Despite flu fear, cases are few

Mar 13, 2010 — The Miami Herald

Fred Tasker

Mar. 13, 2010 (McClatchy-Tribune Regional News delivered by Newstex) -- Swine flu came in like a lion but seems to be going out like a lamb. And the regular flu season never even got started.

After scaring the bejeebers out of us last spring and fall, the H1N1 virus seems to have collapsed by the end of the year. This year, there haven't been any H1N1 deaths in Miami-Dade and Broward, and just six in all of Florida.

Even better, for reasons scientists can't explain, swine flu tended to squeeze out regular seasonal flu. Of all U.S. patients hospitalized for flu this season, 99.4 percent had H1N1, not seasonal flu, according to the U.S. Centers for Disease Control and Prevention.

"We're almost at the end of the flu season. It could be a very mild one," said Dr. Vincent Conte, chief epidemiologist for the Miami-Dade Health Department. "Even seasonal flu cases are few and far between."

Broward has seen "no outbreaks, no hospitalizations since the first of January," said Dr. John Livengood, epidemiologist with the Broward Health Department.

And regular seasonal flu? "Haven't seen any. Not a single one."

The flu season usually starts in November and winds down at the end of March. In a typical regular flu season, about 36,000 people die in the United States. This season, only an estimated 12,000 had died as of Feb. 13. That's even counting back to last April, when swine flu began.

Experts stress that the numbers are based on statistical models, not actual counts, and so are very general. But they agree the trend is there.

How do we know swine flu is on the ropes? Here's how the CDC measures it: In normal times, 2.3 percent of all U.S. doctor visits are for flu. When swine flu peaked in late October, it was 7.7 percent of all visits, with 49 states reporting widespread disease. By January it had plunged to 1.9 percent -- where it remains today -- and no state reported widespread flu of either kind.

What happened?

One answer is that by mid-February, according to the CDC, 70 million Americans had been vaccinated against swine flu and another 59 million had recently had it -- adding up to 43 percent of the U.S. population presumably immune. One way pandemics die is when they run out of potential victims.

Another -- tragic -- reason is that H1N1 flu attacked a younger, healthier, less vulnerable part of the population -- children and young people. In a typical year, 90 percent of all seasonal flu deaths are in people 65 and older and thus more vulnerable. This year only 13 percent of deaths were in that group, according to the CDC.

TAKING CARE

Doctors give some credit for the milder flu season to the public.

"People are actually covering their mouths, washing their hands, wiping surfaces," said Dr. Nancy Eklund, a private physician in Southwest Miami-Dade. "Everybody's carrying hand sanitizer."

South Florida, perhaps because of its weather, got off lighter than some other parts of the United States. Miami-Dade had 38 swine flu deaths and 476 hospitalizations since April 2009. Broward had 12 deaths and 91 hospitalizations. Overall, Florida had 210 deaths and 1,267 hospitalizations.

Local vaccination efforts sputtered and soared. In Miami-Dade, health department clinics gave 57,697 vaccinations and provided another 566,800 doses to private doctors, commercial pharmacies and others. Its campaign to vaccinate schoolchildren reached only 3,984 students out of a total of 345,000 because of chronic problems getting parents to fill out and return permission clips. The health department returned 8,338 doses to manufacturers after they expired from lack of demand.

Broward's health department gave 143,000 doses of vaccine including 120,000 in schools, reaching 40 percent of students. It disposed of 3,790 doses after they expired from lack of demand. It has plenty left.

"We still give a couple dozen vaccinations a week," Livengood said.

Even now, of course, we don't get to relax entirely.

"Flu is now below the normal activity we expect to see at this time of year," said Tom Skinner, spokesman for the U.S. Centers for Disease Control and Prevention. "But it would be no surprise to see this level continue through the spring and into the summer."

STILL A CONCERN

Experts point out that the infamous 1918 flu pandemic that waxed, then waned like this season's H1N1 pandemic later mutated and waxed again with a vengeance -- killing more than 500,000 Americans and 50 million worldwide.

In Geneva, the World Health Organization says it's "premature" to say the worldwide pandemic has peaked. It says the H1N1 virus continues to spread in Africa and Southeast Asia, and another wave could hit the Southern Hemisphere as winter arrives there.

But one good thing about the H1N1 strain is that, traveling around the world as it has, it shows no signs of that 1918-style mutation.

Still, health officials say people should keep washing their hands and get flu shots, regular and swine.

Given the flu's collapse, was the fight against swine flu overreaction?

Said Skinner: "Ask the parent of a child or a pregnant woman if we overreacted. We mobilized very quickly. We developed a vaccine very quickly. We made more than 100 million doses of vaccine.

"We saved a lot of lives."

Newstex ID: KRTB-0123-42852418