41州で広汎に流行しており、インフルエンザによる病院受診が全体の6.1%となっている。ＣＤＣの Anne Schuchat博士は、10月としては最高の数値であり、8月30日以降で43人の子どもが死亡しており例年の季節性インフルエンザ死亡の１シーズンの数に相当する。2才以下が3人、2-4才が5人、5-11才が16人、12-17才が19人であった。ここ１週間で11人も死亡が増えた。驚くほどの数であり、さらに増大する可能性が高い。入院患者の15-20%がＩＣＵ治療を必要とした。
新型インフルエンザ 子どもの死亡が急増／米国 H1N1ブタインフルエンザ ＣＤＣ
Weekly 2009 H1N1 Flu Media Briefing
October 16, 2009, 12:00 p.m.
Anne Schuchat: Yes. Pediatric deaths are reportable to us. Those that are believed to be from influenza are reportable to us. Since august 30th, there have been 43 reports of pediatric deaths from influenza. 38 of those are -- I think 38 of those are known to be the H1N1 and the others are believed to be, but the typing hasn't been fully completed. What I can say is that three of those deaths occurred in children under 2. Five of the deaths were in children 2 to 4. 16 of the deaths were in children 5 to 11 years of age and 19 of the deaths were in teenagers 12 to 17 years of a these are very sobering statistics. 43 deaths essentially in one month is a lot. We hope that the continuing deaths in children will be as few as possible but this is a very brisk number, usually in a whole season that lasts from going to September all the way to may, you would only have about 40 or 50 deaths so in just one month's time we've had that many. What I can say is it's very important for parents to know the warning signs in their children. We think even viral medicines can be very important in people who have influenza-like illness and have either underlying conditions like asthma, diabetes or are pregnant or other chronic conditions like cancer and aids suppression. In very young children under 2, fever and respiratory systems need to be taken seriously. In all children, there are a couple of warning signs that parents are can look for. Child that's difficult to wake. A child that's not taking feeding well, a child that is having trouble breathing, is turning blue or grayish, an important warning sign for parents is if your child is ill and getting better, then starts to get worse, that's a warning sign. That can be a sign that a second bacterial pneumonia is coming in on the heels of influenza and that's something you need to take seriously and get in touch with your health care provider but influenza can weaken our bodies and a bacterial pneumonia invading on top of flungz can be very, very rapid in its course. But any viral medicines for influenza in particular circumstances can be very helpful and bacterial treatment of suspected bacterial pneumonia is also important. So these -- every death we take seriously but as a society the deaths in the young are very, very hard to take. And many of the children, of course, do have chronic underlying conditions that are very severe, muscular dystrophy, cerebral palsy but some have been totally healthy and that hits home for people. Next question from the phone, please.
Officials See a Shortage in Vaccine for Swine Flu
By DENISE GRADY
Published: October 16, 2009
Health officials on Friday predicted a shortfall in the supply of swine flu vaccine, as the numbers of cases, hospitalizations and deaths grow to levels unprecedented for this time of year.
Flu caused by the H1N1 virus is now widespread in 41 states, and flulike illnesses account for 6.1 percent of all doctor visits.
“That’s high for any time, particularly for October,” said Dr. Anne Schuchat, the director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention.
Forty-three children have died from swine flu since Aug. 30 ― about the same number that usually die in an entire flu season. Nineteen of the 43 who died were teenagers, and 16 were ages 5 to 11 years old; the rest were under 5.
“These are very sobering statistics,” Dr. Schuchat said in a news briefing, “and unfortunately they are likely to increase.”
Fifteen percent to 20 percent of the patients who were hospitalized for the flu wound up in the intensive care unit, a rate comparable with that for seasonal flu. Although the disease continues to spread, its severity is not increasing.
Projections of the supply of swine flu vaccine have widely varied. During the summer, health officials said 120 million doses would be ready in October. They later dropped the estimate to 40 million doses by the end of the month.
Now, Dr. Schuchat said, they expect only 28 million to 30 million doses, adding that the exact numbers were impossible to predict and could change daily. She said vaccine manufacturers were reporting that production was behind schedule.
“I wish we could be more predictable, but this is how influenza vaccine goes,” Dr. Schuchat said.
“Vaccine production for influenza is pretty complex,” she said in explaining the delay, “and the complex process this year is taking a bit longer than we had hoped. The yield of antigen is lower than they had hoped for.”
The antigen is the part of a virus included in vaccine to stimulate the body’s protective response. It is crucial; a vaccine will not work without it.
Dr. Schuchat also said that once batches of vaccine were prepared, they had to be tested for potency and purity.
“We are not cutting any corners,” she said. “It’s important to us that this process be done carefully and safely.”
She acknowledged that some people were having trouble obtaining vaccinations, saying, “I’m sorry it’s a difficult time in terms of looking for vaccine.”
As of Wednesday, Dr. Schuchat said, 11.4 million doses of the H1N1 vaccine were available, with more being shipped. She predicted that by early November, there would be widespread vaccine availability and information on where people should go for it.
Explaining how just 30 million doses could translate into widespread availability, a spokesman for the disease centers, Tom Skinner, said: “ ‘Widespread’ means it’s going to be in a lot of places. It doesn’t mean that a lot is going to be in a lot of places. It just means it’s going to be out there.”
Dr. Schuchat acknowledged that some people had fears about the H1N1 vaccine, but she emphasized that it was safe and urged pregnant women to be vaccinated because they were especially prone to severe complications and had accounted for a disproportionate number of deaths.
Studies of the swine flu vaccine are being conducted in pregnant women. But, Dr. Schuchat said, “if I were pregnant, I would not wait for the results of those trials; the risk in pregnancy has been very striking.”
On the seasonal flu, Dr. Schuchat said 82 million doses of vaccine had been distributed, out of an expected total of 114 million.
But the vaccine has been running low in some areas. Dr. Schuchat urged the public to “keep looking” and emphasized that there was time because seasonal flu did not usually take hold until December. Virtually all cases now are the H1N1 swine flu, she said.
Page last updated at 01:22 GMT, Saturday, 17 October 2009 02:22 UK
US swine flu vaccines 'delayed'
An H1N1 vaccine being injected at a clinic in Cleveland, 15 October 2009
Some 11.4 million vaccines have been made available in the US
US officials have warned of delays in the delivery of swine flu vaccines just as deaths from the H1N1 virus climb above epidemic level in some states.
Only 28-30 million doses would be available by the end of the month, said Anne Schuchat of the US Centers for Disease Control and Prevention (CDC).
That was down from an earlier estimate of 40 million.
Swine flu has had an especially strong impact on children, 86 of whom have died this year, Ms Schuchat said.
The number of children who have died so far this year from the H1N1 virus was greater than the number that normally die in an entire flu season, Ms Schuchat said.
Forty-three children are reported to have died from flu since 30 August, with 38 of those confirmed to have been caused by the H1N1 virus.
Half of those deaths were in children aged between 12 and 17.
"These are very sobering statistics," Ms Schuchat said. "Some of these children have been totally healthy."
Ms Schuchat said swine flu activity was widespread in 41 states, and deaths had reached the epidemic threshold in some states and cities.
"Influenza is widespread in the country and illnesses, hospitalisations and deaths continue to increase," she said.
"It's unprecedented for this time of year to have the whole country seeing such high levels of activity."
Testing the vaccines for strength and purity was cited as one reason for a delay in their delivery.
"We are not cutting any corners in the safety of the production of this vaccine or the testing and oversight of the vaccine," Ms Schuchat said.
Some 11.4 million vaccines have so far been made available in the US.
At a meeting on swine flu in Washington, officials from the World Health Organisation said the H1N1 strain was killing unusually quickly.
"In severe cases, patients generally begin to deteriorate around three to five days after symptom onset," said the WHO's Nikki Shindo.
"Deterioration is rapid, with many patients progressing to respiratory failure within 24 hours, requiring immediate admission to an intensive care unit."
Hitting Early, Swine Flu Claims 11 More Kids in US
For now, flu vaccine scarcer than expected; kids at higher risk as disease strikes US early
By LAURAN NEERGAARD AP Medical Writer
WASHINGTON October 17, 2009 (AP)
The Associated Press
Nurse Kate Guzman administers the H1N1 vaccine to firefighter Kevin Tomaszewski at the Wayne County Department of Public Health, Friday, Oct. 16, 2009. The county administered the vaccine to first responders. (AP Photo/Carlos Osorio)
As the swine flu outbreak strikes the U.S. early and hard, health officials note a worrisome number of child deaths and warn that supplies of vaccine will remain scarce for at least the next couple of weeks.
Delays in producing the vaccine mean 28 million to 30 million doses, at most, will be divided around the country by the end of the month, not the 40 million-plus states had been expecting. The new count from the Centers for Disease Control and Prevention means anxiously awaited flu-shot clinics in some parts of the U.S. may have to be postponed.
It also delays efforts to blunt increasing infections. Overall, what CDC calls the 2009 H1N1 flu is causing widespread disease in 41 states, and about 6 percent of all doctor visits are for flu-like illness ― levels not normally seen until much later in the fall.
Federal health officials said Friday 11 more children have died in the past week because of the virus.
The Centers for Disease Control and Prevention says about half of the child deaths since September have been among teenagers.
And overall for the country, deaths from pneumonia and flu-like illnesses have passed what CDC considers an epidemic level.
"These are very sobering statistics," says the CDC's Dr. Anne Schuchat.
This new strain is different from regular winter flu because it strikes the young far more than the old, and child deaths are drawing particular attention. Eighty-six children have died of swine flu in the U.S. since it burst on the scene last spring ― 43 of those deaths reported in September and early October alone, said Schuchat.
That's a startling number because in some past winters, the CDC has counted 40 or 50 child deaths for the entire flu season, she said, and no one knows how long this swine flu outbreak will last.
Also in contrast to regular winter flu, swine flu sometimes can cause a very severe viral pneumonia in otherwise healthy young adults, the World Health Organization warned.
Typically, influenza weakens people so they're vulnerable to bacterial pneumonia, especially those over age 65. But the new H1N1 can dive deeper into the lungs, in "small subsets" of patients who go into respiratory failure within days, said WHO medical officer Dr. Nikki Shindo.
"Do not delay the treatment," she said as WHO ended a three-day meeting of 100 international flu specialists gathered in Washington.
The new swine flu strain also may have hit some pigs at the Minnesota State Fair in late August, animals possibly infected by some sick 4-H students. If the infection is confirmed, it wouldn't be a surprise: A sick farm worker first infected pigs in Canada last spring, and herds have been hit in Australia and Argentina, too. The virus doesn't spread to humans who eat pork.
Fortunately, most people recover from the new strain with simple at-home care, just as with the regular flu. While there aren't precise counts, states have reported more than 2,000 deaths from pneumonia or flu-like illnesses to the CDC since Aug. 30. And Schuchat said other tracking systems show those deaths have reached the level that each year is used to declare an influenza epidemic, months early.
As of Wednesday, states had ordered 8 million of the 11.4 million doses of swine flu vaccine the government has ready to ship. Just over half of the vaccine now available is in shot form and the rest as a nasal spray. First in line for scarce H1N1 vaccine are supposed to be pregnant women, anyone age 6 months to 24 years, health care workers and people under 65 with flu-risky conditions.
CDC's Schuchat urged patience, saying eventually enough vaccine will be here for everyone who wants it.
Regular winter flu kills 36,000 Americans a year, and around the country some clinics aren't getting shipments of seasonal vaccine as quickly as expected either, as manufacturers juggle the extra work. About 82 million doses of seasonal vaccine have been shipped, and 114 million eventually will arrive, enough for typical demand, Schuchat said.
――― On the Net:
Flu info: http://www.flu.gov
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