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Is A/H1N1 (Swine Flu) Pandemic Over????

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By Miller J. Wilson
Over the past few weeks we have seen the general public’s concern about the H1N1 virus go from the verge of panic to almost nothing. The reason for this is that despite the increasing number of cases reported there have been few deaths outside of Mexico and so the average person is beginning to believe that the worst is over, but is it?

The sad thing is that we don’t know for sure how deadly the H1N1 virus will become until September or October when the next flu season starts. In fact, if we look at the chart for the 1918 H1N1 pandemic deaths in the US we can see that similar conditions existed about this time when it first began.
chart from CDC website
Now lets look at the numbers for the current H1N1 virus for both the entire world and where the deaths have occurred. The numbers were taken from the World Health Organizations H1N1 update on 05/14/2009 and so are current at the time of this article.
World Wide H1N1 Confirmed Cases and Deaths (confirmed cases include deaths):
Cases: 6,497 (100% World Wide Cases)
Deaths: 65 (100% World Wide Deaths)
Mortality Rate: 1%
Deaths per 1,000 cases: 10
United States:
Cases: 3,352 (51.59%% World Wide Cases)
Deaths: 3 (4% World Wide Deaths)
Mortality Rate: 0.089%
Deaths per 1,000 cases: 0.89
Cases: 2,446 (37.65% World Wide Cases)
Deaths: 60 (92.3% World Wide Deaths)
Mortality Rate: 2.5%
Deaths per 1,000 cases: 25
Cases: 389 (5.99% World Wide Cases)
Deaths: 1 (1.54% World Wide Deaths)
Mortality Rate: 0.25%
Deaths per 1,000 cases: 2.57 (Projected from current death:case ratio)
Costa Rica:
Cases: 8 (0.12% World Wide Cases)
Deaths: 1 (1.54% World Wide Deaths)
Mortality Rate: 12.5%
Deaths per 1,000 cases: 125 (Projected from current death:case ratio)
All other locations:
Cases: 302 (4.65% World Wide Cases)
Deaths: 0 (0% World Wide Deaths)
Mortality Rate: 0%
Deaths per 1,000 cases: 0
Now if we look at the current numbers, especially the deaths per 1,000 cases in both US and total for the world, we see that we are at about the same numbers that the 1918 H1N1 had around June 29, 1918 and that after a quick spike in cases and deaths around the middle of July it disappeared only to return with 5-6 times the deaths in September 1918. It is because of this that epidemiologists that specialize in the influenza are still concerned about where this H1N1 virus will lead.
So what will this H1N1 virus do? The answer to that question is something that we do not know but there are few possibilities which follow:

  • It could become like the 1976 swine flu and simply do nothing
  • It could recombine with the common flu and become resistant to anti-virals (Tamiflu) but also become only a nuisance.
  • It could follow the path of the 1918 pandemic (which it shows signs of doing) and infect 30% of the world population and kill 120 million people.
  • It could genetically recombine with the H5N1 Avian Flu (60% mortality rate), infect 30% of the world population and kill 1.2 Billion people.

As you can see the biggest worry is that while H1N1 spreads around Asia, where it is now, or other regions where the H5N1 is found in humans it will have a chance to genetically recombine. This recombinant strain could lose its high communicability rate gain a high mortality rate and become able to pass human to human. Or it could keep its high communicability rate, gain H5N1’s resistance to anti-virals (Tamiflu,) and gain the high mortality rate of H5N1 which is 60% and kill 1,000,000,000+ (1 Billion+) people around the world.
Now I know all this can seem scary, especially when you look at the numbers alone, but that is not my intention. For the first time in history we are able to track the H1N1 virus in real time and so will be able to see how it mutates. This will allow us to prepare better and allow developed nations to reduce the number of deaths. Now if this does not help alleviate your fears we can put the current situation into perspective by comparing the numbers for the H1N1 virus in the US with the annual numbers for the seasonal flu in the US. According to the Center for Disease control the seasonal flu infects 15,202,986-60,811,945 people or 5%-20% of the total population. Out of these 200,000 people or 0.3%-1.3% of the total cases are hospitalized and 36,000 people or 0.06%-0.2% die. This equals 0.6-2 deaths per 1,000 cases. As you can see the current numbers for the H1N1 virus and the seasonal flu are about the same as far as mortality rate.
Now that you are informed I hope that you are better able to put everything in perspective so that you can prepare for the worst without worrying.
Miller J. Wilson is currently an AMU student working on his BA in Intelligence Operations. In addition he is a volunteer for his local Medical Reserve Corps and Citizens Emergency Response Team (CERT).

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