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September 04, 2009

CDC Reports H1N1 Cases Already Increasing; Urges Vaccination of School Children



Martha Kerr
September 3, 2009 — The US Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, announced today that the 2009 influenza A (H1N1) season has been "very unusual," in that cases have continued to be reported throughout the summer and the number of reported cases is already increasing.
The southeastern United States, in particular, is reporting large numbers of cases of H1N1 viral infection, possibly due to the early start of school in that region, to a lower-than-average number of cases in the spring, or both, CDC Director Thomas R. Frieden, MD, MPH, announced at a press briefing today.
"The good news is that, so far, everything that we've seen both in this country and abroad shows that the virus has not changed to become more deadly," Dr. Frieden asserted. "That means that although it may affect lots of people, most people will not become severely ill."
According to a report in today's issue of the CDC's Morbidity and Mortality Weekly Report, as of August 8, 2009, there have been 477 deaths in the United States associated with the 2009 H1N1 influenza pandemic. Of these, 36 deaths were in children younger than 18 years.
Children younger than 5 years or with certain underlying chronic medical conditions, such as respiratory or heart diseases, are at an increased risk of complications and death from influenza. Children who have become severely ill or died who did not have underlying chronic conditions in most cases had underlying bacterial infections.
"The take-home message...I think, is that particularly kids with underlying conditions need to be treated promptly if they develop fever and be first on line, or at the front of the line, for vaccination when it becomes available.... Treatment in the first 48 hours can make a big difference in hastening your recovery," Dr. Frieden said.
"We also know that as of now, not only has the virus not become more virulent or more deadly, but we haven't seen lots of drug-resistant strands. So, the drugs that we have available are still very effective against the virus at this time."
An important message for physicians, Dr. Frieden said, is that patients, especially young children, who first get better then become ill again with a high fever, should be treated with antibiotics for underlying bacterial infections.
In addition to school-aged children, other groups that should be vaccinated first if vaccine supplies are limited are pregnant women and all individuals with underlying conditions that would put them at higher risk.
Dr. Frieden cautioned that influenza illness in general and H1N1 in particular is unpredictable. He said that the CDC will closely monitor disease characteristics and patterns and "be ready and prepared" to adapt to any changes in disease activity.
Referring to an Institute of Medicine report calling for the protection of healthcare workers, which was reported earlier today by Medscape Infectious Diseases, Dr. Frieden emphasized the importance of vaccination of healthcare workers as soon as a vaccine becomes available. "They are our first line of defense," he said.
"We continue to anticipate that [an H1N1] vaccine will be available by mid-October," Dr. Frieden stated. "The vaccine itself will be free," although in some places there may be administrative costs. He said that a 2-dose series for children is likely, and there will be outreach to parents urging them to get their children vaccinated.
"We are in the process of releasing about $1.5 billion in vaccine planning, preparedness, and administration funding," Dr. Frieden reported.
Virologic data from the Southern Hemisphere shows that "the H1N1 virus strains currently circulating [there] are similar to those detected in the US" and that individuals at highest risk there are similar to those in the United States.
The CDC's information on the 2009 H1N1 influenza pandemic is available at http://www.flu.gov/.

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