Recent Spike in H1N1 cases

Health officials are carefully watching a spike in cases of the pandemic H1N1 flu in the Southeastern U.S.

Georgia in particular is worrisome, with 40 people admitted to hospital for the flu last week — more than in any other state, according to Anne Schuchat, MD, director of the CDC’s National Center for Immunization and Respiratory Diseases.

Georgia has outpaced the rest of the nation in laboratory-confirmed H1N1 flu cases admitted to hospitals for the past three weeks, Schuchat said in a telephone press conference.

While the death figure is lower than the 36,000 usually attributed to seasonal flu every year, Schuchat said that’s misleading. Most of the deaths occurred among people younger than 65, where the death rate is five times higher than usual.

The press conference — the first in several weeks to discuss the pandemic — was called largely because of the situation in Georgia, she said. The rate of H1N1 disease overall nationally is lower on average than last fall.

The increase in Georgia is “unusual and we did want to spotlight that,” she said.

Schuchat added that the number of hospital cases in the state is higher now than it was in early October, and since many cases of influenza-like illness are not tested for the virus, it’s possible that the number is underestimated.

As well, she said, “H1N1 has been causing more disease recently in the Southeast.” Georgia is one of three states reporting regional flu activity, she said. The others are Alabama and South Carolina.

Six other Southeastern states — Arkansas, Louisiana, Mississippi, North Carolina, Tennessee, and Virginia — plus Hawaii, New Mexico, and Puerto Rico are seeing local flu activity.

The flu that’s causing anxiety in Georgia, Schuchat said, is caused by the H1N1 strain and is mainly affecting adults with underlying conditions. The virus itself has not changed, she said.

Schuchat said most of the people affected by the flu in Georgia have not been vaccinated, and indeed the state had one of the lowest vaccination rates in the country.

Although investigation of the spike is still under way, she said, the CDC decided to call attention to it in order to reinforce the message that vaccination remains an important preventive measure.

Surgeon General Regina Benjamin, MD, said the supply of H1N1 vaccine last week reached 24 million doses “but many Americans are still vulnerable to the H1N1 (flu) because they haven’t gotten vaccinated yet.”

She added that minorities are staying away from the vaccination program, even though they have higher rates of some of the underlying diseases that make the flu more dangerous.

Benjamin added that an estimated 60 million Americans have been infected by the virus, 265,000 have needed inpatient care, and nearly 12,000 have died.

While the death figure is lower than the 36,000 usually attributed to seasonal flu every year, Schuchat said that’s misleading. Most of the deaths occurred among people younger than 65, where the death rate is five times higher than usual.

On the other hand, those over 65 have been “relatively spared,” she said.

Schuchat added that the seasonal flu has been largely missing in action so far. “We’ve not seen seasonal flu in substantial numbers at all,” she said.