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H1N1 flu starting third outbreak in East Tennessee? - surveillance suggests not.

Ronan Kelly

Ronan Kelly

Retired 2020
Posted: 3:47 AM Mar 12, 2010

H1N1 flu starting third outbreak in East Tennessee

Reporter: Michele Silva
Email Address: michele.silva@wvlt-tv.com

-snip-

?Things hung around in October and there was a little blip in December, said Dr. Jay Hammett at Mercy Health. ?I don?t know what causes it, but it just came back into town.?

Dr. Hammett expected the H1N1 virus to come back again, and he believes the so-called ?Swine Flu? is just starting its third outbreak.

?These things have a way of working their way around the globe, it?s a cycle thing like a tsunami wave, it starts there and comes back like an echo," he said. ?I've had about 7 to 9 flu tests this week. We had been averaging one two weeks ago."

-snip-

full article available at;

http://www.volunteertv.com/home/headlines/87441567.html
 
Last edited:
Re: H1N1 flu starting third outbreak in East Tennessee?

Re: H1N1 flu starting third outbreak in East Tennessee?

Missouriwatcher said:
ILI: 2.73% up from 1.10% last week (baseline 2%)
Percent positive: 19.6% up from 7.8%
RSV: 15% and decreasing
ACHA lists attack rate 4.9 (avg 3)
http://health.state.tn.us/ceds/WeeklyReports/Results.asp
http://www.acha.org/ILI_Project/ILI_LatestWeek.cfm
http://www.cdc.gov/surveillance/nrevss/rsv/state.html
Click to expand...

Not sure I get it, Ro and Mo

The only "data" in the media article is this MD saying: ?I've had about 7 to 9 flu tests this week. We had been averaging one two weeks ago."

Testing 9 patients doesn't mean a third wave is starting.

As for Mo's links:

The first link is dead.

The second link from American College Health Assn shows a 44% DECREASE in ILI in TN for week of Mar. 5 compared to previous week.

All I can find on the third link for TN is a graph for RSV showing they are in a downward trend, too.

Does any of this information justify the thread title - even though it has the question mark? Seems overly alarmist to me.

We're still in flu season. Every up-tick in ILI and every local MD who wants a headline is not a harbinger of an H1N1 wave. People have closed down on the whole vaccine idea because of the "Wolf! Wolf!" syndrome. If a next wave ever does come, we'll be a month into it before people believe what they read about it. Of course, then it will be too late for getting vaccinated.

I think governments at all three levels keep feeding this stuff to the press with the good intentions of trying to get as many takers for the vax as possible.
 
Re: H1N1 flu starting third outbreak in East Tennessee?

Re: H1N1 flu starting third outbreak in East Tennessee?

Thanks everyone.

We are tracking the flu. We look at all changes.

A large surge starts with an uptick.


:)
 
Re: H1N1 flu starting third outbreak in East Tennessee?

Re: H1N1 flu starting third outbreak in East Tennessee?

North Carolina is on the Eastern border of Tennessee -


North Carolina Div of Public Health <small><small> (last data upload 2010-03-11 22:31 - image generated 2010-03-12 03:19) </small></small> <small><small>
* North Carolina Influenza Website </small></small>
daily_counts_fever.ratio_ncdetect_14_20.png


http://isds.cirg.washington.edu/distribute/countstimeseries.php?period=daily
 
Re: H1N1 flu starting third outbreak in East Tennessee?

Re: H1N1 flu starting third outbreak in East Tennessee?

@Denis: I too felt that the title of the original article was too strong based on the evidence provided, and added a question mark to promote further evidence gathering one way or another. I kept the original wording as this helps to avoid multiple postings of the same article under different titles.

As you know, sentinel data is generated from amalgamated individual doctor's reports, an individual report showing a 3-4 fold increase may or may not be statistically significant, but worth paying attention to as a starting point.

The first link provided by Missouriwatcher shows an increase in %ILI from 1.1 to 2.73% from weeks 8 to 9. In addition the % of positive tests has increased by 2.5 times from week to week. Unfortunately, since less than half of the sentinel providers have reported, this is still not conclusive evidence of an uptick, but could indicate something is going on. The (preliminary) % positive is the highest it has been since week 38 at the end of the fall wave.
 
Re: H1N1 flu starting third outbreak in East Tennessee?

Re: H1N1 flu starting third outbreak in East Tennessee?

I absolutely agree that there must be some suspension of skepticism with respect to "sentinel data", which are really more anecdotes than "data."

But reporting just % increase without any absolute numbers is often a gimmick used by fear mongers and ought to be discouraged. An increase from 1 case to 2 is a 100% increase. Such "data" reported as going from 1 case to 2 is a yawner. Reported as a 100% increase everybody goes into a flap, when they ought to be yawning.
 
Re: H1N1 flu starting third outbreak in East Tennessee?

Re: H1N1 flu starting third outbreak in East Tennessee?

The H1N1 flu season hasn't been as bad as previous years, except for those who've died (the majority with preexisting conditions). For those with such conditions, the flu shot and avoiding people are about their only recourse.

Watching where it might be emerging may be helpful. The CDC has given Region 4 (where TN resides) an ILI baseline during flu season of 2%. TN currently has ILI of 1.24%. The percent positive tests is 8.1%. ACHA shows TN has had higher attack rates than the rest, would it mean that more students have gained immunity? Of course, there are anecdotal reports of people testing positive up to 3 times in different time frames; perhaps because they haven't gotten sick enough?

Whether all this means anything, who knows. We report what is out there. Individuals need to extrapolate...even the experts have no "crystal ball".
http://health.state.tn.us/ceds/WeeklyReports/WeeklyReports.asp?sYear=2010

NOTE: The figures were adjusted based on TN sentinels reporting. My argument is now not so valid.
 
Re: H1N1 flu starting third outbreak in East Tennessee?

Re: H1N1 flu starting third outbreak in East Tennessee?

The week 10 report is out with the updated figures on week 9. About 85% of the Sentinels have now reported in. Ili statewide rose from 149 to 183 cases from week 8 to 9, with %ili rising from 1.11 to 1.48%.

Even now, only one of the three collaborating testing labs has reported for week 9, with 11 positive from 61 tests - 18% positive, but until the other labs release their results, the margin of error in this does not allow comparison to previous weeks.

With regard to week 10 figures, only 18 of the 60 or so sentinels reported giving a preliminary %ili of 2.04%. One testing laboratory reported 7 positive (all H1N1) from 17 tests (41.2%).

http://health.state.tn.us/ceds/WeeklyReports/WeeklyReports.asp?sYear=2010
 
Re: H1N1 flu starting third outbreak in East Tennessee?

Re: H1N1 flu starting third outbreak in East Tennessee?

Week 11 report is out with updated surveillance on week 10. Statewide ili dropped to 136 cases, 1.24%.

With only 18 sentinels reporting for week 11, the preliminary numbers are 20 ili cases (0.48%).

Updated figures on testing are as follows

Week-- # of labs--positive tests--total tests--% positive
8---------3-----------16-----------178---------9.0
9---------2-----------16-----------210---------7.6
10--------2-----------13-----------161---------8.1
11--------1-----------9-------------42---------21.4
http://health.state.tn.us/ceds/WeeklyReports/WeeklyReports.asp?sYear=2010

In short, both # of positives and % positives has dropped from highs exhibited in Weeks 2,3,4. No new wave is suggested from these numbers.
 
Re: H1N1 flu starting third outbreak in East Tennessee? - surveillance suggests not.

RoRo, thank you for pointing out about the surveillance. I had not been watching for sentinels that had reported. As they report in, figures adjust downward. The TN site updates regularly, and most have checked in by the following week.
 
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