Public Health News Stories of the Month

Posted on December 21, 2009

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CDC Estimates Suggest H1N1 Has Sickened 47 Million, Killed 10,000

New federal Centers for Disease Control and Prevention (CDC) estimates suggest that the H1N1 influenza virus has infected approximately one in six Americans, or about 47 million, and killed approximately 10,000, the New York Times reports. The new CDC estimates show a sharp rise from previous statistics that said the virus had infected 22 million Americans and killed approximately 4,000. In addition, the report finds that the virus has hospitalized approximately 213,000.The agency said the spike likely reflects the increase in cases the nation saw after the second wave of H1N1 “peaked” in October, according to the Associated Press. The New York Times reports that the ultimate H1N1 death toll will depend on whether a third wave of the virus emerges after the new year and whether more virulent or drug-resistant strains appear. According to the CDC, the new numbers underscore the importance of the H1N1 vaccination program, noting that 85 million doses of the vaccine are now available (McNeil, New York Times, 12/10/09 [registration required]; Stobbe, AP/Washington Post, 12/10/09 [registration required]; CDC estimates, 12/10/09).

H1N1 Pandemic Less Severe Than Previously Forecast, Study Suggests

A study published in a recent issue of the journal Public Library of Science (PloS) Medicine suggests that the H1N1 influenza pandemic may be less severe than previously predicted, with the virus’ death toll projected to range from “considerably below” to “slightly higher” than that of the seasonal flu, Reuters reports. For the study, researchers from the Harvard School of Public Health and Britain’s Medical Research Center analyzed data on H1N1 patients in New York City, including data on hospitalizations, intensive care unit (ICU) admissions or mechanical ventilation, and deaths between April and July 2009. This data was combined with similar data collected from Milwaukee, as well as telephone survey data from New York City about self-reported influenza-like illness (ILI). After combining the data, incorporating prior evidence and adjusting for severity level, the researchers found that during the spring 1.44 percent of symptomatic H1N1 patients in the United States were hospitalized, 0.239 percent required ICU care or mechanical ventilation and 0.048 percent of patients died. In addition, the researchers estimate that for every 10 percent of the U.S. population symptomatically infected with H1N1, between 1,500 and 29,000 H1N1 deaths may occur. As a result, the researchers note that H1N1’s mortality rate is comparable to the seasonal flu, which kills approximately 36,000 individuals annually. The new projection is significantly lower than the “plausible scenario” that the President’s Council of Advisors on Science and Technology presented in August, which estimated that between 30,000 and 90,000 Americans may die of H1N1 this fall and winter. Although the study’s authors say the results should be “reassuring” to public health officials and lawmakers, they note that there is no guarantee that the pandemic’s severity will not increase or a new strain will not emerge. They further suggest that close monitoring of H1N1’s severity may help assess how hospitalization, ICU and death patterns vary “in space and time and across age groups” (Fox, Reuters, 12/7/09; Sternberg, USA Today, 12/7/09; CDC H1N1 Situation Update, 12/4/09; Presanis et al., PLoS Medicine, December 2009).

H1N1 Pulls Resources, Staff, From Other Public Health Programs

Routine public health programs—including childhood immunization clinics, home health visits and chronic disease programs, among others—have “taken a back seat,” as many public health clinics nationwide have been forced to divert staff and other resources to meet the needs of the H1N1 vaccination effort, the Wall Street Journal reports. Although the current H1N1 wave may have peaked, staff at many clinics continue to vaccinate patients in the event that another H1N1 wave emerges next year. According to the Wall Street Journal, the cuts highlight the need for a more robust and steadier stream of federal funding for state and local public health departments. For example, although the federal government allotted $1.5 billion to the H1N1 vaccination campaign earlier this year, fluctuating grants provide the bulk of funding, making it difficult to financially support staff. In an effort to aid the public health departments, the Centers for Disease Control and Prevention says it will extend deadlines for meeting grant requirements on a case-by-case basis to accommodate for staff diversion (McKay,Wall Street Journal, 12/10/09 [subscription required]).

EPA Suggests Greenhouse Gases Could Pose Public Health Threat

The U.S. Environmental Protection Agency (EPA) recently announced that greenhouse gases (GHGs) pose a threat to the American public’s health and welfare, following a thorough review of scientific evidence and public comments, the Los Angeles Times reports. According to the agency, GHGs can be a trigger for longer, more intense heat waves that place the sick, poor and elderly at risk, adding that increased ground-level ozone pollution may exacerbate asthma and other respiratory illness. The EPA’s announcement could be a major step toward implementing federal pollution limits for cars, power plants and factories. In addition, the announcement carries political overtones, as President Barack Obama recently traveled to an international conference on climate change in Copenhagen, Denmark, where he launched a “charm offensive” to show world leaders that the United States takes global warming seriously (Tankersley, Los Angeles Times D.C. Now blog, 12/9/09; AP/CBS News, 12/7/09; EPArelease, 12/7/09).

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