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Commentary
High
H3N2 Death Rate at Akita Japan Hospital Raises Concerns
Recombinomics
Commentary 22:30
November 6, 2010
The above comments describe efforts to control a spreading H3N2 infection in a hospital in Akita, Japan where 6 patients died over a six day period. Rapid tests identified influenza A, and one patient had confirmed H3N2. The six patients were elderly, indicating all were likely victims of H3N2.
An increase in H3N2 deaths in the elderly was expected this season. The spread of pandemic H1N1 last season crowded out H3N2 leading to a reduction in deaths in those over 65. The elderly population was largely free from pandemic H1N1 because most had antibodies to H1N1 which were developed when the population was much younger and these early antibodies offered cross protection against pH1N1. The pH1N1 spread led to a high number of deaths in those under 65, including children.
Thus, the size of a frail elderly population was larger this season, which led to concerns of excessive deaths from H3N2 infections.
Those concerns were increased by sequence data which defined an emerging sub-clade which had low reactors with the current vaccine directed against the Perth/16 strain, which emerged in early 2009.
The clustering of low reactors suggested that many would fail vaccination, but reports of six deaths in six days in one hospital raise concerns that this season the H3N2 will be more deadly than usual.
The large number of deaths over a short time frame in one hospital, coupled with the relatively early appearance of this death cluster in the flu season, raises concerns that the number of H3N2 deaths this season will be unusually high, especally in the elderly population.
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