 H1N1 influenza vaccines are available to all ages. Inyo County Health and Human Services is offering free vaccines at the Public Health Office in Bishop. File photo Dr. Rick Johnson
Inyo Mono Health Officer
12-22-2009 Do you think this pandemic is a big deal, or has public health and the media “cried wolf” again? Your perspective depends on whether or not you or a family member became seriously ill or died.
As of Nov. 14, more than 47 million have been infected approximately 15 percent of the population, 213,000 have been hospitalized, and more than 9,800 have died. In California, this translates into about 4.3 million cases, with 7,546 hospitalizations, and 397 deaths.
In the Eastern Sierra (Inyo and Mono counties), there have been approximately 4,500 cases, with several dozen hospitalizations, and no deaths. But there is a larger than average amount of Native Americans suffering from influenza.
New data confirms our impression locally that the American Indian population has been especially hard hit. In the 12 states where American Indians represent 3 percent of the population, they have experienced 10 percent of the deaths. The reasons may include genetics, poverty, lack of access to care, a low vaccination rate, and a higher incidence of chronic conditions such as asthma, diabetes and obesity. In Inyo County, 50 percent of the hospitalized patients were American Indians.
Let’s compare these total numbers of all residents to the annual seasonal influenza:
• It is estimated that seasonal influenza on the average causes 31 million cases annually in the U.S. So, even though we are not done yet, there have been 16 million more cases of H1N1 infection than in the average year of seasonal influenza, with nearly 2,000 school closings affecting 616,000 students, and untold days of work absenteeism.
Seasonal influenza usually causes about 200,000 hospitalizations annually. We are past that, and not finished yet. The impact on the healthcare system has been significant.
But you may say that the number of deaths is far less than the often quoted 36,000 that die each year from the seasonal influenza. Two comments to give perspective:
• Only about 9,000 of those deaths are due directly to influenza or pneumonia. The rest are among persons who have influenza, and die of events like heart attacks or stroke. Think of someone who has a heart attack while shoveling snow, and his death is labeled “storm-related”.
• More than 90 percent of the estimated seasonal influenza deaths are in the elderly, while only 13 percent of deaths with the 2009 H1N1 influenza have been in those over 65 years of age. The death of an 87-year old person with advanced Alzheimer’s disease is just as tragic as the death of a 22 year old otherwise healthy pregnant woman, but we can agree they are not the same in terms of years of potential life lost.
The current pandemic to date dwarfs seasonal influenza in this important measure. 1,090, or 11 percent of deaths have occurred in children 0-17 years of age, 7,450, or 76 percent in people 18-64 years of age, and 13 percent, or 1,280 in people over 65 years of age.
National, state, and local influenza activity continues to decrease, although new cases, hospitalizations, and deaths are still continuing at epidemic levels. California still reports widespread activity in the week ending Dec. 5, with 278 hospitalizations and 31 deaths. This includes 2 pediatric deaths, and 2 deaths among pregnant females. Almost all influenza is the H1N1 strain, with seasonal influenza uncommon so far.
Resistance to Tamiflu is rare. Other viruses such as Respiratory syncytial virus or (RSV), which causes infection of the lungs and breathing passages, is a major cause of respiratory illness in young children are starting to appear, as expected for this time of year.
Vaccination is now available up through age 64 through the Health Department and various providers, and within weeks, will be available to everyone. So far, several thousand doses have been given in Inyo County. The safety record of this H1N1 vaccine, with over 85 million doses now given worldwide, is excellent.
Influenza is expected to still be circulating for months and additional waves may come, especially with holiday gatherings and when seasonal strains emerge.
The American College Health Association just reported that after weeks of decline, H1N1 influenza activity on college campuses increased 27 percent from the previous week among students returning from the Thanksgiving holiday break.
There are still plenty of unanswered questions and unknown factors at play this influenza season.
Will that happen in our schools in January? How bad will the seasonal flu be this year? Will there be a third wave of the H1N1 this spring? Will the virus undergo a critical mutation making it resistant to Tamiflu or a more efficient killer? All of these are unknown possibilities for which we will be very closely watching.
What should you be doing?
Get vaccinated.
About 15 percent of the population has been infected already, 15 percent vaccinated, 15 percent with prior protection from years ago, leaving over 50 percent of the population still vulnerable. Protect yourself and your family over the holidays by getting vaccinated NOW – call (760) 873-7868.
To keep from getting sick, stay away from sick persons, wash your hands frequently, drink plenty of non-alcoholic fluids, and get plenty of rest. Enjoy the beautiful outdoors, your family and friends, and all the holiday festivities.
If you get sick, stay home from work, keep sick children out of school, skip that holiday gathering, cover your cough with your elbow, wash your hands frequently, treat your fever, drink plenty of non-alcoholic fluids, and call your healthcare provider if you are concerned, especially if you are pregnant or have a chronic medical condition.
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