Has H1N1 started to peak?

H1N1 cases fall in U.S. but could rise with Thanksgiving travel, gatherings – washingtonpost.com.

For the first time, this week showed a drop in case of H1N1 with only 43 states noting widespread H1N1 activity.  I was at a critical care conference this week and one of the speakers mentioned this very report.  He also raised concerns about a “second wave” problem related to holiday travel, that there will be a surge post-Thanksgiving due to family get-togethers and increased travel.  He also noted reports out of the Ukraine of mutated strains of the virus.  From the article:

The news came as scientists in Norway announced that they had detected a mutated form of the swine flu virus in two patients who died of the flu and in a third who was severely ill. It is the most recent report of mutations in the virus that is being watched closely for any change that could make it more dangerous.

In a statement, the Norwegian Institute of Public Health said the mutation “could possibly make the virus more prone to infect deeper in the airways and thus cause more severe disease,” such as pneumonia.

The institute said that there was no indication that the mutation would hinder the ability of the vaccine to protect people from becoming infected or impair the effectiveness of antiviral drugs in treating people who became infected…

The World Health Organization said viruses with a similar mutation had been detected in several other countries, including Brazil, China, Japan, Mexico, Ukraine and the United States. “No links between the small number of patients infected with the mutated virus have been found and the mutation does not appear to spread,” the WHO said in a statement.

With my apocalyptic thinking cap on I can see a “second wave” of the mutated resistant strain of H1N1 sweeping the world turning us all into zombies.  If only…

The only thing this really means is that there may be less ILI cases landing in our ED and thus onto our obs unit.  Which may or may not be a good thing.  Interesting stuff nonetheless.



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