H1N1, Seasonal Flu Deaths Aren't Comparable, WHO Says
Dec. 4 (Bloomberg) -- The World Health Organization, facingcriticism that it exaggerated the threat of swine flu, said it’stoo soon to decide whether the pandemic is more or less deadlythan seasonal flu and comparing death rates may be misleading.
Mortality from the new H1N1 strain is “unquestionablyhigher” than the death toll reported by national authorities,the Geneva-based agency said in a report seen by Bloomberg Newsbefore its scheduled publication today. Deaths totaled more than7,820 as of Nov. 22, said WHO, which estimates as many as500,000 people die each year from seasonal strains.
Health authorities worldwide are assessing whether theirresponse to swine flu is justified by its threat as cases offlu-like illness retreat in the U.S. and U.K. While a majorityof patients recover within days and reported fatalities are afraction of the seasonal flu toll, these figures mask the fullimpact of swine flu on society, WHO said.
“Compared with seasonal influenza, the H1N1 virus affectsa much younger age group in all categories -- those mostfrequently infected, hospitalized, requiring intensive care, anddying,” WHO said in the report.
In Australia, about 3,000 people aged 50 or older die fromseasonal flu each year, according to statistical modeling.Officials counted 190 deaths associated with confirmed swineflu, Jim Bishop, the nation’s chief medical officer, said lastweek in a report in the New England Journal of Medicine.
Younger Victims
The median age of patients who died was 53, compared with83 in seasonal epidemics, and the number of patients treated inintensive care units for viral pneumonia was about 14 timesgreater than normal, Bishop said in a telephone interview fromCanberra today.
“It’s a different type of virus affecting younger peopleand putting more people into hospital and ICU,” he said. “It’snot attacking older people in nursing homes.”
The pandemic’s impact is better gauged by the number oflife-years lost because of the younger age of victims comparedwith seasonal flu, said Michael Osterholm, director of theUniversity of Minnesota’s Center for Infectious Disease Researchand Policy in Minneapolis.
“If you look at years of personal life lost, it’s muchhigher, and that’s the point we have to get across,” Osterholmsaid in a telephone interview today. “A death in an otherwisehealthy 24-year-old, to me, is a major defeat for society.”
Pregnant Women
Of those infected worldwide, 1 percent to 10 percent haverequired hospitalization and as many as a quarter of thosepatients have needed intensive care, WHO said today in theWeekly Epidemiological Record newsletter. Pregnant women have a10 times higher likelihood of requiring admission to an ICUcompared with the general population, and at least 1 in 14 ofall hospitalized cases are women in their second or thirdtrimester of pregnancy, it said.
Bishop said WHO’s decision to declare swine flu a pandemicin June helped guide the nation’s response, which he said was“proportionate and relevant.”
The United Nations agency moved to the top level of itspandemic alert following advice from a group of scientists andhealth officials who may have ties to the pharmaceuticalindustry, Sweden’s Svenska Dagbladet newspaper said last week,citing reports in Danish newspaper Information and the journalScience. WHO spokesman Gregory Hartl told the newspaper that thedecision to declare a pandemic was made by Director GeneralMargaret Chan alone.
‘Machine Grinding’
In July, epidemiologist Tom Jefferson told Germany’s DerSpiegel that WHO, public health officials, virologists andpharmaceutical companies may have had ulterior motives inpromoting the pandemic threat.
“They’ve built this machine around the impendingpandemic,” Jefferson was quoted as saying.
“There’s a lot of money involved, and influence, andcareers, and entire institutions,” he said. “All it took wasone of these influenza viruses to mutate to start the machinegrinding.”
Public perceptions about the pandemic and nationalpreparedness plans have been influenced since 2004 by the threatof bird flu, “widely regarded as the virus most likely toignite the next influenza pandemic,” WHO said in a statementyesterday. The H5N1 strain of avian influenza killed 59 percentof the 444 people known to have been infected, according to WHO.
Adjusting Perceptions
“Adjusting public perceptions to suit a far less lethalvirus has been problematic,” WHO said. “Given the discrepancybetween what was expected and what has happened, a search forulterior motives on the part of WHO and its scientific advisersis understandable, though without justification.”
Since April, at least 622,482 people have been infectedwith the virus in more than 207 countries and territories,according to WHO.
Swine flu infections and deaths reported to WHO are basedon laboratory confirmed tests rather than mathematical modelingused to estimate fatalities from seasonal flu, the agency said.
“With the current pandemic, we really have data which isalmost an anomaly, when we look at how influenza has beencounted in the past,” Keiji Fukuda, WHO’s special adviser onpandemic influenza, told reporters on a conference call fromLondon yesterday. “People do not typically count influenzadeaths on a one-by-one basis. And so, we do not have a lot ofdata on laboratory-confirmed deaths for seasonal influenza.”
Accurate assessments of deaths and mortality rates willprobably be possible only one to two years after the pandemichas peaked, WHO said.
“What we’re doing is reporting on the final score andwe’re only at half time,” said Osterholm at the University ofMinnesota. “We have no clue what’s going to happen in the nextthree to six months.”
To contact the reporter on this story:Jason Gale in Singapore at j.gale@bloomberg.net
Last Updated: December 4, 2009 06:00 ESTSource: Bloomberg
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