November 12, 2009
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This week’s Ontario Ministry of Health Influenza Bulletin shows continuing increases across all metrics. Clinic hours have expanded, and the definition of “high risk” groups entitled to be vaccinated has expanded. Also this week, the CDC reported a cumulative total of 4,000 swine flu deaths.
The Ontario numbers continue to look grim:
- Nine new institutional influenza outbreaks were reported
- 212 hospitalized cases were reported from October 28 to November 4 as compared to 104 from October 21 to October 28
- Seven deaths caused by H1N1 were reported from October 28 to November 4
Here’s the overall picture:
October 31, 2009
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Checking out this week’s Influenza Bulletin, indications are that the Fall’s Swine Flu outbreak in Ontario is going to get worse before it gets better. Unfortunately, the vaccine is just starting to become available. This coming week, there will be 10 public clinics open in the greater Toronto area, but still only for those among the currently-eligible “high-risk” groups.
Sadly, two Ontarians died as a result of the virus this week. To date (pdf), including over the summer:
“Thirty deaths have been reported among confirmed cases. Almost all of these fatalities (26/28 or 87%) were hospitalized prior to death… Of the fatal cases, 73% (22/30) occurred in individuals over the age of 40 years… [and] 26 (87%) had underlying chronic medical conditions reported.”
So Evan Frustaglio is a very sad exception to the general rule.
Here’s some of this week’s data:
The graph below shows the total number of swine flu cases. The brown rising line on the left is the current situation (with 553 cases this week), and the green peak on the right is the data from the first swine flu wave this past summer.
This graph shows hospitalizations due to swine flu. It lags a bit because the relevant records have to wend their way into the relevant database, but you get the picture.
October 27, 2009
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The latest actual figures on Ontario Swine Flu are in Ontario’s weekly “Influenza Bulletin”. See below for some interesting data from last Friday’s edition.
While you’re perusing those, note that vaccine is on the way. The message from Deb Matthews, Ontario’s Minister of Health and Long-Term Care is: “Get vaccinated when it’s your turn.”
First in line:
- People under 65 with chronic conditions;
- Pregnant women;
- Healthy children 6 months to under five years of age;
- People living in remote or isolated communities;
- Health care workers; and
- Household contacts and care providers of persons at high risk who cannot be immunized or may not respond to vaccines.
Here’s the data for new confirmed cases. The big bump is the summer’s wave, the rising bars on the right are where we are today.
Here’s a view of how this Fall stacks up historically. That early-riser on the left is 2009. Not encouraging. Wash your hands, and go get vaccinated. Then wash your hands again.
June 11, 2009
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Ontario’s update yesterday brought the total number of cases in the province to 1,562 with two deaths, both fatalities having been people with underlying medical conditions. The number of people hospitalized has increased from 6 to 10 since our last update (no word on the turn-over in that number), some of whom do and some of whom do not have underlying medical conditions.
Notably, the World Health Organization finally gave up the ghost today and declared Swine Flu to be a Phase 6 pandemic (duh), but made sure to note that it’s not severe:
“At this early stage, the pandemic can be characterized globally as being moderate in severity,” WHO said in the statement. A spokesman added that the term pandemic was “measure of the spread of the virus, not the severity of the virus.”
So we have a historic, but not too scary, announcement. I guess the delay allowed some desensitization to the idea of a Phase 6 pandemic declaration. Meanwhile, lest you slip from panicked straight to complacent, here are the Ontario stats:
Some leveling-off on new cases, maybe:
June 3, 2009
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Coverage of Swine Flu has declined, but incidence of Swine Flu has not. Yesterday, we got the report of a second swine flu-related death in Ontario.
Although the press release goes out of it’s way to emphasize that almost all the cases are considered mild, there is an interesting tidbit here:
Six people who have the H1N1 flu virus were in hospital as of June 2, a number of whom have underlying medical conditions.
… implying that at least some of those hospitalized do not have underlying medical conditions — i.e., they actually have a fairly severe case of flu.
Also, swine flu is on the rise in the Southern hemisphere and WHO is seriously considering moving to level 6, but may add some kind of severity indicator.
Here’s the Ontario data:
what’s that word again? Oh, right … exponential. Here’s the new case average count, which I’ve moved to a 7-day rolling average:
Keep carrying that sanitizer a little longer, I think.
May 26, 2009
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Ontario reported yesterday that:
A 44-year old Toronto man with a chronic pre-existing medical condition passed away on May 23rd. On May 24th laboratory testing confirmed a positive test for H1N1 in this individual. It is not clear what role the H1N1 virus played in the fatality which is now under investigation by the Office of the Chief Coroner.
Also, there were 58 new cases since the previous report on May 22, bringing the total to 352. Here’s how things have looked so far in Ontario, where we appear to be averaging about 15-18 new infections per day:
Also, the cumulative total:
May 14, 2009
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Ontario reported 36 new cases of Swine Flu today. All cases are still considered mild, although one patient was hospitalized for unrelated reasons.
I thought this would be a good time to look back at the Ontario press releases and plot the number of new cases reported since Ontario started releasing numbers on April 28th. When I did that, the plot was very erratic, so I took a 3-day rolling average. Here it is:
We’ll see where this goes over the next few days.
May 11, 2009
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Ontario has reached a total of 110 confirmed human swine flu cases, all still considered mild. The age range is between 1 and 62. Canada reported its first swine flu fatality, an Alberta woman with asthma.
ScienceInsider has had outstanding coverage, and I’m adding their swine flu RSS feed to the sidebar on the right side of this page. Interesting extracts from today:
- Epidemiologist Neil Ferguson of Imperial College London estimates an R0 of about 1.5 (consistent with last week’s report).
- Based on available data, Ferguson estimates a case fatality rate of 0.4%, with a range between 0.3% and 1.5%. That’s far less than the 1918 pandemic, and likely to decrease as more mild cases (less likely to have been reported or tested early) are confirmed.
Also, Colbert had author Laurie Garrett on his show last week talking about the Swine Flu outbreak.
You can watch here from the U.S.: http://www.colbertnation.com/the-colbert-report-videos/226864/may-06-2009/laurie-garrett
And here from Canada: http://watch.thecomedynetwork.ca/the-colbert-report/full-episodes/may-6-2009/#clip169176
You may also apply a level of skepticism appropriate for listening to someone who has their own eponymous website.
Ontario confirms 13 new cases as of Wednesday afternoon, bringing the total to 49 in the province, all considered mild. A lot of the public health messaging over the last 48 hours has been advising people not to relax too much.
Today also saw an interesting Canadian development on the scientific front. Although commentary around the different numbers of flu deaths in Mexico versus other areas has included the possibility that there are genetic variations in the virus, genetic differences do not appear to be responsible. Researchers at the National Microbiology Lab in Winnipeg sequenced Mexican and Canadian isolates and found no significant differences. According to Dr. Frank Plummer, the chief science adviser of the national lab:
“Essentially, what it appears to suggest, is that there is nothing at the genetic level that differentiates this virus that we got from Mexico and those from Nova Scotia and Ontario, that explains apparent differences in disease severity between Mexico and Canada and the United States.”
Also, speaking of not relaxing too much, the FDA just announced that they have approved a new Sanofi Pasteur vaccine manufacturing facility in Swiftwater, PA.
There are five new confirmed cases in Ontario today, according to the press release following the 3pm call, bringing the total to 36.
Nature has a good scientific update, including the latest thinking on the basic reproductive rate, R0, “which is the number of new cases that an infected individual will give rise to,” and the generation time.
The WSJ Health Blog has its live blog posts on today’s CDC update call and WHO update call.
Here are our other (Canada-centric) posts on H1N1.
As testing capacity ramps up in Ontario, suspect cases are becoming confirmed cases at a rapid rate — 17 new confirmations from yesterday (and two being re-assessed) brings the total number of confirmed cases in Ontario to 31. The geographic and age range are both expanding, but all cases are reportedly still considered mild. Here’s the full press release.
Oh, and in case you didn’t catch this bit of weekend payback: pigs on an Alberta farm were infected with H1N1 by a farm worker returning from Mexico.
The WSJ Health Blog has a full global update.
UPDATED Sunday: A press release from Dr. David Williams, Ontario’s Acting Chief Medical Officer of Health, confirms 2 new cases of Human Swine Flu (aka H1N1 Influenza, aka Grippe Porcine) in Ontario
today Sunday, bringing the total confirmed so far to 1416, with all reporting mild symptoms and recovering at home.
More from the press release:
The breakdown of the Ontario cases is as follows:
FiveSix men and nineten women
- Three are in York, six are in Durham, one is in Peel and
foursix are in
- The age range of the cases is
21 – 4021-49
- People returning from Mexico who have symptoms of respiratory illness should contact their health care provider or call TeleHealth Ontario at 1-866-797-0000.
- For general information on the human swine flu, call the ServiceOntario INFOline at 1-800-476-9708.