H1N1 could overwhelm U.S. in the next two months

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Some hospitals in the southeastern U.S. are already swamped with pandemic flu cases, and within a few weeks a similar scenario could play out in Minnesota hospitals.

At least that's one prediction offered Thursday during a University of Minnesota panel discussion on the new H1N1 influenza virus.

Emergency rooms in Atlanta have been overwhelmed this week with sick kids complaining of flu-like symptoms. The jump in illnesses comes just a few weeks after school started across much of the southeast.

Michael Osterholm directs the Center for Infectious Disease Research and Policy at the University of Minnesota. He told a U of M audience that health workers in Atlanta can barely keep up with the situation.

"I actually have the data from just as late as last night in the emergency departments of Atlanta and I'm telling you they are in free fall," Osterholm said. "As we speak today, they tripled the highest number of in-patient visits they'd ever had, even dating into June and July time period, for kids with influenza-like illness. They have virtually run out of liquid Tamiflu.

"That is a harbinger of things to come that we're going to see here because we're off by about two to three weeks," he said.

In Minnesota, most schools opened within the past week. So presumably it would take a few more weeks for a similar wave of illness to develop here.

While there are no guarantees that Minnesota will experience a surge in flu cases during that time frame, Osterholm said the odds favor a widespread outbreak. He cited information from the World Health Organization that shows the new strain of pandemic flu spreads four times faster than other viruses.

"...college campuses will continue to be the primary seeding location."

There's already evidence that the virus is circulating on college campuses all around the country, including the University of Minnesota where at least 60 influenza-like cases have been reported to the college health services.

"I'll make a prediction today that college campuses will continue to be the primary seeding location for much of the rest of the country, which over the next weeks will then filter out from there," Osterholm said.

But public health officials say the virus can be slowed down by good hygiene practices. They urge people to cover their coughs and sneezes and to avoid going out in public if they're sick. They hope those practices will buy more time so Americans can get inoculated against the virus.

The vaccine for H1N1 isn't expected to arrive in most states till Oct. 15. Early clinical trial results suggested that most people would need two doses of the vaccine in order to achieve immunity against the virus. But Osterholm said he's heard that at least two of the five U.S. vaccine manufacturers might receive single dose approval for their product for people over age ten.

Panelist Sanne Magnan, Commissioner of the Minnesota Department of Health, said that would speed up the vaccination process considerably. But she cautioned against getting too excited about the prospect of a single dose.

"I'm not going to speculate yet that [we're going] to be able to get it in one dos," Magnan said. "My job is to prepare for the worst. So I'm going to prepare that we're still going to have two doses.

"But it would be fabulous from an actual implementation," she said. "Europe looks like they've been able to do. We'll have to see if the manufacturers and so forth can get it to happen here."

It's also possible that more people might be able to get the H1N1 vaccine as soon as it's made available. Magnan told the audience she's heard that the CDC is considering changing its recommendations that limit the first vaccine doses to five priority groups.

"There is a prioritization but I just heard yesterday that CDC was saying that possibly we would say here are the priority groups but anybody that wants it can go ahead and get it," Magnan said.

So far, most of the illnesses associated with the new H1N1 virus have been considered mild. But some people have become severely ill and in some cases died.

Public health officials say what's unusual about the deaths from this new virus is that they are mostly in young people, many of whom were relatively healthy.