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Swine Flu Information and Updates
Written by Naoum Issa, MD, PhD   

We have compiled a set of resources for medical professionals to help follow and deal with the Swine Flu emergency.

This includes WHO and CDC guidance for professionals, scientific information about the virus as it becomes available, and tracking of confirmed swine flu cases across the US and the world.

Swine flu
Source: CDC

Swine Flu Resources

Guidance for Professionals from the CDC

Travel Notices

World Health Organization Updates

CDC Updates

July 2009: WHO is set to make a statement discouraging nations with H1N1 outbreaks from testing; rather they should assume flu symptoms are indicative of H1N1 infection. Source: Chicago Tribune. 

June 29, 2009: The first case of tamiflu-resistant H1N1 (Swine Flu) has been reported in a patient in Denmark. Oseltamivir and zanamivir are alternative antivirals that are effective against H1N1. Source: BBC News.

June 28, 2009: US health officials at the CDC estimate that over 1 million Americans have contracted Swine Flu. Mortality rates are lower than initially expected with 127 deaths. Source: CDC and BBC News.

June 11, 2009: WHO declares Swine Flu (H1N1 2009) is a pandemic, raising pademic status to phase 6. Source: WHO.  

Swine Flu Spread Data

 

US Cases of Swine Flu in Humans as reported by the CDC.

States 5/19 5/18 5/15 5/14 5/13 5/12 5/11 5/10 5/9 5/8 5/7 5/6 5/5 5/2 5/1 4/30 4/29 4/28 4/27
Alabama 61

61

55 41

9

9 4 4 4 4 4 4 4
Arkansas 3 3 2 1                        
Arizona 488 476 435 431 187 187 182 182 182 131 48 48 17 4 4 1
California 553 553 504 473 221 193 191 282 171 107 106 67 49 24 13 14 10 7
Colorado 56 56 55 47 44 44 39 39 41 25 17 17 6 2 2
Connecticut 56 53 47 38 33 28 24 24 14 4 4 4 2 1
Delaware 69 65 60 58 54 45 44 44 44 39 38 33 20 4 4
Florida 103 101 68 65 58 55 54 53 44 6 5 5 5 2
Georgia 25 24 18 36 8 4 3 3 43 3 3 3 1
Hawaii 21 21 10 10 6 6 6 6 6 5 3 3
Idaho 8 8 5 5 3 2 1 1 1 1 1 1 1
Illinois 707 696 638 620 592 554 487 466 421 392 204 122 82 3 3
Indiana 96 81 71 70 70 61 39 39 39 29 15 15 3 3 3 1 1
Iowa 71 66 66 58 55 55 43 43 43 5 5 1 1
Kansas 34 34 30 28 23 22 18 36 12 12 7 2 2 2 2 2 2 2
Kentucky* 16 14 13 13 10 10 10 3 3 3 2 2 1 1 1
Louisiana 65 57 57 45 33 20 9 9 9 7 7 7 7
Maine 10 12 14 13 6 6 4 4 4 4 4 1 1
Maryland 39 34 28 28 23 23 23 23 23 4 4 4 4
Massachusetts 156 143 135 109 107 107 88 88 89 83 71 45 6 8 2 2
Michigan 165 158 142 141 134 133 130 114 103 49 9 8 2 2 2 1 2
Minnesota 38 38 36 34 31 24 7 7 1 1 1 1 1 1 1
Missouri 20 19 19 20 18 14 14 10 10 9 4 2 1 1
Montana       5   1                
Nebraska 28 28 27 23 21 19 13 13 13 4 4 4 1 1
Nevada 31 30 26 25 21 12 9 9 9 8 5 5 1 1 1 1 1
New Hampshire 20 19 18 18 17 16 4 4 4 3 2 2 1
New Jersey 18 15 14 12 8 7 7 7 7 7 7 7 6 7 5
New Mexico 68 68 68 51 44 30 30 30 30 8 8 3 1
New York 267 254 242 224 211 192 190 190 190 174 98 97 90 50 50 50 51 45 28
North Carolina 12 12 12 12 12 11 11 7 7 7 7 7 1
North Dakota 3 3 2 1                              
Ohio 13 13 14 12 11 7 6 6 12 6 5 5 3 1 1 1 1 1 1
Oklahoma 42 32 26 22 22 14 14 14 4 4 1 1
Oregon 94 94 94 94 74 74 17 17 15 15 15 15 15
Pennsylvania 55 56 47 50 22 17 10 10 10 2 2 1 1
Rhode Island 8 8 8 8 7 7 7 7 7 7 2 2 1
South Carolina 36 36 36 34 32 32 32 32 42 29 17 16 16 13 16 10
South Dakota                 1 1      
Tennessee 85 82 74 63 57 54 54 54 46 36 2 2 2
Texas 556 556 506 439 293 206 179 108 110 93 91 61 41 28 28 26 16 6 2
Utah 91 91 91 80 72 67 63 63 60 24 8 1 1
Vermont 1 1 1 1 1 1 1 1 1            
Virginia 23 21 21 20 17 17 16 16 16 14 11 3 3 2 2
Washington 362 294 246 195 176 176 128 102 83 33 23 9
Washington D.C. 13 13 12 10 9 7 4 4 4 1      
Wisconsin 766 613 613 510 496 437

384

357 317 240 26 6 3
TOTAL 5469 5123 4714 4298 3352 3009 2600 2532 2254 1639 896 642 403 160 141 109 72 64 40

5/26/2009: Old influenza vaccines may have imparted immunity to H1N1, explaining why a larger fraction of the young population than older population are susceptible to the virus. Source: Nature News.

5/24/2009: "It's most likely that if you're sick with the flu, that you have the H1N1 virus" says Jessica Scaperotti, spokeswoman for New York City's Department of Health and Mental Hygiene spokeswoman. Patients with flu symptoms and underlying health issues should be prescribed Tamiflu. Source: ABC News.  

5/11/2009: Google Flu Trends shows negligible increase in tracked keywords despite "Swine Flu" scare. Lack of bump may accurately reflect minimal actual impact of Swine Flu.

5/9/2009: CDC release "FluView" report for 2008-2009, ending May 2, 2009

5/6/2009: Updates from CDC and WHO.

Tables (or data in tables) are from from CDC and WHO.

CDC guidance has changed regarding school closure due to Swine Flu: closures are no longer recommended as a prevention method, and efforts should focus on early identification of ill students and staff, and on hygiene. Source: CDC school guidance.

A second patient in the US has died with Swine Flu (2009 H1N1), although it is clear that the virus was the cause of death since she had a long-term chronic illness. Source: CNN

 

5/5/2009: Update on US cases of Swine Flu (CDC update)

Some states and municipalities will no longer require reporting of probable cases of Swine Flu unless the patient is hospitalized. This will likely reduce the number of cases reported moving forward.

Federal agencies now note that the severity of 2009H1N1 is no worse than typical seasonal flu. (CDC press briefing)

The CDC has completed the distribution of 25% of the strategic reserve of antiviral medication, as well as delivery of doses to Mexico. (CDC press briefing)

5/3/2009:

WHO update: A swine herd in Alberta Canada is infected with the Influenza A 2009 H1N1 virus.

5/1/2009:

An excellent piece by the BBC health reporter, Emma Wilkinson, describes the leading hypothesis for why the Swine Flu virus seems to be causing mostly mild disease rather than severe disease: What scientists know about swine flu.

The take home message is that the swine flu (H1N1) binds to receptors in the nasopharynx causing a URI and does not induce a cytokine storm. More deadly virus strains, like avian flu (H5N1), bind to receptors in the lung, so when viral load causes cell lysis there is damage to the cells of the lung and inflammation in the lung causing pneumonia.

 

4/29/2009 PM: WHO pandemic threat level raised from phase 4 to phase 5 (the second highest level) for Swine Flu on 4/29/2009.

WHO Director-General credits preparations for the threat of H5N1 virus (Avian Flu) for rapid response to the Swine Flu.

Source: WHO announcement

4/29/2009 AM: CNN reports the first death in the US from Swine Flu, a 23-month old from Mexico being treated in Houston, Texas.

Edgar Hernandez, a child in a mountainous region of Mexico (La Gloria in the state of Veracruz), is identified as "Patient Zero" of the Swine Flu outbreak that now appears to have started around April 2, 2009. Source: CNN.

In addition, there are confirmed reports in new states, including Arizona, Indiana, Massachusetts, Michigan, Nevada. Several possible infections are being tracked in many states, with the University of Chicago Hospitals reporting several cases are suspected and being tested.

4/28/2009: 64 cases now reported in the US, most in New York City (0 deaths in the US at this point). The following table is from the CDC.

 

4/28/2009: Swine flu genetics unusual: "Its genetic make-up is unlike any that researchers have seen: a swine H1N1 strain that combines an existing triple assortment first identified in 1998 — including human, swine and avian influenza — with two new pig H3N2 virus genes from Eurasia, themselves of recent human origin." Source: Nature News.

4/27/2009: WHO raises its pandemic threat level to phase 4. From WHO update:

"The Emergency Committee, established in compliance with the International Health Regulations (2005), held its second meeting on 27 April 2009. The Committee considered available data on confirmed outbreaks of A/H1N1 swine influenza in the United States of America, Mexico, and Canada. The Committee also considered reports of possible spread to additional countries. On the advice of the Committee, the WHO Director-General has raised the level of influenza pandemic alert from the current phase 3 to phase 4."

4/27/2009: Update on cases and locations. Source: WHO

40 cases of Swine Flu confirmed in the US. Source: CDC

4/26/2009: The 20th case of Swine Flu in the US has been reported in Ohio. US administration declares "emergency", to release 1/4 of strategic stockpile of antivirals, ramps up detection efforts. Source: LA Times

4/25/2009: WHO:"The first meeting of the [WHO] Emergency Committee was held on Saturday 25 April 2009...

The Committee nevertheless agreed that the current situation constitutes a public health emergency of international concern.

Based on this advice, the Director-General has determined that the current events constitute a public health emergency of international concern, under the Regulations."

4/23/2009: CDC announces existence of the Swine Flu virus (H1N1).

 
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