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so, assuming a probability of 85/42718 that any confirmed case will be lethal,
the probability that there are no deaths with 14325 cases is less than 10^-12,
so something is wrong here.
AFAIK Germany reports a case as confirmed when it is tested positive
or has contact to a positive tested person and has symptoms
thanks for the interesting paper, which I hadn't seen before
(or forgot).
But it doesn't solve the mystery.
Do you think there is a German excess of underreporting
seasonal influenza deaths ?
mortality burdon from flu is 20%-30% higher in Germany than in USA.
I think some of the experts should comment why there are no deaths.
I think some of the journalists should ask.
This is strange and striking - why do they all ignore it ???
I can't find anything in internet.
some more key-phrases for searchengines
the mystery of the lacking German flu deaths
the mystery of the lacking German swineflu deaths
no German swine flu deaths
lack of German swine flu deaths
no deaths from swine flu in Germany
noch keine Schweinegrippe Toten in Deutschland
noch kein Deutscher starb an Schweinegrippe
Here is the list of countries as of August 24, 2009 sorted in descending order, of the total number of reported H1N1 infections and the number of reported H1N1 fatalities (based on Wikipedia data). Obviously the actual number of infected individuals is now unknown because many countries have stopped counting cases. Only two countries in the world with more than 2350 confirmed H1N1 cases have not reported any H1N1 related deaths, Germany and China.
STOCKHOLM, Aug. 24 (Xinhua) -- A European health agency said on Monday that 1,048 new A/H1N1 flu cases were reported in European countries within the last 24 hours.
Of the new cases, 585 were confirmed in Germany, 223 in Portugal and 207 in Greece while other cases were reported in the Czech Republic, Bulgaria, Romania and Finland, the European Center for Disease Prevention and Control (ECDC) said in its daily situation report.
The cumulative number of confirmed cases of the A/H1N1 flu virus in the EU (European Union) and EFTA (European Free Trade Association) countries increased to 43,152, with 14,325 cases in Germany, 12,957 in Britain, 2,210 in Portugal, 1,631 in Greece and 1,538 in Spain, the ECDC said.
The total number of fatal cases rose to 93, with nine new fatal cases from France and one from Spain, the ECDC added.
The ECDC publishes a daily situation report about the H1N1 flu cases in the EU and EFTA countries based on official information from these countries.
Sie haben eine Internetseite des Robert Koch-Instituts gewählt, die leider nicht oder nicht mehr existiert. Am besten Sie besuchen unsere Startseite (klicken Sie dazu einfach links oben auf das RKI-Logo) und folgen dem gewünschten Pfad – über die horizontale Hauptnavigation, die A-Z-Module oder das Inhaltsverzeichnis am Fuß der Seite. Sollten Ihnen darüber hinaus fehlerhafte Links auffallen, wären wir für einen Hinweis an das Postfach Webmaster dankbar.
?Addressing chronic disease is an issue of human rights ? that must be our call to arms"
Richard Horton, Editor-in-Chief The Lancet
Eindämmung und Verlangsamung der Ausbreitung waren anfangs das Ziel der Strategie gegen die Neue Grippe. Bei deutlich steigenden Fallzahlen aber steht jetzt der Schutz von Risikogruppen im Vordergrund. Die Zahl der Erkrankungen an der Neuen Influenza...
Google translation
New Influenza Working Group
New Influenza: Current Situation and Strategy
MEDICAL REPORT
responsible: Dr. Andreas Gilsdorf
(GilsdorfA@rki.de), Marleen Dettmann
PD Dr. Gabriele Poggensee, Dr. Walter Haas
Reduce and slow the spread was initially the target
the strategy against the new flu. With significantly rising numbers of cases but now is the protection of vulnerable groups in the foreground.
The number of cases of the new influenza A/H1N1 has grown significantly over the last few weeks in Germany as in other European countries (see graph). Until 6 August 2009 are here 9 213 cases have been reported. The reports are made according Meldeverordnung of 30 April by the doctors to the health authorities and in accordance with ? 7 paragraph 1 Infection Protection Act also through the labs. In the following cases are described that up to 29 July, health authorities and reported electronically to the Robert Koch Institute (RKI) was provided (N = 5 324).
Onset of the first case was 20 April. This is a person who had traveled to Mexico and even there became ill. By the end of May there were only a few cases, mostly associated with travel, but also partly secondary infections, which were due to travel returnees. In June, the number of new cases is about ten to 50 per day, the daily number of notified cases, however, increased significantly since mid-July.
Average age of sufferers is 23 years
54 percent of sufferers are male. The average age is 22.8 years (range: 0 to 89 years). Most patients (77 percent) are ten to 29 years old. Four percent of the cases are younger than ten years, 18 percent are 30 to 59 years old, less than one percent of reported cases are 60 years and older.
From 5 291 (99 percent) cases, which were listed in which a likely country of infection, 22 percent had acquired the infection in Germany. In the first weeks of the pandemic was mentioned reiseassoziierten diseases especially North America as its main objective.
Since early July, the proportion of infections acquired in other European countries, much bigger. During this period, was indicated in 84 percent of infections reiseassoziierten Spain as a travel destination, followed by Britain (five percent) and North America and Bulgaria each (two percent). The high proportion of cases imported from Spain, but speaks for a relevant infectious events in Spain, but also reflects the travel behavior of Germans, according to the Federal Statistics Office flew June to August 2008 approximately 1.1 million people every month from Germany to Spain, in addition, There are also many bus passengers.
In Meldewochen 27 to 30 an increase in the incidence (cases per 100 000 inhabitants) is seen, which began in the northern and western provinces, and continuing through the last weeks in east and south. This can also by travelers, notably the different holidays began to be conditioned in the provinces.
Interestingly, the proportion of persons who are hospitalized because of illness: The information on the one hand, hospitalization may indicate the severity of the disease, on the other hand it also reflects an impression of the additional burden to hospitals by the New influenza.
A limiting must be assumed that a proportion of cases for differential diagnosis diagnosis and isolation measures was hospitalized. This would mainly apply to cases that were hospitalized in the first weeks after the onset of the disease in Germany. In all, 578 individuals (eleven percent) reported to be hospitalised.
In the calendar weeks 29 to 31 of hospitalization was 8.5 to 10.5 percent. The average age of the patients hospitalized during these weeks was 22 years, and corresponded to that of not hospitalised.
Risk factors such as respiratory, cardiovascular disease, diabetes or pregnancy have a strong influence on the disease process. With 2 212 cases (42 percent), there was information on risk factors. Risks were available in 77 cases (3.5 percent). Here the focus was on chronic respiratory diseases, followed by cardiovascular disease, diabetes and pregnancy. Of these, 77 people were hospitalized 22 (29 percent). The share is in this group, almost three-fold increase compared to all cases.
The progress of cases in Germany in the early stages of the pandemic, speaks for the effectiveness of the strategy pursued initially on halting and slowing the spread through the early detection of cases and the interruption of the infection chain by means of strict infection protection measures in patients and contacts.
Adaptation of the strategy with an increasing number of cases
With the significant increase in particular cases reiseassoziierten end of June this approach meant an increasing burden on the resources of the public health. Based on a better understanding of the new pathogen, the clinical course and the most vulnerable groups were, therefore, after extensive discussions between the Federation and countries, a strategy adjustment. The objective now is to have the known risk groups, the higher risk for complications from infections with the new influenza, protected from possible infection.
The Arztmeldepflicht is a major component. It is particularly important that the doctors at the medical history, even after the possible contacts of patients with high-risk groups to ask and report them to the health department. To describe the most vulnerable groups in Germany to be, was established in the surveillance, a systematic survey of risk factors, the first based on the above figures for Germany.
The strategy for the prevention of infections in the general population is primarily due to active information to avoid risks of transmission and basic hygiene measures.
Latest figures from the Sentinel of the Association of influenza is currently also show that the majority of acute respiratory disease currently occurring continue is not caused by influenza (Positivenrate in 29 to 31 Meldewoche = eight to 15 percent). Among the positive samples, there were almost exclusively of new influenza cases, but also occasionally to infection with seasonal circulating influenza viruses.
Since among patients with acute respiratory disease, the rate is still low, with A/H1N1-Infizierten therefore, should normally be made only after a therapeutic intervention laboratory diagnostic confirmation.
In the seasons 2007/08 and 2008/09, almost 100 percent of the circulating seasonal Influenza-A/H1-Viren were resistant to the neuraminidase inhibitor oseltamivir. With the new influenza have been detected in Germany so far no resistance, worldwide there have so far been isolated. The risk of resistance development in the new influenza, however, increases with an untargeted use and the proportion of self-medication. In the treatment of persons associated with an increased risk for a severe course in the center of policy adjustment. In their early treatment should be started, possibly even prior to the laboratory diagnostic confirmation.
Job-related medical personnel is one of the group of persons is both at an increased risk of becoming infected than the same time has contact with vulnerable groups. Therefore, the exposure protection is especially important, and these are the recommendations of the occupational already observed consistently in all cases of acute respiratory illness. This serves not only to protect themselves and family members, but in particular the protection of patients receiving care.
To proceed in the future quickly and successfully to prevent the spread and impact of the pandemic, which is explicitly dependent on the public health service doctors that supply in primary care patients. Here are mainly in the diagnosis, early treatment of vulnerable groups and the message in the foreground.
New influenza working group,
Division of Infectious Disease Epidemiology,
Robert Koch Institute, Berlin
VULNERABLE GROUPS
When infected by new influenza following persons are at risk,
To develop complications:
- Pregnant
- Children, adolescents and adults with increased health risks due to an underlying disease, such as:
- Chronic respiratory disease (including asthma and COPD)
- Chronic cardiovascular, liver and kidney diseases
- Diabetes and other metabolic diseases
- Multiple sclerosis with relapses triggered by infection
- Congenital or acquired immunodeficiencies
- Severe obesity
?Addressing chronic disease is an issue of human rights ? that must be our call to arms"
Richard Horton, Editor-in-Chief The Lancet
..........apparantly Germany doesn't publish these numbers ?!?
Are you saying they're keeping it secret?
.
"The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation
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