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Coping with College Swine Flu (H1N1) and Too Little Too Late? Vaccine Supply May Miss Swine Flu Peak

COPING WITH COLLEGE SWINE FLU (H1N1)

Got a child in college this fall?  Welcome to swine flu and college life! In 2001, 9/11 shook college freshmen and families across the globe. In 2005, Hurricane Katrina changed the lives of the incoming college freshmen who headed to Tulane and Loyola, as well as the New Orleans’ families devastated by this event. 2009? Welcome to the world of quarantine, being relegated to an infirmary or sent home to recuperate with symptoms of H1N1…brave new world!

Weekly New College Cases by State - Clinical Attack Rate
Weekly New College Cases by State - Clinical Attack Rate. The top winner? Washington, followed by Georgia, Kansas and Mississippi

During the week of Aug. 29 through Sept. 4, The College Health Association counted a total of 4,974 cases with just 8 hospitalizations. Seventy-two percent of the 236 colleges and universities reported cases of ILI, compared to 54% the prior week. The nationwide attack rate was 17.8 cases/10,000 students, more than double the prior week’s rate. The highest rates of activity were observed in the Northwest and Southeast regions of the country. Data from some states show 126 to 367 cases per 10,000 students. Again, no deaths were observed among the reporting institutions.

H1N1 College Cases by Gender
H1N1 College Cases by Gender

So the mantra: expect the unexpected. Pay attention, be careful and learn from whatever experience you have at College. College IS life, so whenever there is a challenge, look for the silver lining.

The College Health Association http://www.acha.org/

Weekly Surveillance Reports http://www.acha.org/ILI_Surveillance.cfm

NY Times http://maplewood.blogs.nytimes.com/2009/09/10/college-corner-coping-with-swine-flu/?scp=4&sq=h1n1%20swine%20flu&st=cse

CORNELL STUDENT, 20, DIES OF SWINE FLU

September 11, 2009 — A 20-year-old Cornell University student has died of complications related to H1N1 flu and influenza-type illness has been diagnosed in 520 other students in the past three weeks, the university reported Friday.

David Skorton, the college’s president, released a statement Friday evening saying that the 20-year-old, Warren J. Schor, died that day. The student’s hometown was not immediately released.

In a student message on the university’s Web site, campus health officials said that most of the students who had gone to the campus infirmary with flu symptoms had had mild illness and recovered fully. They advised students with flu symptoms to stay in their rooms and at least six feet away from others until they have been fever-free for 24 hours. The university has nearly 20,000 students.

http://www.nytimes.com/2009/09/12/nyregion/12cornell.html?scp=5&sq=h1n1%20swine%20flu&st=cse

VACCINE SUPPLY MAY MISS SWINE FLU PEAK

Several prominent epidemiologists are warning that even though the new H1N1 vaccine works much better than expected, it will still come too late to blunt the peak of this season’s pandemic.

The epidemiologists said last Friday that they expected the peak to come as early as next month, long before enough vaccine to protect all 159 million Americans who need it most will be ready.

“It would be bizarre for it to peak in January or February, the way seasonal flu does,” said Dr. Marc Lipsitch, an epidemiologist at the Harvard School of Public Health and a consultant on flu epidemics to the President’s Council of Advisors on Science and Technology.

Dr. Lipsitch noted that the pandemics of 1918 and 1957, which were also caused by new viral strains, had both peaked early. Influenza cases are usually near zero at this time of year, but Friday’s weekly report from the CDC rated flu activity as “widespread” in 11 states, mostly in the Southeast but also in Arizona, Alaska and Oklahoma. (Widespread is the highest of five levels.)

The second pandemic wave as demonstrated by the uptick in the red line has begun
The second pandemic wave as demonstrated by the uptick in the red line has begun

Dr. Anne Schuchat, the agency’s chief of immunization and respiratory illness said 98 percent of those flu cases were the new H1N1 swine flu.

On Thursday, federal officials reported that one dose of the new vaccine, rather than the two they had expected, appeared to fully protect recipients against swine flu. They said that meant there would eventually be plenty of vaccine for everyone given first priority for shots: health care and emergency workers, pregnant women, everyone ages 6 months to 24 years, adults up to age 64 with medical problems, and people caring for infants under 6 months old.

The officials expect about 50 million doses of swine flu vaccine to reach government warehouses by Oct. 15, and 20 million more to be ready each week after that until 195 million is reached.

Then those lots must be shipped to health centers, schools and other vaccination sites, people must be injected, and each must develop immunity. Immune responses are different in each individual, but the clinical trials suggest that most will be protected after 8 to 10 days.

So if the epidemic’s peak comes in late October, millions of people are likely to catch the flu before the vaccine is available.

“A month would have made a huge difference,” said Ira M. Longini Jr., an author of a report by an epidemic-modeling team at the Fred Hutchinson Cancer Research Center in Seattle and the University of Washington.

If one shot turns out to be protective in children and if the flu peaks in late December, as the 1968 Hong Kong flu did, “we could be O.K.,” Dr. Longini said. “But that’s a lot of ifs.”

In response, federal officials said there was no way to tell whether the pessimistic models would be right, since flu peaks at different times in different regions each year.

In any event, most cases are expected to be mild. The virus has not changed significantly since the spring and, while a few cases of strains resistant to the antiviral drug Tamiflu have been detected, they have not yet become widespread.

http://www.nytimes.com/2009/09/12/us/12flu.html?scp=3&sq=h1n1%20swine%20flu&st=cse

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