I forgot the exact number but we are reaching 150 cases in Germany now. I guesstimate from now on cases will increase dramatically.

Who doesn't?

Here are the current numbers - not too diffocult either - 172 infections.
Situationseinschätzung zur Neuen Influenza

Number of pig flu cases in Germany rises to 172

London, 14 June (AFP) - In Germany there are now 172 cases of swine flu. Since Saturday was thus confirmed four more cases, such as the Robert Koch Institute (RKI) announced. With other diseases should be expected.

In Dusseldorf grew, according to the city administration, the number of confirmed cases on 84th Of these, 65 pupils of the Japanese school. When the first European casualties of the pig flu is, according to press reports a 38-year-old, who only days before her death a baby was brought to the world.

Even parents of five pupils, two teachers and a support bus drivers, school children on a trip according to Hesse and Thuringia accompanies, was the pig flu virus H1N1 demonstrated how a city spokesman said. In Dresden, a nursery of the illness after a three-year-old girl was temporarily closed.

http://www.tlz.de/tlz/tlz.politik.v...her=&dbserver=1

The hits are coming closer regionally and reaching 300 confirmed. Official (or rather from some of our "experts") guestimate is 3000 plus.

credits german-doctor

H1N1 infections to Germany are introduced via travelling. Case histories show that Mallorca and Ibiza could be possible infection sources. The kindergarden of Hannover`s Medical College was closed because a three year old and her parents returned infected from her trip to Ibizza. Three more children from the day care center are possibly infected. The family of three home quarantines, the father being a physician at the medical College. It´s not quite clear whether the infections were acquired on the islands itself or whether on the air plane or at the airports.
Still the German Health agencies hope to curb the spread of the infections with contract tracing and self-quaranting. We will see what the outcome will be.

A total of 12 new cases was reported for Lower Saxony on Friday (misleading local reporting).

On Friday 12 new cases of swine flu were confirmed in the state of Lower Saxony. The total case load has increased from 96 on 15 July to 112 on 17 July. The RKI is so to speak out of order for technical reasons and cannot inform about the German case total.

source: HAZ

I expect jumps in cases during the next week with more tourists returning from different corners of the globe. With the increasing case load the local state health department is already strained to its limits and disorganization spreads or informal reorganization takes place. Flu swabs should now be sent by mail to the health department and tubes for the swabs could be bought in the local pharmacy, if the GP has not any at hand.
In the not-so-long-ago days of few cases the health department sent a courier to the physician(s) to collect the swabs. These days of deluxe treatment are definitely over. Intensive contact tracing will also be over pretty soon, I dare say- moneywise and staffwise. The health department is chronically understaffed over here.

Here the latest update on cases in Germany (lab confirmed and close contact cases without lab confirmation):


Bundesland bestätigt davon autochthon
Baden-Württemberg 511 110
Bayern 425 156
Berlin 121 42
Brandenburg 46 14
Bremen 53 21
Hamburg 33 4
Hessen 285 49
Mecklenburg-Vorpommern 43 2
Niedersachsen 971 135
Nordrhein-Westfalen 2184 497
Rheinland-Pfalz 172 11
Saarland 80 4
Sachsen 100 33
Sachsen-Anhalt 96 37
Schleswig-Holstein 107 21
Thüringen 97 15
Summe 5324 1151



The State Health Departments are understaffeand cannot cope with the workload. There is backload of lab cases. Another issue is who pays for all the testing. There is not much money in the public health system. Same issues as in the rest of the world.

Though a cumulative of about 14 300 swine flu cases has been reported in Germany everyday life goes on like usual. 20% of the confirmed cases are from local infections (household contacts of travellers). Community spread is not reported at the moment, even though vacations in several states ended and schools as well as kindergartens have started, some even operated all summer.
So far hospitalizations and serious cases have not been reported.

But there are changes in regulations concerning schools and kindergartens. They differ from state to state. A child with a cold may not attend its kindergarten unless a doctor declared it to be free from influenza. Similar regulations are implemented at schools. Handsanitation is stressed and coughing nettiquette.

Public health departments are stressed because they are understaffed and overloaded with work.
Pandemic vaccines have been ordered, I think some 25 million doses. Health care workers are among the first to get vaccinations and person with health risks as well as their contacts. How the mass vaccination is going to be organized is still a matter of debate. Still not completely settled is the question of who pays for the vaccinations. Govermental health insurance companies must pay for the first 35 million members who want to get a flu shot. Private health insurance companies pay for their members. And then?
The states and the federal government fight about payment for more people who might like to get a shot. Seniors might not need one because they could have some immunization from earlier pandemics. Most probably will not know.

Apart from these questions life is in general not troubled by swine flu. Even the world championships in Berlin have not caused - so far- a major jump in flu cases.

Why the overall flu situation is presently relatively calm and so different from the UK, I do not know.

Quite a few early cases were hospitalized, not for seriousness of disease but infection control.


82 million doses, that is (assuming two vaccinations per person) half the population. 40 million doses for a start, vaccinations will start in a few weeks. Everyone who wants can get a vaccine for free, priority for the first batches is given to: pregnant, healthcare personell and police and firemen and (just the non high risk groups get it later) people with severe underlying health problems.
No recommendation as of yet for vaccinating kids (that is mainly because of one adjuvant).


It differs locally, drills for pandemic vaccinations have been done years ago. Many vaccinations will be given by primary

No then. All covered.
Payment is the least of the problem.

Germany does not have governmental health insurance, it has tightly regulated state mandated insurances, hundred of them and fewer private ones.

It is completely settled who pays, the insurances pay for their members (government refunds parts of that to state mandated insurances and private insurances pay for it out of their own interest anyway. Insurances (all of them) pay up to one billion of the cost, the rest, if there is any is paid by government funds.


They always fight about funds.


Seniors is not a category specifically important as indeed no one knows and being in a risk group depends on other factors much more.


None of those are questions. The main problem at the moment is on the private office physician level as the information is "scientifically" correct but many details are not sorted (at least not in a checklist way that they prefer if in private pactise). There are no clear guidelines for what to do with pregnant women for example.

Patients are encouraged to call and doc visits them at home if they are probable cases (or the practise is large enough to keep them seperated). Hospitals usually have about 6 per day in the ambulance (probable, not confirmed ones) except for a few centers with lots of travellers arriving.
Hotlines of all kinds answer questions too.
Usually frequency of calls fuctuates with media attention (who would have thought) by tenfold.



I do not know either. All I know is that it is not a big subject and that we have a higher density of doc offices per population head and that there are not many serious cases.

HF,
Thanks for the detailed clarifications.
BJ

There are still a lot of differences in treating probable cases at a doctor`s office or an ER. I know a probable child case who could just walk into the ER and sit right next to the other paediatric cases. No separation was recommended.
In some paediatric practises the patient is treated in separate rooms or the paediatrician treats the probable case in the car waiting in the parking lot. In the early phase of the pandemic a few probable cases walked into the doctor`s office and when confirmed the office was closed for 8 days.

Presently, Germany reports a cumulative total of 16,116 swine flu infections. The daily reported case numbers are falling momentarily. But no long term trend should be derived from the receding cases.
One 35 year old patient is still treated in intensive care but is reported to be improving. So far he seems to be the only patient with very severe disease on the brink of death. THe RKI talks about a few more cases with more severe disease but did not give any details. A few patients were hospitalized, espcially in the beginnning of the pandemic. How severe their disease was, I do not know.
In the ECDC updates Germany has not reported any hospitalizations so far.

The general flu activity is still low and the beginning of school has so far not started more intensive flu spread.

The seasonal influenza vaccines have been distributed and one can could start on this vaccination round before the pandemic vaccine will be available for the recommanded group of persons later in fall.
Even though pandemic influenza seems to outcrowd seasonal flu, one never knows what will happen in the coming winter season. Thus I think will get the seasonal vax with its limitations.

google translated

Swine influenza virus was confirmed

Woman dies of 'super-infection'

A 36-year-old woman is possibly the first casualties of swine flu in
Be Germany. She died on Friday (25.09.09) from a severe viral infection
Eating in the University Hospital. The H1N1 pathogen was in the woman
identified.


Dangerous for patients at risk: the swine flu virus

The 36-year-old died, according to the hospital with acute multi-organ failure. Whether the
Swineflu virus was responsible for her death, are now more
Investigations revealed, "said a spokesman for the clinic in Essen.

After a protracted flu the 180 pound in a smoker was
Hospital and then had to come because of their poor health
be on a respirator.

Because of better treatment options she was in
The University Hospital has been relocated. During the investigation there were among other
Pathogens including the swine flu virus discovered. Should the virus to their death
be responsible, they would be the first Schweinegrippen victims in Germany.


Professor Hartmut Hengel from the Institute of Virology at the University of Dusseldorf
WDR.de told that there is already longer feared to have been statistically
was that there were also deaths in Germany. Having started with only young,
Healthy people who are infected, for example, on holiday with the virus,
reach the swine flu now assigned to subjects who have high-risk groups
could be. "Then too serious curves are predestined," said Hengel.

To date, there were, according to the Robert Koch Institute 150 deaths in Europe. The
Most of these people would have had pre-existing conditions and would therefore on
a particularly vulnerable risk group includes pregnant women, elderly, or
obese people.

Laumann wants rapid vaccination

In NRW, will soon begin the vaccination
In Germany, are known so far about 20,000 cases of swine flu, which shares
Robert Koch Institute on with. It had in the past weeks and months
already some serious cases of swine flu given. In general, running
infections after but mild. In a severe case was a few weeks ago
young man in Cologne, life-threatening illness. As with the now deceased wife
was with him the "baseline risk" exists, in any form of influenza difficult to
. ill Thus in Germany die each year from 8000 to 11,000
People Gripperkrankungen.

NRW-Health Minister Karl-Josef Laumann (CDU), expressed to the families of the dead
his condolences. He emphasized that the flu does not "lightly" to
take it. Once approved, the vaccine against the virus by verifiers
was to begin in NRW vaccination. Then you could also risk patients such as the
Deaths protect preemptively.

http://www.wdr.de/themen/gesundheit...tyle=gesundheit

google got that wrong, she was a 180 kg, or 360 pound women, so severely obese, plus a smoker.

Yes, thanks , I was too lazy to correct the machine-translation.

The woman definitely belonged to a riskgroup, even 3 riskgroups: Obese, Diabetes , Smoking. She died from multi organ failure and sceptic shock.

One could ask: would she have survived if she was healthy, not obese, no diabetes, no smoker, etc.

We don't know.

In Germany the number of in-country acquired swine influenza infections has increased, while the total number of new infections has continually decreased so far. Today the RKI reported 65 new infection of which 75% were acquired in Germany. The Institute will not differentiate anymore between ex-and in-country acquired infections.


Hard to say what will happen in the coming weeks, whether the numbers of infections will go up or else?

There were confirmed cases in my village weeks ago---these patients never made it to the statistics-- I checked the cases reported for my area (county) and they just didn´t show.

Hi LJay,

are you talking about rumours? Are there any facts and specifics ?

Whether the cases known are all reported to the RKI I do not know. The institute has itself some reservations about the number of cases.
Nevertheless, at the moment in my area people do not drop down like flies and and there were no school or class closure but only sporadic isolated cases. This might change and it maybe different in other regions of Germany.

Our doctor told me.

Will be interesting to see what will hit the finishing line first in Germany, the rise in swine flu cases or the pandemic vaccine distribution which is announced for the latter part of October.
Cases might slowly be on the rise but nothing definite yet. 481 new cases were reported to the RKI as of September 30.

Danke !

Source: http://www.bild.de/BILD/news/bild-e...t=10018284.html

SWINE FLU

Five-year-old German boy dies of virus

A five-year-old boy has died of swine flu in Germany. The youngster died of the H1N1 virus at the Schwabing Klinikum in Munich.

He had been weak from an underliying long-term health problem. He had also contracted a lung infection.

Doctors have been able to note traces of the swine flu virus in his blood, but how the boy contracted it is not yet known.

He had been held in isolation from the moment he arrived, and no other cases of the virus have appeared at the hospital.

thanks to Shiloh

In Germany the swine flu clinics will start at the end of October or the beginning of November. It`s a little different from state to state, I guess. The GPs are involved. My GP has set up certain weekdays for the swine flu clinic and you have to sign up in advance for a specific day to get the vaccination. The whole family intends to get the vaccination. ALso, paperwork will be involved. One has to sign that the GP has informed about the possible adverse effects and a special swine flu vaccination confirmation will be handed out.
But there is a great reluctance among the general population because of the contradictory reporting re the possible adverse effects. The fact that the army gets a different vaccine than the rest of the population heightens the nervousness among the populace.
The question which vaccine is suitable for pregnant women and small children has also not been settled satisfactorily.

The number of swine flu infections in Germany has been increasing over the last three weeks from 1860 confirmed cases three weeks ago to 3075 new cases two weeks ago (RKI). ) 90 percent are in-country infections. So the swine flu train is taking up speed in Germany.
Vaccinations have started for the public but each state has its own specific flu clinic offers.

Influenza A/H1N1 is on the rise in Germany and seasonal influenza is not (hardly) seen, though many other types of respiratory infections.
Nine persons died of the A/H1N1 disease in Germany.
Vaccine supplies seem to be unequally distributed in the 16 states and shortages are reported.

As far as I am aware in my state, I consider it a total organisational failure. Hospitals are vaccinating their staff and that is about it around here.
Guess I will have to gather my own group to share a batch of ten vaccinations and order it myself. As soon as pharmacies can order these small quantities.

We are capable to produce vaccine for other countries but not capable to distribute it efficiently within our own country. What a shame.

Since so far the pandemic has not had much consequences here and very few deaths and with all that discussion about the two different vaccine types, there are not many people eager to be vaccinated. And those who should be first in line to get vaccinated wonder how to and where. Argghhh

11 swine flu deaths reported so far;
vaccine chaos very much evident with high risk people not being top priority getting the jab (at least some);
As a prospective vaccinee you really have to inform yourself in quite an intensive manner to find a GP and/or pediatrician who vaccinates, some refuse. IMO too much red tape involved.

Mann nach Schweinegrippe-Impfung gestorben

Berlin (dpa) - Ein Mann aus Thüringen ist nach einer Schweinegrippe-Impfung gestorben. Wie die «Thüringer Allgemeine» berichtet, hatte sich der 55-Jährige aus Leinefelde im Eichsfeld am Donnerstag impfen lassen und starb in der Nacht. Thüringens Gesundheitsministerin Heike Taubert sagte dem Blatt, dass ein möglicher Zusammenhang mit der Impfung untersucht werde. Sie gehe davon aus, dass eine Obduktion vorgenommen wird. Über Vorerkrankungen oder Unverträglichkeiten des Gestorbenen sei noch nichts bekannt.

(Erschienen: 15.11.2009 19:30)

http://www.szon.de/deutschland+welt...id,4011640.html

translation: a 55 year old man recieved the swine flu vaccine on Thursday and died that same night. Authorities are investigating.

20 swine flu fatalities in Germany

RP

27 acknowledged swine flu death/ 7 cases with no or unknown risk factors

RKI


For reasons I do not know, Germany does not send any information concerning the number of hospitalized or ICU patients to the European Centre for Disease Prevention and Control, though there are a lot of patients in the ICU departments fighting for their lives on ventilators. At the moment the numbers are increasing.
Federal problems, information deficits?

update 30 swine flu deaths