H1N1現状

一昨日帰国した。モーガンタウンでNIOSHとウエストバージニア大学医学部を訪問。呼吸器内科と産業医学科を訪問し、そこのスタッフと議論を交わした。このことは、後ほど。
今日は、ATSのメルマガより。一万人の死亡があり、３分の一は若年者だが、季節性のインフルエンザによる死亡率より少ない。２０万人が入院。これは季節性フルによる年間の入院と既に同じ。一ヶ月前には４千名の死亡と推定されていただけに、急な増加に驚いているとのこと。１月にくると思われる第三波で死者が増えるかどうかはウイルスの変異の程度と薬物耐性に状況による。現在までに、米国の１５％が感染したとのこと。日本についての記述もあり、日本の対策がアグレッシブだったため、影響が少ないと褒めている！！抗ウイルス剤の使用頻度が高いことと、マスクの使用を含めた対策！
わたしは、抗ウイルス剤を処方してもらえて、保険でカバーしてもらえる先進国としての優位性と国民皆保険制度のおかげだと思うけれど。

ABC World News (12/10, story 7, 0:25, Gibson) reported that "even more worrisome" is that "the flu has caused 10,000 deaths, three-fourths of those among young adults, though that is still less than the normal death rate from the seasonal flu."
USA Today (12/11) reports that up to "Nov. 17, 200,000 people have been hospitalized," which USA Today notes is "about the same number of people hospitalized during the entire flu season, which usually lasts until May."
The New York Times (12/11, A26, McNeil) points out that a month ago, the CDC "estimated that only about 4,000 had died." But "several flu experts said they were not shocked by the sudden jump because the new figures were as of Nov. 14, when this fall's wave of swine flu cases was reaching its peak." The number of people who "will ultimately die of the H1N1 flu depends heavily on whether there is a third wave in January...and on whether the virus changes to be more lethal or drug-resistant."
With 15% of Americans having been infected, Dr. Frieden said, "That still leaves most people not having been infected and still susceptible," the Los Angeles Times (12/11, Maugh) reports. "Frieden said the 200,000 hospitalizations since the beginning of the pandemic seven months ago is about the same as in a usual flu season. The deaths are lower than the 35,000 associated with seasonal flu in a typical year, but the breakdown is sharply different." The deaths "include 1,100 children and 7,500 adults 18 to 64."
Japan's "aggressive" response to swine flu seen as effective. Bloomberg News (12/11, Matsuyama, Gale) reports that Japan's "aggressiveness" against the H1N1 pandemic "means the country has fared better than the US or the UK" in their efforts against the virus. According to a report from the World Health Organization, Japan's mortality rate "is 2 deaths for every 100,000 people," which "is higher by 11 times in the UK, 16 times in the US and 43 times in Australia." The low rate was credited to "Japan's status as one of the biggest users of antiviral medicines," and a willingness to conform to hygiene recommendations such as wearing masks.