Latest weekly flu review points to beginning of third wave in nth hemisphere - should see some sound relenza buying out of the us/europe this quarter and if production increses were on schedule as at jan 10 - we are in for a major increase in royalties this quarter - payable to bta april 2010.
There were 9 influenza-associated pediatric deaths: MS (1), TX (1), CO (1), CA (6)
The above pediatric deaths for week 4 are in Friday?s MMWR and will be in the CDC week 4 report. The six deaths in California are striking and once again signal a high level of fatalities when there is no seasonal influenza A and reported pandemic H1N1 levels are low. In addition, the Pneumonia and Influenza deaths for week 4 will be 8.1%, virtually unchanged from the spike reported in week 3, which increased the rate to 8.2%
The 9 pediatric deaths are week above the 5 year average for week 4, which is 2 deaths. These newly reported cases raise the number of confirmed pediatric deaths in the 2009/2010 season to 248. 247 of the 248 were due to pandemic H1N1. This number is well above the any report since pediatric death reports were mandatory. Last year the level broke 100, but that was due to the pandemic H1N1 deaths in the spring and summer. Deaths from seasonal flu were well below 100.
The latest additions are not a surprise. Pandemic H1N1 is far more lethal to children as well as all age groups under 65, internet and media disinformation campaigns notwithstanding. The disinformation campaigns compare projections based on lab confirmed cases to US (36,000) or world (500,000) deaths created by extrapolations linked to pneumonia deaths, which lack influenza confirmaton.
Moreover, recent data signal the start of wave 3, which is likely to be higher than wave 1 last spring or wave 2 in the fall. The traditional flu season peaks are in February/March and the recent H1N1 increases position wave 3 to coincide with more traditional seasonal flu trends.
These recent increases raise concerns that the new wave will be more severe and deadly than earlier waves. The released sequences with D225G/N are on the rise, and in the Duke outbreak these changes were linked to fatal cases who were infected with Tamiflu resistant H1N1.
Moreover, Mill Hill data on a Ukrainian isolate with D225G designated the isolate a low reactor, indicating titers with reference antisera was at least four fold lower than the reference isolate.
Thus, a higher frequency of severe and fatal cases is expected in wave 3.
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