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Disturbing Flu Patterns in Many States in the U.S.

JimO

Well-known member
Having looked at the most recent reports from several states (FL, GA, AL, MS, SC, NC, PA, NJ in particular), a familiar pattern has emerged. With the exception of PA, either seasonal H3N2 or influenza B were the only strains reported in any numbers before the first of the year, and the peaks related to number of positive tests appear to have occurred in mid-January. However, in the past three weeks, the following pattern is emerging:

  • The number of postive tests have decreased, even though the percents positive have increased;
  • As a proportion of the number of isolates identified, H3N2 and B have decreased, dramatically in some states, while pH1N1 has shown up for the first time and steadily increased in many cases;
  • The overall %ILI has flattened out or dropped slightly due to the somewhat dramatic drop in seasonal flu - some states are currently within this dip while others saw a brief decrease, followed by higher rates;
  • Hospitalized cases are starting to increase as a percentage of flu cases identified;
  • There is no indication from the public health officials that the mutated pH1N1 could be a significant threat, or that we could see what the UK saw a few weeks ago - no plans for school closings - no warnings of any kind.

It appears that pH1N1 is spreading steadily and will soon be the dominant strain. Based on what I've read regarding the mutation of pH1N1 (not my area of expertise), there seem to have been sufficient mutations that are widespread and that might allow it to escape the vaccine.

Isn't one of the main roles of the CDC is to look for early warning signs like these and recommend actions? Are they crossing their fingers and hoping it'll be no worse than last season?

Here are some charts that illustrate the trend:

North Carolina
flu1011.gif
flupositivetests1011.gif

New Jersey (courtesy of RoRo :tiphat: from http://www.flutrackers.com/forum/showthread.php?t=153811)
NJ.webp

Florida
FL.webp

Alabama
AL Isolates.webp

AL ILI.webp

South Carolina
SC Isolates.webp
 
Re: Disturbing Patterns in Many States in the U.S.

Re: Disturbing Patterns in Many States in the U.S.

It is possible that US will follow European Region, where initially a substantial fraction of isolates were either A(H3) or B, especially in eastern countries like Russian Federation.

The only thing that continues to remain obscure is the proportion of susceptible on H1N1 (2009) among population, the determinant of epidemic curve.

If the proportion is substantial, another wave of H1N1 (2009) is anticipated.
 
Re: Disturbing Flu Patterns in Many States in the U.S.

I probably should have posted the charts in that thread. West Virginia just updated their chart.

WV.webp
 
Re: Disturbing Flu Patterns in Many States in the U.S.

Vermont is showing a sharp increase in pH1N1 and the percent positive is over 80%!

VT.webp
 
Re: Disturbing Patterns in Many States in the U.S.

Re: Disturbing Patterns in Many States in the U.S.

My concern is that few people in the U.S. will be protected because of the S188T and/or S186G mutations (I think those are the correct positions) (among others), which seem to have become established in pH1N1 and which are associated with immunological escape. As I understand it, most of the sequences from December and January carry these mutations and the latest sequences nearly all have them.

Again, I am limited in my understanding of virological genetics, but in the places where pH1N1 has recently been detected, the cases are increasing rapidly.
It is possible that US will follow European Region, where initially a substantial fraction of isolates were either A(H3) or B, especially in eastern countries like Russian Federation.

The only thing that continues to remain obscure is the proportion of susceptible on H1N1 (2009) among population, the determinant of epidemic curve.

If the proportion is substantial, another wave of H1N1 (2009) is anticipated.
 
Re: Disturbing Flu Patterns in Many States in the U.S.

Regarding the States that have the highest number of cases of PH1N1? Last year were these States affected badly? I remember the WHO stating that it H1N1 would still be around this season, and it is by the graphs but just curious if all the states that are being hard hit, were affected as badly as last year.
Also, I have noticed the States that are having more h1n1 are states that are having extreme weather, as well. Eg: like England and H1N1 was predominant whereas we here in the states have all 3 strains floating around.
I hope I am in the right place for asking this question, if not I apologize. I am brand new to this forum. Thank you
 
Re: Disturbing Flu Patterns in Many States in the U.S.

It's a little early to tell because pH1N1 hasn't made it to the Southwest or California in any numbers, which was a region that was hit hard last year. However, the Southeast had it pretty rough too and it appears that the same thing is starting this year. As I pointed out above, some studies suggest that recent sequences from fatal or serious cases are showing mutations that have the potential to escape the immunity conferred either by vaccination or by having caught H1N1 in 2009. The next three to six weeks could be rough.
Regarding the States that have the highest number of cases of PH1N1? Last year were these States affected badly? I remember the WHO stating that it H1N1 would still be around this season, and it is by the graphs but just curious if all the states that are being hard hit, were affected as badly as last year.
Also, I have noticed the States that are having more h1n1 are states that are having extreme weather, as well. Eg: like England and H1N1 was predominant whereas we here in the states have all 3 strains floating around.
I hope I am in the right place for asking this question, if not I apologize. I am brand new to this forum. Thank you
 
Re: Disturbing Flu Patterns in Many States in the U.S.

New York had most H1 in 2009/10

they just had a H3-wave this year and since Jan it is declining
 
Re: Disturbing Flu Patterns in Many States in the U.S.

I don't know about other states, but here in MO we've had a fairly mild winter up until a couple of weeks ago. Our P&I deaths have been elevated since week 40 when compared to last year and the 5-year median. Beginning week 51, 2009 A(H1N1) was detected (no other viruses detected prior) and has been increasing ever since. So, I'm not sure it's tied into our weather
http://www.flutrackers.com/forum/showthread.php?t=153717
 
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