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Commentary
18 H3N2 Deaths
In Pennsylvania In Week 1
Recombinomics
Commentary 22:30
January 8, 2013
A majority of reported deaths are among the elderly (persons >65 years of age). However, two deaths involved otherwise healthy young individuals under 50 years of age.
No pediatric flu-related death has been reported season to date.
The above comments from the week 1 report from Pennsylvania note the dramatic jump in lab confirmed flu fatalities. 18 were reported in week 1, while the 3 of the other 4 deaths were reported for the prior week (week 52). Most if not all of the deaths are likely due to H3N2 (see hospitalization chart above).
In week 1, 90% of the influenza in Pennsylvania was H3N2. In week 48, the CDC reported two H3N2 “low reactors”, each of which had an independent marker linked to immunological escape (T128A and L157S) The CDC recently released H3N2 sequences from the 2012/2013 season, including two from Pennsylvania. One isolate, A/Pennsylvania/20/2012 (October 24 collection date), had T128A, while the other, A/Pennsylvania/21/2012 (November 11 collection date) had L157S. The co-circulation of these isolates which are closely related to the two identified low reactors raises concerns that the frequency of these two changes has increased markedly in December, leading to the recent dramatic spike in deaths.
In addition to the reported deaths, Pennsylvania hospitalizations rose to 487 for week 1 from 244 reported in week 52, raising concerns that the death toll will continue to mount. Similarly, the number of lab confirmed cases in week 1 rose to 4256 from 3158 in week 52.
These dramatic spikes linked to H3N2 cases increases concerns that the upcoming Pneumonia and Influenza death rate for the country will be above the epidemic threshold in the week 1 and/or week 2 reports by the CDC.
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