New swine flu wave possible in Norway

[tetano]

Photo: Wikimedia Commons

Two admitted

A baby and a man in his 60s ended up in intensive care after contracting the virus in the past two weeks, according to VG.

The man from Buskerud was hospitalized on December 30 and belongs to one of the risk categories, which include individuals with diabetes, heart or lung conditions, excessive obesity, neurological diseases, the elderly, as well as pregnant women.

The baby, who was admitted on Christmas Eve, is now stable, according to Karin R?nning, Senior Medical Officer at the Norwegian Institute of Public Health (NIPH/Folkehelseinstituttet).

?The child did not belong to any risk group. The condition of the baby was fine when I last spoke with the hospital, and it was due to taken off the respirator,? Mrs. R?nning told VG.

Neither of the two patients has been vaccinated against the H1N1 virus.
Under control

25 cases of swine flu have been recorded in Norway since September, according to Department Director Bj?rn Iversen, but most have not been diagnosed.

?We believe these are just the tip of the iceberg,? he says.

Norway is just one European country where the swine flu virus has been detected this season, but Mrs R?nning believes the outlook is better than for the UK, which has been hit the worst. 190 people were admitted to hospitals before Christmas, and there are 14 registered fatalities.

?We believe that our society is in a better position than England because so many Norwegians were vaccinated last year. We do not think we will see catastrophic proportions here,? Mrs. R?nning said.

http://theforeigner.no/pages/news/new-swine-flu-wave-possible-in-norway/

[Vibrant62]

Re: New swine flu wave possible in Norway

I have not been able to find a formal reference for what proportion of Norwegians were vaccinated last year, but as memory serves it was a vast majority of thier population. (IRO 80% I think but cannot verify)

Added to this picture - as imperfect as it may be - an examination of Google Flu trends (which assesses numbers of flu related search queries at any point in time) indicates that last year there may have been quite a substantial pH1N1 infection rate amongst the population, a trend which is confirmed by official flu data for last year. This would tend to suggest that a high proportion of the norwegian population either have been vaccinated and/or had a p[revious swine flu infection, so there should be reasonable levels of herd immunity in this country at this time.

So what of the current situation there?

Interestingly, current Flutrends data http://www.google.org/flutrends/no/#NO shows quite high levels of flu related search queries at this time, and the graph growth trajectory is steep - which leads us to some interesting suppositions.

a) if this trend continues, and it is confirmed that there are signficant levels of H1N1 swine flu in Norway over the coming weeks (as opposed to other subtypes), one must conclude that the virus has evolved away from the vaccine and natural immunity created by past infections.

b) If a) is true and yet the rate of serious illness and deaths remain low in Norway, past infection and vaccination may be confirmed as providing a degree of protection from serious infection. This wont help anyone this year, but we can have a reasonably high suspicion (based on past pandemic viruses tendencies to increase in virulence over time for the first few years after introduction) that this flu may be around in a yet more virulent form next year and that susceptibility may be high. This observation can help guide vaccination strategy next year in all countries.

c) if however the rate of serious infections in Norway this year are high or on a close parralel to say the UK, then it would indicate a bigger problem - not just this year, but the potential for a repeat or worsening of the situation next year.

In such circumstances, one would hope that the WHO and national authorities revise and review their strategies, and enact pandemic measures, regardless of the 'official' pandemic status of the H1N1 swine flu virus.

All in all, Norway bears watching closely over the coming weeks to see how its population fares this season, and provide us with some stronger clues as to what we might expect to have to face next year.

Edit: I did not consider the impact of H3N2 and FluB in this assessment, both strains of which have been dominant rather than H1N1 at the time of writing this post - which was an error. However, if you substitute the rationale for H1N1 flu only, the idea still works.

[Vibrant62]

Re: New swine flu wave possible in Norway

Swine flu returns with a vengeance (Norway)

http://www.newsinenglish.no/2011/01/13/swine-flu-returns-with-a-vengeance/

January 13, 2011

There are no signs of panic like there were last year, but state health authorities confirm that the number of cases of swine flu in Norway is rising quickly with 35 persons now admitted to hospital. Eleven of them are or have been in intensive care.

snip

The cases of swine flu have risen 10-fold from just three last week. One patient is an infant in Oslo, another a 56-year-old man from Molde who was transferred to St Olavs Hospital in Trondheim. Only two of the 11 patients now in hospital are women, while seven of the most seriously ill are aged 30-49, reports newspaper Dagsavisen.

Last year, 31 persons died from swine flu in Norway. Health officials are prepared that the virus can spread over the next few weeks. The most seriously patients are being sent to the National Hospital (Rikshospitalet) in Oslo.

Dr Egil Lingaas at Rikshospitalet said he was surprised by the outbreak in recent weeks, because so many Norwegians were vaccinated last year. ?They should be at least partly immune,? Lingaas told Dagsavisen. ?A lot of people also got sick with the swine flu, so should also be immune now.?

Comment: google flu trends has shown intense levels of flu - like illness over the last couple of weeks, and until last week, H3N2 and FluB levels were reported to be high, with only modest levels of H1N1. This situation appears to be reversing, according to the above report..

Sequences from these hospitalised cases for analysis as soon as possible are going to be important