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Swine Flu Waning, But Could Return
Date:12/1/2009

CDC urges H1N1 vaccination because pandemic's course remains unpredictable

TUESDAY, Dec. 1 (HealthDay News) -- A U.S. health official said Tuesday that H1N1 swine flu infections appear to be on the wane nationally, but many experts agreed the virus could return in force later this winter.

The flu is now widespread in 32 states -- down from 43 states the week before, Dr. Thomas R. Frieden, director of the U.S. Centers for Disease Control and Prevention (CDC), said during an afternoon press conference. In addition, H1N1 vaccine supplies are increasing.

"We are going from a time where there was lots of disease and not enough vaccine to a time where disease is gradually decreasing, and we are having a steady increase in the amount of vaccine that is available," Frieden said.

While there are fewer new cases of the swine flu, it is still not gone, and it may return, he said.

Flu is highly unpredictable, Frieden said. Of the experts the CDC polled on the odds of another surge, about 50 percent said there would be one, and about 50 percent said there would not be one -- and one expert said "flip a coin."

Frieden noted that in the flu pandemic of 1957-1958, cases surged at the start of the school year and then waned, but surged again from December to February.

There is no way of telling whether or not that will happen this year, he said. But people should take advantage of the current lull in flu activity to get vaccinated just in case the flu comes back.

Despite a decline in the number of cases, "we are far from out of the woods," Frieden said.

Right now, close to 70 million doses of vaccine are available, with more on the way, and most people should be able to get vaccinated this month, he said.

And there was one more piece of good news. Duke University Hospital in Durham, N.C., which last week reported four cases of very ill patients with H1N1 that did not respond to the antiviral Tamiflu, said in a news release Tuesday that it has uncovered "no additional cases" of the potentially dangerous, drug-resistant strain. No such cases have appeared throughout the state either, the university said.

But not of all the news has been good: 35 flu-related pediatric deaths -- 27 from lab-confirmed H1N1 -- were reported to the CDC this week, bringing to 234 the total number of flu-related child deaths since April. According to the Associated Press, this week's jump in pediatric flu deaths is the largest one-week increase since scientists first spotted the H1N1 virus in April.

Overall, hospitalizations and deaths continue "to be higher than expected for this time of year," the CDC said.

These reports follow on news last week that the ongoing pandemic may be driving a recent spike in dangerous pneumonias among younger patients.

"We are seeing an increase in serious pneumococcal infections around the country," Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases at the U.S. Centers for Disease Control and Prevention, said during a press conference last Wednesday. "Pandemics put us at risk for not just flu problems, but also bacterial pneumonia problems," she added.

These bacterial infections commonly infect the lungs and sometimes the bloodstream. During most flu seasons, secondary infections such as pneumonia typically occur in people 65 and older, she said.

However, in this pandemic the increase in pneumococcal infections is being seen primarily among younger people, Schuchat said.

Questions about the safety of the H1N1 vaccine have lingered, but Schuchat sought to assuage any fear with some of the first safety data available since mass vaccinations began.

"So far, everything we have reviewed is extremely reassuring," she said during last Wednesday's press briefing. "In our look at all of the safety data in the U.S. so far, we are seeing patterns that are pretty much exactly what we see with the seasonal flu vaccine."

More information

For more information on H1N1 swine flu, visit the Flu.gov.



SOURCES: Dec. 1, 2009, teleconference with: Thomas R. Frieden, M.D., M.P.H., director, U.S. Centers for Disease Control and Prevention; Nov. 25, 2009, press conference, Anne Schuchat, M.D., director, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention; Associated Press


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