Given the 50 percent accuracy rate of flu test results, health-care officials assume that anyone with flu symptoms right now has the H1N1 or swine flu.
Homer’s data chart shows that he has seen one case of H1N1 flu a week in the month of August.
The Food and Drug Administration approved the new swine flue vaccine – a long anticipated step as the government works to start mass vaccinations next month. Limited supplies should start trickling out the first week of October.
And as we in the Northern Hemisphere brace for the 2009-2010 swine-influenza pandemic, one thing – and one thing, only – is clear.
“We are in uncharted territory,” Centers for Disease Control and Prevention Director Thomas Frieden, M.D., announced last week.
Frieden’s speech came on the heels of some good news in the race to immunize those most vulnerable to the new and mutating H1N1 swine-flu virus that surfaced in Mexico last April, going on, by late July, to infect more than one million Americans, 5,000 of whom were hospitalized and 302 of whom died.
Last week, results from an Australian trial study of the vaccine developed specifically for the H1N1 virus indicated that just one dose, instead of the previously anticipated two doses, taken a month apart, offers protection against the H1N1 swine-flu virus.
Results of that study of healthy adults given a single 15-microgram dose of the H1N1-flu vaccine were published online by The New England Journal of Medicine, on Friday, Sept. 11. (No children took part in the study.)
Three days later, researchers in California announced that a single intravenous dose of an experimental drug, peramivir, cleared up flu symptoms in five days, making it as effective as the already stockpiled Tamiflu, which does double duty as a vaccination and treatment for flu victims.
Another plus: Peramivir is administered intravenously, a boon for flu patients who might have trouble swallowing pills, and whose bodies better absorb intravenously administered than orally administered medications.
But epidemiologists worry that the good news – an effective doubling of the amount of the precious H1N1 vaccination stockpile, and an increase in the amount and efficacy of flu-combating treatments – is still overshadowed by the bad, and the bad news is this: Help may still come too late to prevent those most vulnerable to the H1N1 swine-flu virus from getting it given the H1N1 flu’s relatively uncharacteristic timing.
“It would be bizarre for it to peak in January or February,” said Marc Lipsitch, M.D., an epidemiologist at the Harvard School of Public Health and consultant to the President’s Council of Advisors on Science and Technology, of H1N1 flu, “the way seasonal flu does.”
Already, parts of the American Southeast are experiencing flu levels usually seen in mid-winter.
The H1N1 virus, with transmission characteristics distinguishing it from the more garden-variety seasonal flu virus, a variation of which passes through the world’s population every year, came on the scene in late April, when the early-winter-to-early-spring flu season was over in the Northern Hemisphere, and well before it had begun in the Southern Hemisphere.
Over the course of the summer – a time of year not associated with flu season – the New York Times reports that the H1N1 virus caused a total of 6,506 hospitalizations and 436 deaths in the U.S. Another unusual characteristic: Its victims are young (with 17 the median age in Mexico), unlike the usual predominance of elderly victims of the more garden-variety seasonal flu that strikes every year in the winter months, killing an estimated 250,000 to 500,000 people worldwide.
The rapidity of the H1N1 outbreak alarmed officials, as did the heretofore unseen strain of H1N1 flu passing from human to human, according to Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases.
This human-to-human transmission differentiates the H1N1 from the H5N1 avian flu that has kept world health authorities anxious for several years because 257 of the 421 people who contracted it (or 61 percent) died. But unlike H1N1, H5N1 has little if any ability to pass from person to person (it mostly infects poultry), and some experts have suggested that there may be something about the H5N1 virus that makes it inherently less transmissible among people.
Despite the unlikeliness of human-to-human transmission, outbreaks a few years back of H5N1 led to the World Health Organization’s development of quantification standards that led, this summer, to the WHO’s designating the H1N1 swine-flu pandemic.
Some scientists argue that the H1N1 flu virus lacks the genetic earmarks of a highly lethal strain; others argue that it could pick up dangerous human flu genes as it circulates. It has, like the pandemic flus of the last century – the 1918 Spanish flu and lesser outbreaks in 1957 and 1968 – tended to strike young, healthy people the hardest. On a positive note, scientists say a majority of the tens of millions of those who died worldwide from the Spanish influenza of 1918 to 1919, which spread fast and widely, would not have died today, thanks to the anti-flu drugs, antibiotics and mechanical ventilators now available. Anticipating a worst-case scenario nonetheless, epidemiologists prioritized a group of approximately 150 million Americans – roughly one-half of the population, including critical health-care workers and emergency medical responders as well as those with the highest risk of complications and severe illness from the new H1N1 virus – as eligible for the first round of H1N1 flu vaccinations. Also prioritized: pregnant women; children and young adults from 6 months to 24 years of age and their caretakers; right behind them are anyone age 25 to 64 with medical problems, and anyone caring for infants younger than 6 months. In a complete departure from seasonal-flu vaccination policy, the last group eligible for the H1N1 vaccine is healthy people over age 65, who indicate some resistance to the virus.
U.S. Department of Health and Human Services Secretary HYPERLINK "http://topics.nytimes.com/top/reference/timestopics/people/s/kathleen_sebelius/index.html?inline=nyt-per"Kathleen Sebelius, who received her seasonal shot last week, has urged Americans to “take some individual responsibility to stay healthy during the flu season” by getting their seasonal flu vaccinations now.
Precautions range from the relatively simple – frequent and thorough hand-washing; no touching of the hands to the eyes or nose; covering the mouth when sneezing – to the relatively complex – ascertaining one’s place in the seasonal flu and the H1N1 swine-flu vaccination program.
And while the U.S. government has ordered nearly 200 million doses of the H1N1 flu vaccine, in addition to the 120 million doses of seasonal flu vaccine now on the market, the fact that it is, at best, available early next month is a serious concern to epidemiologists and health officials, who fear it may be needed sooner.