H1N1 influenza infects 22 million Americans
in first 6 months, estimates CDC
Agency reports an estimated 98,000
hospitalizations and 3,900 deaths from April through October
17.
H1N1 “big
picture”
Approximately 22 million cases of 2009 H1N1
influenza have surfaced in the United States since the pandemic first
began in April, reported CDC on November 12. The agency also indicated
an estimated 98,000 hospitalizations (range 63,000–153,000) and
3,900 deaths (2,500–6,100).
The data are the first “big
picture” estimates offered by CDC; up until this point, the agency
has been reporting laboratory-confirmed cases, hospitalizations, and
deaths related to H1N1 influenza. The estimates are for the first 6
months of the H1N1 pandemic (April through October 17). CDC used two
surveillance systems in determining the estimates. (1) The
agency’s Emerging Infections Program network, which is a
collaboration among 10 states and 62 counties within the states. The
network collects extensive data from hospitalizations from influenza,
including laboratory testing and demographics such as the age of
patients. (2) Aggregate state reports of laboratory-confirmed
hospitalizations and deaths were also used (data gathered via the
CDC’s Aggregate Hospitalization and Death Reporting Activity
system). Broken down into age groups, the estimates stack up as
follows:
Younger than 18 years: 8 million ill / 36,000
hospitalized / 540 deaths 18 to 64 years: 12 million ill / 53,000
hospitalized / 2,900 deaths 65 years or older: 2 million ill / 9,000
hospitalized / 440 deaths
Additional information is available at the CDC
website, CDC estimates
of 2009 H1N1 influenza cases, hospitalizations and deaths in the United
States, April–October 17, 2009.
Current supply: H1N1 and seasonal
vaccine
CDC also reported that 41.6 million doses of
H1N1 vaccine are available to be ordered by states. According to the
agency, this total is somewhat less than what manufacturers had expected
to have reached at this point. CDC expressed disappointment in this
current supply and noted the difficulty in predicting vaccine production
for influenza. Current supply estimates are available at the CDC
website, 2009
H1N1 influenza vaccine supply status.
The agency reported that immunization efforts
continue to be focused on the priority groups: pregnant women, health
care workers, children and young adults up to 24 years of age, adults
aged 25 to 64 years with chronic health conditions, and parents or
caretakers of young children younger than 6 months.
A variety of approaches have been used to
vaccinate these populations, said CDC, noting that states and cities are
in the best position to distribute the vaccine among their patient
populations. The agency has observed methods for vaccinating such as
school-located clinics, mass community clinics, and employer-based
clinics. According to CDC, these methods are sensible given the broad
demographics of the groups needing to be vaccinated.
CDC expects access to H1N1 vaccine to become
less restrictive as supply increases. According to the agency, states
are receiving a supply of vaccine that is proportionate to their
populations and that vaccinating some parts of the country may take
longer than others.
The agency has also issued the following
PDF: Summary
of 2009 monovalent H1N1 influenza vaccine data: Vaccine Adverse Event
Reporting System.
Also on November 12, FDA approved the use of
the CSL Limited’s 2009 H1N1 influenza vaccine in patients 6 months
of age or older. Previously, the vaccine was approved only for use in
adults aged 18 years or older. Additional information on the vaccine is
available at the FDA website, Influenza
A (H1N1) 2009 monovalent vaccine (CSL Limited). Earlier in the
week, FDA
approved a supplemental biologics license application for
GlaxoSmithKline's unadjuvanted H1N1 vaccine.
Regarding the vaccine for seasonal influenza,
CDC reported that 94 million doses have been distributed thus far.
Estimates provided to CDC by manufacturers indicated that 114 million
doses of seasonal vaccine will be available by the end of 2009.
Patients with diabetes: Priority group
to receive H1N1 vaccine
November is American Diabetes Month, and CDC
took the opportunity to highlight the importance of patients with
diabetes receiving H1N1 vaccine. Patients with diabetes have an
increased risk of severe illness from any form of influenza, and wide
fluctuations in blood glucose can occur for patients with diabetes
affected by influenza.
CDC reported that about 12% of all
hospitalizations from H1N1 virus have been for patients with diabetes.
In adults with diabetes and H1N1, about 19% will require hospitalization
and, of those, about one in four patients will end up in the intensive
care unit. According to CDC, patients with diabetes should be encouraged
to do the following:
Get the H1N1 vaccine (the
injection, not the nasal spray) when it is available in their
community. If they have fever and cough or other symptoms of
respiratory illness, patients with diabetes should see their health
provider immediately because antiviral medications may be
warranted—providers should not wait for test results to
come back. Get the pneumococcal polysaccharide
vaccine. CDC has observed a low rate of patients with diabetes
and other chronic conditions receiving this vaccine and has seen cases
of pneumonia and pneumococcal infection in this patient
population.
For more information, APhA has compiled a comprehensive
resource document on current key points pertaining to 2009 H1N1
influenza and vaccine.
Web links
Joe Sheffer (jsheffer@aphanet.org)
Posted November 13, 2009
Updates November 19, 2009
Related Files
CDC VAERS H1N1 data (Adobe PDF File)
H1N1 key points (Adobe PDF File)
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