In US: H1N1 STILL UP, NOW WIDESPREAD in 37 STATES!

Furthermore, that during the week of September 27 to October 3, 2009, Swine flu activity increased, along with consultations and visits with the doctors for influenza-like illnesses and that it exceeded higher than it was expected for the 3^rd Quarter of this year 2009.

Aside from the spread of the morbidity, the mortality continues to multiply as well.

A report called FluView that mandates CDC to analyze information about influenza disease activity in U.S. (and publishes findings of key flu indicators); found that H1N1 activity had increased tremendously nationwide.

Below is the summary of the most recent key indicators, released by CDC:

• Visits to doctors for influenza-like illness (ILI) continued to increase in the United States, and overall, are higher than levels expected for this time of the year.

• Total influenza hospitalization rates for laboratory-confirmed influenza are higher than expected for this time of year for adults and children. And for children 5-17 and adults 18-49 years of age, hospitalization rates from April - October 2009 exceed average flu season rates (for October through April).

• The proportion of deaths attributed to pneumonia and influenza (P&I) based on the 122 Cities Report has increased and now exceeds what is normally expected at this time of year. In addition, 19 flu-related pediatric deaths were reported this week; 16 of these deaths were confirmed 2009 H1N1 and 3 were unsubtyped influenza A and likely to be 2009 H1N1. A total of 76 laboratory confirmed 2009 H1N1 pediatric deaths have been reported to CDC since April.

• Thirty-seven states are reporting widespread influenza activity at this time. They are: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Texas, Tennessee, Virginia, Washington, and Wyoming. Any reports of widespread influenza activity in September and October are very unusual.

• Almost all of the influenza viruses identified so far is 2009 H1N1 influenza. These viruses remain similar to the virus chosen for the 2009 H1N1 vaccine, and remain susceptible to the antiviral drugs oseltamivir and zanamivir with rare exception.

CDC recently released the Updated Interim Recommendations for the Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010 Season, to provide additional and updated guidance to health providers; doctors, or clinicians, in prescribing antiviral medications for treatment and prevention of H1N1 during the season of 2009-2010.

The said interim recommendations are constantly updated for the following reasons:

1. Provide additional context and guidance for clinicians regarding the risk for complications and treatment considerations for young and very young children;

2. Provide more information about the possible underlying physiological conditions that may be associated with neuromuscular and neurocognitive disorders that might contribute to the increased risk of influenza-related complications in persons with these disorders.

3. Provide information regarding the oral dosing dispenser included in the Tamiflu® oral suspension packaging to insure that units of measure on the dosing device and the prescription instructions match.

It was also noted that the most healthy persons who developed illnesses consistent with this flu virus, or persons who appear to be recovering from influenza, do not need antiviral medications for treatment or prophylaxis. However, individuals presenting with suspected influenza and more severe symptoms; such as evidence of lower respiratory tract infection or clinical deterioration should receive prompt empiric antiviral therapy, regardless of previous health or age.

Meanwhile, a recent US research reported that H1N1 may cause blood clots and some other unusual damages on the lungs, which call doctors to be on the lookout and be more vigilant on handling and treating flu cases.

Also, based from the two studies published by the American Journal of Roentgenology; it is critical to check X-rays and CT scans for unusual features, as swine flu can be really tricky to diagnose on most ill patients.

Although, it is not that deadly, younger adults and older children (who didn't experience the worst of a seasonal flu), are more prone than all other age brackets.

"It is therefore essential that clinicians be able to recognize possible cases of pandemic H1N1 influenza in high-risk groups so that they order the appropriate diagnostic tests, begin specific antiviral therapy, and prepare to provide intensive supportive measures as needed," according to Dr. Daniel Mollura of the National Institutes of Health Clinical Center in Maryland.

To date, 375,000 laboratory confirmed cases of H1N1 2009 and over 4500 deaths were reported to WHO.

Extra caution is highly encouraged throughout the season of fall and until end of winter.