H5N1 in the US

From NBC News, January 22, 2015:

A green-winged teal shot by a hunter in northern Washington state has tested positive for H5N1 bird flu — a relative of the virus that’s infected nearly 700 people globally and killed 400 of them.


To make matters more complicated, this strain of H5N1 found in the teal appears to be a mix of H5N1 and the H5N8 found in Washington state and elsewhere in the U.S. as well as in Europe, South Korea, Japan and Taiwan.

The pandemic potential of this version of H5N1 is unknown.


Over 3,100 dead Americans

Over 3,100 people have died in the US from pandemic H1N1. This is likely a gross underestimate as it only includes people with laboratory-confirmed H1N1. The willingness of States to report their deaths varies greatly. For example, Ohio does not report most of its adult deaths.

From The Daily Standard, February 4, 2010

Ohio Department of Health spokeswoman Jen House said the state has confirmed 51 deaths from H1N1. However, most of those represent deaths of children because health officials are not required to report adult deaths from H1N1, she said.

Unlike seasonal flu, the vast majority of deaths due to H1N1 have been in people under the age of 65, many of them children.

Looking only at reported, confirmed H1N1 deaths, the current number indicates that at least 1 in every 100,000 Americans has already died of pandemic influenza.

Although few cases have been reported in the media in recent months, department of health releases from the States paint a different picture. Many deaths have been reported in the last two weeks.

This isn’t over.

Pandemic Update – October 17, 2009

There have been over 5,342 reported deaths due to the new H1N1 virus. Many countries have ceased reporting their deaths, so the actual figure is likely much higher.

In the United States, some cities and states have stopped reporting their H1N1 deaths, but others continue to provide this information. There have been over 1,000 lab-confirmed H1N1 deaths in the United States, thus far. Since the schools opened, the number of children who have died of pandemic flu has skyrocketed, to well over 100. There are anecdotal reports suggesting that more adults are starting to become infected. Outbreaks are unevenly distributed across the US. Regions where schools opened early are particularly hit hard. In some cities, ICUs are already full. Except in a few cases, most of the US stockpile of Tamiflu has not been released to the general public. People are having increasing difficulty in obtaining this medication, especially the children’s liquid.

Deaths continue to be reported in some South American countries: 153  in Peru; 111 in Colombia and 91 in Venezuela.

In Europe, deaths have started to increase in numbers in the United Kingdom. There are now at least 106 dead in the UK. 45 are reported dead in Spain. Some reports suggest a cover up of some deaths at the local level. 32 have reportedly died in France, although most of these deaths are in its Overseas Departments. There is controversy over whether or not there have been deaths in Russia. One prominent virologist suggests that a cover up of the severity of the pandemic in Russia is ongoing.

In Asia, some countries have simply stopped reporting their deaths: these include Indonesia, Malaysia and the Phillipines. China has reported two deaths on the Mainland, one in Tibet and the other in Xinjiang. The lack of reports of any deaths in the populous cities on the Eastern Seaboard is not credible. India now reports at least 405 deaths.

There is increasingly good evidence that the new H1N1 virus is far more lethal than seasonal flu. The lung pathology of patients reminds investigators of H5N1. There have been a number of suggestions that there may be multiple strains of the new H1N1, some of which are more severe than others.

Pandemic Update – September 20, 2009

There have been over 4,370 deaths reported due to the new H1N1 virus. Brazil has the most reported deaths in the world with 1,024. The United States has altered its reporting system which makes it more difficult to discern how many deaths have occurred, but the number appears to be 687 lab-confirmed deaths. Argentina has reported 596 deaths. Thus, the greatest number of reported deaths remains in the Americas.

In Asia, the greatest number of reported deaths continues to be in India where at least 240 people have died. The absence of reported deaths in adjacent Pakistan strains credibility. Similarly, although 70 deaths have been reported in Malaysia, only 10 have been reported in adjacent Indonesia. Mainland China still has not reported a single death despite reporting over 11,000 cases. Adjacent Hong Kong has reported 22,000 cases and 12 deaths. Failure to acknowledge cases and deaths in Pakistan, Indonesia and Mainland China is dangerous to the health of their citizens. The rest of the world is also put at risk as all three countries have experienced lethal cases of H5N1 influenza. These three countries are at elevated risk for being ground zero for the production of a H1N1/H5N1 hybrid virus which may have the most damaging characteristics of its parent strains.

In Australia and New Zealand, the number of infected appears to be decreasing. How much respite these countries will have is not clear. The Spanish influenza caused the most death in these countries during their summers.

In Europe, the UK continues to be the worst affected country in terms of deaths: at least 80. There are some suggestions that the resumption of school is leading to a new increase in cases. The health care system continues to show signs of severe strain which appears to have resulted in deaths of individuals who did not have the new H1N1 virus but who did not receive adequate care due to misdiagnosis over the phone.Germany continues to report large numbers of cases, over 19,000, but no deaths.

There have been anecdotal reports of very rapid progression of disease, onset of symptoms to death within 72 hours, both in India and the United States. Whether this represents a different, more severe strain of H1N1 is unknown at this time. But, given the significance of such an event, this possibility should be given careful consideration.

Pandemic Update – September 14, 2009

There have been over 3,590 deaths reported due to the new H1N1 virus. However, several countries appear to have stopped reporting their deaths. Brazil has not offiically reported any deaths since last week, when the total was 657. The United States has officially announced that it will no longer count H1N1 deaths. Thus, the true total number of deaths due to the pandemic virus is becoming increasingly difficult to discover.

In North America, the number of new cases appear to be exploding in the United States and Mexico. It is less clear what is happening in Canada. The vast majority of the new cases in the US are associated with the opening of school. At least 15 children, and likely more, have already died as result of going to school and getting infected with the new H1N1. At least two university students have already died. Emergency rooms are starting to be overwhelmed in some hospitals, especially in the South. Increasing concern is being expressed regarding the capacity of ICUs to handle the influx of new cases.

In the Southern Hemisphere, fewer new cases have been reported, although new deaths continue to occur. It is worth noting that during the 1918 pandemic, countries in the Southern Hemisphere experienced their biggest impact during their summer, at the same time that countries in the Northern Hemisphere were experiencing their Fall/Winter.

In Europe, deaths have been reported in more countries. However, countries that had reported large numbers of deaths, the UK and Spain, are reporting few or no additional deaths.

In Asia, India now has reported the greatest numbers of deaths: at least 188. The number of cases and deaths continue to increase rapidly there. Other countries in Asia that had been reporting large numbers of cases, such as Malaysia and Thailand, no longer appear to report all of their deaths. The Indonesian government has apparently decided not to report more than a fraction of their deaths. The Chinese government still does not report any deaths on the mainland, but acknowledges that the situation is “grim”.

Some vaccine is likely to become available in the next few weeks, although it is not clear how much. It is likely that only a small percent of the world’s population will receive vaccine before they are infected with the new H1N1 virus.