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Record Number of Lab Confirmed H1N1 Pediatric Deaths in US
Recombinomics Commentary 16:09
November 16, 2009

Thirty-five influenza-associated pediatric deaths were reported to CDC during week 44 (Alabama, Arizona, Arkansas [2], California [8], Delaware, Georgia, Illinois, Michigan [2], Missouri, New Jersey, Ohio [2], Oklahoma [3], Tennessee [2], Texas [6], Utah, Virginia, and Washington). Twenty-six of these deaths were associated with 2009 influenza A (H1N1) virus infection, eight were associated with an influenza A virus for which the subtype is undetermined, and one was associated with an influenza B virus infection. These deaths occurred between March 15 and November 7, 2009

The above comments from the latest CDC weekly report (week 44) describe a record number of pediatric deaths.  This release follows the CDC announcement that the earlier report of 129 H1N1 deaths is an underestimate and the true number of deaths is closer to 540, due to false negatives and a lack of testing, even though reporting of pediatric flu deaths is mandatory.  Prior to the H1N1 outbreak the reporting of mandatory cases had not exceeded 100 for any season.  Last season that record was broken, due largely to the wave of H1N1 fatalities that began in late spring and extended through the summer.  The latest table indicates that there were 82 swine H1N1 deaths prior to August 30, 2009. Thus, the number of H1N1 deaths after the peak of seasonal flu activity last season was greater than the 2006-2007 season and almost as high as the 2007-2008 season.  However, the tally for pediatric deaths lags, and the newly reported deaths included two new H1N1 fatalities from last season, so eventually the recorded swine flu deaths may exceed the seasonal flu tally for 2007-2008.

Media reports have described dozens of pediatric fatalities that have not yet been entered, so the number of cases in the past several weeks will continue to climb as these fatalities are added.  The current record of 127 deaths for last season will be broken in the next report because there are already 117 cases recorded for this season, and recent reports were well above the 10 case differential between this season and last.

Thus, the record for pediatric fatalities will be broken by every report going forward and the tradition date for large increases in flu deaths for this season has been reached.

The comparison of pediatric deaths season to season is more valid than media comparisons of lab confirmed deaths for swine H1N1 with estimates for seasonal flu, which are extrapolated from pneumonia deaths and other causes of death.  These seasonal flu numbers are largely based on deaths of those over 65 (>90%), while swine flu deaths are predominantly cases below 65 (>90%).

Thus, the comparison of lab confirmed pediatric deaths clearly demonstrates the increased virulence which is on the rise. One or more additional waves of H1N1 are expected in early 2010, as conditions favor the spread of H1N1, which has already been previewed by the recent strong uptick in hospitalizations and deaths reported in the past few weeks across the northern hemisphere.

Thus, the record number of pediatric deaths reported in week 44 clearly demonstrates the increased virulence of pandemic H1N1, and the number of cases per week as well as the number of fatalities per season will continue to set new records, as the lab confirmed fatalities for H1N1 accelerate.

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