H1N1 Virus: What is REALLY the “epidemic”?

I keep getting forwarded memos from the state about the Swine Flu, or H1N1 virus, due to my position as an educator.

These are my thoughts on the swine flu:

I do not want at all to diminish the seriousness of A H1N1, and I know that as a public institution we need to be aware of public health issues, however I believe that there are other contagious diseases just as serious that we never get memos about, yet they occur all year long. Typically schools are not shut down until a certain percentage of the population is known to have been infected.

Upon examining the CDC site, for example, I looked at just one week, week 14, of pneumonia and influenza season in the U.S.:  http://www.cdc.gov/flu/weekly/weeklyarchives2008-2009/weekly14.htm

in which it was reported that:

During week 14, 7.8% of all deaths reported through the 122-Cities Mortality Reporting System were due to P&I. This percentage is equal to the epidemic threshold of 7.8% for week 14.

I have not taken the time to investigate the weeks prior to this, however the CDC reports that an average of 36,000 people die EACH YEAR from influenza:

http://www.cdc.gov/flu/about/disease/us_flu-related_deaths.htm

Perhaps it is the relative number of incidents that is causing alarm?

My son  was having flu like symptoms yesterday and today.  He tried to call in sick, but his employer told him he had to come to work and that being "sick" wasn’t an excuse for missing.  So he went to the doctor. At the doctor’s office, everyone, including patients in the waiting room ,was wearing masks.  The doctor concluded that my son has a general virus and nothing to worry about at this time, but tested him for swine flu anyway.  He reported to work as commanded by his supervisor.  Once there, he reported the outcome of his visit to the doctor and when he mentioned that he had been tested for swine flu, he was ordered to go home immediately.

So it wasn’t good enough that my son had a virus that could infect everyone, but the thought of possibly having the swine flu virus was enough to make him go home.

So really, what is the "epidemic" here?

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Influenza A H1N1 (Swine Flu)
Utah Public Health Situation Report
5/1/2009

UDOH operations center (801) 535-0113  (0800-1700 hours)
Call 211 after hours

Note: The Centers for Disease Control and Prevention (CDC) have
updated the name of the virus to Influenza A H1N1 (Swine Flu)

Status summary as of Friday, May 1:

       Utah:
       Public health is reporting:
               0 confirmed             9 probable cases of H1N1 (4 more than 4/30)
Influenza-like illness, as reported by sentinel providers, is
currently at 0.65%, below the outbreak level of 1.72%.

6 cases from Summit County
2 cases from Salt Lake County
1 case from Weber-Morgan Health District

       U.S. and World:
The World Health Organization (WHO) is reporting the following world
situation for swine influenza and the CDC for the U.S.:
·       Worldwide               363 confirmed cases (197 more than 4/30)
·       United States           141 confirmed cases     1 death
o       This is 32 cases more than 4/30
o       Cases detected in 19 states ? eight more than yesterday
o       The death was in a 22 month old child in Texas
·       Mexico          156 confirmed cases9 deaths*    (130 more than 4/30)
·       Canada          34 confirmed cases      0 deaths        (21 more than 4/30)
·       Spain           13 confirmed case       0 deaths        (9 more than 4/30)
·       United Kingdom  8 confirmed cases       0 deaths        (3 more than 4/30)
·       New Zealand     3 confirmed cases       0 deaths
·       Germany         3 confirmed cases       0 deaths
·       Israel          2 confirmed cases       0 deaths
·       Austria         1 confirmed case        0 deaths
·       Switzerland     1 confirmed case        0 deaths        (1 more than 4/30)
·       Netherlands     1 confirmed case        0 deaths        (1 more than 4/30

CDC reports:
·       They have not yet developed a severity index.  The US case fatality
rate is 0.7% and the world case fatality rate is 2.8%.
·       There is NO ASSOCIATION between H1N1 illness and swine.  There is no
increase in illness in swine.
·       Findings indicate that transmission in Mexico involves
person-to-person spread with multiple generations of transmission.

* The WHO only reports confirmed deaths.  There are many deaths that
are being attributed by the media to this outbreak.  This situation
report will only reflect cases that are confirmed.

Alert phase:
The WHO alert phase was increased to level 5: Human-to-human spread of
the virus into at least two countries in one WHO region.  While most
countries will not be affected at this stage, the declaration of Phase
5 is a strong signal that a pandemic is imminent and that the time to
finalize the organization, communication, and implementation of the
planned mitigation measures is short.

Travel Advisories:
At this time, the CDC recommends that U.S. travelers avoid all
nonessential travel to Mexico.  The WHO is not advocating restricting
travel.

Public Health Activities:
Guidance:
Several new interim guidance documents have been published by the CDC:
·       School Dismissal and Childcare Facilities
·       Alert for Institutions of Higher Education
·       HIV Infected Adults and Adolescents
·       Clinician Guide Pregnant Women
·       Guidelines for Submission of Tissue Specimens for Pathologic
Evaluation of Influenza Virus Infections
·       Biosafety Guidelines for Lab Workers
·       Flight Crews Arriving from Affected Areas
·       Psychological Support for Essential Workers During a Pandemic
Several new guidance documents have been published by the Utah
Department of Health:
·       Clinician Guidance on Who and When to Consider Prophylaxis
·       Infection Control Guidance on Patient Care (Confirmed or Suspect
Cases) in Healthcare Setting

Things You Can Do to Stay Healthy:
Community Activities:
·       Be aware that community-level ?social distancing? or ?keeping our
distance? from each other will lessen the spread of flu.
·       When the disease enters a community, social distancing measures such
as school closures, teleworking, etc. may be recommended as a means of
limiting spread.

Personal Activities:
·       Stay home from school, work, and other social gatherings when you
are ill.  Stay home for 7 days or until your symptoms go away,
whichever is longer. *NEW*
·       Cover your nose and mouth with a tissue or your elbow when you cough
or sneeze.  Throw the tissue in the trash after you use it.
·       Wash your hands often with soap and water, especially after you
cough or sneeze. Alcohol-based hands cleaners are also effective.
·       Consider developing a family emergency plan as a precaution.  This
should include storing extra food, medicines, facemasks, and other
essential supplies.

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