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US, Other Nations Stop Counting Pandemic Flu Cases

US, Other Nations Stop Counting Pandemic Flu Cases

Associated Press/AP Online

October 09, 2009

ATLANTA – U.S. health officials have lost track of how many illnesses and deaths have been caused by the first global flu epidemic in 40 years.

And they did it on purpose.

Government doctors stopped counting swine flu cases in July, when they estimated more than 1 million were infected in this country. The number of deaths has been sitting at more than 600 since early September. Health officials had previously counted lab-confirmed cases, though the tally was skewed because many people who got sick never were tested.

Other nations have stopped relying on lab-confirmed cases, too, and health officials say the current monitoring system is adequate. But not having specific, accurate counts of swine flu means the government doesn’t have a clear picture of how hard the infection is hitting some groups of people, said Andrew Pekosz, a flu expert at Johns Hopkins University.

The novel H1N1 flu seems to be more dangerous for children, young adults, pregnant women and even the obese, according to studies based on small numbers of patients. And federal health officials are keeping track of children’s deaths. But exactly how much more at risk kids and other groups are is hard to gauge if the overall numbers are fuzzy.

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“This wasn’t as critical early on, when case numbers were low,” said Pekosz. But now, it’s hard to say exactly how swine flu’s dangers vary from group to group, he said.

The Centers for Disease Control and Prevention is relying on a patchwork system of gathering death and hospitalization numbers. Some states are reporting lab-confirmed cases. Others report illnesses that could be the new swine flu, seasonal flu or some other respiratory disease.

Some say that’s a more sensible approach than only counting lab-confirmed cases. Many people who got sick never get tested, so the tally of swine flu cases was off almost from the very beginning, they say.

“It was a vast underestimate,” said Dr. Zack Moore, a respiratory disease expert for the North Carolina Department of Health and Human Services.

What’s more, as the initial panic of the new virus ebbed, fewer people were fully tested, so the results weren’t as accurate or comprehensive. “The kinds of numbers you were getting later in the summer were different from the numbers early on,” said Dr. Daniel Jernigan, deputy director of the CDC’s influenza division.

That’s why the CDC shifted to counting the new flu like it counts seasonal flu cases, agency officials said. “We’re concerned folks are focused on the numbers and missing that influenza is monitored by looking at trends,” Jernigan said.

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