Oct 30, 2009 (CIDRAP News) – The H1N1 influenza virus is now widespread in all but two states and has claimed the lives of 114 children, 19 more than the toll a week ago, the Centers for Disease Control and Prevention (CDC) reported in an update today.
"Essentially what we see is more virus, more vaccine, and more deaths," CDC Director Dr. Thomas Frieden said at a press briefing.
An online CDC update says 22 flu-related pediatric deaths were reported this week, of which 19 were due to confirmed H1N1 infection and 3 were due to influenza A strains that were not subtyped. Since April, 114 pediatric deaths have been confirmed as H1N1-related and another 12 were from non-subtyped influenza A.
More than two thirds of the 114 children who died had underlying health conditions that increased their risk, said Frieden.
He said the national trend in H1N1 cases continues upward, though there have been decreases in a few areas, particularly in the Southeast. The only two states not included on the CDC's online list of those with widespread flu are Hawaii and South Carolina.
Recent CDC survey data indicate that many people at risk for severe H1N1 cases have not sought treatment when sick, Frieden reported.
"One thing we're surprised to see is that even among people who have an underlying condition, only half sought care for flu-like illness," he said. Those with health conditions that put them at risk should seek treatment promptly, he added. The CDC has been stressing the importance of early antiviral treatment for such patients.
To relieve spot shortages, the CDC is releasing the remaining 234,000 treatment courses of liquid oseltamivir (Tamiflu) for children in the Strategic National Stockpile, Frieden reported. The agency had released 300,000 courses on Oct 1.
Some of the supply was held in reserve awaiting a clearer picture of the needs around the country, he said, adding, "It's now clear that it's best to release all we have and get more from the manufacturers as soon as they can provide it."
Delivery of more liquid oseltamivir is expected from the manufacturers early in 2010, he said. In the meantime, pharmacists can make a liquid formulation by using adult capsules and a syrup, he noted.
On the H1N1 vaccine supply, Frieden said the cumulative total of doses available (including doses already distributed) has reached 26.6 million, which is 10.5 million more than a week ago. CDC officials recently predicted that the supply would reach about 28 million doses by the end of October.
As for vaccine uptake, some "very preliminary and partial information" is that about half of the doses are going to children and half to adults, Frieden reported. Only about 1% to 2%, he said, is going to people aged 65 and older, who are not a priority group because they seem less susceptible to the virus than younger people.
He said the CDC is just beginning to get information about the results of school-based vaccination programs. Because of logistical challenges and the need for parental consent forms, "We are encouraged if we see half or more of the kids get vaccinated in school; we don't expect to see anything like 80% to 90%."
In other comments, he said 89 million doses of seasonal flu vaccine have been distributed, out of about 115 million doses expected this season. The vast majority of doses have been administered, and the vaccine remains in short supply, he said. The CDC has not seen any seasonal flu strains circulating so far.
CDC H1N1 update