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Pneumonia & Influenza deaths in El Paso; Week 14-23 2011 more fatalities than 2008, 2009 & 2010 combined

Re: Pneumonia & Influenza deaths in El Paso; Week 14-23 2011 more fatalities than 2008, 2009 & 2010 combined

Code: 
El Paso, total deaths and deaths from P+I per month  1962-2002
1962,161,10,155,12,154,10,156,5,131,7,133,9,125,3,127,3,109,4,122,2,146,5,160,12
1963,158,6,123,5,150,14,134,6,143,7,130,3,145,5,142,2,130,6,120,1,152,4,148,7
1964,184,11,137,10,145,7,135,8,120,4,120,4,153,8,99,3,113,5,113,6,132,7,136,6
1965,151,10,136,12,178,5,124,9,124,1,148,7,134,6,133,2,144,3,136,6,122,8,155,8
1966,140,9,156,9,186,23,156,4,142,9,141,3,155,2,160,5,119,2,178,7,114,5,164,11
1967,190,11,184,11,173,9,151,7,189,8,175,6,150,2,178,7,146,4,161,5,147,6,162,5
1968,180,12,176,6,166,10,148,11,170,9,158,3,180,6,165,5,167,10,170,5,161,10,201,16
1969,191,15,166,6,177,10,172,3,184,7,173,11,170,6,178,9,159,4,157,6,162,12,176,8
1970,225,21,177,13,177,9,174,9,168,7,159,3,167,6,175,5,169,5,159,5,176,4,150,8
1971,194,8,168,6,184,13,159,2,203,8,163,6,151,5,147,5,165,3,184,8,156,3,189,4
1972,220,12,178,16,164,10,158,8,176,10,168,2,166,10,158,4,178,10,168,4,186,4,198,8
1973,227,16,210,19,219,8,225,2,213,4,184,3,180,4,178,7,170,5,186,9,169,4,171,8
1974,192,6,167,7,190,7,192,5,186,2,181,7,182,4,166,3,180,2,166,7,186,6,206,8
1975,204,8,191,10,183,3,173,10,183,5,174,4,173,5,190,5,169,5,197,8,184,6,200,7
1976,213,8,210,14,211,15,157,7,176,7,167,2,170,4,163,5,164,2,185,4,173,7,188,6
1977,191,9,171,4,201,4,177,6,186,5,184,5,155,0,182,6,190,2,178,9,182,10,182,14
1978,202,9,208,9,166,0,211,8,178,4,212,4,199,5,174,8,169,0,182,11,173,4,202,10
1979,176,1,185,0,187,9,194,4,159,1,153,5,182,4,166,4,191,4,177,8,187,5,190,1
1980,204,9,206,4,186,4,175,1,190,1,212,3,190,3,199,3,159,2,48,1,202,6,224,10
1981,210,6,186,4,200,2,194,2,162,0,168,8,182,0,188,0,156,2,182,6,200,4,216,2
1982,210,8,204,2,230,4,166,2,212,4,184,0,212,2,188,2,170,4,206,8,224,8,202,8
1983,227,6,224,6,210,5,196,2,227,1,173,3,195,4,192,5,176,0,208,4,212,5,230,7
1984,235,4,254,8,235,8,185,7,210,3,196,1,207,3,213,5,179,4,218,6,212,10,229,5
1985,277,8,246,12,227,11,210,2,231,8,207,2,202,3,215,1,202,5,188,6,231,3,264,14
1986,276,11,206,7,241,8,206,3,206,8,214,6,214,1,209,4,202,4,257,4,246,2,264,7
1987,268,16,240,10,245,7,230,6,222,8,211,5,219,2,198,9,204,2,239,2,226,3,235,7
1988,236,5,219,8,242,5,224,10,204,3,221,5,211,6,224,7,199,2,251,3,246,8,285,10
1989,295,14,239,13,268,10,205,1,242,4,237,4,239,5,228,7,209,1,249,7,245,5,318,9
1990,301,8,240,9,255,7,251,8,250,5,253,5,221,4,208,7,228,6,238,6,249,5,264,3
1991,270,9,245,6,275,6,274,8,249,8,244,2,229,3,244,4,213,4,242,2,295,5,308,18
1992,294,6,288,11,264,8,243,6,196,3,273,6,262,4,250,7,224,5,280,5,258,10,300,12
1993,303,11,277,5,308,16,304,7,251,5,245,5,256,6,275,5,265,1,255,6,269,3,284,5
1994,295,13,288,9,319,5,257,8,252,3,264,3,277,12,256,7,260,1,272,8,268,7,295,7
1995,307,7,276,8,274,7,282,8,262,4,246,6,265,2,250,3,250,2,282,4,280,13,339,13
1996,324,10,272,5,300,9,287,14,263,4,264,9,261,7,280,4,259,3,301,4,287,7,330,13
1997,322,20,300,7,313,18,286,8,277,10,255,3,248,2,243,6,252,4,294,4,279,6,361,15
1998,360,18,255,11,310,13,285,4,285,4,307,5,252,2,273,5,302,7,280,1,271,4,332,10
1999,338,11,334,13,350,9,286,9,289,4,249,4,248,3,262,3,274,4,301,4,282,7,395,7
2000,386,12,286,3,282,2,308,6,283,4,251,0,295,6,294,2,313,2,302,5,277,2,310,3
2001,362,11,315,12,363,15,305,8,292,5,291,2,305,5,325,4,275,4,307,7,266,8,288,4
2002,366,9,322,9,377,9,326,8,353,5,305,5,282,1,315,4,267,2,290,7,318,2,349,12
 
Re: Pneumonia & Influenza deaths in El Paso; Week 14-23 2011 more fatalities than 2008, 2009 & 2010 combined

above list just has all cases where P+I was the primary condition of death.

I think MMWR has all deaths where P+I appears anywhere
on the death-certificate.
And they often have 2ndary ... conditions.

So these are more.

And it looks plausible that they maybe changed the reporting
on the death certificates.
Maybe they give more often 2ndary or tertiary conditions now than
they did before.
That would already significantly increase the P+I-deaths.

However, I can't remember that I saw such a thing in other cities
 
Re: Pneumonia & Influenza deaths in El Paso; Week 14-23 2011 more fatalities than 2008, 2009 & 2010 combined

It's entirely plausible that the reporting method has changed. That being said, all CDC has to do is confirm that. Whether or not something unusual is happening in El Paso can only be suspected once changes in reporting methodology have been excluded. I'm still awaiting a reply from CDC, but will pass along any information that I receive.

Copied below are my queries to CDC;

To Whom it may concern,

Good morning,

I sent a request for information on pneumonia and influenza a few weeks ago
that has, as yet, gone unanswered (attached). The numbers being reported
from El Paso continue to be of concern. Weeks 22 and 23 reported 10 and 11
P&I fatalities respectively. There have been more P&I fatalities reported in
weeks 14-23 this year than the 2008,2009 and 2010 combined! The % of
fatalities due to P&I in weeks 14-23 this year in El Paso is 12.5% as
compared to a 2006-2010 average of 4.0% (Range 3.7-4.4%).
In the most recent two weeks the %P&I stands at 10.5 %
Does CDC have any information available to shed some light on why reported
P&I fatalities have tripled in El Paso during this 10 week period?

Thank you for your attention in this matter,

XXXX
-----Original Message-----

From: XXX
Sent: 6/6/2011 9:53:10 AM
To: CDCINFO@cdc.gov
Subject: El Paso P&I fatalities from the weekly MMWR

To Whom it may concern,

I am an amateur disease tracker and have been noticing the number of
pneumonia and influenza fatalities in El Paso as reported in the weekly MMWR
since week 14.
This year from weeks 14-21, 106 fatalities have been reported. In
comparison, the previous five years ranged from 24 to 32 fatalities for the
same period.
Has there been any testing/reporting regime change to account for this
300-400% increase?
If no change in testing or reporting, then a 3-400% increase in fatalities
is of concern. Has there been any investigation into the causative agents?
If so, what are the results? How do the demographics of the fatalities
compare with previous years?
Any information you may provide would be greatly appreciated.

Thanks in advance,
XXXX
 
Re: Pneumonia & Influenza deaths in El Paso; 11 in week 23

Re: Pneumonia & Influenza deaths in El Paso; 11 in week 23

sharon sanders said:
It looks like, as a percentage of all deaths, P&I deaths are going down, while the total of P&I deaths has remained constant at 10-15 for the last 6 weeks:

Week 23 - 9.7%

Week 22 - 11.5%

Week 21 - 15.2%

Week 20 - 12.2%

Week 19 - 12.7%

Week 18 - 12.0%


Who compiles the El Paso data? El Paso public health department or the CDC? :confused:
Click to expand...

Up from week 23. For week 24 with 72 total deaths and 10 pneumonia/ILI deaths:

Week 24 - 13.9%

What is interesting is that total deaths are less - 72. A decrease of 36%.

This corresponds to a decrease in elderly total deaths for week 24 of 46%.

Total deaths in the younger age groups decreased by only 15%.

So what does this tell us? This tells us that the pneumonia and flu deaths are disproportionately hitting the younger age groups. This is not typical epidemiological behavior for pneumonia. It typically kills those who have compromised immune systems, the chronically ill, the elderly, those who have not had medical care for a lingering respiratory infection.

The conclusion I draw is that these are flu deaths in the young (which is not typical seasonal flu behavior) and this leads me to A/H1N1.

It also appears the trend is continuing based on week 24 data.
 
Re: Pneumonia & Influenza deaths in El Paso; Week 14-23 2011 more fatalities than 2008, 2009 & 2010 combined

On this separate post I would like to make the comment that we follow the facts here. We do not sell anything and despite continuing rumours, we are not funded or guided by any local, state, national, or international public health entities.

We do our own thing at FT.

Thank you to everyone who has been following this issue. All of the data on all of the sites is very informative.

Is there an A/H1N1 problem in the El Paso area? In a general sense, with 10ish deaths last week out of a population of 649,121 this does not appear to be a wildly spreading flu pandemic situation.

But - one of the things we do here is to anticipate and analyze potential public health threats.

And we are keeping our eye on this.

Also of concern are the following public health threats. Please see these threads:

Avian influenza - situation in Egypt - update 54 (WHO, June 22 2011): 1 New Fatal Case, Qena

Egypt - Menoufia - 1 WHO confirmed death, 1 FAO confirmed case, 1 suspected case - veterinary teams deployed

Hong Kong: 2011 Scarlet fever warnings/cases

China - Ministry of Health Announces Creation of a "Blacklist" for reporters that do not report government approved information

China - Experts Call for More Stringent Standards for Cleaning Eggs - Avian Flu Mentioned As Risk

Bihar’s mystery disease identified as toll rises to 41

The continuing radiation situation in Japan

Measles

EHEC

Indonesia - Agam, West Sumatera ::: A family treated of bird flu suspicion
 
Re: Pneumonia & Influenza deaths in El Paso; Week 14-23 2011 more fatalities than 2008, 2009 & 2010 combined

P&I Deaths in El Paso Spring 2011

Week - %Deaths ages 25-64 - %Total P&I

Week 15 - 30.5% - 18.3%
Week 16 - 29.5% - 10.3%
Week 17 - 18.2% - 4.0%
Week 18 - 26.9% - 12.0%
Week 19 - 31.4% - 12.7%
Week 20 - 22.0% - 12.2%
Week 21 - 36.5% - 15.3%
Week 22 - 26.4% - 11.5%
Week 23 - 27.4% - 9.7%
Week 24 - 37.5% - 13.9%

Week 24 had the highest percentage of total deaths in El Paso aged 25-64 this season, which is puzzling even if they have changed how they define P&I deaths.
 
Re: Pneumonia & Influenza deaths in El Paso; Week 14-23 2011 more fatalities than 2008, 2009 & 2010 combined

total MMWR-reported deaths in El Paso weeks 15-24
1/1996 - 19/2011 = 12898

total MMWR-reported P+I-deaths in El Paso weeks 15-24
1/1996 - 19/2011 = 650

5.0%


week 1-10: 15604,948,6.1%


USA,1-10:2006343,158642,7.9%
USA,15-24:1739529,117238,6.7%
 
Re: Pneumonia & Influenza deaths in El Paso; Week 14-23 2011 more fatalities than 2008, 2009 & 2010 combined

About the 'unusual' inter-pandemic 2010-2011 season, ECDC-WHO expressed some considerations. See below an extract:

Source: European Centre for Disease Prevention and Control, fu ll PDF document: http://ecdc.europa.eu/en/press/events/Documents/11_06_EISN_meeting_Ljubljana_Working_doc.pdf


MAY 31ST 2011 WORKING ECDC DOCUMENT

Severe-end influenza disease surveillance in Europe - Reflection on two seasons of experience Objectives Future Options


Background:

Surveillance for severe disease due to influenza has been expanding in parts of WHO?s European Region during the past 5 years. More countries in the EU/EEA undertook surveillance at the start of the 2009 influenza pandemic [1, 2] and a number continued in the subsequent season of 2010-2011.

An ECDC expert meeting, entitled ?Patterns of Influenza Infection and disease in Europe?, was held in Stockholm on May 3-4th, 2011. The objectives of the meeting were:

  • to review and understand the patterns of severe influenza disease during the 2010-2011 season which was the first after the pandemic with the ?new? seasonal influenza.
  • To agree on objectives of severe-end influenza surveillance, which essentially means influenza cases that are severe enough to result in hospitalisation
  • To develop options and recommendations for future surveillance for the joint ECDC/WHO meeting in Ljubljana in June 7-9th, 2001.
The description of the season 2010-2011 is being incorporated into a revised Risk Assessment for the season and will not be considered further in this paper.

However it was noted that the seasonal influenza seen in Europe in the 2010-2011 season was different from what had been observed in the last inter-pandemic period and was closer to the experience of the pandemic as befits a season dominated by the new A(H1N1)2009 virus plus some B viruses.

A presentation of the experience from the USA for 2010-2011 was of A(H3) and B viruses predominating hence the pattern of dominance of the A(H1N1) 2009 virus was by no means universal or inevitable for future seasons. I.e. the nature of the interpandemic influenza from 2010/2011 onwards is not yet clear.

(ICU Surveillance)... These had performed a particular epidemic intelligence function in some European countries in 2010-2011 season in detecting the start of the season.

In addition in some countries the units had experienced unusually high stress in 2010-2011 when measured as prevalent influenza cases requiring intensive care per 10^5 population. However other countries did not experience this as reported in the ECDC Weekly Influenza Surveillance Overview.

(...)

-
-----
 
Re: Pneumonia & Influenza deaths in El Paso; Week 14-23 2011 more fatalities than 2008, 2009 & 2010 combined

Compared with 1/2011 to 24/2011

Total Deaths - 2,430
P&I Deaths - 207
Rate - 8.5%

And compared with only 15/2011 to 24/2011

Total Deaths - 973
P&I Deaths - 118
Rate - 12.1%

Gs - do you have the data to calculate the number of deaths ages 25-64 in Weeks 1-24 for 1996 through 2011, as well as Weeks 15-24 for 1996 through 2011? I'd be interested in comparing just total deaths in those age groups for those periods with total deaths and see if 2011 is anomalously high. Thanks.

gsgs said:
total MMWR-reported deaths in El Paso weeks 15-24
1/1996 - 19/2011 = 12898

total MMWR-reported P+I-deaths in El Paso weeks 15-24
1/1996 - 19/2011 = 650

5.0%


week 1-10: 15604,948,6.1%


USA,1-10:2006343,158642,7.9%
USA,15-24:1739529,117238,6.7%
Click to expand...
 
Re: Pneumonia & Influenza deaths in El Paso; Week 14-23 2011 more fatalities than 2008, 2009 & 2010 combined

yes, all the data, but only until week 19 so far
Maybe it's normalized (missing data estimated), I'm not sure


934912=number of deaths in USA 122 cities ages 25-64 in Weeks 1-24 for 1996 through 2011
366214=number of deaths in USA 122 cities ages 25-64 in Weeks 15-24 for 1996 through 2011


for 1959-2007 I have all the death-certificates, but some data are missing,
e.g. location since 2005, often only month of death, not day, 1972 only half
cause of death is by ICD8,9,10 - 10 age-groups

deaths from most diseases are seasonal , cancer,accidents only very little,
respiratory most
 
Re: Pneumonia & Influenza deaths in El Paso; Week 14-23 2011 more fatalities than 2008, 2009 & 2010 combined

http://www.dshs.state.tx.us/idcu/disease/influenza/surveillance/2011/


Streptococcus pneumoniae, invasive disease?
All ages

211, week 1,...,24

USA: 253,245,176,208,208,161,183,247,235,251,222,214,184,183,190,153,159,149,211,196,109,143,153,102
Texas: 5,22,22,25,12,0,3,6,10,34,15,16,1,3,16,10,17,10,69,70,21,14,31,17


http://wonder.cdc.gov/mmwr/mmwr_reps.asp?mmwr_year=2011&mmwr_week=23&mmwr_table=2J


increase in Texas in weeks 19,20
 
Re: Pneumonia & Influenza deaths in El Paso; Week 14-23 2011 more fatalities than 2008, 2009 & 2010 combined

According to Galgiani, valley fever is an endemic fungal infection (coccidioidomycosis) that is caused by spores typically found in the soils of Tucson, Pinella and Maricopa County (Phoenix). The disease is not contagious and occurs when spores from the soil are inhaled. "Up to two-thirds of all infections occur in that 150-mile stretch of the interstate, and the total number of infections per year we estimate at 150,000," said Galgiani, an expert in infectious diseases. "This is important for residents and tourists alike. If you get pneumonia in this part of the country, the chance that it is due to valley fever is about one in three. That is true for any tourist who goes home and in the next month gets pneumonia."

San Joaquin and Central Valleys of California, Southern Arizona (particularly Phoenix and Tucson), Southern Nevada, Southern Utah, Southern New Mexico and Western Texas (especially around El Paso).
-------------------------------------
Local hospitals were expecting an increase in a disease known as Valley Fever, a fungal pneumonia, because of the storm. The fungus thrives in the hot and arid Southwest and is found just a few feet beneath the earth's surface; it can be stirred up by construction, wind and other activity.
http://www.facebook.com/note.php?note_id=10150174015138667
Cryptococcal infection may cause a pneumonia-like illness, with shortness of breath, coughing and fever.

Monday, March 7, 2011
Respiratory MRSA Confirmed
COLORADO SPRINGS, Colo. -- A
The infected person was staying at the Community Alternatives of El Paso County
A facility spokesperson told KRDO NEWSCHANNEL 13 that the building has been cleaned and is now operating normally. A spokesperson with the Department of Health said there is no public health concern.

Maricopa County and Pima County Coccidioidomycosis
An abrupt end to this autocorrelation relationship occurs near the the onset of the summer precipitation season
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0021009
median time from symptom-onset-to-diagnosis was 55 days and an average of 209 days
the relationship between exposure rates and concurrent precipitation during the months of August-March is negative

first rain in El Paso in early June (after the snow in early Feb.)
http://www.wunderground.com/history...011&req_city=NA&req_state=NA&req_statename=NA

---------------------------------------------
http://www.tceq.texas.gov/cgi-bin/compliance/monops/yearly_summary.pl
---------------------------------------------
 
Re: Pneumonia & Influenza deaths in El Paso; Week 14-23 2011 more fatalities than 2008, 2009 & 2010 combined

pmep1.GIF
 
Re: Pneumonia & Influenza deaths in El Paso; Week 14-23 2011 more fatalities than 2008, 2009 & 2010 combined

pason.GIF
 
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