Thursday, December 19, 2013

Montgomery County Flu Updates – Dec 19th

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# 8092

 

We’ve a brief statement from the Montgomery County Public Health Department this evening on their ongoing investigation into a number severe `flu-like’ illnesses that now confirms that 2 of the 8 suspect cases have tested positive for the H1N1 virus.  Additional testing is underway.

 

We also have a news story, and some Tweets from the KHOU-TV Managing Editor, that provide additional details not included in the official release.  After which I’ll be back to try to put this into some kind of perspective. 

 


First stop, the MCPH update from their Facebook page.

Contact: Jennifer Nichols-Contella FOR IMMEDIATE RELEASE

Cell: (936) 444-9724 12/19/13
Email:
jnichols@mchd-tx.org


UPDATE - INFLUENZA LIKE ILLNESS ARISES IN MONTGOMERY COUNTY

As of Thursday afternoon, one additional case of H1N1 has been confirmed in Montgomery County. This patient is currently in an area hospital receiving treatment. Labs are being repeated on all remaining cases by the CDC. There are currently two confirmed H1N1 cases in Montgomery County.

The Montgomery County Public Health District is coordinating with regional and state resources to manage the case investigations. Health officials continue to encourage the public to be vaccinated for the flu, especially those who are at high risk.

Montgomery County Public Health District is monitoring the situation closely and will provide more information as it arises.
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Meanwhile KHOU-TV is reporting that doctors now suspect that all eight of the Conroe Medical Center cases are infected with the (new in 2009) H1N1 virus, and that additional severe cases have been reported from two other counties in the region.

H1N1 kills 6 people, leaves 14 critically ill in Greater Houston area

By Jeremy Desel / KHOU 11 News and KHOU.com staff

Posted on December 19, 2013 Updated today at 5:28 PM

HOUSTON – Health officials say there have been six confirmed deaths from H1N1 in the Houston area recently, KHOU 11 News confirmed Thursday afternoon. That includes the four deaths at Conroe Regional Medical Center.

At least 14 people have become critically ill in Harris, Montgomery and Jefferson counties, including the four patients at Conroe Regional Medical Center.

This is the same strain of H1N1 that caused a pandemic in 2009. Doctors have been seeing hundreds of new cases recently in Texas and nationwide. In fact, H1N1 is one of the viruses included in this year’s flu shot.

Health officials from all over the region spent Thursday afternoon in a conference call comparing notes about all the cases. They suspect that all of the cases at the Conroe Regional Medical Center are H1N1, or what used to be called the “swine flu.”

(Continue . . .)

 

In the past couple of hours, Bill Bishop, Managing Editor fro KHOU-TV News has tweeted the following updates from his account.

 

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While the 2009 H1N1 virus is no longer a `pandemic’ virus, it – like all seasonal influenza viruses – still has the ability to cause considerable morbidity and mortality.  Last year, we had a fairly serious flu season, but it was dominated by the H3N2 virus – one that traditionally impacts those over the age of 65 the hardest. 

 

And as one would expect, the elderly were particularly hard hit last winter.

 

This year, early reports (see MMWR Update: Influenza Activity — United States, September 29–December 7, 2013) indicate that H1N1 – not H3N2 virus – is the dominant strain in the United States right now.   One of that strain’s characteristics is that it hits younger patients particularly hard.  Here is what the CDC had to say about the impact of the virus during the pandemic.

 

2009 H1N1 Pandemic Hits the Young Especially Hard

This study estimated that 80% of 2009 H1N1 deaths were in people younger than 65 years of age which differs from typical seasonal influenza epidemics during which 80-90% of deaths are estimated to occur in people 65 years of age and older. To illustrate the impact of the shift in the age distribution of influenza deaths to younger age groups during the pandemic, researchers calculated the number of years of life lost due to 2009 H1N1-associated deaths. They estimated that 3 times as many years of life were lost during the first year of 2009 H1N1 virus circulation than would have occurred for the same number of deaths during a typical influenza season.

 

While it may be distressing, it wouldn’t be surprising to see the H1N1 virus causing the same lopsided impact today.  The virus remains antigenically very similar to what emerged in 2009, and for many people who may have not bothered to get a flu shot this year, their immunity levels may be waning.

 

Nor would it be unusual to see a resurgence of a pandemic strain several years after the pandemic has ended.  In fact, that has been the pattern in year’s past.   The chart below shows that type of activity in the six years following the H2N2 pandemic of 1957.  Notice how the mortality rates dropped in 1958-59, and 1960-1962, only to jump again in 1963.

 

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H2N2  Pandemic Waves - NEJM 2009

 

All of this is a not-so-gentle reminder that seasonal flu can still pack a wallop, and that individual immunities wane over time, making it a good move to update that flu shot every year. It is certainly not too late to get the shot, as we have several months of flu ahead.


I’m sure we’ll revisit this story as more details become available.