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Commentary
Georgia Under-count On pH1N1 Fatalities Raises Concerns
Recombinomics
Commentary 17:39
March 31, 2010
"We have had 70 hospitalizations since May 2009" in District 4, she said. Ten of those were Coweta residents, she said.
"We have had 11 total deaths for the district since May 2009," said Hall. "Six of the 11 have occurred since January of this year. Two Coweta residents have died from influenza-associated illness."
The above comments are from two recent media updates on H1N1 fatalities in District 4 in Georgia. The March 19 report cited one death on March 9, while the March 31 report cites two additional 2010 deaths strongly suggesting that there were 3 pH1N1 deaths in district 4 since March 9. However, the GA department of health website only lists 4 deaths for the entire state since March 9, even though District 4 is one of 18 health districts in GA.
These data indicate the 60 pH1N1 fatalities in Georgia since the start of the pandemic is a serious undercount, which is also suggested in the GA press release on the jump in hospitalizations and deaths, which indicated there were 1012 hospitalizations and 72 deaths in GA since the start of the pandemic. If the 12 additional fatalities described in the press release were recent, the 72 deaths would signal a recent record spike in pH1N1 fatalities in Georgia.
The hastily called CDC press conference on Monday did not mention a spike in fatalities in GA, but was more focused on the spike in hospitalizations as well as the need for an increase in the vaccination rate in the state. The comments also suggested that the hospitalizations had a somewhat different geography that cases in the fall, but the above comments indicated there were five fatalities in District 4 in 2009 and six more this year suggesting pH1N1 was hitting the same region in 2009 and 2010.
Moreover, the city of Atlanta, which is adjacent to District 4 has reported 28 P&I deaths in the past two weeks, compared to 6 deaths for the same time period in 2009. Since there is no seasonal flu in Georgia this year, and respiratory disease due to other microorganisms is declining at this time, the 22 excessive deaths may be largely due to pH1N1.
These data raise concerns that the number of deaths being reported by the Georgia department of health represents a serious undercount, and the spike in pH1N1 hospitalizations this month may also be linked to a spike in fatalities.
Although the CDC has stated that there were not sequence differences between recent isolates and earlier sequences, only one 2010 sequence (February) from Georgia has been made public, and the CDC has discounted the role of D225G/N in fatalities reported at Duke Medical Center, as well as Ukraine, raising credibility issues regarding sequence analysis.
Release of pH1N1 sequences from serious and fatal cases in Georgia in March would be useful.
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