http://www.medicalnewstoday.com/articles/169254.php#at"A new study suggests that the 44,000 lab-confirmed cases of H1N1 swine flu in the US in the spring were just the tip of the iceberg and that up to 5.7 million Americans were actually infected with the virus.
The study was the work of Dr Carrie Reed from the US Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, and colleagues from the CDC and Harvard School of Public Health in Boston, Massachusetts, and is due to be published in the December print issue of Emerging Infectious Diseases, although an Epub ahead of print version was put online earlier this week.
Reed and colleagues used a modelling approach to work out what the likely prevalence of infection in the overall US population was likely to have been during the spring outbreak, based on the officially reported lab-confirmed and hospitalization cases.
Using this method they estimated there were between 1.8 to 5.7 million cases of swine flu, including between 9,000 and 21,000 hospitalizations, in the US in the period April to 23 July 2009.
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That's quite a range, but it's very difficult to assess.