UK: Flu Hospitalizations Up 700% in 2009

 

UPDATED

 

# 4484

 

 

While the pandemic of 2009 could have been a lot worse, we are seeing evidence of its impact in new numbers released by the NHS in the United Kingdom. 

 

Specifically, a 7-fold increase in flu-related hospitalization days over the previous year.

 

This from the Telegraph-UK.

 

Record number of patients in hospital with flu last year: official data

Seven times more hospital beds were filled with flu sufferers last year than in 2008 as England battled against swine flu, it has emerged.

 

By Rebecca Smith, Medical Editor
Published: 1:06PM BST 09 Apr 2010

Figures from the NHS Information Centre revealed 33,376 bed days were taken up by people with flu as their main reason for admission, compared to 4,163 in 2008.

 

The rise was steepest later in the year, with the number of bed days rising to 20,744 between October and December compared to 1,585 in the same period in 2008.

 

This means the number of bed days was 13 times higher in 2009 than in 2008. ."

 

(Continue . . .)

 

 

The assurances towards the end of this article by an NHS spokesperson that the NHS was `ready to cope with the increase in demand’ comes about only because the number of hospitalizations wasn’t much worse than it was. 

 

Had the 2009 H1N1 virus been even slightly more virulent, the ability of health care systems to cope would have been severely tested.

 

UPDATED

 

 

My thanks to my good friend Chacal who commented that 2008 was an exceptionally bad flu year in the UK . . . something that should be taken into account when comparing the pandemic of 2009 to the previous flu season.

 

Chacal wrote:

good article Mike, but also remember the 2008 winter was thought to be the worst in 7 years before H1N1 came along, and 2008 winter accounted for 35,000 excess deaths( up from the usual 10,000 excess deaths)
Chacal

9:51 AM

 

 

the Guardian reported in December 2009:

 

Flu outbreak is worst for eight years

Sarah Boseley, health editor

The Guardian, Wednesday 24 December 2008

Britain is in the grip of a flu outbreak greater than anything seen in the last eight years, with soaring numbers of people falling ill, new figures show.

 

The last big flu outbreak occurred in 1999/2000, when 22,000 people died, which is 10 times the average for a winter flu season.

 

The latest figures from the Royal College of GPs show 69 cases of flu in 100,000 population for this week. In the last two weeks, the rate has climbed steeply, from 28 in 100,000 two weeks ago, to 40 last week and now 69.

 

The rise is across all regions of the UK and all age groups, but it appears to be the young and middle-aged adults who are hit hardest. The rate has soared to 80 in 100,000 in the 15 to 44 age group and to 76 among 45 to 64-year-olds. These tend to be more socially active people - teenagers, young adults and workers who refuse to stay home when they feel ill.

 

And this chart from the UK Statistics website shows the relative increase in winter mortality in 2008.

 

Canada: H1N1 Sent More To ICU Than Seasonal Flu

 

 

# 4345

 

 

While not in the same league as the pandemic of 1918, or bird flu, the novel H1N1 pandemic virus has offered up its own quirks, and challenges.  To call it `no worse’ than seasonal flu – as some have suggested - would be a serious mischaracterization.

 

Each week we learn more about how the pathogenesis and impact of this virus differs from seasonal strains. 

 

Today, a study out of Canada  shows that this pandemic virus sent more people – and younger people in particular – to the hospital than seasonal flu.  And of those, a higher percentage than usual ended up in the ICU or requiring mechanical ventilation.

 

The 26 page study H1N1 in Canada—A Context for Understanding Patients and Their Use of Hospital Services  compares Canadian baseline acute hospitalization data from 2007-2008 against recent data collected on H1N1 hospitalizations.

 

This analysis is released through the Canadian Institute of Health Information.  Below you’ll find excerpts from a press release summarizing the study.

 

 

H1N1 patients required more intensive hospital care than typical flu patients

 

Pregnant women represented a greater percentage of those hospitalized than in a typical flu year

February 11, 2010—When compared to a typical flu, the H1N1 virus resulted in a higher proportion of patients requiring specialized hospital services—and affected younger people more—according to a new study released today by the Canadian Institute for Health Information (CIHI).

 

The study, H1N1 in Canada—A Context for Understanding Patients and Their Use of Hospital Services,is the first of its kind to examine at a pan-Canadian level how hospitalizations for H1N1 differed from hospitalizations associated with a typical flu. It compares Public Health Agency of Canada FluWatch analysis from April to December 2009 with CIHI hospital statistics for the baseline year 2007–2008. The comparison group included patients with influenza and/or pneumonia, the most common complication of influenza.

 

“The H1N1 pandemic was met with an unprecedented response from public health officials. As the spread of the virus subsides, it is important to pause and look at how H1N1 compares to a typical flu season,” says Jean-Marie Berthelot, Vice President of Programs at CIHI. “Our study shows that proportionately more H1N1 patients needed specialized and intensive hospital services than what we’ve come to expect in a typical flu season.”

 

Specifically, the study found that from April 12, 2009, to January 2, 2010, the proportion of hospitalized H1N1 patients requiring intensive care was 50% higher than for those admitted to hospital with influenza or pneumonia in the baseline year—with almost one in six H1N1 hospitalized patients admitted to an intensive care unit (ICU). In addition, an estimated 1 in 10 patients admitted to hospital with H1N1 required ventilation to assist with breathing; proportionally, this was more than double the influenza/pneumonia group.

(Continue . . .. )

CDC Updates Estimates Of Infections, Hospitalizations, and Deaths From H1N1

 

 

# 4259

 

 

Attempts to count individual deaths from the H1N1 virus in the US ceased during the summer when it was determined that it was no longer possible to keep any kind of accurate tally.

 

 

That was expected since, even during a regular flu season, we don’t count individual flu deaths.  The oft repeated number of 36,000 flu-related deaths annually is an estimate.

 

 

In November the CDC released their estimates of the pandemic’s impact here in the US up until mid-October.  At that time, they estimated 22,000,000 people had been infected and roughly 4,000 had died.

 

In December, the CDC has updated those numbers through November 14th, and they show a significant increase over the previous numbers.  A mid-range estimate of 47 million infections and nearly 10,000 deaths.

 

Today, the CDC once again updates their estimates to carry through to the 12th of December.    Their mid-range estimates are of 55 million infections and 11,160 deaths in the US from H1N1 since April of 2009.

 

 

 

 

CDC Estimates of 2009 H1N1 Influenza Cases, Hospitalizations and Deaths in the United States, April – December 12, 2009

January 15, 2010 1:00 PM ET

April – October 17 Estimates
April – November 14 Estimates

On this Page

• Background
• The Numbers
• Table: CDC Cumulative Estimates of 2009 H1N1 Cases and Related Hospitalizations and Deaths from April-December 12, 2009
• Method to Estimate 2009 H1N1 Cases, Hospitalizations and Deaths
• Background Emerging Infections Program
• Seasonal Influenza-Associated Hospitalizations in the United States
• Seasonal Influenza-Associated Deaths
• Under-Counting of Flu-Related Deaths
• Related Links

Background

Estimating the number of individual flu cases in the United States is very challenging because many people with flu don’t seek medical care and only a small number of those that do seek care are tested. More people who are hospitalized or die of flu-related causes are tested and reported, but under-reporting of hospitalizations and deaths occurs as well. For this reason CDC monitors influenza activity levels and trends and virus characteristics through a nationwide surveillance system and uses statistical modeling to estimate the burden of flu illness (including hospitalizations and deaths) in the United States.

When the 2009 H1N1 flu outbreak began in April 2009, CDC began tracking and reporting the number of laboratory-confirmed 2009 H1N1 cases, hospitalizations and deaths as reported by states to CDC. These initial case counts (which were discontinued on July 24, 2009), and subsequent ongoing laboratory-confirmed reports of hospitalizations and deaths, are thought to represent a significant undercount of the actual number of 2009 H1N1 flu cases in the United States. A paper in Emerging Infectious Diseases authored by CDC staff entitled “Estimates of the Prevalence of Pandemic (H1N1) 2009, United States, April–July 2009” reported on a study to estimate the prevalence of 2009 H1N1 based on the number of laboratory-confirmed cases reported to CDC. Correcting for under-ascertainment, the study found that every case of 2009 H1N1 reported from April – July represented an estimated 79 total cases, and every hospitalized case reported may have represented an average of 2.7 total hospitalized people. CDC then began working on a way to estimate, in an ongoing way, the impact of the 2009 H1N1 pandemic on the U.S. in terms of 2009 H1N1 cases, hospitalizations and deaths. CDC developed a method to provide an estimated range of the total number of 2009 H1N1 cases, hospitalizations and deaths in the United States by age group using data on flu associated hospitalizations collected through CDC’s Emerging Infections Program.[e1]

The Numbers

(Print table)

On November 12, 2009 CDC provided the first set of estimates on the numbers of 2009 H1N1 cases and related hospitalizations and deaths in the United States between April and October 17, 2009.

Estimates from April – October 17, 2009:

• CDC estimated that between 14 million and 34 million cases of 2009 H1N1 occurred between April and October 17, 2009. The mid-level in this range was about 22 million people infected with 2009 H1N1.
• CDC estimated that between about 63,000 and 153,000 2009 H1N1-related hospitalizations occurred between April and October 17, 2009. The mid-level in this range was about 98,000 H1N1-related hospitalizations.
• CDC estimated that between about 2,500 and 6,000 2009 H1N1-related deaths occurred between April and October 17, 2009. The mid-level in this range was about 3,900 2009 H1N1-related deaths.

Updated Estimates from April – November 14, 2009

Using the same methodology CDC updated the estimates to include the time period from April through November 14, 2009 on December 10, 2009.

• CDC estimated that between 34 million and 67 million cases of 2009 H1N1 occurred between April and November 14, 2009. The mid-level in this range was about 47 million people infected with 2009 H1N1.
• CDC estimated that between about 154,000 and 303,000 2009 H1N1-related hospitalizations occurred between April and November 14, 2009. The mid-level in this range was about 213,000 H1N1-related hospitalizations.
• CDC estimated that between about 7,070 and 13,930 2009 H1N1-related deaths occurred between April and November 14, 2009. The mid-level in this range was about 9,820 2009 H1N1-related deaths.

Updated Estimates from April – December 12, 2009

Using the same methodology CDC has updated the estimates to include the time period from April through December 12, 2009.

• CDC estimates that between 39 million and 80 million cases of 2009 H1N1 occurred between April and December 12, 2009. The mid-level in this range is about 55 million people infected with 2009 H1N1.
• CDC estimates that between about 173,000 and 362,000 2009 H1N1-related hospitalizations occurred between April and December 12, 2009. The mid-level in this range is about 246,000 H1N1-related hospitalizations.
• CDC estimates that between about 7,880 and 16,460 2009 H1N1-related deaths occurred between April and December 12, 2009. The mid-level in this range is about 11,160 2009 H1N1-related deaths.

Note: Less than 5% of increases in the estimates from one reporting date to the next are the result of delayed reporting in cases, hospitalizations and deaths.

The previous estimates of 2009 H1N1 cases, hospitalizations and deaths through November 14 encompassed the peak of 2009 H1N1 activity in the United States. The latest estimates through December 12 show a modest increase in the total number of 2009 H1N1 cases, hospitalizations and deaths since the 2009 H1N1 virus emerged. The additional four weeks of flu activity data added to the previous estimate correlate with a four week period of decreasing flu activity in the United States.