be: What percentage, if any, of the people who are getting sick from H1N1 have had it before? Did they have it in 2009? If so, are they getting mild cases? Of the people getting H1N1; did any of them receive the vaccine, either this year or in past years?

These questions are not necessarily for the people who are currenty hospitalized with H1N1, but instead for the entire population of patients who are coming down with H1N1.

Perhaps in a few months we will know more...

gsgs · Dec 23, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

> What percentage, sick from H1N1 have had it before? Did they have it in 2009? If so, are they
> getting mild cases?

this is sometimes tested for institutions, nursing homes,schools,military.
It was tested in 1918-1920 (e.g. Vaughn survey in Boston)
You can also compare ILI in cities, whether those who got much
in 2009 get fewer in 2013.
My guesstimate would be that you are maybe 20% less likely to get it in
2013 if you had it in 2009. For being less severe my estimate would be higher,
probability of being hospitalized 40% down if you had it before.
Just my feeling from numbers that I saw.

For the vaccine see Australia, France, US-military, the effectivity studies.
In average vaccination reduces your chance to attend a doctor for ILI
by ~20% for that season, from 5% to 4% or such. (my estimate)
So a 1% reduction.

sharon sanders · Dec 24, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

morningperson said:
Questions I would love to have answered, but really don't see how they can be: What percentage, if any, of the people who are getting sick from H1N1 have had it before? Did they have it in 2009? If so, are they getting mild cases? Of the people getting H1N1; did any of them receive the vaccine, either this year or in past years?

These questions are not necessarily for the people who are currenty hospitalized with H1N1, but instead for the entire population of patients who are coming down with H1N1.

Perhaps in a few months we will know more...

I want to know this too.

Also, if the genetics has changed slightly to make H1N1pdm13-14 a bit more virulent than 2010-2012 (inclusive), then is the current H1N1pdm09 component in the flu shot effective at all?

Giuseppe · Dec 24, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

All things suggested so far in this thread mean that:

a) H1pdm09 suffered a major genetic constellation change;

b) H1pdm09 drifted away with multiple antigenic site changes.

The b) is less likely since H1 (both old seasonal and new strain from 2009 pandemic) have circulated so widely into population that the antibodies repertoires have to be very large and would ecompass several antigenic forms.

It would be interesting to see how other respiratory pathogens are circulating into communities affected and what kind of genetic changes in H1 possibly made it more aggressive.

The co-circulation of other subtypes cannot be entirely excluded since H3N2v is also present in US swine stock.

Among the great number of unsubtyped A viruses some may be variants but we cannot know until labs will process some of these samples and P.R. cooked well the news.

Abs against H1, H3 & N1, other than vs M1, surely present in US population, seem to exclude major antigenic drifts.

NS1 · Dec 26, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

Texas HA 225 Receptor Binding Variance Potential

An examination of the potential for Receptor Binding Site (RBS) Polymorphisms in the Texas High-CFR cases, including detailed near-term and mid-term genetic probabilities and projections

NS1 · Jan 6, 2014

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

pH1N1 Child Vaccine Escape
CDC Early 2013

Map - Active and Detailed

<div style="text-align: center;">
<hr style="width: 30%;" />41 Cases over 43 Sequences<hr style="width: 30%;" /></div>
Introduction

In the 30 days covering 2013-02-28 to 2013-03-29, the United States CDC released a total of 43 pH1N1 sequences at GISAID on 41 human cases sampled from October 2012 to February 2013. Geographic surveillance includes America, Africa, Asia and Russia. Although pH1N1 in most locales during the 2012-2013 season was the minority serotype, the sequences in this Analytic Report describe a high level of human-infective diversity and an ease of avian genetic acquisition, including multiple instances demonstrating concentrated transport of High-CFR pH1N1 Upsilon polymorphisms onto single sequences.

. . .

Read the Open-Access, Full-Text
Investigational Analytic
including Genetic Details

NS1 · Jan 7, 2014

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

71 Fatalities in Texas
by
2014-01-05 *

pH1N1 Dominant Texas Fatality by County [Excel]
pH1N1 Dominant Texas Fatality by County [html/css]
Distribution of pH1N1 Influenza Fatalities in Texas [map by Al]

* 2014-01-05 Updated Stats from Jim Oliveros

NS1 · Jan 7, 2014

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

pH1N1 Child Vaccine Escape
CDC Early 2013

Map - Active and Detailed

<div style="text-align: center;">
<hr style="width: 30%;" />41 Cases over 43 Sequences<hr style="width: 30%;" /></div>
Introduction

In the 30 days covering 2013-02-28 to 2013-03-29, the United States CDC released a total of 43 pH1N1 sequences at GISAID on 41 human cases sampled from October 2012 to February 2013. Geographic surveillance includes America, Africa, Asia and Russia. Although pH1N1 in most locales during the 2012-2013 season was the minority serotype, the sequences in this Analytic Report describe a high level of human-infective diversity and an ease of avian genetic acquisition, including multiple instances demonstrating concentrated transport of High-CFR pH1N1 Upsilon polymorphisms onto single sequences.

. . .

Read the Open-Access, Full-Text
Investigational Analytic
including Genetic Details

NS1 · Jan 7, 2014

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

pH1N1 Drug Resistant Low Reactor
CDC Fall 2013

Map - Active and Detailed

<div style="text-align: center;">
<hr style="width: 30%;" />46 Cases over 49 Sequences<hr style="width: 30%;" /></div>
Introduction

In the 32 days covering 2013-10-17 to 2013-11-19, the United States CDC released a total of 49 pH1N1 sequences at GISAID on 46 human cases sampled from February 2013 to October 2013. Geographic surveillance includes America, Africa, Asia, Brazil, Ecuador, Paraguay and Peru. 

The sequences in this Analytic Report describe a high level of genetic activity at the Hemagglutinin antigenic area between aa155 and aa158 with 5 amino variations and 4 silent revisions. HA 225G is present in quasi-species on 2 American samples and as dominant form in 2 tropical countries. The Dominican Republic HA 225G Low Reactor appears on a TamiFlu Resistant strain. Drug Resistance is also found in 2 US sequences and 1 South American case.
. . .

Read the Open-Access, Full-Text
Investigational Analytic
including Genetic Details

Discussion thread: USA - Texas: H1N1pdm09 December 17, 2013+

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