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Swine Flu Update

Vaccine for swince flu is safe and serious reactions were reported in 204 of 46.2 million doses of H1N1 vaccines distributed.

Treatment of swince flu is effective. Swine flu A (H1N1), Seasonal flu A (H1N1), Seasonal flu A (H3N2) and Seasonal flu (type B) are all sensitive to Zanamivr. All (but seasonal flu A) are sensitive to Oseltamivr.

H1N1 Epidemic Update
During influenza week 47 (November 22-28, 2009), influenza activity continued to decrease in the United States.[4] More than 99% of strains that were subtyped were 2009 influenza A (H1N1).

Summary:

1. Virtually all influenza at this time is swine flu. Seasonal flu has not started.
2. The number of outpatient visits for influenza-like illnesses is 3.7%, which is above the national baseline of 2.3% but lower than earlier reports. Hospitalizations and deaths due to influenza are down.
3. The second wave is subsiding, but there is still widespread illness in 25 states.
4. Resistance testing shows that 15 of 1540 (less than 1%) 2009 H1N1 strains were resistant to oseltamivir. Nearly all 15 had previous exposure to oseltamivir.
5. Oseltamivir is still active against nearly all strains, especially in patients who have not had oseltamivir exposure.
6. Pediatric deaths attributed to this influenza strain in the United States now total 198, including 34 in children younger than 2 years of age. Of these, 89 had cultures of normally sterile sites and 28/89 (31%) showed bacterial superinfections involving a predictable menu of pathogens.
7. There is increasing concern and attention on bacterial superinfections. Clues are (1) biphasic course, (2) elevated WBC, (3) x-ray showing lobar consolidation, and (4) sputum showing the likely pathogens: pneumococcus, Staphylococcus aureus, or Group A streptococcus.

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