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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

It’s likely that millions of Americans have been sickened by swine flu by now, CDC officials say. New York City alone estimates it had roughly 1 million cases since swine flu first hit last spring.

While everyone would like an exact measure of how every disease is affecting society, that simply doesn’t exist. “We don’t even have a good measure of how many heart attacks there are every day,” which would seem like a relatively easy thing to track, noted Marc Lipsitch, a Harvard University professor of epidemiology.

More comprehensive tracking is not possible with current resources and medical record-keeping, some public health advocates say.

“The fact that it is a challenge to come up with these data proves that we have underdeveloped surveillance systems in this country,” said Jeff Levi, executive director of Trust for America’s Health, a Washington-based public health research organization.

Most disease investigation and case-counting is done by state and local health departments. But quality varies state to state, and in many places it may be getting worse: State budget shortfalls and other problems led to the elimination of 7,000 health department jobs last year and 8,000 more jobs in the first six months of this year.

“You take for granted this work goes on. But it is difficult to take for granted any longer, with these cuts going on,” said Robert Pestronk, executive director of the National Association of County and City Health Officials.

However, Pestronk and others think the government’s current system of flu tracking is adequate and getting better.

The CDC has nine ways of monitoring influenza. Some focus on people who die from flu-like illness – one tracking deaths of children, another counting pneumonia and flu deaths of all ages in 122 cities.

Other systems gather flu-testing information from labs across the country. And some rely on reports of flu-like illness from hospital emergency departments and from estimates from state and territorial health officials.

Those systems combine to give a good general picture of whether more or fewer people are going to the doctor with flu, and how often lab samples are showing swine flu as compared to other respiratory bugs, health officials say.

There are problems that make even that data incomplete or inaccurate. Rapid flu tests – which are used in counting hospitalizations – are often wrong when they indicate a patient doesn’t have swine flu, CDC studies have shown. In some cases, flu or swine flu was only confirmed at autopsy. But most deaths are not autopsied.

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