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Commentary

Swine H1N1 Cases Explode in Queens New York
Recombinomics Commentary 12:57
May 15, 2009

The assistant principal works at Intermediate School 238, in the Hollis section of Queens, and was said to have become critically ill. Neighbors and school officials identified the man as Mitchell Wiener, who is in his mid-50s and has worked for the school system for about three decades.

Swine flu has been documented in four other students at I.S. 238, at 88-15 182nd Street, and more than 50 students with flu-like symptoms have been sent home from the school since May 6, the mayor said.

Three public schools in Queens - the middle school where the assistant principal worked, as well as Intermediate School 5 in Elmhurst and Public School 16 in Corona - are being closed, effective Friday, because of the outbreak, officials said. The three schools together enroll some 4,500 students.

At I.S. 5, at 50-40 Jacobus Street, 241 students were absent from classes on Thursday. And at P.S. 16, 41-15 104th Street, 29 students reported flu-like symptoms at the nurse's office on Thursday.

The above comments describe a serious swine H1N1 outbreak in Queens.  This outbreak follows an earlier outbreak in Flushing (see updated map), that was linked to students returning from a trip to Mexico.  However, officials had recently offered assurances on the containment of that outbreak.

The assurances had no basis in fact.  An AP report had suggested that as many as 1000 New Yorkers were infected, and the above numbers leave little doubt that the number of cases in orders or magnitude higher.

Most cases are mild and are unreported.  In other cases, doctors offer assurances that the influenza A is seasonal flu, even though the recent CDC reported demonstrated that swine H1N1 has outpaced seasonal flu, and the distance been swine and human flu is likely to increase in the northern hemisphere as the seasonal flu season winds down.

The swine H1N1 has an avian PB2, which favors growth at high temperatures (41 C), which will offer a distinct advantage over the summer.  As seen in the above numbers, the virus spreads easily, especially among students.

 The number of cases in the US has already overwhelmed the CDC, who has hand-off confirmations to the states, but the shortage of testing kits has limited confirmatory testing.  In the past, states were reporting probable cases (influenza A positive, but seasonal flu negative), but now many states have limited testing to more severe cases.

Thus, the mild nature of most cases, coupled with limited testing, has produced gross under-estimates of the extent of the spread.

As the number of cases rise, the number of severe cases also increases.  There have been four deaths in the United States, and the number of hospitalized cases continues to rise.

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