New US CDC Hospitalizations and Death Counts - 522 Deaths

[alert]

http://www.cdc.gov/h1n1flu/update.htm#totalcases

 

[Pathfinder]

Flu still spreading in US, CDC says

Flu still spreading in US, CDC says

RPT-Flu still spreading in US, CDC says
08.21.09, 01:58 PM EDT



WASHINGTON, Aug 21 (Reuters) -

Swine flu is still spreading widely across the United States, officials said on Friday, with 75 percent of serious cases and 60 percent of deaths among people under the age of 49.

The U.S. Centers for Disease Control and Prevention has officially confirmed 7,963 hospitalizations and 522 deaths from the pandemic H1N1 flu, CDC's Dr. Jay Butler told reporters in a telephone briefing.

It is important to remember that at this time of year we don't normally have influenza,' Butler said. He said the government expected to have 45 million to 52 million swine flu vaccine doses by mid October, when vaccination is expected to begin, and 195 million by the end of the year.


http://www.forbes.com/feeds/afx/2009/08/21/afx6803521.html

 

[wotan]

Re: Flu still spreading in US, CDC says

Re: Flu still spreading in US, CDC says

522 deaths from the pandemic H1N1 flu,

Wow, that was quite a jump.

 

[Mamabird]

Re: Flu still spreading in US, CDC says

Re: Flu still spreading in US, CDC says

Wow, that was quite a jump.

Yep, and compared to July 24 CDC report of 302 deaths, quite alarming since IFI in the US has been on the wane during this timeframe.

 

[Farmer]

Re: Flu still spreading in US, CDC says

Re: Flu still spreading in US, CDC says

Deaths may be a lagging indicator of severity as people may spend weeks in a hospital before they die.

I would expect the rate of new cases to decrease before the rate of new deaths does...

 

[Ronan Kelly]

Re: Flu still spreading in US, CDC says

Re: Flu still spreading in US, CDC says

The number of deaths per week has been pretty constant throughout the summer (aside from the obvious exception see below). It should be noted that the # of reported deaths in the past 10 weeks averages higher per week than for seasonal flu (48 vs 35). I can only imagine that it will get even worse as the total number of infections increases during the fall and winter.

Date;Reported Deaths that week;Average per Day;Total Deaths;Hospitalized
5/1 ;1 ;0.14 ;1 ;-
5/8 ;1 ;0.14 ;2 ;-
5/15 ;2 ;0.29 ;4 ;-
5/22 ;5 ;0.71 ;9 ;-
5/29 ;6 ;0.86 ;15 ;-
6/5 ;12 ;1.71 ;27 ;-
6/12 ;17 ;2.43 ;44 ;-
6/19 ;43 ;6.14 ;87 ;-
6/26 ;40 ;5.71 ;127 ;-
7/2 ;43 ;6.14 ;170 ;-
7/10 ;41 ;5.86 ;211 ;-
7/17 ;52 ;7.43 ;263 ;-
7/24 ;39 ;5.57 ;302 ;-
7/31 ;50 ;7.14 ;352 ;-
8/7 ;84 ;12.00 ;436 ;-
8/14 ;41 ;5.86 ;477 ;7511
8/21 ;45 ;6.43 ;522 ;7983
US Deaths by week to Aug 21st
Source CDC.

 

[Mamabird]

Re: Flu still spreading in US, CDC says

Re: Flu still spreading in US, CDC says

Deaths may be a lagging indicator of severity as people may spend weeks in a hospital before they die.

I would expect the rate of new caess to decrease before the rate of new deaths does...

Agreed. Perhaps we can glean some better information from data that has less of a lag built in. Say hospitalizations:

Current report: 7,983

July 24 report: 5,514

My alarm bell is still going off.

Can anyone out there shed some more light on these figures? Do we just have some timing issues or is the information a bit contradictory? Or, heaven forbid, this thing is getting uglier?

 

[wotan]

Re: Flu still spreading in US, CDC says

Re: Flu still spreading in US, CDC says

Agreed. Perhaps we can glean some better information from data that has less of a lag built in. Say hospitalizations:

Current report: 7,983

July 24 report: 5,514

My alarm bell is still going off.

Can anyone out there shed some more light on these figures? Do we just have some timing issues or is the information a bit contradictory? Or, heaven forbid, this thing is getting uglier?

Those are cumulative, correct? Still, that is 2000 new hospitalizations in less than a month, and flu activity has been relatively low (versus during flu season). Obviously that is still considerably higher than normal in the summer.

 

[Mamabird]

Re: Flu still spreading in US, CDC says

Re: Flu still spreading in US, CDC says

Those are cumulative, correct? Still, that is 2000 new hospitalizations in less than a month, and flu activity has been relatively low (versus during flu season). Obviously that is still considerably higher than normal in the summer.

Yes, the hospitalization figures are the cumulative totals reported each week by the CDC.

According to the CDC graphs for week 19 through current (basically 3 months worth of data), outpatient visits for IFI have steadily declined. However, just for the period July 24 to current, hospitalizations have increased 45%.

I am trully at a loss here. Please help clarify.

 

[wotan]

Re: Flu still spreading in US, CDC says

Re: Flu still spreading in US, CDC says

Yes, the hospitalization figures are the cumulative totals reported each week by the CDC.

According to the CDC graphs for week 19 through current, outpatient visits for IFI have steadily declined. However, just for the period July 24 to current, hospitalizations have increased 45%.

I am trully at a loss here. Please help clarify.

I'm not sure what to make of it. Does that provide indirect evidence of increasing severity? Aside from the 2 patients in Washington just released, what are the newest sequences from the US? It seems like we haven't had any lately.

I had been trying to look for excess deaths in the US from the MMWR. Nationwide I found ~1000 in the 1-64 age group over the last ~15 weeks versus the same period over the preceeding 6 years. However, in the 25-44 age group there were fewer deaths during that time period versus the last 6 years. The same held true in NYC, I couldn't account for the known deaths there. Overall mortality this year in the US seems considerably lower than the past several years, which is no doubt skewing that analysis, assuming my methodology was sound to begin with.

One thing of note. Mortality is generally down this year, but the amount of P&I deaths this summer has been very close to previous summers (though slightly lower). Now, with only a few exceptions, the proportion of P&I deaths has been below epidemic levels, but I don't know exactly how they determine that. Perhaps if I get time again I will look into that one, see what percentage of deaths over that time period were for P&I and compare it to previous years. It is certainly possible I am seeing something with my eyes that is not as significant as it at first seems.

 

[Farmer]

Re: Flu still spreading in US, CDC says

Re: Flu still spreading in US, CDC says

Yes, the hospitalization figures are the cumulative totals reported each week by the CDC.

According to the CDC graphs for week 19 through current (basically 3 months worth of data), outpatient visits for IFI have steadily declined. However, just for the period July 24 to current, hospitalizations have increased 45%.

I am trully at a loss here. Please help clarify.

I don't know, but one hypothesis may be that ILI visits are more heavily influenced by public perception of risk. Remember the long lines at hospitals in NYC with people seeking care for even mild ILI symptoms that coincided with news of H1N1 deaths in the community?

Numbers of hospitalizations presumably represent more actual severe cases of illness.

When the news is full of novel H1N1 news again this fall, we may see an increase again in people seeking care for their milder ILI symptoms.

This just supports the CDC announcement today that the infection is still circulating despite reductions in ILI visits.

 

[Ronan Kelly]

Re: Flu still spreading in US, CDC says

Re: Flu still spreading in US, CDC says

Mamabird,

42% of the US deaths have also occurred in the past 4 weeks. However if you look at the last 10 weeks, fatalities have been around 45 per week for the each. This is well above normal, but seems to be holding steady. (See post #5).

The surveillance reports indicate about 1000 new hospitalizations each week for weeks 30-31. The current hospitalization # is 7983,up 472, but that may change by the time MMWR 32 comes out. Lets wait and see.

 

[Mamabird]

Re: Flu still spreading in US, CDC says

Re: Flu still spreading in US, CDC says

I don't know, but one hypothesis may be that ILI visits are more heavily influenced by public perception of risk. Remember the long lines at hospitals in NYC with people seeking care for even mild ILI symptoms that coincided with news of H1N1 deaths in the community?

Numbers of hospitalizations presumably represent more actual severe cases of illness.

When the news is full of novel H1N1 news again this fall, we may see an increase again in people seeking care for their milder ILI symptoms.

This just supports the CDC announcement today that the infection is still circulating despite reductions in ILI visits.

Yea, good point. That very well could be the case. Perhaps we are just getting more comfortable with this bug.

I am concerned, though with Region 4, SE US. Their activity has been increasing steadily over this period. Does anyone have an ability to determine from what CDC Regions the hospitalizations are occurring?

 

[wotan]

Re: Flu still spreading in US, CDC says

Re: Flu still spreading in US, CDC says

Agreed. Perhaps we can glean some better information from data that has less of a lag built in. Say hospitalizations:

Current report: 7,983

July 24 report: 5,514

My alarm bell is still going off.

Can anyone out there shed some more light on these figures? Do we just have some timing issues or is the information a bit contradictory? Or, heaven forbid, this thing is getting uglier?

Another statistic that would be of interest is average length of stay until recovery or death. 2000+ new hospitalizations in less than a month who are averaging 4.5 weeks (to pull a number out of thin air) is also disconcerting. Also, what percentage of these are in the ICU, how many are requiring ventilation and for how long, etc.

 

[Flufreak]

Re: Flu still spreading in US, CDC says

Re: Flu still spreading in US, CDC says

I don't know, but one hypothesis may be that ILI visits are more heavily influenced by public perception of risk. Remember the long lines at hospitals in NYC with people seeking care for even mild ILI symptoms that coincided with news of H1N1 deaths in the community?

Numbers of hospitalizations presumably represent more actual severe cases of illness.

When the news is full of novel H1N1 news again this fall, we may see an increase again in people seeking care for their milder ILI symptoms.

This just supports the CDC announcement today that the infection is still circulating despite reductions in ILI visits.

Another hypothesis is that asymptomatic or very mild spread is enhanced during "off season", therefore less ILI visits. Severe cases could still be at the same proportion of total. Lends much support to WHO statement of "explosion" this fall.

 

[Niko]

Re: Flu still spreading in US, CDC says

Re: Flu still spreading in US, CDC says

RPT-Flu still spreading in US, CDC says
08.21.09, 01:58 PM EDT



WASHINGTON, Aug 21 (Reuters) -

Swine flu is still spreading widely across the United States, officials said on Friday, with 75 percent of serious cases and 60 percent of deaths among people under the age of 49.

The U.S. Centers for Disease Control and Prevention has officially confirmed 7,963 hospitalizations and 522 deaths from the pandemic H1N1 flu, CDC's Dr. Jay Butler told reporters in a telephone briefing.

It is important to remember that at this time of year we don't normally have influenza,' Butler said. He said the government expected to have 45 million to 52 million swine flu vaccine doses by mid October, when vaccination is expected to begin, and 195 million by the end of the year.


http://www.forbes.com/feeds/afx/2009/08/21/afx6803521.html

Snipped from the briefing transcript found here: CDC Joint Briefing with NIH & FDA on 2009 H1N1 Influenza

Jay Butler: Thank you, Glen. Good afternoon and good morning to everyone. I want to touch on three topics at this time, cover -- provide an update on novel H1N1 activity in the U.S., activity in the southern hemisphere, and also talk about where we stand right now in regards to influenza vaccination planning. Here in the United States, we're seeing low levels of flu activity, although almost all that we're seeing is primarily novel H1N1 virus disease. It's important to remember that this time of year, we don't normally have influenza, so even a low level is an unusual event. To date, there have been 7,963 hospitalizations and 522 deaths that have been laboratory confirmed as caused by novel H1N1 vaccine. It's important to keep in mind that these numbers radically underestimate the number of cases that actually occur, because many cases go without testing, and in many areas, there is not routine testing of people who are not sick enough to require hospitalization. The novel H1N1 continues to disproportionately affect younger persons, so it behaves very differently from seasonal influenza, where we see much of the severe influenza among the elderly. 75% of the hospitalizations are in those aged under 49 and 60% of the deaths are in those underage 49. Most state health officials are reporting local or sporadic influenza activities. Two states, Alaska and Maine, are reporting widespread influenza activity at this time. Reports of widespread influenza activity in August are very unusual, as I mentioned earlier. Most of the influenza viruses typed are novel 2009 influenza AH1N1. These viruses remain similar to the ones that were chosen for the vaccine that's in development, and vast majority remain susceptible to anti-viral drugs, also Tamiflu and Zanamivir. Flu is unpredictable and it's hard to say what our season will look like, but preparation is important. Moving on to our southern hemisphere update, the activity from the 2009 H1N1 virus appears to be decreasing. The virus remains a predominant influenza virus circulating worldwide. Decreases in disease due to the 2009 H1N1 continue to be reported from South America and parts of Australia. The epidemiology of the disease caused by the virus in the southern hemisphere is very similar to that described in the United States this past spring. There have been no significant changes detected in the influenza virus, isolated from persons in the southern hemisphere as compared to viruses isolated from persons in the northern hemisphere. As you're aware, we've been watching the southern hemisphere very closely for any changes in the behavior, the epidemiology of the virus or in the virus itself, and we have not seen those events. In other parts of the world, the United Kingdom is reporting national decreases in disease due to H1N1 and Japan is experiencing an increase in cases. I'd like to move on to talk about vaccine for the 2009 H1N1. We're making progress in developing the plans for distribution, once the vaccine becomes available. This is what we currently know and are planning. We're expecting somewhere between 45 million and 52 million doses of vaccine to be available by mid-October. This will be followed by weekly availability of vaccine up to about 195 million doses by the end of the year. Keep in mind, these numbers are driven by a number of variables in the manufacturing process. There are five manufacturers working, so and everybody's doing the best they can to get as much virus available -- as much vaccine available as soon as possible, and so those numbers can be subject to change. Initially, the number of vaccine doses that will be available to each state will be based on the state's population. The distribution of the vaccine will be very similar to what's done currently for the vaccine for children program, so this will be a program that will be enhanced to enroll a larger number of providers rather than a completely new program that's developed. The states will receive orders from providers for the number of doses of vaccine needed, and will coordinate with CDC. These orders will be transmitted to a central distributor, who will be receiving vaccine from the five manufacturers and subsequently shipping those to the states, along with ancillary supplies for administration of vaccine. Today, the advisory committee on immunization practices recommendations for use of the H1N1 influenza vaccine were published in the "MMWR" and posted online. These final recommendations include target groups for vaccination, including those which according to the epidemiology that's been observed in the United States and indeed globally, focuses on the persons at highest risk of infection and severe disease, this includes pregnant women, children, and young adults aged 6 months through 24 years, as well as persons aged 25 through 64, who have medical conditions that put them at higher risk for influenza-related complications. Two other risk groups are those who are at higher risk of exposure or transmitting the virus to those who may be at high risk such as health care workers and emergency medical service workers, and persons who live with or care for infants younger than 6 months of age, that is, who are too young to be vaccinated.

In closing, let me make a couple key points. Influenza is unpredictable and while we're working to get -- working to make sense of much of the information as possible, we don't know what lies ahead in the coming weeks and months. We may see lots of flu activity in September and October. On the other hand, we may not. Second, it's best that we plan and prepare for lots of flu activity, and that's a good assumption, given that we expect to see both the 2009 H1N1 virus and the seasonal influenza viruses, causing illness this fall. I've talked mostly about vaccine but it's important to remember that we have to continue to do the other important things to control the spread of influenza, including hand washing, respiratory etiquette, that is, cover your cough and to protect others, stay home if you're sick. And finally, we can't stop the tide of flu any more than we can turn a hurricane in its course or stop the earth shaking during an earthquake, but we can mitigate the effects and question help prevent people from becoming severely ill by preparing well and acting effectively. At this point I'll turn it over to Dr. Jesse Goodman from the FDA and I look forward to taking your questions later.

 

[Andy2000]

Re: New US CDC Hospitalizations and Death Counts - 522 Deaths

Is there a list of hospitalizations by week?