Swine Flu: Live Blogging CDC’s Monday Conference Call

Good stuff from the WSJ Health Blog:

an excerpt:

The WHO said earlier today that there have been 40 cases of swine flu confirmed in the U.S. So far, cases in this country appear to have been mild, but officials have warned that more severe cases could emerge. Richard Besser, acting head of the CDC, is providing an update to reporters this afternoon. Here’s what he’s saying.

1:09 There have been 40 confirmed U.S. cases in five states. The 20 newly confirmed cases are associated with the previously reported outbreak in a New York school. The new cases represent additional testing, not newly discovered cases.

1:10 No fatalities have been reported in the U.S.

1:12 The CDC recommends that people avoid non-essential travel to Mexico. “This is out of an abundance of caution,” Besser says.

Obama administration concerned about growing shortage of primary-care doctors

From Cleaveland.com:

Obama administration officials, alarmed at doctor shortages, are looking for ways to increase the number of physicians to meet the needs of an aging population and millions of uninsured people who would gain coverage under legislation championed by the president.

The officials said they were particularly concerned about shortages of primary-care providers who are the main source of health care for most Americans.

One proposal — to increase Medicare payments to general practitioners, at the expense of high-paid specialists — has touched off a lobbying fight.

Family doctors and internists are pressing Congress for an increase in their Medicare payments. But medical specialists are lobbying against any change that would cut their reimbursements. Congress, the specialists say, should find additional money to pay for primary care and should not redistribute dollars among doctors — a difficult argument at a time of huge budget deficits.

More Swine Flu Resources

MMWR (CDC subset)

On April 21, 2009, CDC reported that two recent cases of febrile respiratory illness in children in southern California had been caused by infection with genetically similar swine influenza A (H1N1) viruses. The viruses contained a unique combination of gene segments that had not been reported previously among swine or human influenza viruses in the United States or elsewhere . Neither child had known contact with pigs, resulting in concern that human-to-human transmission might have occurred. The seasonal influenza vaccine H1N1 strain is thought to be unlikely to provide protection. This report updates the status of the ongoing investigation and provides preliminary details about six additional persons infected by the same strain of swine influenza A (H1N1) virus identified in the previous cases, as of April 24. The six additional cases were reported in San Diego County, California (three cases), Imperial County, California (one case), and Guadalupe County, Texas (two cases). CDC, the California Department of Public Health, and the Texas Department of Health and Human Services are conducting case investigations, monitoring for illness in contacts of the eight patients, and enhancing surveillance to determine the extent of spread of the virus. CDC continues to recommend that any influenza A viruses that cannot be subtyped be sent promptly for testing to CDC. In addition, swine influenza A (H1N1) viruses of the same strain as those in the U.S. patients have been confirmed by CDC among specimens from patients in Mexico. Clinicians should consider swine influenza as well as seasonal influenza virus infections in the differential diagnosis for patients who have febrile respiratory illness and who 1) live in San Diego and Imperial counties, California, or Guadalupe County, Texas, or traveled to these counties or 2) who traveled recently to Mexico or were in contact with persons who had febrile respiratory illness and were in one of the three U.S. counties or Mexico during the 7 days preceding their illness onset.

CDC – Influenza (Flu) Swine Influenza

Human cases of swine influenza A (H1N1) virus infection have been identified in the United States. Human cases of swine influenza A (H1N1) virus infection also have been identified internationally. The current U.S. case count is provided below.

Investigations are ongoing to determine the source of the infection and whether additional people have been infected with swine influenza viruses.

CDC is working very closely with officials in states where human cases of swine influenza A (H1N1) have been identified, as well as with health officials in Mexico, Canada and the World Health Organization. This includes deploying staff domestically and internationally to provide guidance and technical support. CDC has activated its Emergency Operations Center to coordinate this investigation.

Swine Flu on the WSJ

A nice resource, via this link

What’s Confusing About Swine Flu

From the Wall Street Journal Health Blog:

With the U.S. declaring a public-health emergency to deal with the growing threat of swine flu and health officials world-wide mobilizing against the outbreak, one question is key: Why have the cases in Mexico been so much more serious than those in the U.S.?

“One possibility is that there’s a surveillance difference,” Joseph Bresee, chief of the epidemiology and prevention branch at the CDC’s influenza division, told the WSJ. Because Mexico has a lot of cases — the illness may have killed more than 100 there — the country may have focused its surveillance mainly on hospitals with the sickest patients. The outbreak also started during flu season, adding confusion.

If there are a lot more people who have had mild cases of this flu but haven’t been included in the count, that could mean that a person’s risk of falling into the serious group is smaller than it may seem now. “We may just be looking at the tip of the iceberg, which would give you a skewed initial estimate of the case fatality rate,” Martin Cetron, director of global migration and quarantine for the CDC, told the New York Times.

It’s also unclear just what this bug is going to do next. Flu viruses evolve rapidly, some becoming more mild and others becoming more severe, said Keiji Fukuda, interim assistant director-general at the World Health Organization, as quoted by WSJ.

Hospitals see fiscal stress: AHA survey

From Modern Healthcare:

The American Hospital Association’s latest survey of the economy’s toll on healthcare found fewer patients admitted to hospitals or seeking elective care, and stress on hospital operating budgets. The number of patients covered by safety net insurance has increased among 46% of respondents, significantly so for 8% since the beginning of the year compared with the same period a year ago. Nearly six out of 10 reported fewer elective procedures. Of those, 18% reported a significant decline. And 38% and 17% said hospital admissions have dropped moderately and significantly, respectively, mirroring what other hospital executives have experienced.

Nearly six out of 10 hospitals reported operating margins fell, and of those, about half reported significant declines, for the calendar year to date compared with the same period last year. Close to half of hospitals reported jobs cuts since September; 22% said they have reduced services and 9% said they were considering a merger in response to the economy. Roughly 1,080 hospital chief executives responded to the e-mail and fax poll conducted in March

Track Swine Flu Reports via Google Maps

Here’s the link