Feb. 4--Visits to emergency departments and urgent-care centers for flu-like illness remain low in most of Virginia, with only a few health districts in the state reporting elevated flu activity.
Experts are divided on whether there will be a third wave of H1N1 swine-flu outbreaks. The flu season so far has turned out to be milder than predicted, prompting some to ask whether the World Health Organization exaggerated when it declared a pandemic in June.
"I have seen all those charges that it was trumped up," said Dr. Richard P. Wenzel, an infectious-disease expert and professor at the Virginia Commonwealth University School of Medicine.
"Globally there is a mistrust of large organizations and government, and I suppose some of that is related," Wenzel said.
"Although the mortality rates were low, and that's very clear, the thing I would point out is the usual high-risk people were not the ones dying," Wenzel said.
"The people we saw dying were children and young adults. Therefore, it's probably a little imprecise to call it mild when you see the young people whose lives are taken even though the total rates are low."
Normally, seasonal flu hits very young children and older adults the hardest. With H1N1 influenza, many of the deaths have been in people younger than 65.
The H1N1 virus was first detected in Mexico in April and in the United States just weeks later. When the World Health Organization declared a pandemic in June, 30,000 cases had been confirmed in 74 countries. Because it was a new virus that had not circulated in humans before and was easily transmitted, officials were unsure what to expect.
"We are not out of the woods yet," said Dr. Diane Helentjaris, director of the office of H1N1 response at the Virginia Depart ment of Health.
"We know historically that other pandemics saw additional waves of increased activity happening in the February-March time range," Helentjaris said.
According to lab studies, the H1N1 virus seems to have crowded out the seasonal flu virus, Helentjaris said.
The health department is still urging people to get H1N1 flu shots. Vaccine is plentiful. Virginia has been allocated 3.8 million doses. As of late January, about 1.4 million doses of H1N1 vaccine had been administered. Helentjaris said the actual number of vaccine doses administered is probably higher because there is a delay in the time vaccine is allocated, delivered to providers and administered to people.
Demand for flu vaccine, as evidenced by some recent flu-shot clinics, remains strong when health officials make it convenient for people instead of asking them to come to health departments.
Health officials said about 18 percent of state residents have gotten H1N1 flu shots -- close to a health department goal of at least 20 percent of the population vaccinated.
Nationally, the proportion of outpatient visits for flu-like illness was 1.7 percent for the week that ended Jan. 23, which is below the national seasonal baseline of 2.3 percent.
In Virginia, for the week ending Jan. 23, the proportion of flu-like illness cases was higher than 3 percent in the Pittsylvania/Danville, Crater, West Piedmont, Central Virginia and Cumberland Plateau health districts.
Contact Tammie Smith at (804) 649-6572 or TLsmith@timesdispatch.com.
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