October 30, 2009 - New York Times

Swine Flu Hit Millions in Spring, Agency Says

By DONALD G. McNEIL Jr.

There were 1.8 million to 5.7 million cases of swine flu in the country during the epidemic’s first spring wave, according to a new estimate from the Centers for Disease Control and Prevention released Thursday.
From 9,000 to 21,000 people were hospitalized as a result, and up to 800 died from April to July, when it largely faded out, according to the estimates, which were conducted by the C.D.C. and the Harvard School of Public Health and published online in the journal Emerging Infectious Diseases.
The agency has previously refused to be more specific than to say there were “more than a million” cases. About 44,000 cases during that time were laboratory confirmed, with 5,000 hospitalizations and 302 deaths.
The agency has been working for months on a model that took into account the fact that most flu cases were not tested by doctors and that some people were hospitalized for conditions exacerbated by the flu without the flu ever having been diagnosed.
Also on Thursday, federal officials said nearly 25 million doses of swine flu vaccine were now available. That is enough so they expect many states and cities to hold vaccination clinics as early as this weekend.
“We aren’t where we want to be, but are seeing forward progress,” Dr. Anne Schuchat, director of immunization and respiratory disease for the disease control agency, said at a news conference.
Many Americans are frustrated because their private doctors have no vaccine and local public health clinics have canceled vaccination days because of the shortages.
Also, many parents of children who have the flu are similarly frustrated because they cannot find the antiviral Tamiflu in pediatric doses, and especially in liquid forms.
Dr. Schuchat said those shortages appeared to be local and spotty. About 300,000 courses of liquid Tamiflu were sent from the national stockpile to the states on Oct. 1 in anticipation of shortages, she said. Her agency is trying to help states move them to where they are needed.
Dr. Schuchat reassured parents who had been given children’s Tamiflu capsules that they could safely open them and mix the powder with chocolate syrup. And, she said, some pharmacy chains were opening adult capsules and mixing them with sweet syrup to make pediatric doses. She warned parents not to try doing that themselves, for fear of miscalculating and giving a child too much or too little.
Also, preliminary results from a study by Yale medical school researchers showed that babies born to women who got flu shots during pregnancy were hospitalized less often than babies whose mothers did not.
The study, which is still under way and followed 387 babies hospitalized at Yale-New Haven Hospital, was presented at a medical conference in Philadelphia.
Babies younger than six months are at serious risk if they catch flu but are still too young for flu shots, so doctors try to protect them by vaccinating their parents and siblings.
Vaccinating mothers was 89 percent effective in preventing hospitalization of infants that young, said the lead researcher, Dr. Marietta Vázquez.
At the same conference, that of the Infectious Diseases Society of America, researchers presented tantalizing preliminary evidence that statins — cholesterol-fighting drugs like Lipitor and Zocor — might help save people at risk of dying from the flu.
Statins reduce inflammation, as well as cholesterol, and much of the lung damage in life-threatening flu infections is caused by the “cytokine storm,” the inflammatory overreaction of the body’s immune system to invasion by the virus.
The study, paid for by the disease control agency, followed 2,800 people hospitalized in many states for regular flu in previous years. Those who were already on statins, presumably for heart problems, were half as likely to die in the next month as those who were not.