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contagious conditions, canaries in coalmines

By leigh | January 2, 2010

some folks (including prominent natural healers) whom i respect and esteem are still saying swine flu hasn’t been virulent, compared to seasonal flu. i continue to beg to differ… here’s an update.

you’ll recall that the centers for disease control (cdc) usually count seasonal flu deaths among kids under 18, rather than among older folks, because older folks might die from sepsis and pneumonia for lots of reasons, while with kids, it’s pretty clear when it’s flu. so the kids are our canaries in the coal mine:

2005 season: 41 pediatric deaths from seasonal flu
2006 season: 68 pediatric deaths from seasonal flu
2007 season: 83 pediatric deaths from seasonal flu
2008 season: 55 pediatric deaths from seasonal flu
[plus... a total of 7 infections with h1n1 "swine" flu had been confirmed when that last report was issued, last spring (april 18th). in the following 3 months, there were 25 child h1n1 deaths. three months after that, 70 more...]

h1n1, 2009:
[Since April 26th, 2009,] “243 deaths in children associated with 2009 influenza A (H1N1) virus infection have been reported to CDC.”
[compare to 2 deaths from seasonal influenza among kids, during the same timespan.]

the world health organization says that worldwide, from april through december, h1n1 caused “at least 12,220 deaths”, and add:

“…In the US… rates of hospitalization among cases aged 5-17 years and 18-49 year far exceeded rates observed during recent influenza seasons, while rates of hospitalizations among cases aged >65 years were far lower than those observed during recent influenza seasons.” [emphasis added]

an oregon doctor (in the coalmine, as an infectious-disease specialist) writes about h1n1:
“A month ago all the ICU beds were full, most of the ventilators were in use and we were wondering how we were going to triage the next batch of patients who needed advanced life support and we had none to offer. Then, right as we reached maximum capacity and had no more wiggle room, the rates plummeted.

“…Oregon has had 1200 hospitalizations and 68 deaths. We had about 8 deaths from H1N1 in my hospital system. We would have had twice that number, but one of our hospitals is a trauma center and offers ECMO (Extra Corporeal Membrane Oxygenation) and we managed to save a number of people who would have died if they had been in a lesser hospital. The national statistics mirror our experience. None of the deaths were in the elderly.”

so now it’s seasonal-flu time (january-february), and if this year is like last year, the third wave of h1n1 will follow. but i think a lot more folks got shots, so the wave might not be quite so intense… ICUs, vents and ECMO? oh, my.

… … … … … …

so now you want to hear more about infectious disease? i am just the gal to get you tuned in! selected updates from the cdc’s “morbidity and mortality weekly report” – now with even more exclamation points:

cumulative numbers for the USA, year 2009
1,081,083 cases of chlamydia – use safe sex!
12,707 cases of syphilis – safe sex!
251 babies born with congenital syphilis – please!

28,707 new cases of lyme disease – watch out for ticks!
814 new cases acute hepatitis c – don’t share needles!

55 cases infant botulism – no honey for babies under one year old!
12 cases of tetanus – get your shots!
7 cases of plague – down with rats!
4 cases of rabies – stay away from bats!

…and furthermore:

“In 2008, a total of 12,898 tuberculosis (TB) cases were reported in the United States… [including] 125 cases of multidrug-resistant TB.” (brrrr!)

a little extra background from 2008:
“One in 100 Americans is behind bars in 2008, about 2.4 million people currently are incarcerated… Rates of positive or latent tuberculosis are 50 percent to 100 percent higher for inmates.”

plus, “While the number of men in State and federal prisons has grown 67% since 1990, the number of incarcerated women has increased by 92%” (1998 statistics). (there were 114,852 females in prison in 2008 (1,109 in oregon).

76 new cases of TB in oregon in 2009.

what about hiv?

the most recent “point estimate” data are, as usual, rather delayed:
42,655 cases reported in 2007 in 33 states* only (guess the remaining states don’t report?).

most recent death count: 14,997 “deaths in persons with AIDS” in 2006 alone, all states reporting; cumulative, 547,484 deaths since the start of the epidemic.

i just re-read randy shilts’ fine history of the early days, so i’ve had hiv on my mind. (did you know randy shilts started his writing career at UO in eugene? or that he died of – you guessed it – AIDS, the year after the HBO movie came out?)

remember “gay cancer”?
not to mention our friends, family members, and heroes, who died… well, anyway… 270 cases of “hiv-aids” were reported in oregon in 2009.

wear your hat! don’t forget your rubbers! baby, it’s cold outside.

*Alabama, Alaska, Arizona, Arkansas, Colorado, Florida, Idaho, Indiana, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Jersey, New Mexico, New York, Nevada, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming. click here or even here, for an explanation of why the statistics are a huge mess.

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