Influenza Update - December 14

Pandemic H1N1 Update Dr. Stuart B. Weiss INFLUENZA UPDATE Dec 14, 2009 SUBSCRIBE: Click button at bottom or send email to: sbw1@MedPrepGroup.com Give yourself an early holiday gift, get vaccinated. As influenza activity in the U.S. and much of Europe continues to wane and vaccine stockpiles continue to increase, now is the time to get vaccinated for H1N1 (2009) before the winter wave arrives. Current Situation: The CDC confirmed that the number of states reporting widespread influenza activity has decreased again, from 25 states down to 14. The number of people visiting physicians in the US for influenza-like illness has decreased again this week. the CDC released new projections indicating that approximately 50 million American have gotten pandemic H1N1 or about 15% of the U.S. population. The flu has resulted in about 200,000 hospitalizations so far, a number that equals a usual entire flu season (and we are only in December), and approximately 9820 deaths with 1,090 children, 7450 adults 18-64 and only 1280 people over 65. This is markedly different from the usual flu pattern. The number of new influenza cases on college campuses increased after the Thanksgiving break. It had been dropping for the past several weeks. The WHO reports that while there is slowing of influenza activity in North America and most of Europe, activity continues across the northern hemisphere: Europe: Activity has peaked or is peaking across Europe except in France where activity is still rising. East Asia: Increasing influenza-like illness in Japan and northern China. Hong Kong and Chinese Taipei are showing increasing activity after a previous peak. South and Southeast Asia: India and Sri Lanka continue to show increasing flu intensity. Africa: Limited data shows continued activity across the continent (except in South Africa where it is summer) Southern Hemisphere: Little to no activity. Vaccine Update: The CDC reported that 73 millions doses of vaccine has been released. Many states across the U.S. are relaxing their vaccination guidelines to include anyone who wishes to be vaccinated. CDC reported 16 additional pediatric deaths this week due to flu related complications. Two studies came out showing a disparity in death rates among ethic minorities. A study in Illinois showed the death rate in Blacks and Hispanics to be twice the rate of Caucasians. A second study in New Mexico showed a higher death rate in Native Americans. There are many factors that may have contributed to this and it will take more time to sort this out. A new study looked at the death rates for this pandemic. The death range, depending on how it is calculated, ranges from slightly above a typical flu season to markedly less than a typical flu season. More time will be required to come to more definitive numbers. Another study looked at immunity and suggested that many people many have some partial immunity which explains that large number of cases but the low death rate. There was a report in the British Medical Journal and investigated by a British Television station looking into the usefulness of Tamiflu to prevent serious complications of seasonal flu. After reading the articles and the rebuttals, it seems there is much more being written about access to data than about the usefulness of Tamiflu. this report focused on seasonal flu and did not discuss pandemic flu. the bottom line is that more transparency in study data is necessary in the future. The USDA licensed the first pig H1N1 (2009) vaccine that can be used by pork producers. It is produced by Pfizer Animal Health division. HOUSEKEEPING ITEM: If you get this Alert through a mailing list and not directly from us, subscribe by clicking the button at the bottom or send an email to me at sbw1@MedPrepGroup.com ANALYSIS: I had the opportunity to speak to a large group of legislators this past weekend about H1N1 (2009). One of their main questions was whether we are done with the flu or will there be a third wave. While it is impossible to know for certain, there are several factors which makes me think we may not be through with this flu. First, if you look back at the 1957 flu, there was a great big peak in early winter which died down nicely and then renewed its attack rate in February/March 1958. Second, if we look at the illness rate on college campuses after Thanksgiving break, when students returned from home, we saw a bump in the number of cases and Christmas break is rapidly approaching. Third, only 15% of American have gotten the illness and have immunity. Even if you add in the immunity that some older American have, and the folks getting vaccinated, we still have a large number of people who are susceptible in this country (probably more than half our population). Taken together, it seems like it is likely that we will have another wave. So although I don't have a crystal ball, I continue to advise clients to keep their eye on this problem and keep their pandemic planning efforts up to date. This is what I told the legislators as well. I also reminded them that influenza viruses are notorious for mutating. This virus has remained stable so far but that is another unknown in the equation and another reason to keep your planning efforts on track at some level. Lastly, if you think this is a mild flu, just look at the pediatric death rate. We have almost 1100 kids that have died already from H1N1 (2009) complications. That is many times the normal number of children that died of flu. So although most people recover uneventfully, this is taking a hard toll on our children. ADVICE: Get vaccinated. It is a safe vaccine and now that there is enough, it should be not problem to get you and your family and co-workers vaccinated. Speak to your doctor or visit a local health clinic. Do it now. Take this opportunity to compile lessons learned over the past 8 months. Look at what worked and what didn't work and revise your plans. This breather we are having is a gift you should take advantage of. If I am correct and we have a third wave, if you have updated your plans, you will be ready. TOOLS: Pandemic QuickStart - If you need to quickly bring your company up to speed with its pandemic planing efforts, we can help with our quickstart resources. Virtual Medical Director - If you don't have a corporate medical director, our Virtual Medical Director program may be a good solution for you. Our Virtual Medical Director service provides you with 24 hour access to physicians and experts trained in emergency medicine, disaster medicine, business continuity, occupational health and mental health crisis management to give you situation updates, analysis and advice. We have affordable decision support plans that you can enroll in. Pandemic Planning Assistance - We have a policy matrix, policy toolkits, FAQ's, posters, employee educational materials, a trigger based action plan template . We can help you jumpstart your planning or take a look at your current plans with a fresh set of eyes. Not preparing now would be a serious mistake. If you have any questions or concerns that we can help you with, please feel free to reach out to me. My email is: sweiss@MedPrepGroup.com MedPrep Consulting Group is internationally recognized as a leader in pandemic, disaster and business continuity planning, training and exercising. We have resources and expertise that you can count on. Ask us about our Virtual Medical Director Program. Dr. Stuart Weiss is the CEO of MedPrep Consulting Group. For more information, visit www.MedPrepGroup.com Stuart Weiss, MD, CBCP MedPrep Consulting Group LLC