15 May, 2009

Swine Flu in United States - H1N1Update, May 14, 2009

Case numbers increased significantly from yesterday, an additional 946. CDC reports 4,298 cases of swine flu, H1N1, in the United States. Only four states have no reported cases, Alaska, Mississippi, West Virginia and Wyoming.

The curious mix of case locations continues. The twelve states in the Midwest have 35% of the total U.S. cases (1,522) while the four states that border Mexico have 32% (1,394). Those numbers are not reflective of a region-wide outbreak, since New Mexico reports 51 cases while the other three border states have over 400 each. In the Midwest, the cases are primarily limited to Illinois-620, Wisconsin-510 and Michigan-141. The other states in the Midwest have only 251 cases between them.

Five states have reported 57% of the swine flu, H1N1 cases, Illinois, Wisconsin, California, Texas and Arizona.

Current Statistics

As of 11:00 AM (ET), the United State is reporting 4,298 confirmed and probable cases of H1N1 influenza in 46 states and the District of Columbia. The death count remains at 3. Specifically:

Alabama -- 41 cases

Arkansas -- 1 case

Arizona -- 431 cases

California -- 473 cases

Colorado -- 47 cases

Connecticut -- 38 cases

Delaware -- 58 cases

Florida -- 65 cases

Georgia -- 36 cases

Hawaii -- 10 cases

Idaho -- 5 cases

Illinois -- 620 cases

Indiana -- 70 cases

Iowa -- 58 cases

Kansas -- 28 cases

Kentucky -- 13 cases

Louisiana -- 45 cases

Maine -- 13 cases

Maryland -- 28 cases

Massachusetts -- 109 cases

Michigan -- 141 cases

Minnesota -- 34 cases

Missouri -- 20 cases

Montana -- 5 cases

Nebraska -- 23 cases

Nevada -- 25 cases

New Hampshire -- 18 cases

New Jersey -- 12 cases

New Mexico -- 51 cases

New York -- 224 cases

North Carolina -- 12 cases

North Dakota -- 1 case

Ohio -- 12 cases

Oklahoma -- 22 cases

Oregon -- 94 cases

Pennsylvania -- 50 cases

Rhode Island -- 8 cases

South Carolina -- 34 cases

South Dakota -- 5 cases

Tennessee -- 63 cases

Texas -- 439 cases and 2 deaths

Utah -- 80 cases

Vermont -- 1 case

Virginia -- 20 cases

Washington -- 195 cases and 1 death

Washington, D.C.-- 10 cases

Wisconsin -- 510 cases.

A New Influenza Virus

Novel influenza A (H1N1) is a new flu virus of swine origin that was first detected in April, 2009. The virus is infecting people and is spreading from person-to-person, sparking a growing outbreak of illness in the United States. An increasing number of cases are being reported internationally as well.

It’s thought that novel influenza A (H1N1) flu spreads in the same way that regular seasonal influenza viruses spread; mainly through the coughs and sneezes of people who are sick with the virus.

It’s uncertain at this time how severe this novel H1N1 outbreak will be in terms of illness and death compared with other influenza viruses. Because this is a new virus, most people will not have immunity to it, and illness may be more severe and widespread as a result. In addition, currently there is no vaccine to protect against this novel H1N1 virus. CDC anticipates that there will be more cases, more hospitalizations and more deaths associated with this new virus in the coming days and weeks.

Novel influenza A (H1N1) activity is now being detected through CDC’s routine influenza surveillance systems and reported weekly in FluView. CDC tracks U.S. influenza activity through multiple systems across five categories. The fact that novel H1N1 activity can now be monitored through seasonal surveillance systems is an indication that there are higher levels of influenza-like illness in the United States than is normal for this time of year. About half of all influenza viruses being detected are novel H1N1 viruses.

CDC Response

CDC continues to take aggressive action to respond to the outbreak. CDC’s response goals are to reduce the spread and severity of illness, and to provide information to help health care providers, public health officials and the public address the challenges posed by this new public health threat.

CDC is issuing updated interim guidance daily in response to the rapidly evolving situation.

Clinician Guidance

CDC has issued interim guidance for clinicians on identifying and caring for patients with novel H1N1, in addition to providing interim guidance on the use of antiviral drugs. Influenza antiviral drugs are prescription medicines (pills, liquid or an inhaler) with activity against influenza viruses, including novel influenza H1N1 viruses. The priority use for influenza antiviral drugs during this outbreak is to treat severe influenza illness, including people who are hospitalized or sick people who are considered at high risk of serious influenza-related complications.

Public Guidance

In addition, CDC has provided guidance for the public on what to do if they become sick with flu-like symptoms, including infection with novel H1N1. CDC also has issued instructions on taking care of a sick person at home. Novel H1N1 infection has been reported to cause a wide range of symptoms, including fever, cough, sore throat, body aches, headache, chills and fatigue. In addition, a significant number of people also have reported nausea, vomiting or diarrhea. Everyone should take everyday preventive actions to stop the spread of germs, including frequent hand washing and people who are sick should stay home and avoid contact with others in order to limit further spread of the disease.

Testing

CDC has developed a PCR diagnostic test kit to detect this novel H1N1 virus and has now distributed test kits to all states in the U.S. and the District of Columbia and Puerto Rico. The test kits are being shipped internationally as well. This will allow states and other countries to test for this new virus. This increase in testing will likely result in an increase in the number of confirmed cases of illness reported. This, combined with ongoing monitoring through Flu View should provide a fuller picture of the burden of disease in the United States over time.

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