My Pandemic Plan

 

 

July 18, 2009

U.S. health officials are preparing intensively to combat an anticipated wave of outbreaks of the new H1N1 flu when children return to school and the pace of cases picks up.

Anne Schuchat, chief of immunization and respiratory diseases at the U.S. Centers for Disease Control and Prevention, said Friday that the agency expects an increase in cases before the normal start of the flu season in mid-autumn, because children are likely to spread it to one another once they go back to school. Infectious diseases normally spread readily among children, and this virus has hit children and young adults harder than the elderly, who normally suffer the heaviest toll from flu.

“We’ve seen it in camps and military units,” Dr. Schuchat said. “I’m expecting when school reopens and kids are all back together, in some communities at least we may see an increase.”

The number of confirmed U.S. infections is now 40,617, with 263 deaths, the CDC said Friday. But the agency believes that more than one million people have been infected and weren’t tested for the virus or didn’t visit a doctor. The disease has become so widespread that the agency will probably suspend tallying individual case counts within the next few weeks and focus instead on tracking clusters, severe cases, deaths and other unusual events — a more traditional approach to tracking diseases, Dr. Schuchat said.

The CDC would be following the WHO, which said on Thursday that it is abandoning individual case counts.

Most of those who have the new flu get only mildly ill for a few days and don’t need treatment. But officials are concerned about the virus because it is new and could easily mutate and become more virulent as it spreads through the population. Argentina declared a nationwide animal-health emergency Friday after finding the virus possibly jumped from humans to two pig herds, a development that flu experts say could potentially spur mutations. The country’s death toll from the virus stands at 137.

Global officials are also concerned because the new H1N1 virus has caused severe illness in some children and young people. Some recently published studies suggest it can cause more severe illness than seasonal flu. Deaths from flu are normally rare among children and young adults, who account for the bulk of the U.S. deaths from the pandemic strain. Nor is it clear why the virus is striking pregnant women, as well as people with asthma, diabetes and other conditions hard.

To combat the virus, federal officials are preparing to mount a massive immunization campaign, and are also urging communities, businesses and individuals to make contingency plans for possible school closures, multiple employee absences for illness, surges of patients in hospitals and other effects of potentially widespread outbreaks.

Clinical trials are expected to begin later this month to test whether a vaccine developed to combat the virus is safe and effective, and the CDC is working with state and local public-health authorities to figure out how to get as many as 600 million doses, or two for every U.S. resident, into people’s arms. Results of the trials aren’t expected until early October, but officials say they expect to have the first 100 million doses of vaccine ready by mid-October.

The WHO and some vaccine manufacturers reported this week that the vaccine was proving difficult to manufacture because the viruses used to make the shots are yielding only 25% to 50% of the active ingredient they normally get for flu vaccines.

But Dr. Schuchat said that wasn’t affecting the U.S. government’s plans. “We haven’t heard news that has changed our expectations for vaccine availability in the fall,” she said. “Based on what has been described to us so far, it’s within the range of our planning assumptions, but that doesn’t mean we won’t have more surprises.”