Mortality rates during a normal flu season vs pandemic

[mnhtnbb]

With all the hoopla over the incidence of swine flu and the media hysteria, I thought I would
see if I could dig up some numbers for comparison. I have yet to see an article that puts
the few swine flu deaths into perspective.


Pandemic years are associated with many more cases of influenza and a higher case fatality rate than that seen in seasonal flu outbreaks. It is common to encounter clinical attack rate ranges for seasonal flu of 5% to 15% in the literature. For pandemic flu, clinical attack rates are reported in the range of 25% to 50%.

During a typical year in the United States, 30,000 to 50,000 persons die as a result of influenza viral infection. Frequently cited numbers are 20,000 deaths each year, and 37,000 annual deaths. About 5-10% of hospitalizations for influenza lead to fatal outcome in adults.

In normal years, although most influenza infection is in children, the serious morbidity and mortality is almost entirely among elderly people with underlying chronic disease.

<snip>

Influenza-related deaths can result from pneumonia and from exacerbations of cardiopulmonary conditions and other chronic diseases. Deaths of older adults account for > 90% of deaths attributed to pneumonia and influenza.

<snip>

A different pattern may emerge in a pandemic. The 1918-19 pandemic affected mainly healthy young adults and seemed to spare those at the extremes of life. In the USA, the mortality rate during the 1918 pandemic pandemic was around 2.5%. Similarly, in 1957, the brunt fell on schoolchildren and young adults.


Info from: http://www.globalsecurity.org/security/ops/hsc-scen-3_flu-pandemic-deaths.htm


We all need to realize that we are nearing the end of the flu season. Maybe I have my head in the sand, but I would be a lot more worried if these cases of swine flu had appeared four or five months ago.
So far, we're hearing about isolated cases. We are not hearing about tens of thousands of people
catching this flu, which are the kinds of numbers needed to generate worry about a pandemic with its
associated higher mortality rates than normal flu season.

Is there cause for concern? Yes. Hysteria? I'm not there yet. Personally, I think the media
is looking for something to distract all of us from the real danger to our health, which is what goes on
in D.C.

[Mojorabbit]

1. I got an interesting email from promed

which is a listserv for infectious disease physicians from around the world.
Here is part of a discussion.

Swine influenza and the UK
--------------------------
I haven't been able to read every single ProMED-mail report covering
the new "swine" influenza outbreak but it is possible that the
reports have missed an important point concerning the UK and the rest
of Northern Europe.

I apologise if you or someone have already pointed it out, but for
the time being at least, we should have a breathing space in the
sense that influenza virus epidemics don't normally occur in Northern
Europe during the late spring and summer period.

So it would have to be totally outside precedent if this virus caused
significant infections at this time of the year in the UK.

--
Professor EA Gould
CEH Oxford
Mansfield Road
Oxford OX1 3SR
United Kingdom
<[e-mail]>

Northern hemisphere stops in the beginning of May. The best analysis
I have found is this paper: Viboud et al. JID 2005;192:233-48.

Even if the present A/H1N1 has pandemic potential it is therefore
highly likely that the outbreak will fade out within the next 2 to 3
weeks, but it will reappear in the autumn.

As pointed out in an earlier posting, the second wave can be more
pathogenic than the first wave, and inclusion of the present virus in
the vaccine for the autumn therefore should have the highest priority
(I am sure it does). - Mod.EP]

[mnhtnbb]

2. Precisely. The last phrase is important:

"inclusion of the present virus in the vaccine for the autumn therefore should have the highest priority"

I don't usually get flu shots, but I just might get one next fall, especially if the strain causing
this swine flu is included! Shortages of vaccines could be a problem.

[madrchsod]

5. do`t worry baxter labs in chicago is begging for a sample....

i had a flu shot this year and did`t become really ill. my former employer provided us with free shots and during those years i had only minor bouts.

i`m taking them from now on due to my age and crappy health

[madrchsod]

3. how many people in mexico have the flu?

there are 22 million in the mexico city area...how many have were hospitalized, how many went to clinics, and how many just toughed it out?

there`s been plenty of time for this to become widespread across mexico and according to some there should be a lot of deaths.

i did notice the mexican officials at least were handing out masks and decided against large public gatherings. will we do the same when the death count rises in the usa?


according to the chicago tribune a student at notre dame has the swine flu and is doing fine...

[mnhtnbb]

6. 64 cases have been confirmed in the U.S. That's nothing.

Reports indicate 162 dead in Mexico, which is not overwhelming.

There is a fairly good summary article here:

http://www.msnbc.msn.com/id/30398682/

[Oregone]

4. Did you read or work with any of those numbers?

Look, 100 million people get the flu each year in the US and only 30-50 K die (far, far under 1% mortality, mostly young and old).

This flu has a reported mortality rate of 7% (almost 300X as deadly as standard flu), mostly 20-50 year old adults. Perhaps the mortality rate is reported too high, because of under-diagnosis (suggesting more widespread infection, which isn't really a "good" thing). Regardless, its a whole other animal.

Its deadly. Its just not as widespread. If it were, there would be an issue.

A couple thousand people probably have it. Not 100 million. Pray that doesn't happen.

[mnhtnbb]

8. Yeah, I'm in the habit of posting stuff I don't read.

:sarcasm:

[Oregone]

13. It seems like it

This is nothing to scoff at--it is very deadly. If its some media distraction as you suggest, I guess most health organizations in the world are in on it with Fox and CNN (and the BBC and the CBC and on and on in foreign media). Ohhhh, the dangers in DC....come on. Look at the numbers. Its in everyone's interest to make sure 1 in 3 people do not contract this (the same amount that get the standard flu). If that happens, millions *may* die, not 30 K. If it takes hysteria ad Nancy-Grace-like coverage, so fucking be it.

Plus swine flu has a pretty damn cool name. Why the hell wouldn't they be talking about it?

[ProdigalJunkMail]

14. where do you get this 100million number?

the CDC suggests that between 5% and 20% contract flu annually and either of those is significantly below your inflated number.

http://www.cdc.gov/flu/keyfacts.htm

sP

[Oregone]

19. From the CDC NHIS data

That number you cite comes from the CDC NIAID data I think. I may of also grabbed a high year.

Bottom line, the rate of death for flu infections is under .1 percent. This is far over that. Why are you scoffing?

[ProdigalJunkMail]

21. for several reasons

and not really scoffing but very concerned at the hype this is generating. The primary reason for the so-called scoffing is that in the US, the only outbreaks have been small (to date) and not one death has occurred. The deaths in Mexico that have been attributed to the swine flu have not all been confirmed...rather very few. We also have no idea the actual number of cases that are out there so all of these numbers really mean nothing at this point so all the hype is scary...the fact that people are falling all over themselves over it is even moreso...

sP

[Oregone]

22. No, the numbers may mean nothing at this time...

There may be 3X as many people infected that aren't diagnosed, lowering the mortality rate closer to that of the Spanish Flu. The flipside of that is the notion that this virus is more contagious and widespread.

It isn't the number of infections elsewhere that is concerning. It is how widespread they are. If this is very contagious, and as deadly as early number suggest, we are past the point of stopping an epidemic (it is already spread world-wide).

In the meantime, it doesn't hurt to be aware. The media does that in a rather crass way, but it sure does it.

Is there no middle ground? Either people are screaming about the end of the world or they are scoffing and chalking it up as a media conspiracy.

I don't know. Im not laughing, Im not scoffing, Im not screaming. I think this is a good place to stop a minute and at least read and be informed. For everyone person you convince it is a joke, that may be one person in trouble if you are dead wrong.

[ProdigalJunkMail]

24. i agree that there needs to be public knowledge

but with the education system in this country as screwed up as it is and the media blowing stuff out of proportion you get panic. i don't think there is any sort of conspiracy going on here...just a confluence of factors that could become dangerous for the general population and actually increase the spread of the disease and possibly even increase its mortality rate. why can't people look at situation like this and say, "wow, flu is kicking back up and it looks like a nasty one. perhaps i should take some personal precautions."? but no, you get the opposite extremes. i tend to the extreme that believes this is already blown out of proper proportions and the idiots are beginning to run amok...let's see how many people show up in emergency rooms over the next couple of weeks for 'a mild cough that i don't want to turn into something worse'...i would wager that number has dramatically trended up already.

sP

[mnhtnbb]

18. Car accidents are deadly. Guns are deadly. Heart disease is deadly.

Cancer is deadly. Strokes are deadly.

Where is the furor about those numbers? Where is the concern that we could do something about those death rates?

The powers that be want you afraid. Are you giving them what they want?

[Oregone]

20. Are 7% of people stepping in cars ending up in the morgue?

A lot of people get into cars each day. Hopefully the number of people who get this flu will remain far, far under that number.

But that probably isn't going to happen by accident. An informed poplance is a method of approaching this.

[mnhtnbb]

26. There are 64 reported cases in the U.S. at this point. There is no need for hysteria.

[mnhtnbb]

27. 115 people die every day in the U.S. from car accidents.

http://www.car-accidents.com/pages/stats.html

[Oregone]

28. For fucksakes

More people get in their car than have this flu. The point now is to prevent this from changing.

If this flu spreads, and the mortality rate hangs anywhere above 1%, FAR, FAR more than 115 people will die a day from it.

[mnhtnbb]

30. Ah,prevention! Yes. Wash your hands. Stay home if you're sick.

Cover your mouth when you sneeze. I agree. But the media is not just emphasizing appropriate public health measures to reduce rates of infection. They're scare mongering.

Mexico City (where the outbreak appears to be centered within Mexico)is taking appropriate measures.

[DainBramaged]

7. You should have been here over the weekend when I said I'm not worried

It was just evil incarnate.

[mnhtnbb]

9. I'm not surprised. After Bush left and Obama took office, there was

a palpable feeling of hope in this country. The powers that be don't like that. They don't want us
hopeful. They want us scared and scared for our lives. What better way to scare the crap out of people
than catching a deadly virus because somebody sneezed your way?

Look, I take health threats seriously. I'm a retired hospital administrator. I do not have a clinical
background in anything--medicine, nursing, pharmacy, etc--but I've been around health care professionals
since I was a teenager (and that was 40 some years ago).

We have significant mortality from car accidents. We have significant mortality from guns.
We have heart disease, cancer, stroke deaths.

We are the only industrialized nation without health care available to everyone. THAT IS THE PROBLEM--
not the incidence of a nasty form of flu at the end of flu season, which started across the border
from where all those illegal immigrants come!

[Blackhatjack]

10. Be prepared to be pummeled ... I posted an OP backed up by these same statistics/LINK and ...

I was accused of all kinds of fear mongering.

Some posters here don't want to be reminded of even the slightest risk which might possibly affect them.

[mnhtnbb]

11. That's funny. I posted the statistics to put into perspective how LOW

the risk is at this point.

We're at the end of flu season.

[nadinbrzezinski]

12. The end of season and sudden spike was the first sign

down there that something was amiss

FYI

Saw it in the papers

And yes, some folks don't want to read it

I mean WE ARE ALL GONNA DIE (tm)

And the data scares them shitless

[librechik]

15. we haven't had a true pandemic since 1918--unsanitary conditions

poor nutrition and the chaos of war cause the death toll to soar.

Those conditions are not present today. We have sanitary water and plumbing in a lot more places, humans are better fed, and know more about precautions. I imagine they don't want to focus on deaths as defining the pandemic, rather the incidence of cases and their locations anyway.

Regular annual flu kills about 75,000 people a year in this country alone.

It could be more, less or who knows, since the strain is new and unstudied.

The swine flu epidemic of 1976 caused a panic but only 200 deaths or so.

The panic was used to try to ram through the new flu vaccine (failed, and cause a lingering distrust of the later far safer versions)

Maybe this panic is being used to veil the issue of Bush's torture policies. Since Rummy's making a profit off of it, anything could happen, IMO.

[mnhtnbb]

16. Illegal immigration? Fear of travel (broadening horizons)? Closing

borders both ways: in and out?

I don't know. I do know the right wing (the media) likes to keep everyone afraid.

[nadinbrzezinski]

17. Yes we have

1957 and 1968

By the way, if you said we haven't had a pandemic involving the H1N1 virus since 1918 you'd be correct

[librechik]

23. 50 to 100 million deaths worldwide in 1918

34,000 and 20,000 with Indonesian and Hong Kong in the 50s and 60s. It's not definitional, but you can see my point.

And that's only flu. Cholera and typhus are also on the pandemic list for a lot more deaths than the flu.

But it's all speculation at this point. Let's pray it won't be as bad as 68. I had it that year, followed by pneumonia. Not fun.

[mnhtnbb]

25. Per the Ambassador from Mexico to the U.S. on The News Hour tonight

the rate of infection and death rate from swine flue in Mexico appears to be decreasing.

He admitted that the 120 deaths attributed to swine flu in Mexico HAVE NOT BEEN VERIFIED post mortem.

[Danger Mouse]

29. No, they haven't.

The real verified number is much lower.
The media is fucking with our heads.

[bobbert]

31. That's absolutely right, only 26 deaths found this strain present

I find the lack of water in Mexico City to be the true underlying problem

http://www.laht.com/article.asp?ArticleId=331618&CategoryId=14091

[mnhtnbb]

32. Yeah, it 's tough to wash your hands without water.