Flu Season Hits Hard, Swine Flu Dominates

The CDC reported this week that flu season is well underway with more than half the country reporting “wide-spread” cases of influenza. The dominant strain this winter is H1N1,or “swine flu,” which has not been prevalent since the 2009-10 flu season. The H1N1 strain is making up more than half of the cases reported so far.

Sermo spoke with James Wilson, M.D., Director of the National Infectious Disease Forecast Center, about this flu season and he strongly urged that anyone who is unvaccinated get a flu shot as soon as possible. His center released the following information today:

  1. The National Infectious Disease Forecast Center publicly forecasted anticipation of an A/H1N1-dominant season with excellent vaccine match beginning in August. Expectation was that it would be a mild season.
  2. Thus far, physicians and infection control practitioners directly involved with patient care of H1N1 cases in Mexico, the U.S., and Canada have unanimously indicated ICU admissions and fatalities are seen in unvaccinated patients. In a minority of cases, they are unclear about vaccination history.
  3. All H1N1 isolates submitted to CDC have matched this season’s vaccine strain based on reporting from Week 52. At a national level, the overall picture of the season is mild/moderate. There is a slight inflexion of the epi curve reported in Week 52. Our Forecast Center is hopeful this is indicative of peaking out, however prior seasons have shown a similar brief inflexion before additional case surge. Obviously, monitoring subsequent reports will shed more light on where we are going with this.
  4. It is our belief that, from the perspective of those individuals who have chosen not to vaccinate for this year’s influenza, we are basically seeing another pandemic wave of H1N1 transmission with the associated potential for severe clinical outcomes. For those who are vaccinated, the experience is a mild one.

Point #4 highlights a bit of irony for our team, where we are attempting to forecast certain features of the influenza season. What we have found is the possibility of anti-vaccination politics playing a major role in interfering with the validation of our forecast. We have observed through direct clinical experience that anti-vaccination sentiment, particularly for influenza, remains strong in the U.S. and is tied to politics. It is clear to those of us monitoring the situation that such views have a mortality rate.

Those are very strong words about vaccination from Dr. Wilson. We asked him if there were any particular groups at risk and he said, “Yes. While we are seeing pediatric mortality, there has been an apparent shift in the pattern where we are seeing reports of 20-50 year olds affected [with] admissions to the intensive care unit or death.”

Sermo physicians are actively discussing cases of H1N1 and the severity of this season. One doctor said, “It’s much worse in my part of Texas than I remember from a few years ago.”

A pediatrician wrote, “The amount of people wanting to vaccinate is much higher now, what with the news coming out. And we’re running out fast.”

A third physician noted a clear difference between vaccinated and unvaccinated patients. “They [the unvaccinated] seem to be sick about four days, then the immune system kicks in. The rest suffer. And I have sent many to the [Emergency Room] for admit. It is out of hand in northern Georgia; feels like 2003-04 and 1993-94. 2009 was all about kids. This one is more serious.”

We will be discussing this in detail inside Sermo as physicians support each other through an active season. If you’re an M.D. or D.O., please join the conversation inside Sermo.

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