# 3275
Richard Knox writing for NPR has tonight’s must-read article on the uncertainty over tracking changes in the virulence of the H1N1 virus, and the vaccine decisions that loom over the next few months.
I’ve only posted the opening paragraphs, this one is well worth following the link to read in its entirety.
Swine Flu Forecast: More Uncertainty Ahead
by Richard Knox
Will we all be lining up for swine shots soon?/Toby Talbot/AP
The big push to make a swine flu vaccine is on.
The Centers for Disease Control and Prevention is starting to ship vials of "seed" viruses to drug companies so they can begin making vaccine against swine flu.
Important decisions loom. Many are technical and complex. How much vaccine needs to be in each dose? Should a booster substance be added to make the vaccine go further? How many people should get vaccinated? Who?
Then there's the really big decision: Should hundreds of millions of people get vaccinated next fall against swine flu?
As we’ve discussed on several occasions over the past few weeks (including here, and here) surveillance and reporting of flu-related deaths, even in countries like the United States, is often a hit or miss affair.
We hear about 36,000 flu related deaths each year, but that is simply an estimate, not a real count. Influenza is assumed to be a contributing factor to a lot of deaths that end up being attributed to other causes.
And so it is with this novel H1N1 virus.
We are probably catching fatalities among the young, and those who died while hospitalized, but an unknown number of others are likely going unidentified.
While a big spike in the mortality rate would likely show up on our surveillance networks, a smaller increase might not be readily apparent.
And even a small increase in this virus’s virulence could mean a big impact on our society and our health care system.
