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Return of Swine Flu in the Fall Worries Health Officials

CDC says cases might not remain mild in a resurgence

TUESDAY, May 12 (HealthDay News) -- As the swine flu continues to spread across the United States -- and most cases continue to be mild -- federal health officials said Monday that they're shifting their focus from individual cases of infection to trying to project what is likely to occur with the virus in the fall.

The U.S. Centers for Disease Control and Prevention is conducting field studies to "strengthen our knowledge about how this new virus is spreading, who is most at risk for illness, how effective prevention measures are, antiviral treatment and so forth," Dr. Anne Schuchat, the CDC's interim deputy director for science and public health program, said during an afternoon teleconference.

The CDC is concerned with what will happen as this new virus moves into the Southern Hemisphere, where the flu season is about to start. The CDC is also preparing for the virus' likely return in the fall to the Northern Hemisphere, Schuchat said.

Because the new swine flu virus -- technically called H1N1 -- is a highly unusual genetic mix of bird, flu and human viruses, health officials worry that it could continue to mutate and return in a more virulent form for next winter's flu season.

As of Monday, there were slightly more than 2,600 confirmed cases in 43 states and the District of Columbia, with three confirmed deaths and 94 people hospitalized, Schuchat said. All three patients who have died had underlying health problems before their infection with the flu. Some states do not report data over the weekend, so the number of new cases is likely to rise dramatically tomorrow, she said.

Schuchat added that the confirmed cases are likely just the tip of the iceberg. Many people who become ill don't seek medical attention and are never tested for this strain of flu. "The numbers we are reporting are a minority of the actual infections that are occurring in the country," she said.

The United States has now surpassed Mexico -- believed to be the source of the outbreak -- as the country most affected by the outbreak, according to World Health Organization statistics. As of Tuesday, the agency was reporting 5,251 confirmed cases of swine flu in 30 countries, with Canada, Spain and the United Kingdom having the most cases outside of the United States and Mexico.

While the swine flu is similar to seasonal flu, there are some important differences, Dr. Richard Besser, the CDC's acting director, said last week. "One thing we are seeing, unlike seasonal flu, a higher percentage seem to be having vomiting and diarrhea," he said.

Besser said most new cases of swine flu in the United States were now caused by person-to-person transmission and not some link to Mexico, as was the case when the outbreak began more than two weeks ago.

Testing has found that the swine flu virus remains susceptible to two common antiviral drugs, Tamiflu and Relenza, according to the CDC.

Meanwhile in Mexico, the country continued to emerge from a virtual shutdown designed to limit infections. High schools, universities, dance halls, movie theaters and bars have reopened, and primary schools were to reopen this week, the Associated Press reported.

U.S. Human Cases of H1N1 Flu Infection
(As of May 11, 2009, 11:00 AM ET)
States # of
Alabama 4  
Arizona 182  
California 191  
Colorado 39  
Connecticut 24  
Delaware 44  
Florida 54  
Georgia 3  
Hawaii 6  
Idaho 1  
Illinois 487  
Indiana 39  
Iowa 43  
Kansas 36  
Kentucky** 10  
Louisiana 9  
Maine 4  
Maryland 23  
Massachusetts 88  
Michigan 130  
Minnesota 7  
Missouri 14  
Nebraska 13  
Nevada 9  
New Hampshire 4  
New Jersey 7  
New Mexico 30  
New York 190  
North Carolina 11  
Ohio 6  
Oklahoma 14  
Oregon 17  
Pennsylvania 10  
Rhode Island 7  
South Carolina 32  
South Dakota
Utah 63  
Washington 128 1
Washington, D.C. 4  
TOTAL*(44) 2618 cases 3 deaths
*includes the District of Columbia
**One case is resident of Ky. but currently hospitalized in Ga.

Source: U.S. Centers for Disease Control and Prevention

More information

For more on swine flu, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: May 11, 2009, teleconference with Anne Schuchat, M.D., interim deputy director for science and public health program, U.S. Centers for Disease Control and Prevention; May 8, 2009, teleconference with Richard Besser, M.D., acting director, U.S. Centers for Disease Control and Prevention; Associated Press

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