Silent but how deadly Seasonal Flu Epidemic Update

As sites continue to focus on the worries concerning a Pandemic involving H5N1, a real epidemic is sweeping through the U.S. and the world. A visit to a local social services office found out of 24 employees only 6 were still on the job, the remainder flat (as many described it) with one of the nastiest, worst flus in decades. Amazingly even CDC flu central is only current through March 8, and despite continued assertions it is going away, wave after wave is sweeping the country.

As of March 8, 2008 this was the face of the flu -not Avian in the U.S.

http://www.weatherbug.com/images/bugtoday/flu_031408.jpg?lid=SCSI



the map so far does not appear to display on preview so link is given.

People, we have a problem. As everyone is in the watch mode for Avian Flu, a real epidemic has crept in and poses a threat while hundreds of cases pour through our local ER (300-500) in week - many people staying home - since - what exactly can be done for - the flu, many do not go to ER and many do not see a doctor and it is not reported.  Comments from mainstream health agencies are fairly flat line - saying basically - there were two warnings issued this would be a bad one (the yearly vaccine missed the mark entirely) and very little concern as it is said -its only the seasonal flu that happens every year.

For some it is not like the seasonal flu, and it is not going away. Everyone in our household has it and many online we know have had it for a long time. Even though some have recovered - it may come back 3-4 times again in equal intensity - why?

For one thing we have a lot of strains. Although three are the three main ones circulating, there are actually hundreds of sub strains.

What is closer to the real deal in terms of how bad it is?  Than the illusive - just a really bad flu season?

James West at Weather bug reports

The number of flu cases is decreasing across the U.S. even as 42 states report widespread activity. The virus and its symptoms have been unusually deadly over the last nine weeks, with 8.7 percent of all deaths last week attributed to it.

Utah, Oklahoma, Louisiana, Michigan, and Maryland join New Mexico, Mississippi, and Massachusetts as the only states not reporting widespread flu activity, says the Centers for Disease Control and Prevention. The District of Columbia was still reporting only local flu activity last week.

comment: This means all other states except for 8 are wide spread infected and have epidemic flu.

CDCs last report March 8 is here -

http://www.cdc.gov/flu/weekly/

It looks nasty. It is very conservative and one must most certainly take into account the reported numbers versus the real numbers of those infected.

The proportion of deaths attributed to pneumonia and influenza was above the epidemic threshold for the ninth consecutive week.

So, there is your epidemic. If corresponding numbers were true in other countries, would we already be in a flu Pandemic? Are we?

It is hurting the economy, badly. I will post a separate thread on this.

Although influenza A (H1) viruses predominated through mid-January, an increasing proportion of subtyped influenza A viruses are influenza A (H3) viruses. Influenza A (H3) viruses have been reported more frequently than influenza A (H1) viruses since week 4 (January 20-26), and during week 6 (February 3-9), influenza A (H3) became the predominant virus for the season overall. This season influenza A (H3) viruses have been reported more frequently than A (H1) viruses nationally, as well as in seven of the nine surveillance regions (East North Central, East South Central, Mid-Atlantic, New England, South Atlantic, West North Central, and West South Central). Influenza A (H1) viruses have predominated circulation this season in the remaining two regions (Mountain and Pacific).

Resistance to the adamantanes continues to be high among influenza A (H3N2) viruses with 107 (99.1%) of 108 influenza A (H3N2) viruses tested resistant to the adamantanes.

Finally how many flu sub types are there really according to CDC?

CDC has antigenically characterized 425 influenza viruses [191 influenza A (H1N1), 107 influenza A (H3N2), and 127 influenza B viruses] collected by U.S. laboratories since September 30, 2007.

Rhetorical question : How difficult would it be to develop a vaccine effective against over 600 influenza viruses?

Final comment: One reason that it is not attracting more concern is that despite it is making people extremely sick (as per bed ridden) its kill rate is not high enough, if it subsides, and does not mutate into a more virulent form with its large number of cases to have a high CFR. Then we would and could, have a serious problem.

Medclinician

lamrobertson wrote: Its just a seasonal flu.  Yes every year people die from the flu.  Every single year.  This year the flu vaccine is the states  was off and yes more people died.  But the seasonal flu is just that and nothing else.  Pandemic means a hell of alot more deaths than seasonal flu.  Boy if you think that the flu season is bad how are you going to react when the pandemic really does start! Lorna

I understand and have heard this probably more than a hundred times in the last two months. Looking at this health wise, because the vaccine missed the mark entirely, we have a much larger infected population increasing the chance of a truly nasty mutation occurring leading to a more virulent form.  Probably, as most, after having it come and go since January 1, as some have, and still waiting for it to go away, when it does, after three months of misery on and off, I guess I can focus on the other chronic problems that myself and many others have health wise.

In 1918, it was H1N1. We since have developed some herd immunity, but H1N1 is still with us, and one substrain was a major part of this years outbreak of flu.  The first H1N1 that turned bad was Pandemic.  As we look to this and the last few years development of H3N2 which is one of the main problems -

. Currently all of the resistant viruses are H1N1 viruses, with 51 (9.1%) of 561 H1N1 viruses tested exhibiting a genetic mutation that confers oseltamivir resistance  (CDC)

Yearly, the percentage of resistance to the big four antivirals continues to increase.  Yes, in Indonesia the Avian Flu CFR is 80%+. Our infrastructure can only withstand a 5% CFR. Beyond that it falls apart.

How will we deal with a 50% CFR with an infection base like the current seasonal flu? Some feel this will arrive on a plane from south east Asia and follow the classic storyline in so many movies.  Perhaps. Another scenario, though, is that it begins as just another flu season... season being the ultimate euphemism. It would be like putting a sign over ER that says "well, you know eventually we all die."

It is a matter of degree. Right now this flu season is crippling the function of our local government and hospitals. It is hurting our economy. It is making people miss work, lose money. Like death, this happens every year, but the problem is - each year it continues to get worse. The resistance to our antibiotics, antivirals, and treatment. If one looks at the pattern since the year 2000  and the lack of new readily available alternatives, there is a reason to be concerned.

The point here being at the core of the discussion is that there are two camps at least in the research field. One believes that it will be a dramatic incident, a sudden plane full of coughing blood passengers. The other believes it will be much more subtle. And this is not a small group in the research community. It believes that it will come in waves. The first wave will a bit more nasty than common flu, causing comments and and some warnings, and then a second wave of a worse strain, and finally.. the third wave.  This is an alternative but very feasible sequence of events. It is the one where the flu season becomes the flu Pandemic.

The question is, will there be an official voice that says "it is here, this is it?" and how bad will it have to be before that voice speaks.  Some of us may not live to see the real Pandemic.

Medclinician

lamrobertson wrote: For years,now scientists have warned that highly pathogenic h5n1 could change and become easily transmitted to humans.  Not the strain of seasonal flu that we get every single year. Dont' start freaking people out that seasonal flu could be the pandemic because it isn't!. The sky is not falling yet. By the way this thread should really be in general discussion not latest news.  I dont' see any reference to a news source.

The news source is the CDC given as a link to the week flu report of March 8.  This would be news. A secondary source was the weatherbug page, while not mainstream, does provide a map as well as a more current status.

http://www.cdc.gov/flu/weekly/

Medclinician

Originally posted by lamrobertson

For years,now scientists have warned that highly pathogenic h5n1 could change and become easily transmitted to humans. Not the strain of seasonal flu that we get every single year.

Dont' start freaking people out that seasonal flu could be the pandemic because it isn't!. The sky is not falling yet.



Lorna, I did hear before that different strains of flu can mix, thus creating a pandemic.

One woman in my floor was sick like that for more than a couple months.  She's elderly (60ish), but no one else seems to be sick at this time.  I'm perfectly healthy myself.

Good one BoJingles.

I agree.  Medclinician speaks with knowledge and usually very clearly.  Keep up the great work Medclinician.

Information is information.  If you use it to panic yourself, then that's your problem.  Stopping the information is not a solution.

I hope someone here can help me on this one!  My 18 year old son has god knows what kind of flu.  He has had this for three weeks and been to the ER once and the doctor and they do nothing!!!   He has these symptoms:

To be honest, the symptoms of the rash are not typical of what I've heard of BF, it sounds like MRSA.  It's been going around in schools in my state of Washington.  Or at least the rash sounds like MRSA, I'm checking wikipedia now again for the symptoms ...done, MRSA sites do not list fever as a symptom.  I have no idea what he has at this time, but you should take him to the doctor for the rash.  If it is MRSA, you need to move fast, it can be fatal.

The doctor saw the rash and it is not mrsa. 

Maybe Medclinician knows what it is and what to do.

johngardner1 wrote: Maybe Medclinician knows what it is and what to do.

I'm not an M.D.  John, officially  as an RN  I would say go to ER, and if the patient is in distress,has  trouble breathing especially , bleeding, etc. call 911.

I can quote a doctor in Vietnam who said in the case of H5N1, even if we have no vaccine or effective anti-viral, we can supplement organ function, which is critical in caring for an Avian patient- respirator, dialysis, etc.  There are a lot of very good ER doctors. They tend to have to deal with extreme urgent situations.

Do it right away. If there is a growing problem, getting to ER sooner will increase your chances of not waiting several days and then being faced with a packed ER and a long wait.  As a health professional, we do the best we can with what we have. That is always the case. Diagnosis is important.  It may not be as serious as it appears, or there may treatment which will help.  Until we don't have the lifeline of medical treatment, use it.

Medclinician

loribearme.........I just got off the phone with my sister..  Who has worked in a hsopital all her life..  We are not doctors or nurses..  This is just a our idea or opinion.