Activity of the pandemic H1N1 influenza virus continues to ebb in the United States, with no states reporting widespread flu activity in the week ending Jan. 23 and only five states reporting regional activity. Hospitalization rates have leveled off, and very few hospitalizations for confirmed swine flu were reported during the week. The proportion of visits to doctors' offices for influenza-like illness was 1.7%, below the baseline level of 2.3% for an epidemic. The proportion of deaths attributed to pneumonia and influenza increased slightly from the previous week and is higher than is normally expected at this time of year. The higher rate is thought to result from an increase in pneumonia-related deaths in older people and is not necessarily related to influenza.
Five new pediatric deaths were reported during the week, four from swine flu and one from a type A influenza that was not subtyped. That brings the total of laboratory-confirmed deaths related to flu to 312 since last April, when the pandemic began.
Virtually all of the flu viruses tested in laboratories have been confirmed to be swine flu, and its composition remains virtually identical to the virus used in preparing the vaccine. A few cases of resistance to the antiviral drug Tamiflu were observed, but most viruses seen remained susceptible to the drug.
As of Thursday morning, 147.3 million doses of the swine flu vaccine were available and about 119 million had been shipped. Most public health authorities are now recommending that the vaccine be given to anyone who wants it.
In other swine flu news:
-- The World Health Organization this week vehemently denied charges that it had been swayed by pharmaceutical companies in its response to the pandemic. Some critics in the Council of Europe had charged that the WHO had overreacted to the outbreak of swine flu virus, causing public health bodies to waste $18 billion on excessive stocks of vaccines. Dr. Keiji Fukuda, special advisor on flu to the WHO director-general, told the body: "Let me state clearly for the record. The influenza pandemic policies and responses recommended and taken by WHO were not improperly influenced by the pharmaceutical industry." He conceded that the agency's response was not perfect but noted, "We do not wait until [global outbreaks] have developed and we see that lots of people are dying. What we try and do is take preventive action."
-- Serbia and Japan joined the list of countries that have tried to cancel part of their orders for swine flu vaccine in light of a tepid response among the public. But vaccine manufacturers such as Novartis warned countries not to cancel their orders, stressing that priority for vaccines in a future epidemic would be given to those countries that honored their contractual obligations. Canada said it would reduce its oversupply of vaccines by donating 5 million doses to the WHO to support vaccination efforts in developing countries, and would contribute $6 million to help distribute the vaccines.
-- Thomas H. Maugh II