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Welcome to G-Line

admin — Mon, 19 Oct 2009 13:38:28 +0000

Mission: To provide health care professionals and the general public with an authoritative, convenient, locally relevant web site to disseminate information about health care emergencies in the Augusta, Georgia region. The current focus is on the H1N1 “Swine Flu” pandemic.

Sponsors: This site was created and is maintained through a collaboration between the East Central Health District offices of the state Health Department and the Medical College of Georgia, which serves as the Regional Coordinating Hospital for Region G (Augusta and nearby counties). All 14 member hospitals of Region G contributed to the design of G-LINE and provide content on an ongoing basis.

National Visits Influenza-like Illnesses: May 28, 2010

admin — Mon, 05 Oct 2009 13:41:12 +0000

This graph posted by the Centers for Disease Control and Prevention (CDC) on May 28 2010 shows visits for influenza-like illness (ILI) nationwide during the week ending May 22. There is generally a one-week lag between data collection and release to the public. The units at the bottom of the graph indicate the date by week of the year. Flu activity has abated signficantly since the peak in October 2009. The current curve shows ILI activity nationally has now been below the epidemic threshold since the beginning of the year. The persistence of circulating influenza in the US Southest that was noted from February to April 2010 has abated.

Note that the ILI curve has declined substantially, well below the epidemic threshold, and is now close to the baseline of 1%. See “What does this curve mean” (below) for an explanation.

The ILI curve began an upward trajectory during the second week of August 2009, corresponding to the “second wave” of the 2009 H1N1 pandemic when children began to return to school after summer vacation. This resurgence began in Georgia and then spread nationwide. It is interesting to note that the US Southeast, including Georgia, was also the last significant region of influenza activity in the pandemic’s second wave.

How is this curve constructed? Each week a group of “sentinel providers” around the country reports to CDC on how many of their patients in emergency departments and clinics have illnesses that match the CDC case definition for “influenza-like illness”, or ILI. ILI is defined as fever PLUS either cough or sore throat that cannot be attributed to another cause such as Strep throat (i.e. Strep throat is NOT an ILI). This data is collected at CDC and posted.

What does the curve mean? The ILI curve does not tell us the total number of people with flu, it tells us what proportion of patients around the country have an illness like the flu. ILI occurs at a low background rate of 1-2% throughout the year, even when flu is not circulating. This background rate of ILI is due to other viruses such as Rhinovirus (cold virus), RSV, and Parainfluenza. Years of experience has shown that when the ILI curve peaks in the winter, it closely correlates with actual influenza activity as determined by more tedious and expensive viral cultures. Thus, the ILI curve provides a convenient way to track the progress of our yearly influenza season, which almost always arrives between December and March. During the winter (i.e., flu season), most people with ILI actually do have the flu. During the summer and autumn months, patients with ILI almost invariably are infected with other respiratory viruses. The summer of 2009 was a major exception to this rule, reflecting the first wave of pandemic flu due to H1N1 during the US summer months.

Weekly Flu Activity Nationwide: May 28, 2010

admin — Mon, 05 Oct 2009 13:12:52 +0000

This map posted by the CDC on May 28 shows activity of 2009 H1N1 ”Swine Flu” nationwide during the week ending May 22, 2010. This is the final CDC update map for the 2009-2010 season. The map is updated weekly, but there is a one week lag between data collection and data availability. The current map shows that virtually the entire country is reporting either sporadic activity (light brown) or no activity at all. Only Hawaii is reporting “local” activity, the next level up from sporadic. The second wave of Swine flu reached its greatest extent during the week of Oct 23 2009, when all but one state in the continental US was reporting widespread activity. As recently as Nov 21, widespread activity was still reported in the majority of the states in the US. During Christmas week there were 7 states reporting widespread flu activity and 18 reporting regional activity.

No state has reported widespread activity since the second week of January 2010. There was a persistence of regional activity in the Southeast US that lasted from mid-January to mid-April, but that has abated. This is the same region where the second wave of Swine Flu began in August 2009.

These data indicate that the second wave of the H1N1 outbreak that began in late August 2009 is over. The first wave appeared from April to August of 2009. There was some speculation that the persistence of regional activity in the US Southeast into April of 2010 could signal a “third wave”, but given the diminution in flu activity even in this region over the past 4-6 weeks, a third wave does not appear to be imminent. Both the CDC and WHO have predicted that 2009 H1N1 will be the predominant strain of flu in circulation in the coming 2010-2011 influenza season, and for that reason the routine influenza vaccine for next season will include protection against 2009 H1N1.

This is the last CDC update on the 2009-2010 flu season. Data are colleced on flu activity through the summer months, but the weekly updates will not start again until the official beginning of the 2010-2011 flu season in October 2010 .

Click here to find the Flu View weekly update maps from CDC. Scroll to the bottom of that web page, then click on the tab for “previous week” to see the weekly maps in reverse consecutive order as far back as October 2008. This encompasses both the seasonal flu during the 2008-2009 flu season as well as waves one and two of the Swine Flu pandemic from April 2009 to April 2010.

An explanation from CDC for each category follows:

Summary of the Geographic Spread of Influenza — State health departments report the estimated level of influenza activity in their state each week through the State and Territorial Epidemiologists Reports. States report influenza activity as no activity, sporadic, local, regional, or widespread. These levels are defined as follows:

No Activity: No laboratory-confirmed cases of influenza and no reported increase in the number of cases of ILI.
Sporadic: Small numbers of laboratory-confirmed influenza cases or a single laboratory-confirmed influenza outbreak has been reported, but there is no increase in cases of ILI.
Local: Outbreaks of influenza or increases in ILI cases and recent laboratory-confirmed influenza in a single region of the state.
Regional:Outbreaks of influenza or increases in ILI and recent laboratory confirmed influenza in at least two but less than half the regions of the state with recent laboratory evidence of influenza in those regions.
Widespread:Outbreaks of influenza or increases in ILI cases and recent laboratory-confirmed influenza in at least half the regions of the state with recent laboratory evidence of influenza in the state.

Click here for the actual CDC site with further information.

Augusta Area Update

admin — Mon, 28 Sep 2009 13:13:05 +0000

H1N1 “Swine Flu” pandemic

May 7 2010

Flu activity in Augusta and in the state appears to have abated over the past 6 weeks. During the period from mid-January to mid-April, there was a slight increase in hospitalizations and deaths reported to the Georgia State Health Department compared to the December-January period. That increase was also noted in Augusta, where a number of hospitals reported additional patients in their intensive care units and hospital inpatient units with suspected or confirmed H1N1. There was also a persistence of patients in Augusta area clinics and emergency departments presenting with flu-like illness. That persistent circulation of flu appears to have abated both in Augusta and in the state of Georgia.

During the week ending May 7, Augusta area physicians and hospitals are reporting little flu activity. One area hospital admitted a previously healthy adult with severe, rapidly progressive pnuemonia five days after she and her husband developed a flu-like illness. The monthly volume in the local Children’s Hospital emergency department in April was down compared to the marked increases seen from August to November 2009, and is more in line with the volume expected for this month based on past years. Local office-based pediatricians are not reporting unusual levels of respiratory illness in children this week.

March 30, 2010

Georgia appears to be at the epicenter of flu activity in the US this week. The state health department issued a release last week stating that hospitalizations are up, and scattered reports of deaths due to 2009 H1N1 continue to be received from around the state. Click here to read the transcript from a CDC press conference held today that focuses on the resurgence of flu in Georgia and the southeast.

Two Augusta area hospitals reported to G-LINE this week about flu activity in their facilities. Both currently have inpatients with proven influenza. 2009 H1N1 has been confirmed in some, with results pending in several others. Although the numbers are small, this does represent more activity than was reported in Augusta 6 weeks ago. At least two Augusta area children were ill enough within the past week to require treatment for influenza in an intensive care unit.

Augustans should not be overly alarmed by this information. The number of infections is much smaller than it was in September, when the second wave of the pandemic peaked in the Central Savanna River Area. Augusta area emergency departments are not reporting unusually high numbers of people with flu-like illness this week.

It is not clear if this is the beginning of a “third wave” of the pandemic. At this point, the numbers do not justify labeling this resurgence as a true third wave.

March 22, 2010

Influenza is still present in the Region G area, but it appears to be circulating at low levels. Two Augusta hospitals reported admissions of patients with flu in the past two weeks, including one patient who was admitted to an intensive care unit (ICU) with confirmed H1N1. One of these hospitals further reported that they admitted 5 patients to their intensive care unit for influenza-like illness in February and nine so far in March.

Local emergency departments and clinics are not reporting unusually high patient volumes. Area hospitals are not reporting unusually high levels of employee absenteeism. It is important to note that Georgia, Alabama, and Mississippi are the only three states in the continental US still reporting regional flu activity, while seven nearby states are reporting local activity. This is the only region of the country that still has significant circulation of flu.

The “second wave” of H1N1 began in August 2009 in Georgia, spread quickly through the South East region, then spread nationally. H1N1 activity peaked in October 2009. It is not yet clear if we will see a third wave of flu from this pandemic. The fact that we have not had an increase in H1N1 during the winter months, the typical period for circulation of influenza, suggests that that the end of this pandemic may be near, at least until our next flu season begins in December.

G-LINE will continue to monitor and report on the situation.

February 4, 2010

Flu activity remains low, but it is not absent. Several primary care physicians in Columbia County reported multiple positive results on flu rapid test in pediatric patients last week. It is important to note that while flu is dramatically down over most of the country, Georgia still remains at Regional activity on the CDC map and is in the center of a South East Region that appears to be the primary focus of flu in the nation.

When H1N1 began to suddenly rise in August in Augusta, all area hospitals instituted policies restricting visitation to inpatient units by children under the age of 18. The reason for this was that children have been the primary targets for this influenza subtype. By restricting their access to the inside of hospitals, officials felt they were better able to protect vulnerable patients and staff. Most regional hospitals have lifted these restrictions now that the second wave of H1N1 appears to be past us. However, visitors with flu-like illness should still voluntarily exclude themselves.

It is not clear if we can expect a third wave of H1N1 this winter. We are well past the second wave, which peaked in October. So far there are no reports of significant numbers of patients reported with typical seasonal flu strains. However, there is still flu activity in the South East Region, which could escalate into a third wave of H1N1. This would prompt the resumption of restrictions.

January 14, 2010

Flu activity in Augusta and in the state of Georgia is now negligible. Volumes in area emergency departments and clinics are down substantially from September and October when H1N1 was circulating heavily in our community. Patients continue to present with influenza-like illness, or ILI, but most of these people are infected with other respiratory viruses and not with flu. The symptoms are quite similar, and just as in patients with flu, most of these patients can be cared for at home with supportive care alone. Viral respiratory infections are generally self limiting, meaning they last a predictible period of time and then resolve without any interventions from a doctor. Antibiotics are of no value in the treatment of any viral infection; they are useful only for infections caused by bacteria, such as Strep throat or urine infection.

H1N1 vaccine is plentiful in the Augusta area for those who would like to receive the vaccine. While H1N1 is largely gone from the Augusta area, it is still possible that we will see its return in a “third wave”, possibly during our usual flu months of January through March.

December 23, 2009

The fall wave of H1N1 appears to have passed Augusta. Patients with influenza-like illness (ILI: sudden onset of fever PLUS cough or sore throat) continue to present for care, but these symptoms do not appear to be due to H1N1; there have been no reports of patients positive for H1N1 in Augusta at three major area hospitals in the past 4 weeks. A significant portion of the patients in emergency departments and clinics with ILI also have conjunctivitis, or “pink eye”, suggesting Adenovirus as the cause. Like flu, adenovirus infections are largely self-limiting and do not respond to antibiotics. Treatment of these viral respiratory infections includes bed rest, lots of fluids, fever lowering medications for comfort, and time. Most patients have shown significant improvement in 5-7 days.

H1N1 vaccine is now plentiful in Augusta and available for anyone who wants it. The vaccine is no longer targeted only for high risk individuals.

Dec 4, 2009

The “second wave” of Swine Flu that appeared in the Augusta region in August is clearly on the decline. None of three major area hospitals reporting to G-LINE this week have confirmed any cases of H1N1 influenza in the past four weeks. The number of patients presenting to area hospitals and emergency departments with influenza-like illness is down substantially. Rates of influenza-like illness in Georgia and around the country have been on the decline for at least four weeks. In response, some hospitals in Augusta have suspended their policies restricting visits to inpatient units by children.

The state Health Department issued a statement today indicating that H1N1 vaccine supply and demand are coming into balance. As a result, H1N1 vaccine is no longer restricted to priority groups. Anyone who wants H1N1 vaccine should now be able to get it. See the update and original letter under “Information for Doctors”.

Nov 20, 2009

The thirteen counties in Region G (Augusta Ga and surrounding counties) continue to see large numbers of patients with ILI, although the numbers appear to be declining. All area hospitals continue to limit visitation by children. No area hospitals have implemented their ER surge or disaster plans for H1N1 at this time. All hospitals continue to monitor flu activity, paying particular attention to people who are sick enough to require admission to an intensive care unit. All hospitals are also monitoring ED visits and sending summary data to the appropriate local, state and federal agencies. So far school absenteeism has not been a major problem, and we anticipate that the coming Thanksgiving break may help to further supress the spread of the H1N1 virus.

Nov 11, 2009

The steady decline in the rate of flu-like illness (ILI) in the state of Georgia appears to have leveled off, with some ILI activity still remaining in our state. Currently about 5-6% of all visits to clinics and emergency departments in Georgia are for ILI after peaking at close to 12% during the first week of September. In Augusta, clinics and emergency departments remain busy but the volume of patients is much lower than it was 6 weeks ago. Augusta area hospitals continued to confirm H1N1 in inpatients during the last two weeks of October, but the number appears to be declining. Tamiflu and Relenza, the two antiviral medications that are effective against H1N1 “Swine Flu”, are still available in the Augusta area, although the pediatric suspension of Tamiflu is reportedly hard to find.

Two deaths have been reported from the Augusta district since the “second wave” of H1N1 began in late August. There have been 30 deaths due to H1N1 in Georgia since Sept 1, including 2 children age 0-4 years, 5 children age 5-18 years, 1 young adult 19-24 years, 11 adults 25-49 years, 10 adults 50-64 years, and 1 adult over the age of 65.

Nov. 2, 2009

The state of Georgia and the Augusta region have shown a steady decline in the proportion of patients with flu-like illness since the middle of September. Area clinics and emergency deparments are still busy compared to the same period last year, but not nearly as much as they were just four weeks ago. Our state was the first in the US to see the resurgence of H1N1 in August, probably because our children go back to school earlier than the children in the rest of the country. The fact that Georgia largely escaped the H1N1 outbreak in May and June may also have played a role in our state leading the resurgence. There were 26 deaths due to H1N1 reported in Georgia from Sept 1 to Oct 29, including two from the Augusta District.

Oct. 1, 2009

The H1N1 pandemic flared in Augusta in mid-August as it did throughout the state, probably due to the start of the new school year. H1N1 has caused a significant amount of illness since then in Region G, which includes Augusta and 8 nearby Georgia counties. Private physician offices and local emergency departments are experiencing markedly increased patient volumes compared with the same period last year. As is true around the country, this pandemic has so far had a much greater effect on children and young adults than on older adults. In the Medical College of Georgia Emergency Department, pediatric volume for the month of September was 60% above that for September of 2008, while the volume of adult patients showed no change. Most of the patients with flu-like illnesss are able to be managed at home, usually without the need for antiviral medications such as Tamiflu. Only a small number of patients have required admission to the hospital due to flu. There has been only one death in Augusta confirmed to be due to H1N1.

Georgia ILI Curve June 25, 2010

admin — Mon, 28 Sep 2009 13:12:26 +0000

This graph from the Georgia Division of Public Health (updated 6-25-2010) shows visits for influenza-like illness (ILI) in our state during week 24. The Georgia ILI curve began a sharp upward trajectory during the second week of August (see below), indicating the resurgence of pandemic 2009 H1N1 when children began to return to school after summer vacation. The resurgence began in Georgia and then spread nationwide. The Georgia curve showed a steady decline from the first week of September until early January, when it leveled off. There was a regional persistence of flu circulation in the South East, including Georgia, that was noted from late January to late March 2010. The ILI rate in Georgia as of week 10 (March 2010) was 3.3%, and hospitalizations and deaths in Georgia due to H1N1 rose slightly during the months of February and March. ILI activity has subsequently declined in our state. As of the end of June, only about 1% of emergency deparment visits in Georgia were for influenza-like illness (see explanation below). The second wave of pandemic 2009 H1N1 is over.

Note that H1N1 vaccine did not become available in Georgia or anywhere else in the United States until mid-October. This means the decline in ILI in Georgia began before the arrival of vaccine against H1N1. It is not clear how much of an impact the H1N1 vaccine had on the decline of flu cases in Georgia or in the nation.

For the complete weekly influenza update from the Georgia Divison of Public Health please click here.

What does the curve mean? The ILI curve does not tell us the total number of people with flu, it tells us what proportion of patients around the country have an illness like the flu. ILI occurs at a low background rate of 1-2% throughout the year, even when flu is not circulating. Years of experience has shown that when the ILI curve peaks in the winter, it closely correlates with actual influenza activity as determined by more tedious and expensive viral cultures. Thus, the ILI curve provides a convenient way to track the progress of an influenza outbreak. During the winter (i.e., flu season), most people with ILI actually do have the flu. During the summer and autumn months, patients with ILI almost invariably are infected with other respiratory viruses that are not influenza. The summer of 2009 was a major exception to this rule, reflecting the spread of pandemic flu due to 2009 H1N1 during the US summer months. Georgia largley escaped the H1N1 outbreak during the first few months of this pandemic. The national curve showed much higher rates of ILI during June and July than did the Georgia curve.

National Impact of 2009 H1N1

admin — Mon, 28 Sep 2009 13:11:44 +0000

June 2010. Flu activity has all but disappeared in the United States after a slight resurgence from February to April in the US Southeast. Only one state (Hawaii) was reporting local activity as of the final CDC report for the 2009-2010 season (May 30), while the rest of the states reported sporadic acitivity or no activity at all. The percentage of visits to clinics and emergency departments for influenza like illness has declined to the summer baseline. The second wave of the 2009 H1N1 pandemic is over.

The last Pediatric death due to 2009 H1N1 occurred in March 2009. From April 2009 to May 2010 there were a total of 285 deaths in children due to the Swine Flu and another 53 deaths from influenza isolates that were not further characterized. The overall mid-point estimate of deaths in all age groups due to pandemic 2009 H1N1 is approximately 12,000.

Some perspective on the pediatric deaths Each year since 2004, CDC has tracked the number of pediatric deaths due to seasonal flu (winter season flu). In the 2003-2004 flu season, 154 children died throughout the nation from “Fujian flu”, a particularly severe strain. Since then, the number of deaths nationally has ranged from 78 to 117 per flu season. There are approximately 75 million children under age 18 living in the United States. Approximately 2,000 children die each year in auto accidents.

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April 30, 2010. Week 16. Flu activity has declined significantly nationwide. Only two states (Alabama and South Carolina) are reprting local activity of influenza, while the rest of the country is reportitng either sporadic activity or none at all. The percentage of visits to clinics and emergency departments for influenza like illness has declined almost to the summer baseline . There have been no pediatric deaths due to influenza anywhere in the US in the past two weeks. The total number of children known to have died from influenza in the past year include 272 since the “second wave” of 2009 H1N1 appeared in late August 2009, and an additional 65 who succumbed during the “first wave” of Swine Flu from April to August 2009.

Impact in All Age Groups Deaths and hospitalizations due to flu remain very low although flu activity has not disappeared. CDC reports 2,125 laboratory confirmed deaths due to flu in the United States since August 2009. However, this is likely an undercount, since many cases are not reported or are undetected. The CDC estimates that as of February 2010, approximately 59 million people nationwide have been infected by 2009 H1N1, and 12,000 have died. Click here for more information from CDC.

World Wide Impact Flu activity is down throughout the world. The primary focus for continued 2009 H1N1 appears to be West Central Africa and South East Asia. There is little flu activity in the temperate regions of the Norther Hemispere (North America, Europe). As of April 30, there was only sporadic activity of flu in the Southern hemisphere. The winter flu season in the Southern hemisphere generally begins in May or June. The WHO reports “at least” 17,919 confirmed deaths due to 2009 H1N1 throughout the world, although this is likely only a small proportion of the actual number of deaths.

Click here to read more from the World Health Organization.

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March 22, 2010. Week 10. Most states in the US are reporting either sporadic influenza activity or none at all. A notable exception is a collection of 10 contiguous states in the South that are reporting regional (3) or local (7) activity. There were two deaths due to flu reported in US children last week, for a total of 331 pediatric deaths since the pandemic began in April 2009. H1N1 caused all but three of the deaths among cases where isolates were fully subtyped.

Impact in All Age Groups Deaths and hospitalizations overall are at their lowest levels since the “second wave” of H1N1 began in August 2009. The latest CDC estimates as of Jan 16 2010:

57 million people in the US have been infected by H1N1 since April 2009

257,000 hospitalized for H1N1

11,690 deaths due to H1N1

The CDC reports that 5.9% of influenza tests submitted nationally last week were positive, a slight increase over the prior week. 98% of the flu A isolates further characterized were 2009 H1N1, and 2% of the isolates were influenza B. Isolation of isolates other than novel H1N1 “Swine Flu” has been rare throughout the 2010 winter season.

For the latest CDC 2009 H1N1 update (March 19) please click here.

For an update on the situation internationally please click here.

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Feb 19, 2010. Week 6. There are now three states reporting Regional flu activity, all in the Southeast, the only region of the country with substantial flu still being reported. Less than 5% of specimes submitted for influenza culture in the past week have been positive for flu, down from a high of over 50% in the fall. While hosptilizations and deaths nationally have decreased markedly since their October highs, there does appear to be a slight increase in deaths over the past 3-4 weeks. There were two additional deaths in pediatric patients reported last week, for a total of 326 since April 2009.

Impact in all age groups Hospitalizations and deaths are far below their October highs. Flu activity is markedly down but not completely gone. There have been only scattered reports of seasonal flu; virtually all of the influenza currently in circulation is still H1N1.

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Jan 2, 2010. Week 52. Only one state in the US (Alabama) is now reporting widespread H1N1 activity. Four of 10 national regions now report mildly elevated levels of influenza-like illness (ILI), and 6 report normal levels. Four deaths in children due to H1N1 were confirmed nationally this week. The total number of pediatric deaths proven or likely due to H1N1 since the second wave began in August is now 228, compared with 63 deaths from April to August 30.

Impact in all age groups The total number of hospitalizations and deaths due to H1N1 have been trending down for 9 consecutive weeks

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Dec 24, 2009 Week 50. The number of flu-related hospitalizations and deaths nationwide has been declining steadily for the past 6-8 weeks after peaking in week 43. Seven of ten US regions now report visits for ILI below region specific levels. Nine influenza related pediatric deaths were reported this week. The number of pediatric deaths due to flu has been on a sharp downward trajectory nationally for at least four weeks. The number of laboratory confirmed pediatric deaths due to influenza since August 30 is 221, and the total since the pandemic began in April is 285.

Impact in all age groups Pneumonia and influenza mortality as a percentage of all US deaths was at 7.2% this week, which puts it below the empidemic threshold for the first time in 11 weeks. The CDC monitors P & I mortality in 122 cities around the coutry throughout the year as a way to assess the severity of an influenza outbreak. P & I mortality was above the epidemic threshold from week 40 (Oct 10) until this week. This indicates that the worst of the second wave of H1N1 is now behind us.

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Dec 11, 2009 There were 16 flu-related pediatric deaths reported nationally this week, 13 of which were confirmed to be due to H1N1. The total number of confirmed deaths in children due to H1N1 is 165 since Aug 30 and 224 since the virus first appeared in late April.

Impact in all age groups The CDC stopped counting the total number of individual cases of H1N1 in mid-summer. At that time, it became clear that it was impractical to keep up with every case of H1N1 “Swine Flu”, since both diagnosis and treatment from that point in the pandemic onward have been based on symptoms, not on the results of laboratory tests for H1N1.

In mid-November, the CDC began to post estimates for the total number of people infected, total hospitalized, and the total number of deaths. These numbers are no longer based on reporting alone, since it became clear that there was substantial underreporting in all of these categories.

The latest update from the CDC, which was posted on Dec 10, incorporated data received up to Nov 14. Based on these data, the CDC estimates that since April 2009 about 50 million people have been infected by H1N1, 213,000 have been hospitalized, and 9,820 have died, including 1,090 children from 0 to 17 years of age. Click here to see the CDC webpage that explains these numbers.

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Nov 20, 2009 There were 21 flu related pediatric deaths from around the United States this week. There have been a total of 171 deaths in children confirmed to be due to H1N1 since April of this year and another 28 deaths due to flu that were not further identified.

Impact in all age groups Since the H1N1 pandemic began in April the CDC has received reports of about 1,200 deaths confirmed to be due to H1N1 influenza. However, this is probably an undercount, since many patients have died without any tests or too late in the illness to detect the virus. CDC has developed methodology to estimate the number of people infected, the number hospitalized, and the number of deaths. This is done to provide a more accurate description of the impact of this pandemic. The first such estimate was posted in Novermber, and included the total from April to October 17. The CDC estimates that approximately 22 million people have been infected by H1N1, 98,000 have been hospitalized, and 3,900 have died.

Click here for the full CDC report.

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Oct 31, 2009 There were 18 deaths due to influenza in children reported to CDC this week, including 15 with proven H1N1. Since Aug 30, when the “second wave” of H1N1 was becoming evident nationwide, there have been 85 pediatric deaths due to flu including 73 with proven H1N1. In the 6 months since H1N1 appeared on April 28, 145 US children have died from flu including 129 with proven H1N1.

Impact in all age groups Nationally, 17,838 people of all ages have been hospitalized with laboratory confirmed H1N1 influenza since Aug 30, and 672 of those patients died (3.8%). However, this probably underestimates the number of deaths due to H1N1 since many people who are late in the course of the complications from flu may not have a positive RT-PCR confirmatory test. The CDC also tracks deaths due to pneumonia and influenza in 122 cities nationwide. The proportion of deaths due to pneumonia and influenza expected for this week in a “normal” year is 6.7%. Currently the 122 cities are reporting pneumonia and influenza to be the cause of death in 7.4% .

Nationally the proportion of visits to clinics and emergency departments for influenza like illness is down slightly after 4 weeks of increase.

Click here to see the data from CDC on deaths due to H1N1.

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Oct 24, 2009 There were 22 flu-related pediatric deaths reported this week; 19 of these deaths were confirmed 2009 H1N1, and three were influenza A viruses, but were not subtyped. Since April 2009, CDC has received reports of 114 laboratory-confirmed pediatric 2009 H1N1 deaths and another 12 pediatric deaths that were laboratory confirmed as influenza, but where the flu virus subtype was not determined. 65 of the laboratory confirmed deaths due to H1N1 in children occurred after Aug 30, when H1N1 began its “second wave” nationally.

Impact in all age groups Nationally, 12,466 people of all ages have been hospitalized with laboratory confirmed H1N1 influenza since Aug 30, and 530 of those patients died (4.25%). However, this probably underestimates the number of deaths due to H1N1 since many people who are late in the course of the complications from flu may not have a positive RT-PCR confirmatory test. To get a better estimate of deaths due to flu, CDC also tracks deaths due to pneumonia and influenza nationwide. Since Aug 30, there have been 25,985 hospitalizations for pneumonia and influenza, and 2,916 deaths.

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Oct 1, 2009 Nineteen influenza-associated pediatric deaths were reported to CDC during week 39 (Alaska, Arizona, Colorado, Florida, Maryland [2], North Carolina, Oklahoma, Tennessee [3], Texas [7], and Wisconsin). Sixteen of these deaths were associated with 2009 influenza A (H1N1) virus infection and three were associated with influenza A virus, for which subtype is undetermined. These deaths occurred between July 19 and October 3, 2009. Since September 28, 2008, CDC has received 147 reports of influenza-associated pediatric deaths that occurred during the current influenza season (28 deaths in children less than 2 years, 15 deaths in children 2-4 years, 45 deaths in children 5-11 years, and 59 deaths in individuals 12-17 years). Seventy-six of the 147 deaths were due to 2009 influenza A (H1N1) virus infections, and 29 of these have occurred since August 30, 2009.

Georgia Related Deaths

admin — Mon, 28 Sep 2009 13:11:23 +0000

April 29: There have been 68 deaths due to influenza in Georgia residents since the “second wave” of 2009 H1N1 began in August 2009. After falling to zero for four consecutive weeks from late December to mid-January, there were 12 deaths reported in February, 6 in March, and 6 more in April. There were no deaths due to H1N1 reported in Georgia in the past week. The slight increase in hospitalizations and deaths due to H1N1 that was noted in Georgia from late January to mid-April appears to have abated.

March 22: There have been 59 deaths due to influenza in Georgia residents since the “second wave” of 2009 H1N1 began in August 2009, including one death in the past week. After falling to zero for four consecutive weeks in late December/early January, deaths due to flu in Georgia residents were reported in increasing numbers through much of January and February. That trend appers to have reversed over the past three weeks.

Some additional information is helpful to better understand these statistics. During routine, seasonal winter influenza outbreaks , approximately 36,000 Americans die due to influenza or its complications. Approximately 90-95% of these deaths are in adults over age 65. Based on the current population of Georgia, we can expect about 700 deaths per year due to seasonal influenza, including 630 adults over age 65. The death rate due to H1N1 has been far below these numbers, especially with regard to people over age 65 years.

The South continues to be the only region in the US with significant flu activity. Georgia, Alabama, and Mississippi are the only states in the continental US still reporting regional activity, and seven additonal states clustered in the South are reporting local activity. The rest of the US is reporting sporadic activity or no activity at all.

Feb 19: There have been 49 confirmed deaths due to influenza in Georgia since Sept 1 2009, including two in the past week. After falling through the late fall and early winter, the graph of weekly deaths was at zero for four consecutive weeks in late December and early January, then deaths began to be reported again. For the past four consecutive weeks, at least one death from influenza has been reported in Georgia. Since H1N1 has accounted for virtually all flu activity in the US over the past 9 months, it is likely that these deaths are associated with H1N1. Similarly, hospitalizations due to flu appear to be on the rise again over the past 4-6 weeks after declining from their September highs. It is not yet clear if this may signal a “third wave” of H1N1 beginning in the Southeast.

Georgia is currently one of only three states, along with Alabama and South Carolina, still reporting Regional flu activity. All other states are at the lower “Local” level or less. The Southeast appears to be the primary focus for continued flu activity.

Feb 04: There have been 44 deaths confirmed to be due to H1N1 in Georgia since Sept 1, including one in the past week. There have been only 6 deaths in the past 2 months. Total hospitalizations due to H1N1 stands at 588, including 20 in the past week. Hospitalizations saw a steady decline after peaking in October, but there has been a sustained increase over the last 5 weeks. It is noteworthy that Georgia and the South East Region are the primary local in the nation for current flu activity.

Dec 10: There have been 38 deaths due to H1N1 in Georgia since Sept 1, including 2 children age 0-4 years, 6 children age 5-18 years, 2 young adults 19-24 years, 16 adults 25-49 years, 10 adults 50-64 years, and 2 adults over the age of 65. There have been no additional deaths reported since the last update on Dec 5.