H1N1 in steep decline

MIAMI — H1N1 flu, which nearly caused a national panic last year before collapsing by year's end, remains very low across the U.S., with no indication it will worsen as the fall flu season nears, federal health officials said Tuesday.

The country will do away with last year's crisis handling of flu, they said, in two ways:

Last year, manufacturers created a new special vaccine specifically for swine flu, or H1N1, because the disease popped up after the regular flu vaccine was already created. It meant most people needed two flu shots instead of one. This year, there will be a single vaccine that will cover H1N1, the seasonal influenza B and a new strain, H3N2. This is the way flu usually is handled.

Last year, the federal government paid for the swine flu vaccine and set up special locations to make it available to the public. This year, it will be disseminated mostly through commercial facilities including private doctors' offices, for-profit clinics and pharmacies. County health departments will still provide it free at their local clinics to low-income individuals, said Dr. Stephen C. Redd of the U.S. Centers for Disease Control and Prevention.

Still, Redd wouldn't completely rule out a return, citing the H1N1 virus' unpredictability.

"It's uncertain what will happen with this virus. We don't know when the flu season will occur, whether it will be early or late. We don't know which flu virus will predominate. We will be tracking it very closely," he said.

In 2009, the U.S. swine flu pandemic began in April, lingered through the summer, exploded when school began, peaked in October and — to the surprise of many — collapsed by New Year's Day.

Between 40 million and 90 million Americans were infected, with 250,000 hospitalized and 9,000 to 18,000 deaths — far fewer than the usual 36,000 or so deaths during typical regular flu seasons.

The U.S. went from a shortage of vaccine in October to a surplus by January. Nearly one-quarter of the swine flu vaccine produced in the U.S. eventually expired, meaning 40 million doses worth about $260 million were discarded.

This year, Redd predicted that the government will ensure an ample quantity of flu vaccine before the regular flu season begins.

In South Florida, flu activity is minimal.

The Miami-Dade Health Department has seen no swine flu case for at least three months, a spokeswoman said, and Broward County has also seen few cases.

"Seems like the usual summer pattern here, which is minimal activity," said Dr. John Livengood of the Broward Health Department.

And Redd called it good news that in the Southern Hemisphere, where it's now winter, flu cases of all kinds have remained low, and H1N1 cases now are mixed with other kinds of flu such as seasonal influenza B and H3N2.

This is the usual pattern for non-pandemic years, he said. And H1N1 has shown no signs of mutating to a more dangerous form.

Redd spoke at a national news conference broadcast on the Internet and hosted by the National Foundation for Infectious Diseases. The World Health Organization, despite criticism, has declined to declare an end to the worldwide H1N1 pandemic.

Experts say a pandemic is defined more by how widespread an illness is than by how many cases exist. And swine flu still is widespread in a few parts of South Asia and Eastern Europe, the agency said.

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