Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Med Life with Dr. Horton
    • Podcasts
    • Videos
    • Alerts
    • RSS
    • Classified ads
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Activate online account
    • Look up login
    • Earn CPD Credits
    • Members Corner
    • Print copies of CMAJ
  • Subscribers
    • General information
    • View prices
    • Activate subscription
    • Look up login
    • Manage account
    • Manage IPs
    • View Reports
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JPN

User menu

  • Subscribe
  • My alerts
  • My Cart
  • Log in

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JPN
  • Subscribe
  • My alerts
  • My Cart
  • Log in
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Med Life with Dr. Horton
    • Podcasts
    • Videos
    • Alerts
    • RSS
    • Classified ads
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Activate online account
    • Look up login
    • Earn CPD Credits
    • Members Corner
    • Print copies of CMAJ
  • Subscribers
    • General information
    • View prices
    • Activate subscription
    • Look up login
    • Manage account
    • Manage IPs
    • View Reports
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
News

High H1N1 prevalence and mortality rates a concern

Patrick Janukavicius
CMAJ February 18, 2014 186 (3) E104; DOI: https://doi.org/10.1503/cmaj.109-4701
Patrick Janukavicius
Montréal, Que.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Responses
  • Metrics
  • PDF
Loading

Type A (H1N1) influenza, the most common flu virus in Canada this year, has a higher than anticipated mortality rate causing some experts to wonder if it’s virulence has increased.

The worrisome factor at this point “is the reported mortality rate in Alberta,” says Dr. Pierre Lebel, an infectious disease specialist at the McGill University Health Centre in Montréal, Quebec. As of Jan. 13, there were ten confirmed deaths in Alberta attributed to type A (H1N1) influenza, as well as one in British Columbia, six in Saskatchewan, six in Ontario, one in Quebec and two in Nova Scotia

“There are more deaths than what we expect for the regular H1N1 influenza,” says Lebel. The strain this year could be more virulent than in past years, but it’s too early to know for sure, he adds. This year’s virus is now being sequenced with the aim of detecting mutations that might cause higher levels of virulence.

Regardless, the best protection is vaccination, says Lebel, particularly for those who are at high-risk of developing bad flu. This year’s flu shot protects against the type A (H1N1) virus, among others. People who were exposed to H1N1 during the 2009 pandemic, either by acquiring the virus or through immunization, can become infected again owing to slight variations in the virus.

According to the Public Health Agency of Canada (PHAC), 96% of this year’s lab-confirmed influenza is type A (H1N1). The virus is unusual in that it appears to affect younger people more than other strains of seasonal influenza. People aged 20 to 65 are being hit harder than usual, comprising 52% of flu cases. Normally, 80% of people who die from seasonal flu are 65 years of age or older, but during the 2009 H1N1 pandemic, between 62% and 85% of those who died were younger than 65.

Figure1

As of Jan. 13, there were 26 confirmed deaths across Canada due to Type A (H1N1) )flu virus.

Image courtesy of Sebastian Kaulitzki/iStock/Thinkstock

The prevalence of Type A (H1N1) influenza this year is worst in Western Canada, from Saskatchewan to British Columbia, says Dr. Michael Gardam, director of Infection, Prevention and Control at the University Health Network in Toronto, Ont. “However, they’re all through the peak. The worst of it is done.”

In Canada, seasonal flu normally contributes to approximately 20 000 hospital admissions and between 4000 and 8000 deaths annually.

During the H1N1 pandemic in 2009, the virus caused more than 284 000 deaths worldwide, according to the US Centers for Disease Control and Prevention. At that time, the World Health Organization declared H1N1 a pandemic virus. However, the virus is now circulating like a seasonal influenza virus.

“We had tons of H1N1 in 2009 and then the last two flu seasons has been predominantly H3N2, with not much H1N1,” says Gardam. “This year, H1N1 has shown up in Canada. However, if you look at Europe, it’s still H3N2. It gives an example of how you never know what the flu is going to do.”

Doctors are using antivirals to lessen symptoms in high-risk patients, such as those with compromised immune systems, says Gardam. However, antivirals are not being used for low-risk patients owing to concerns about the development of resistance to antivirals.

Alberta confirmed a death on Jan. 8, due to the virus H5N1, an avian virus. The deceased woman had recently returned from China. The mortality rate is higher with H5N1 than H1N1, “but fortunately, it’s not an easy virus to transmit,” says Lebel. So far, it seems that there are no cases of H5N1 transmission from human-to-human. It seems like the cases of H5N1 are few and far between and related to contact with birds in China.

PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 186 (3)
CMAJ
Vol. 186, Issue 3
18 Feb 2014
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
High H1N1 prevalence and mortality rates a concern
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
Citation Tools
High H1N1 prevalence and mortality rates a concern
Patrick Janukavicius
CMAJ Feb 2014, 186 (3) E104; DOI: 10.1503/cmaj.109-4701

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
High H1N1 prevalence and mortality rates a concern
Patrick Janukavicius
CMAJ Feb 2014, 186 (3) E104; DOI: 10.1503/cmaj.109-4701
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • Scopus
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Scopus (1)
  • Google Scholar

More in this TOC Section

  • Medical trainees warn practice permits will drive away doctors
  • Coupons for health care a sign of creeping privatization?
  • Canada’s health system is among the least green
Show more News

Similar Articles

Collections

  • Topics
    • Vaccination
    • Infectious diseases

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Videos
  • Alerts
  • RSS

Information for

  • Advertisers
  • Authors
  • CMA Members
  • Copyright and Permissions
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact

Copyright 2019, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

Powered by HighWire