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Commentary
Explosion In Houston Fatal H1N1pdm09 Cases
Expected
Recombinomics Commentary
15:00
December 21, 2013
In Harris County, hospital emergency room visits for flu-like symptoms are at a five-year high.
The above comments indicate there will be an explosion of H1N1pdm09 deaths the Houston area in the upcoming weeks. Focus on severe flu was initiated by the 8 cases at the Conroe Regional Medical Center in Montgomery County (see map). These cases had textbook swine flu symptoms, but tested negative on a rapid test, which has an extremely low sensitivity for H1N1pdm09. Two cases have been confirmed using a more sensitive PCR test administered by an independent agency and the remaining cases are being re-tested by the CDC. Swine flu accounts for almost all of the influenza being reported in Texas and nationwide, so physicians in Texas have been told to assume symptomatic cases are H1N1pdm09 infected, even if the rapid test is negative.
The fatal cases in Harris County are in the age group generating the highest number of deaths in 2009, when swine flu emerged and the vast majority (>95%) of deaths in 2013/2014 in Texas and the United States are expected to be <65 (in 2009 the >65 age group had a very low number of deaths, largely due to immunity generated when they were young and exposed to seasonal H1N1 circulating between 1918 and 1957 and/or received the 1976 swine flu vaccine).
The above data on the three fatal cases cited above suggests there was a significant delay between the date of death and test results confirming H1N1pdm09. It is likely that many cases that have already died have not been confirmed because of initial testing with the rapid test. More aggressive testing of the current critical cases will confim H1N1pdm09 prior to death, so the time gap between death and H1N1pdm09 confirmation will be smaller.
Quicker lab confirmation, coupled with high numbers of emergency room cases, signals an explosion of H1N1pdm09 confirmed deaths in the upcoming weeks in the Houston area.
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