U.S. health officials have lost track of how many illnesses and
deaths have been caused by the swine flu and admit they are not
making any efforts to analyze which strain of flu is affecting
Health officials had previously counted lab-confirmed cases,
though the tally was skewed because many people who got sick never
Most nations have stopped relying on lab-confirmed cases, too,
and many health officials say the current monitoring system is
inadequate. But not having specific, accurate counts of swine
flu means the government doesn't have a clear picture of how hard
the infection is hitting some groups of people, said Andrew Pekosz,
a flu expert at Johns Hopkins University.
The Centers for Disease Control and Prevention is relying on
a patchwork system of gathering death and hospitalization numbers.
Most states are reporting illnesses that could be the new swine
flu, seasonal flu or some other respiratory disease.
What's more, as the initial panic of the new virus ebbed, fewer
people were fully tested, so the results weren't as accurate or
comprehensive. "The kinds of numbers you were getting later
in the summer were different from the numbers early on,"
said Dr. Daniel Jernigan, deputy director of the CDC's influenza
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.
There are problems that make flu 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.
These problems are not unique to the United States. The World
Health Organization deciding that tracking individual swine flu
cases was too overwhelming for countries where they said (without
laboratory analysis) that the virus was spreading widely. The
WHO has continued to update swine flu reports, but with the disclaimer
that countries are no longer required to test and report cases.
Britain also releases weekly swine flu updates, but the numbers
are estimates based on how many people go to their doctors with
flu-like illness, as well as calls logged to the national flu
Singapore government officials stated the classification system
recommended by the the WHO has made the number of reported transmissions
so high, that the government has officially stopped counting the
number of cases.
"There will always be an error factor, misdiagnosis, misclassifications,"
said Pestronk, formerly the head of a county health department
in Michigan. "We'll never be at 100 percent of people getting
tested. The question is what's good enough for purposes of planning
and acting on the burden of disease."
Public health epidemiologist, Michael Hager stated that "there
have been and continue to be major data imperfections when it
come to counting swine flu cases across almost every developed
nation in the world."
Hager said there will always be margins of error, but the misdiagnoses
and misclassifications of H1N1 swine flu are overwhelming. "The
statistical errors made by governments have grossly distorted
swine flu cases by a margin that make it impossible to know how
many actual cases of flu are caused by the H1N1 flu strain."
SUSTAINABLE FUTURES INTERVIEW:
About the H1N1 Vaccine
any reports or comments regarding the flu pandemic in your