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US enters first week of 2009-2010 flu season with mixed statistics on H1N1 and other influenza strains

Although H1N1 outpatient cases are down throughout the US, CDC experts say the activity is higher this year than normal for the season.  Parents nationwide are concerned over increased exposure their children will face as they return to the classroom and elevated levels of social contact.  We enter this year’s flu season wondering whether we can control the H1N1 pandemic and reduce hospitilizations through medicine, common sense and lifestyle choices.  We wonder whether H1N1 will strike our family. 

While influenza-like illness diagnoses have declined since the spring, deaths attributed to H1N1 are on the rise nationally.  The Wall Street Journal cited the CDC’s weekly H1N1 death count of 263 through mid-July, including the very first death caused by H1N1. During the next 8 weeks, ending September 5, 330 deaths were recorded at the CDC.  Through mid-July the US was seeing an average 23.9 deaths per week, versus the more recent average 41.2 per week. 

The state health departments in Georgia, South Carolina and Alabama report H1N1 hospitalizations and deaths are on the rise in recent weeks and the CDC has characterized H1N1 activity for the southeast as "widespread", the most severe category. The southeast is the only region with this designation at this time.  Widespread influenza activity within any region is considered to be uncommon in August.

The most vulnerable population at this time for all influenza (A, B and pandemic H1N1 combined), according to labratory-confirmed influenza hospitalization rates per 10,000 population by age group as per the CDC’s Emerging Infections Program April – August 2009, is children aged 5 – 17.  This group has exceeded national baselines for each week since late June, compared to the average for the same week in the previous 3 flu seasons. Adults 18 – 49 are the next most hospitalized group, matching the baseline each week since mid-July.  Infants 0 – 23 months and children 2 – 4 have shown increases over the summer months but still fall short of baseline statistics. Seniors 65+ show the least vulnerability, falling the farthest behind baselines compared to other age groups.

The H1N1 vaccination is targeted to be available this fall, according to most recent information from the CDC , dated August 28.  But the CDC won’t give a more specific time frame, citing manufacturing and variables and clinical trial findings between now and then. While efficacy of the antigens does not seem to be in question, the vaccine is experiencing some controversy over "limited testing" perhaps in light of conflicting public views on the safety of vaccines recently.  Yet the nature of pandemic response is hurried; officials and medical experts are racing against a deadline that is both impossible to pinpoint on a calendar and thought to be serious and a matter of national security. 

Pregnant women and school age children are the populations given priority for the vaccines.  It is expected that the introduction of the vaccine this fall will reduce the number of cases of H1N1 but the outcome is largely dependent on variables such as how soon it can be introduced, how many affected parties receive the vaccination and how the clinical trials go.

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