We maintain a certain level of concern about pandemic H1N1 due to the experience with the 1957 pandemic (A/H2N2), which in a similar fashion was observed to spread throughout the United States in the fall of 1957. But a later surge in fatalities due to A/H2N2 in the winter was documented, a phenomenon we are vigilant for now.
Below is an abbreviated timeline of New York City's experience with the 1957 pandemic, derived from reporting by the New York Times. The majority of reporting and community impact was observed in the fall. Although a substantive increase in fatalities were noted in the winter, far less attention was devoted to reporting this phenomenon and social impact in terms of medical infrastructure impact and public anxiety was much less.
Here we have the tendency to use history as a guide. The experience with the 1957 pandemic helped us anticipate the fall wave of pH1N1 transmission. It remains to be seen if a winter increase in pH1N1-related fatalities will be observed. We saw no increase in transmission following the Thanksgiving holiday and negligible increase following Christmas. If the same pattern is observed as in 1957, we would expect to see documentation of increased fatalities by the first week of February. Looking at CDC's current influenza activity reports, it would seem unlikely. In biosurveillance, we have learned to expect the unexpected, so we will continue to monitor regardless.
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