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Paradigm Shift Intervention Monitoring
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Dramatic H1N1 CFR
Spike In Mexico Raises Concerns
However, weekly fatalities have been running at about 20, which is approximately 10% of confirmed cases. In contrast, overall figures in Mexico were at 1% of confirmed cases on Dec 7 (713/66,323), but have risen to 1.5% (1035/70,453) in this latest update. This change is either due to a radical change in how cases are selected for confirmation, or a significant increase in H1N1 virulence.
Sequences released in December had D225G, D225N or both in 5 of 10 HA sequences from fatal cases in Mexico, raising concerns that these changes are now more frequent, leading to a dramatic rise in CFR in confirmed cases.
Sequences from recent cases, as well as information on cases selected for lab confirmation, would be useful.