I'm branching out from my usual blog because of the threat this flu season represents. (Addendum below)
This flu season is extraordinary. Normally, I see flu cases start to trickle in around the new year, and peak sometime in March. Flu visits are usually a small but significant portion of my work in the winter months. Some years are worse than others. A couple of years ago, a new strain spread out of Australia after the vaccine had already been formulated. We had more cases than usual, but nothing we couldn't handle.
In a normal year in the U.S. we have somewhere on the order of 36,000 extra deaths due to flu. This is done by a complicated formula, but basically, the CDC looks at baseline deaths due to flu and pneumonia (we don't test that many people, so we have to use a good but less-than-satisfactory baseline). In a normal winter, these numbers are higher. At a certain point, they rise above the threshold one would expect from normal numbers of flu and pneumonia cases, and these extra deaths, based on epidemiologic surveillance, can be attributed to influenza.
In order to track the flu without testing every single case, we track, in addition to actual flu cases, "influenza-like illness (ILI)". Most ILI is not flu, but a lot of it is, especially during flu season. This year, we are not only seeing more ILI, but more positive flu tests, more hospitalizations, and more deaths. You can argue all you want about the complex methods we use to track flu, but unless you're an epidemiologist with a good alternative, you're better off trusting the experts on this one.
Last April, rather than seeing the usual drop off in ILI cases, I saw a fresh spike, which can be seen in the graphs provided by the CDC. This spike dropped off after school let out, but I continued to track cases in summer camps, where flu was rampant. Now that school is back in full swing, I'm seeing many, many more flu cases than I normally would this time of year, and there isn't any indication that things are getting better.
The flu I've been seeing has been miserable, but not all that different from flu in other years---except for one salient fact: it's hitting young people in particularly large numbers. Normally when flu kills, it kills off the elderly and infirm. This year, with so many additional young people falling ill, deaths of young people are rising proportionately. While this flu may be no more virulent than others, it is taking down a different segment of the population.
The other difference I'm seeing this year is a leap in anti-vaccination propaganda. It's always been there, but this year it's really getting through. The swine flu shot is no different from any other flu shot---every year flu vaccinations are produced based on what strains are likely to circulate. If this H1N1 had been found earlier, it would be in the seasonal vaccine with the others. Because it came late, a new vaccine was made up the same way all flu vaccines have been made for decades.
With the numbers still on the rise, I hope the swine flu shots get here in sufficient numbers in time to help blunt this pandemic. The illness is miserable, and those of us on the front line may end up in the unenviable position of implementing pandemic emergency plans. Worse, we may end up with a shortage of acute care and ICU beds and the people to staff them.
This is no joke, folks. It's not The Plague, but this flu has the potential to cause major disruptions in our society and economy at a time when we really don't need that. The seasonal and swine flu vaccines are safe, effective, and damned important. Get out there and get them.
Addendum:
A reader said this feels more like the CDC than dKos. Sorry, but flu and flu insanity doesn't recognize party. The right has it's share of anti-vaccination wackos, but we're in big trouble on "our" side. The Left is stuck with Bill Maher, Arianna Huffington, and more otherwise-reasonable people who don't get it. We have to speak out against our own wackos, too.
