Archive. ECDC: Pandemic Influenza H1N1 2009, Situation Updates (August 4 - December 31, 2009)

[Giuseppe]

Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

Pandemic (H1N1) 2009 Update 21 October 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 21 October 2009, 09:00 hours CEST



Main developments in past 24 hours

• Media reports of influenza infections in turkeys in Canada and in pigs Japan and minks in Denmark;
• First oseltamivir-resistant influenza A(H1N1)v strain identified in Taiwan;
• Outbreak study among US Air Force Academy cadets published;
• Total of 230 fatal cases in Europe and EFTA countries and 5 073 in the rest of the world. have been reported up to date.

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases, as of 20 October 2009 16:00 hours CEST, for the world, and 21 October 09:00 hours CEST, for Europe is presented in Table 2.

New developments


Media reports of influenza A(H1N1) infections in farmed turkeys in Ontario, Canada, a farmed pig in Osaka, Japan.


Media reports also of influenza A(H3N2) infections among farmed minks in Denmark. According to reports, No human cases have been associated with these outbreaks.

The first oseltamivir-resistant strain of influenza A(H1N1)v was detected in Taiwan, according to local media reports.


A study describing an early outbreak of pandemic influenza among U.S. airforce cadets was published in the American Journal of Preventive Medicine. Full article (with subscription) available at: LINK


Epidemiologic update


All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 230 deaths have been reported; the information is available in Table 2. The latest available updates as of October 20, 2009, at 16:00, on new and on confirmed fatal pandemic (H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.


Daily Update contents


ECDC has now stopped publishing numbers of confirmed cases reported from EU/EFTA member states ? as well as from other countries around the world ? in its Daily Update. This is due to the fact that most European countries are now recommending laboratory confirmation only in certain population groups, such as the risk groups.


The World Health Organization has also recommended that countries verify only the first few hundred cases; after that exhaustive sampling is not recommended any more. We will continue to monitor the evolution of the pandemic within Europe mirrored by the number of fatal cases by country and through the Weekly Influenza Surveillance Overview which is published on Fridays. For the countries outside of Europe, we will monitor the number of fatal cases by country and monitor the surveillance reports of selected non-European countries.


It must be emphasized that the numbers of fatal cases per country associated with pandemic influenza are likely to be gross underestimates. Access to healthcare, the quality of the laboratory network in the country, the quality of the surveillance system and the case definition used for identifying fatal cases all affect these figures and will vary from country to country.


Daily Updates will be produced by 09:00hrs every morning Monday to Friday. No updates will be produced during weekends and the Daily Update published on Monday includes the weekend?s information.
The production cycle will be reviewed as needed.


Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 21 October 2009, 09:00 hours (CEST) in the EU and EFTA countries


[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (16.10.) ? ? ? ? ? ? ? ?
2. Belgium (16.10.) ? ? ? ? ? ? ? ?
3. Bulgaria ? ? ? ? ? ? ? ?
4. Cyprus ? ? ? ? ? ? ? ?
5. Czech Republic (15.10.) ? ? ? ? ? ? ? ?
6. Denmark (14.10.) ? ? ? ? ? ? ? ?
7. Estonia (04.09.) ? 0 ? 0 ? 0 ? 0
8. Finland (14.10.) ? ? ? ? ? ? ? ?
9. France (14.10.) ? 34 ? 247 ? 5 ? 30
10. Germany (14.10.) ? ? ? ? ? ? ? ?
11. Greece (14.10.) ? ? ? ? ? ? ? ?
12. Hungary (19.09.) ? ? - 32 ? ? ? ?
13. Iceland (19.10.) ? 26 ? 60 - 4 ? ?
14. Ireland (15.10.) ? 22 - 265 ? ? ? 24
15. Italy (14.10) ? ? - 1155 ? ? ? ?
16. Latvia (13.08.) ? ? - 1 ? ? ? ?
17. Liechtenstein (15.10.) ? ? ? ? ? ? ? ?
18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
19. Luxembourg (02.10.) ? ? ? ? - 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? 1
21. Netherlands (16.10.) ? 24 ? 151 ? 4 ? 23
22. Norway (15.10.) ? 4 ? 101 ? 1 ? 18
23. Poland (14.10.) ? ? ? ? ? ? ? ?
24. Portugal (14.10.) - 20 ? ? - 4 ? ?
25. Romania (19.10) ? ? ? ? ? ? ? ?
26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (09.10.) ? ? - 303 ? ? ? 137
29. Sweden (15.10.) ? 5 - 127 ? ? ? ?
30. Switzerland (15.10.) ? ? - 23 ? ? - 2
31. United Kingdom (a) (15.10.) - 363 ? ? - 74 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.


(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (272 cumulative hospitalisations), Wales (193) and Northern Ireland (280).


Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 21 October 2009, 09:00 hours CEST, and in the rest of the world by country, as of 20 October 2009, 16:00 hours CEST.


[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Belgium ? ? 5
  • Bulgaria ? ? 1
  • France ? ? 32 (a)
  • Germany ? ? 2
  • Greece ? ? 3
  • Hungary ? ? 4
  • Iceland ? ? 1
  • Ireland 1 ? 5
  • Italy ? ? 4
  • Luxembourg ? ? 1
  • Malta ? ? 3
  • Netherlands ? ? 4
  • Norway ? ? 7
  • Portugal ? ? 3
  • Spain ? ? 45
  • Sweden ? ? 2
  • United Kingdom 1 ? 108
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • No deaths reported ? ? ? ?
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Bahrain ? ? 6
  • Egypt ? ? 3
  • Iran ? ? 10
  • Iraq ? ? 2
  • Israel ? ? 32
  • Jordan ? ? 1
  • Kuwait ? ? 10
  • Lebanon ? ? 2
  • Occupied Palestinian Territory ? ? 1
  • Oman ? ? 23
  • Qatar ? ? 3
  • Saudi Arabia ? ? 36
  • Syria ? ? 2
  • United Arab Emirates ? - 6
  • Yemen ? ? 13
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 1
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • South Africa ? ? 91
  • Sudan 1 ? 1
  • Tanzania ? ? 1
• NORTH AMERICA
  
  • Canada ? ? 80
  • Mexico ? ? 260
  • USA ? ? 593
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 38
  • Cuba ? ? 7
  • Dominican Republic ? ? 22
  • El Salvador 2 ? 22
  • Guatemala ? ? 13
  • Honduras ? ? 16
  • Jamaica ? ? 5
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 4
• SOUTH AMERICA
  
  • Argentina ? ? 580
  • Bolivia ? ? 56
  • Brazil 469 ? 1368
  • Chile ? ? 134
  • Colombia ? ? 111
  • Ecuador ? ? 70
  • Paraguay ? ? 52
  • Peru ? ? 162
  • Uruguay ? ? 33
  • Venezuela ? ? 91
• NORTH-EAST & SOUTH ASIA
  
  • Bangladesh ? ? 5
  • China (Mainland) ? ? 2
  • Hong Kong SAR China ? ? 32
  • India 2 ? 415
  • Japan ? ? 27
  • Macao SAR China ? ? 1
  • South Korea 2 ? 20
  • Taiwan ? ? 24
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 3
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 28
  • Singapore ? ? 18
  • Thailand ? ? 170
  • Vietnam ? ? 24
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 185
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 18
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
• TOTAL 478 ? 5303

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 1 in Mayotte and 7 in mainland France.
(?)
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[Giuseppe]

Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

Pandemic (H1N1) 2009 Update 22 October 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 22 October 2009, 09:00 hours CEST



Main developments in past 24 hours

• ECDC review of US post-mortem findings of bacterial pulmonary infections published;
• Total of 238 fatal cases in Europe and EFTA countries and 5 097 in the rest of the world have been reported up to date.

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases, as of 21 October 2009 16:00 hours CEST, for the world, and 22 October 09:00 hours CEST, for Europe is presented in Table 2.


Scientific Advice

Scientific Advance on bacterial pulmonary infections found post-mortem among Pandemic A(H1N1) influenza deaths in the U.S. published.


Bacterial pulmonary co-infections were found in a substantial proportion of autopsy specimens examined by the U.S. Centers for Disease Control and Prevention over a four-month period at the beginning of the pandemic in the U.S. Respiratory specimens (i.e., lung, trachea, and large-airway specimens) collected at autopsy from people who died with Pandemic A(H1N1) influenza infection were submitted to CDC by medical examiners, hospitals, and local and state health departments for additional evaluation.


A variety of microscopic and molecular methods were used to identify bacteria which found S. pneumoniae, S. pyogenes, S. aureus, Streptococcus mitis, and H. influenzae; four cases involved multiple pathogens.


Full ECDC review available at: LINK


Epidemiologic update


All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 238 deaths have been reported; the information is available in Table 2. The latest available updates as of October 21, 2009, at 16:00, on new and on confirmed fatal pandemic (H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.


Daily Update contents


ECDC has now stopped publishing numbers of confirmed cases reported from EU/EFTA member states ? as well as from other countries around the world ? in its Daily Update. This is due to the fact that most European countries are now recommending laboratory confirmation only in certain population groups, such as the risk groups.


The World Health Organization has also recommended that countries verify only the first few hundred cases; after that exhaustive sampling is not recommended any more. We will continue to monitor the evolution of the pandemic within Europe mirrored by the number of fatal cases by country and through the Weekly Influenza Surveillance Overview which is published on Fridays. For the countries outside of Europe, we will monitor the number of fatal cases by country and monitor the surveillance reports of selected non-European countries.


It must be emphasized that the numbers of fatal cases per country associated with pandemic influenza are likely to be gross underestimates. Access to healthcare, the quality of the laboratory network in the country, the quality of the surveillance system and the case definition used for identifying fatal cases all affect these figures and will vary from country to country.


Daily Updates will be produced by 09:00hrs every morning Monday to Friday. No updates will be produced during weekends and the Daily Update published on Monday includes the weekend?s information. The production cycle will be reviewed as needed.


Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 22 October 2009, 09:00 hours (CEST) in the EU and EFTA countries


[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (16.10.) ? ? ? ? ? ? ? ?
2. Belgium (16.10.) ? ? ? ? ? ? ? ?
3. Bulgaria ? ? ? ? ? ? ? ?
4. Cyprus ? ? ? ? ? ? ? ?
5. Czech Republic (15.10.) ? ? ? ? ? ? ? ?
6. Denmark (14.10.) ? ? ? ? ? ? ? ?
7. Estonia (04.09.) ? 0 ? 0 ? 0 ? 0
8. Finland (20.10.) ? ? ? ? ? ? ? ?
9. France (20.10.) ? 37 ? 317 ? 13 ? 43
10. Germany (14.10.) ? ? ? ? ? ? ? ?
11. Greece (14.10.) ? ? ? ? ? ? ? ?
12. Hungary (19.09.) ? ? - 32 ? ? ? ?
13. Iceland (19.10.) ? 26 ? 60 - 4 ? ?
14. Ireland (15.10.) ? 22 - 265 ? ? ? 24
15. Italy (14.10) ? ? - 1155 ? ? ? ?
16. Latvia (13.08.) ? ? - 1 ? ? ? ?
17. Liechtenstein (21.10.) ? ? ? ? ? ? ? ?
18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? - 1
21. Netherlands (16.10.) ? 24 ? 151 ? 4 ? 23
22. Norway (15.10.) ? 4 ? 101 ? 1 ? 18
23. Poland (14.10.) ? ? ? ? ? ? ? ?
24. Portugal (21.10.) - 15 ? ? - 2 ? ?
25. Romania (19.10) ? ? ? ? ? ? ? ?
26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (09.10.) ? ? - 303 ? ? - 137
29. Sweden (15.10.) ? 5 - 127 ? ? ? ?
30. Switzerland (15.10.) ? ? - 24 ? ? - 3
31. United Kingdom (a) (15.10.) - 363 ? ? - 74 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.


(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (272 cumulative hospitalisations), Wales (193) and Northern Ireland (280).


Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 22 October 2009, 09:00 hours CEST, and in the rest of the world by country, as of 21 October 2009, 16:00 hours CEST.


[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Belgium ? ? 5
  • Bulgaria ? ? 1
  • France 4 ? 36 (a)
  • Germany ? ? 2
  • Greece ? ? 3
  • Hungary ? ? 4
  • Iceland ? ? 1
  • Ireland ? ? 5
  • Italy ? ? 4
  • Luxembourg ? ? 1
  • Malta 2 ? 5
  • Netherlands ? ? 4
  • Norway 1 ? 8
  • Portugal ? ? 3
  • Spain ? ? 45
  • Sweden ? ? 2
  • United Kingdom 1 ? 109
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • No deaths reported ? ? ? ?
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Bahrain ? ? 6
  • Egypt ? ? 3
  • Iran ? ? 10
  • Iraq ? ? 2
  • Israel ? ? 32
  • Jordan ? ? 1
  • Kuwait ? ? 10
  • Lebanon ? ? 2
  • Occupied Palestinian Territory ? ? 1
  • Oman ? ? 23
  • Qatar ? ? 3
  • Saudi Arabia ? ? 36
  • Syria ? ? 2
  • United Arab Emirates ? ? 6
  • Yemen ? ? 13
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 1
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • South Africa ? ? 91
  • Sudan ? ? 1
  • Tanzania ? ? 1
• NORTH AMERICA
  
  • Canada 3 ? 83
  • Mexico 11 ? 271
  • USA ? ? 593
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 38
  • Cuba ? ? 7
  • Dominican Republic ? ? 22
  • El Salvador ? ? 22
  • Guatemala ? ? 13
  • Honduras ? ? 16
  • Jamaica ? ? 5
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 4
• SOUTH AMERICA
  
  • Argentina ? ? 580
  • Bolivia ? ? 56
  • Brazil ? ? 1368
  • Chile ? ? 134
  • Colombia ? ? 111
  • Ecuador ? ? 70
  • Paraguay ? ? 52
  • Peru ? ? 162
  • Uruguay ? ? 33
  • Venezuela 2 ? 93
• NORTH-EAST & SOUTH ASIA
  
  • Bangladesh ? ? 5
  • China (Mainland) ? ? 2
  • Hong Kong SAR China ? ? 32
  • India 5 ? 420
  • Japan ? ? 27
  • Macao SAR China ? ? 1
  • South Korea ? ? 20
  • Taiwan 1 ? 25
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 3
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 28
  • Singapore ? ? 18
  • Thailand ? ? 170
  • Vietnam ? ? 24
• AUSTRALIA & PACIFIC
  
  • Australia 1 ? 186
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand 1 ? 19
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
• TOTAL 32 ? 5335

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 9 in mainland France.
(?)
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[Giuseppe]

Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

Pandemic (H1N1) 2009 Update 23 October 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 23 October 2009, 09:00 hours CEST



Main developments in past 24 hours

• Weekly Influenza Surveillance Overview to be published today;
• Eurosurveillance updates published;
• Total of 269 fatal cases in Europe and EFTA countries and 5 113 in the rest of the world have been reported up to date.

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases, as of 22 October 2009 16:00 hours CEST, for the world, and 23 October 09:00 hours CEST, for Europe is presented in Table 2.


Weekly Influenza Surveillance Overview


The ECDC Weekly Influenza Surveillance Overview will be published this afternoon and will be available at: LINK


Eurosurveillance updates


Eurosurveillance published this week a special issue on the development of the pandemic H1N1 influenza in the southern hemisphere which includes an editorial written by MG Baker, H Kelly, and N Wilson. This editorial highlights some of the key findings in the articles from Australia, South Africa, Peru, Brazil and R?union Island, reviews features of pandemic H1N1 influenza epidemiology in these countries, and lists some potential lessons for the northern hemisphere (and possible future waves in the southern hemisphere). LINK


In their editorial, the authors summarise the articles in the special issue as follows:


Investigators from R?union Island (located near Madagascar in the Indian Ocean) used data from multiple surveillance systems, including influenza-like illness (ILI) reports by sentinel practitioners, virological surveillance, surveillance of hospital emergency departments and intensive care units (ICUs), and fatal cases attributed to influenza A(H1N1) infection.


The introduction of the pandemic virus happened later than in other southern hemisphere countries with community transmission not documented until 23 July 2009. The pandemic virus became the predominant circulating influenza virus on R?union within four weeks following its first detection. LINK


The paper from South Africa provides one of the first reports on the pandemic from an African country. It is based on a descriptive analysis of the national epidemiology of the H1N1 pandemic, focussing on laboratory-confirmed cases and deaths. Surveillance included multiple systems and an expected shift in focus as the pandemic progressed. The final analysis was based on a large number of laboratory-confirmed cases (12,331) including 91 deaths. Of particular note was the high proportion of fatal cases who were human immunodeficiency virus (HIV)-positive (53% based on 17/32 tested, against a background HIV prevalence of 18% in 15-49 year-old adults) and pregnant (56%, based on 25/45 women of reproductive age). LINK


Assessment of the pandemic in Brazil was based on surveillance of notified influenza cases and later ILI cases with severe acute respiratory infection (SARI). Reflecting its large population, Brazil reported 34,506 cases of ILI with SARI, although only 16.7% were laboratory-confirmed as pandemic influenza. There were 1,567 recorded deaths among SARI cases, including 645 with confirmed pandemic influenza. The age distribution of cases (peaks in the under five year-olds and in adults 20-29 years, with lower rates in the over 60 year-olds) was similar to that seen in higher income countries such as Australia and New Zealand. Severe illness was associated with pregnancy and a range of co-morbidities (notably chronic lower respiratory and metabolic diseases). The authors also noted marked geographic variations with cases concentred in southern and south-eastern Brazil, regions with more temperate climates bordering other affected South American countries. LINK


Description of the pandemic in Peru was based on established sentinel ILI and virological surveillance of influenza, surveillance of SARI, acute respiratory infection (ARI) and pneumonia, and additional case and cluster investigation. Peru reported 8,381 confirmed cases including 143 fatalities. Most fatal cases (75.5%) had an identified co-morbidity, notably metabolic, cardiovascular or respiratory disease. LINK


This edition includes three separate reports from Australia. Investigators from New South Wales (NSW) provide perhaps the most comprehensive description of the pandemic using multiple surveillance systems (including use of novel systems such as ambulance despatch data and web-based systems for capturing attendances at specialist influenza clinics and ICU utilisation). The pandemic there lasted 10 weeks and had a substantial impact on ICUs, with an increased risk of severe illness, including respiratory failure, in those aged between 35 and 60 years. As seen elsewhere, vulnerable groups included pregnant women, indigenous people (Aboriginal or Torres Strait Islanders), those with chronic respiratory disease, and those with morbid obesity. However, the general influenza-related mortality and overall mortality between April and September 2009 was lower than that seen during the same period in recent years. LINK


Although commencing earlier, the pandemic in Victoria followed a similar epidemic pattern to NSW, based on a general practitioner sentinel surveillance system and notifications of laboratory-confirmed influenza. Peak ILI rates were comparable in magnitude to several previous years. Understanding of the Victorian experience has been strengthened by an accompanying paper which estimates the reproduction number (R) during the epidemic in that state. After accounting for undetected transmission, the authors estimate R at 1.6 (95% credible interval: 1.5-1.8). LINK, LINK


The final paper is focussed on the impact of the pandemic on indigenous people, rather than on a specific geographic area. From the southern hemisphere, this analysis included indigenous people in Brazil (Amerindians), Australia (Aborigines and Torres Straits Islanders), New Zealand (Māori and Pacific peoples), and the Pacific (Polynesians, Melanesians). It also included indigenous people in the northern hemisphere, notably in Canada and the United States. In all of these countries indigenous peoples experienced significantly elevated risks of serious infection, with hospitalisation and mortality rates that were three to seven times higher than those reported for non-indigenous populations. LINK


Epidemiologic update


All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 269 deaths have been reported; the information is available in Table 2. The latest available updates as of October 22, 2009, at 16:00, on new and on confirmed fatal pandemic (H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.


Daily Update contents


ECDC has now stopped publishing numbers of confirmed cases reported from EU/EFTA member states ? as well as from other countries around the world ? in its Daily Update. This is due to the fact that most European countries are now recommending laboratory confirmation only in certain population groups, such as the risk groups.


The World Health Organization has also recommended that countries verify only the first few hundred cases; after that exhaustive sampling is not recommended any more. We will continue to monitor the evolution of the pandemic within Europe mirrored by the number of fatal cases by country and through the Weekly Influenza Surveillance Overview which is published on Fridays. For the countries outside of Europe, we will monitor the number of fatal cases by country and monitor the surveillance reports of selected non-European countries.


It must be emphasized that the numbers of fatal cases per country associated with pandemic influenza are likely to be gross underestimates. Access to healthcare, the quality of the laboratory network in the country, the quality of the surveillance system and the case definition used for identifying fatal cases all affect these figures and will vary from country to country.


Daily Updates will be produced by 09:00hrs every morning Monday to Friday. No updates will be produced during weekends and the Daily Update published on Monday includes the weekend?s information. The production cycle will be reviewed as needed.


Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 23 October 2009, 09:00 hours (CEST) in the EU and EFTA countries


[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (16.10.) ? ? ? ? ? ? ? ?
2. Belgium (16.10.) ? ? ? ? ? ? ? ?
3. Bulgaria ? ? ? ? ? ? ? ?
4. Cyprus ? ? ? ? ? ? ? ?
5. Czech Republic (15.10.) ? ? ? ? ? ? ? ?
6. Denmark (21.10.) ? ? ? ? ? ? ? ?
7. Estonia (04.09.) ? 0 ? 0 ? 0 ? 0
8. Finland (20.10.) ? ? ? ? ? ? ? ?
9. France (20.10.) ? 37 ? 317 ? 13 ? 43
10. Germany (14.10.) ? ? ? ? ? ? ? ?
11. Greece (21.10.) ? ? ? ? ? ? ? ?
12. Hungary (22.10.) ? ? ? ? ? ? ? ?
13. Iceland (19.10.) ? 26 ? 60 - 4 ? ?
14. Ireland (18.10.) ? ? - 325 ? ? ? 26
15. Italy (18.10) ? ? - 1494 ? ? ? ?
16. Latvia (13.08.) ? ? - 1 ? ? ? ?
17. Liechtenstein (21.10.) ? ? ? ? ? ? ? ?
18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (16.10.) ? 24 ? 151 ? 4 ? 23
22. Norway (15.10.) ? 4 ? 101 ? 1 ? 18
23. Poland (14.10.) ? ? ? ? ? ? ? ?
24. Portugal (21.10.) - 15 ? ? - 2 ? ?
25. Romania (19.10) ? ? ? ? ? ? ? ?
26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (22.10.) ? ? - 303 ? ? - 137
29. Sweden (22.10.) ? 13 - 145 ? ? ? ?
30. Switzerland (21.10.) ? ? - 24 ? ? - 3
31. United Kingdom (a) (22.10.) - 506 ? ? - 99 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (380 cumulative hospitalisations), Wales (126) and Northern Ireland (346).


Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 23 October 2009, 09:00 hours CEST, and in the rest of the world by country, as of 22 October 2009, 16:00 hours CEST.


[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Belgium ? ? 5
  • Bulgaria ? ? 1
  • France ? ? 36 (a)
  • Germany ? ? 2
  • Greece ? ? 3
  • Hungary ? ? 4
  • Iceland ? ? 1
  • Ireland 3 ? 8
  • Italy ? ? 4
  • Luxembourg ? ? 1
  • Malta ? ? 5
  • Netherlands ? ? 4
  • Norway ? ? 8
  • Portugal ? ? 3
  • Spain 9 ? 54
  • Sweden ? ? 2
  • United Kingdom 19 ? 128
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Serbia 1 ? 1
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Bahrain ? ? 6
  • Egypt ? ? 3
  • Iran ? ? 10
  • Iraq ? ? 2
  • Israel ? ? 32
  • Jordan 1 ? 2
  • Kuwait ? ? 10
  • Lebanon ? ? 2
  • Occupied Palestinian Territory ? ? 1
  • Oman ? ? 23
  • Qatar ? ? 3
  • Saudi Arabia ? ? 36
  • Syria ? ? 2
  • United Arab Emirates ? ? 6
  • Yemen ? ? 13
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 1
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • South Africa ? ? 91
  • Sudan ? ? 1
  • Tanzania ? ? 1
• NORTH AMERICA
  
  • Canada ? ? 83
  • Mexico ? ? 271
  • USA ? ? 593
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 38
  • Cuba ? ? 7
  • Dominican Republic ? ? 22
  • El Salvador ? ? 22
  • Guatemala ? ? 13
  • Honduras ? ? 16
  • Jamaica ? ? 5
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 4
• SOUTH AMERICA
  
  • Argentina ? ? 580
  • Bolivia ? ? 56
  • Brazil ? ? 1368
  • Chile ? ? 134
  • Colombia ? ? 111
  • Ecuador ? ? 70
  • Paraguay ? ? 52
  • Peru ? ? 162
  • Uruguay ? ? 33
  • Venezuela ? ? 93
• NORTH-EAST & SOUTH ASIA
  
  • Bangladesh ? ? 5
  • China (Mainland) ? ? 2
  • Hong Kong SAR China 1 ? 33
  • India 7 ? 427
  • Japan ? ? 27
  • Macao SAR China ? ? 1
  • South Korea ? ? 20
  • Taiwan ? ? 25
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 3
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 28
  • Singapore ? ? 18
  • Thailand 6 ? 176
  • Vietnam ? ? 24
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 186
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 19
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
• TOTAL 47 ? 5382

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 9 in mainland France.
(?)
-
------

[Giuseppe]

Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

Pandemic (H1N1) 2009 Update 26 October 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 26 October 2009, 09:00 hours CEST



Main developments in past 72 hours

• Weekly overview of non-EU countrie included;
• EMEA maintains recommendation of two doses for pandemic vaccine;
• Isolated oseltamivir-resistant influenza A(H1N1)v strain identified in Hong Kong
• Total of 274 fatal cases in Europe and EFTA countries and 5 576 in the rest of the world have been reported up to date.

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases, as of 25 October 2009 16:00 hours CEST, for the world, and 26 October 09:00 hours CEST, for Europe is presented in Table 2.


Weekly overview of selected non-EU countries

Introduction


A special section on the evolution of the pandemic influenza H1N1 2009 in selected countries outside Europe is being published in the Daily Update on Mondays. On Tuesdays, a review of the situation in USA and Canada is published. The objective of this section is to provide the interested public and professional audience with an easy to access and concise source of information to get an impression on global trends of the H1N1 pandemic.



The contents are mainly based on national surveillance reports or pandemic updates, but may also contain information from media or other public sources.


The countries have been selected on the following criteria:

• They have experienced the 2009 winter influenza season,
• they represent different geographical regions,
• they have adequately large population sizes and
• they have accessible and reliable public-health data.

Global Update


According to the latest pandemic update from the World Health Organization, there have been more than 414 000 laboratory confirmed cases and nearly 5000 deaths reported to the organization globally. Many countries have now stopped counting individual cases, therefore this figure is a gross underestimate.


In general, influenza activity in the northern hemisphere is unchanged from last week, though respiratory disease activity continues to spread and increase in intensity. In tropical areas of the world, rates of illness are generally declining and the temperate region of the southern hemisphere has no significant pandemic activity.


The WHO Pandemic (H1N1) 2009 situation update is available at: LINK


Chile (pop 16.6 million)


The number of pandemic influenza cases reported weekly to the national level decreased since week 28 and have been at low levels since week 30.



Only three confirmed cases of pandemic influenza were reported during week 41. Until 21st October, the number of confirmed cases was 12 257, out of which 1 590 presented with Severe Acute Respiratory Illness (SARI).



The majority of SARI cases were infants (75.7/100 000 pop.) or children between 1-4 years of age (16.6/100 000 pop.). Approximately half (53%) of SARI cases had a chronic underlying illness. Out of the confirmed cases 135 have had a fatal outcome associated with pandemic influenza. The majority (69.1%) of the fatal cases had an underlying illness. The majority of influenza strains identified until week 34 were A(H1N1)v and less than 0.5% were identified as seasonal H1 or H3 strains. Very few influenza viruses were identified through surveillance activities during week 41.


The Chilean surveillance report is available at: LINK, LINK


Brazil (pop. 192 million)


No update identified for this week


Since the beginning of the pandemic until week 36, 46 810 Severe Acute Respiratory Illness (SARI) cases were notified in Brazil, of which 9 249 were subsequently laboratory-confirmed as influenza A (H1N1)v infections.



Underlying risk-factors were reported for 37.4% of the confirmed SARI cases. The number of confirmed cases as well as ILI cases appears to have been decreasing for the last four weeks. Of the confirmed SARI cases, 899 (9.7%) have had a fatal outcome. Mortality due to SARI cases with confirmed influenza A (H1N1)v is currently 0,47/100.000 inhabitants.



Out of the 9 249 SARI cases linked to influenza A (H1N1)v, 37.7% presented with at least one of risk factor (including pregnancy), which does not significantly differ from what is observed for seasonal influenza in the country. Among SARI cases in fertile age 24.3% were pregnant, which does not differ from what is observed with seasonal influenza (16.8%). Out of 18 257 PCR tests conducted up to week 36, 70.1% tested positive for influenza A (H1N1)v. This proportion has not changed much in the last four weeks, although the number of samples being collected is decreasing rapidly.


For entire epidemiological update for week 36 (Portuguese) see: LINK


H1N1 website of the ministry of health: LINK


A recent report on notified SARI cases can be found at: LINK


Australia (pop. 20.7 million)


As of 26 October, Australia has confirmed 37 039 cases. The number of deaths remains at 186. Of these deaths four were pregnant women and 12.9% were of indigenous ethnic origin. Around 2.5% of the Australian population consider themselves indigenous. In the week preceding the report, 11 cases have been newly hospitalised, and one of those were admitted to Intensive Care Units. The cumulative number of hospitalizations since the beginning of the pandemic is 4 904.


Australian Government-Department of Health and Ageing LINK


Australia Influenza Surveillance reports can be found at: LINK


A recent report on critically ill patients in Australia and New Zealand can be found at: LINK


New Zealand (pop. 4.2 million)


The latest surveillance report of week 42 (5-11 Oct) indicates a slight increase in ILI consultation rates from the sentinel surveillance system, however overall the rates remain below the baseline level of 50 consultations per 100 000 persons. It remains highest among children and teenagers aged 0 ? 19 years. Up to 18th October, a total of 4875 influenza viruses have been reported during this season. Very few influenza viruses were reported during week 42. The pandemic influenza (H1N1) 09 has become the predominant strain among all influenza viruses from sentinel surveillance.


NZ Sentinel surveillance report is at: LINK


A recent report on critically ill patients in Australia and New Zealand can be found at: LINK


South Africa (pop. 48.6 million)


As of 20th October, South Africa has confirmed 12 378 cases of pandemic (H1N1) 09. The number of deaths related to the pandemic remains at 91, and has not increased since the last report. The epidemic curve shows a marked decline of reported cases since end of August, and no further deaths have been reported since end September.


South African surveillance report available at: LINK


A recent report on fatal cases from South Africa can be found at: LINK


Other updates

EMEA maintains recommendation of two doses for pandemic vaccine


On Friday, the European Medicines Agency?s Committee for Medicinal Products for Human Use (CHMP) reviewed early data from clinical studies for the three authorised pandemic vaccines, Celvapan, Focetria and Pandemrix. The Committee concluded to maintain the recommendation it adopted in September, namely that the three vaccines be preferably given as two doses, at least three weeks apart. The data currently available for Pandemrix and for Focetria indicate that one dose may be sufficient in adults, but are too limited to allow the Committee to recommend the general use of a single-dose vaccination schedule.


More information is available in the EMEA Questions& Answers document: LINK


Tamiflu-resistant strain identified in Hong Kong


An isolated oseltamivir influenza A(H1N1)v strain was identified in a specimen from a 16-year old girl in Hong Kong. No related cases have been identified. This was the 4th case identified in Hong Kong.


Epidemiologic update


All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 274 deaths have been reported; the information is available in Table 2. The latest available updates as of October 25, 2009, at 16:00, on new and on confirmed fatal pandemic (H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.


Daily Update contents


ECDC has now stopped publishing numbers of confirmed cases reported from EU/EFTA member states ? as well as from other countries around the world ? in its Daily Update. This is due to the fact that most European countries are now recommending laboratory confirmation only in certain population groups, such as the risk groups.


The World Health Organization has also recommended that countries verify only the first few hundred cases; after that exhaustive sampling is not recommended any more. We will continue to monitor the evolution of the pandemic within Europe mirrored by the number of fatal cases by country and through the Weekly Influenza Surveillance Overview which is published on Fridays. For the countries outside of Europe, we will monitor the number of fatal cases by country and monitor the surveillance reports of selected non-European countries.


It must be emphasized that the numbers of fatal cases per country associated with pandemic influenza are likely to be gross underestimates. Access to healthcare, the quality of the laboratory network in the country, the quality of the surveillance system and the case definition used for identifying fatal cases all affect these figures and will vary from country to country.


Daily Updates will be produced by 09:00hrs every morning Monday to Friday. No updates will be produced during weekends and the Daily Update published on Monday includes the weekend?s information. The production cycle will be reviewed as needed.


Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 26 October 2009, 09:00 hours (CEST) in the EU and EFTA countries


[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (16.10.) ? ? ? ? ? ? ? ?
2. Belgium (16.10.) ? ? ? ? ? ? ? ?
3. Bulgaria ? ? ? ? ? ? ? ?
4. Cyprus ? ? ? ? ? ? ? ?
5. Czech Republic (15.10.) ? ? ? ? ? ? ? ?
6. Denmark (21.10.) ? ? ? ? ? ? ? ?
7. Estonia (23.10.) ? ? - 11 ? ? ? ?
8. Finland (20.10.) ? ? ? ? ? ? ? ?
9. France (20.10.) ? 37 ? 317 ? 13 ? 43
10. Germany (14.10.) ? ? ? ? ? ? ? ?
11. Greece (21.10.) ? ? ? ? ? ? ? ?
12. Hungary (22.10.) ? ? ? ? ? ? ? ?
13. Iceland (21.10.) ? 31 ? 80 - 6 ? ?
14. Ireland (18.10.) ? ? - 325 ? ? ? 26
15. Italy (18.10) ? ? - 1494 ? ? ? ?
16. Latvia (13.08.) ? ? - 1 ? ? ? ?
17. Liechtenstein (21.10.) ? ? ? ? ? ? ? ?
18. Lithuania (13.08.) ? ? ? ? ? ? ? ..
19. Luxembourg (21.10.) ? ? ? ? - 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (23.10.) ? 54 ? 205 ? 7 ? 31
22. Norway (22.10.) ? 15 ? 142 ? 4 ? 27
23. Poland (23.10.) ? ? ? ? ? ? ? ?
24. Portugal (21.10.) - 15 ? ? - 2 ? ?
25. Romania (19.10) ? ? ? ? ? ? ? ?
26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (22.10.) ? ? - 303 ? ? ? 137
29. Sweden (22.10.) ? 13 - 145 ? ? ? ?
30. Switzerland (21.10.) ? ? - 24 ? ? ? 3
31. United Kingdom (a) (22.10.) - 506 ? ? - 99 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.


(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (380 cumulative hospitalisations), Wales (126) and Northern Ireland (346).


Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 26 October 2009, 09:00 hours CEST, and in the rest of the world by country, as of 25 October 2009, 16:00 hours CEST.


[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Belgium ? ? 5
  • Bulgaria ? ? 1
  • France ? ? 36 (a)
  • Germany 1 ? 3
  • Greece ? ? 3
  • Hungary ? ? 4
  • Iceland ? ? 1
  • Ireland ? ? 8
  • Italy ? ? 4
  • Luxembourg ? ? 1
  • Malta ? ? 5
  • Netherlands 2 ? 6
  • Norway 2 ? 10
  • Portugal ? ? 3
  • Spain ? ? 54
  • Sweden ? ? 2
  • United Kingdom ? ? 128
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Serbia ? ? 1
  • Moldova 1 ? 1
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Bahrain ? ? 6
  • Egypt ? ? 3
  • Iran 6 ? 16
  • Iraq 1 ? 3
  • Israel ? ? 32
  • Jordan 1 ? 3
  • Kuwait ? ? 10
  • Lebanon ? ? 2
  • Occupied Palestinian Territory ? ? 1
  • Oman ? ? 23
  • Qatar ? ? 3
  • Saudi Arabia 3 ? 39
  • Syria ? ? 2
  • Turkey 1 ? 1
  • United Arab Emirates ? - 6
  • Yemen ? ? 13
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 1
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe 2 ? 2
  • South Africa ? ? 91
  • Sudan ? ? 1
  • Tanzania ? ? 1
• NORTH AMERICA
  
  • Canada 3 ? 86
  • Mexico 7 ? 278
  • USA (b) 411 ? 1004
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 38
  • Cuba ? ? 7
  • Dominican Republic ? ? 22
  • El Salvador ? ? 22
  • Guatemala ? ? 13
  • Honduras ? ? 16
  • Jamaica ? ? 5
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago 1 ? 5
• SOUTH AMERICA
  
  • Argentina 5 ? 585
  • Bolivia ? ? 56
  • Brazil ? ? 1368
  • Chile 2 ? 136
  • Colombia 7 ? 118
  • Ecuador ? ? 70
  • Paraguay ? ? 52
  • Peru ? ? 162
  • Uruguay ? ? 33
  • Venezuela ? - 93
• NORTH-EAST & SOUTH ASIA
  
  • Bangladesh 1 ? 6
  • China (Mainland) ? ? 2
  • Hong Kong SAR China ? ? 33
  • India 3 ? 430
  • Japan ? ? 27
  • Macao SAR China ? ? 1
  • Mongolia 1 ? 1
  • South Korea ? ? 20
  • Taiwan ? ? 25
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 3
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 28
  • Singapore ? ? 18
  • Thailand ? ? 176
  • Vietnam 7 ? 31
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 186
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 19
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
• TOTAL 468 ? 5850

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 9 in mainland France.
(b) Update today includes reported laboratory-confirmed influenza-associated U.S. fatal cases since August 1.
(?)
-
------

[Giuseppe]

Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

Pandemic (H1N1) 2009 Update 27 October 2009, 09:00 hours CEST (ECDC, edited)

[Source PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 27 October 2009, 09:00 hours CEST



Main developments in past 24 hours

• Total of 280 fatal cases in Europe and EFTA countries and 5 642 in the rest of the world have been reported up to date.
• Update from U.S.A. indicates ILI rates above threshold and pneumonia and influenza-related mortality above threshold level for season;

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases, as of 26 October 2009 16:00 hours CEST, for the world, and 27 October 09:00 hours CEST, for Europe is presented in Table 2.


Updates from U.S.A. and Canada

United States


Update Data as of 23 October 2009 16:00 CEST, for week ending 17 October, 2009 (Week 41)

Virology: 100% of all subtyped influenza A viruses reported to CDC were 2009 influenza A (H1N1) viruses. 99.8% of all specimens were type A and 0.2% were type B. 2009 influenza A (H1N1) viruses continue to be similar to the strain chosen for the vaccine. Since September 1, 2009, five infections with oseltamivir resistant 2009 influenza A (H1N1) viruses have been identified in the United States. The 5 cases represent an increase of one case over the previous week. Since the emergence of the 2009 influenza A (H1N1), all isolates tested have been resistant to the adamantanes (amantadine and rimantadine).

Mortality Surveillance:
Pneumonia and Influenza Hospitalization and Deaths: From August 30 ? October 17, 2009, 8,204 laboratory-confirmed influenza associated hospitalizations, 411 laboratory-confirmed influenza associated deaths, 21,823 pneumonia and influenza syndrome-based hospitalizations, and 2,416 pneumonia and influenza syndrome-based deaths, were reported to CDC.

Pneumonia and Influenza (P&I) Mortality Surveillance: During week 41, 6.9% of all deaths reported through the 122-Cities Mortality Reporting System were due to P&I. This percentage was above the epidemic threshold of 6.6% for week 41 and the percentage has been above the threshold for three weeks.

Influenza-associated Pediatric Deaths: Influenza-Associated Pediatric Mortality: Eleven influenza-associated pediatric deaths were reported to CDC during week 41. Nine of these deaths were associated with 2009 influenza A (H1N1) virus infection and two were associated with an influenza A virus for which the subtype is undetermined. These deaths occurred between 14 June and 10 October 2009. One death reported during week 41 occurred during the 2008-09 season. Since 30 August 2009, CDC has received 53 reports of influenza-associated pediatric deaths that occurred during the current influenza season (47 due to 2009 influenza A(H1N1) and 6 due to undetermined subtype influenza A). Among the 53 deaths in children, 32 children had specimens collected for bacterial culture from normally sterile sites and seven (21.9%) of the 32 were positive; Staphylococcus aureus was identified in five (71.4%) of the seven children. A total of 95 deaths in children associated with 2009 H1N1 virus have been reported to CDC.

Influenza-associated hospitalizations: Laboratory-confirmed influenza-associated hospitalizations are monitored in the U.S. using a population-based surveillance network comprising 10 Emerging Infections Program sites and 6 new sites. Laboratory-confirmed influenza-associated hospitalization rates were reported during 01 September ? 17 October 2009 (rates include influenza A, influenza B, and 2009 influenza A (H1N1)). Rates [EIP (new sites)] for children aged 0-4 years and 5-17 years were 1.9 (3.0) and 0.9 (1.6) per 10,000, respectively. Rates [EIP (new sites)] for adults aged 18-49 years, 50-64 years, and ≥ 65 years were 0.6 (0.6), 0.6 (0.6) and 0.5 (0.4) per 10,000, respectively.

Influenza-like Illness (ILI): Nationwide during week 41, 7.1% of patient visits reported through the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) were due to influenza-like illness (ILI). This percentage is above the national baseline of 2.3%. On a regional level, the percentage of outpatient visits for ILI ranged from 2.7% to 12.5% during week 41.

Geographic spread: Widespread influenza activity was reported by 46 states. Regional influenza activity was reported by Guam and three states. Local influenza activity was reported by the District of Columbia, Puerto Rico, and one state. The U.S. Virgin Islands did not report.

Other information: President Barack Obama declared the swine flu outbreak

a national emergency on 23 October, giving the Secretary of the Department of Health and Human Services the power to let hospitals move emergency rooms offsite to speed treatment and protect noninfected patients.


The 2009-2010 U.S. Influenza Season (for purposes of surveillance and reporting) began 4 October 2009.

• For more information: U.S. Centers for Disease Control and Prevention ?What's New on the H1N1 Flu Site? LINK
• U.S. Centers for Disease Control and Prevention Weekly Influenza Surveillance Report LINK
• Overview of Influenza Surveillance in the United States LINK

Canada


Update Data as of 23 October 2009, for week ending 17 October, 2009 (Week 41)

Virology: 99.9% of all subtyped influenza A viruses being reported to Public Health Agency of Canada (PHAC) were 2009 influenza A (H1N1) viruses. One type B was reported. The proportion of tests that were positive for influenza was 16.9% which was a significant increase to the previous week. 2009 influenza A (H1N1) viruses continue to be similar to the strain chosen for the vaccine. Of 2009 influenza A (H1N1) viruses tested by PHAC for resistance to neuraminidase inhibitors (oseltamivir and zanamivir) one were found resistant to oseltamivir.

Hospitalizations and Deaths: 64 hospitalizations and 3 deaths were reported for week 41.

Paediatric Influenza Hospitalizations and Deaths: No laboratory-confirmed influenza-associated paediatric hospitalizations or deaths were reported through the Immunization Monitoring Program Active (IMPACT) network.

Influenza-like Illness (ILI): The national ILI consultation rate increased to 48 consultations per 1,000 patient visits this week which was an increase for a fifth consecutive week and was above the expected range for this time of the year.

Geographic spread: Four regions reported widespread activity and 14 regions reported localized activity, while 23 regions reported sporadic activity and 13 regions reported no activity. 57 influenza outbreaks in schools and one outbreak in a long-term care facility were reported.

Other information: The Minister of Health announced on October 21, 2009, that Health Canada has approved AREPANRIX, a vaccine against the Pandemic (H1N1) 2009 virus.


For more information:

• Public Health Agency of Canada LINK
• Public Health Agency of Canada FluWatch LINK

Epidemiologic update


All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 280 deaths have been reported; the information is available in Table 2. The latest available updates as of October 26, 2009, at 16:00, on new and on confirmed fatal pandemic (H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.


Daily Update contents


ECDC has now stopped publishing numbers of confirmed cases reported from EU/EFTA member states ? as well as from other countries around the world ? in its Daily Update. This is due to the fact that most European countries are now recommending laboratory confirmation only in certain population groups, such as the risk groups.


The World Health Organization has also recommended that countries verify only the first few hundred cases; after that exhaustive sampling is not recommended any more. We will continue to monitor the evolution of the pandemic within Europe mirrored by the number of fatal cases by country and through the Weekly Influenza Surveillance Overview which is published on Fridays. For the countries outside of Europe, we will monitor the number of fatal cases by country and monitor the surveillance reports of selected non-European countries.


It must be emphasized that the numbers of fatal cases per country associated with pandemic influenza are likely to be gross underestimates. Access to healthcare, the quality of the laboratory network in the country, the quality of the surveillance system and the case definition used for identifying fatal cases all affect these figures and will vary from country to country.


Daily Updates will be produced by 09:00hrs every morning Monday to Friday. No updates will be produced during weekends and the Daily Update published on Monday includes the weekend?s information. The production cycle will be reviewed as needed.


Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 27 October 2009, 09:00 hours (CEST) in the EU and EFTA countries


[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (16.10.) ? ? ? ? ? ? ? ?
2. Belgium (16.10.) ? ? ? ? ? ? ? ?
3. Bulgaria ? ? ? ? ? ? ? ?
4. Cyprus ? ? ? ? ? ? ? ?
5. Czech Republic (15.10.) ? ? ? ? ? ? ? ?
6. Denmark (21.10.) ? ? ? ? ? ? ? ?
7. Estonia (23.10.) ? ? - 11 ? ? ? ?
8. Finland (26.10.) ? ? ? ? ? ? ? ?
9. France (20.10.) ? 37 ? 317 ? 13 ? 43
10. Germany (21.10.) ? ? ? ? ? ? ? ?
11. Greece (21.10.) ? ? ? ? ? ? ? ?
12. Hungary (22.10.) ? ? ? ? ? ? ? ?
13. Iceland (21.10.) ? 31 ? 80 - 6 ? ?
14. Ireland (18.10.) ? ? - 325 ? ? ? 26
15. Italy (18.10) ? ? - 1494 ? ? ? ?
16. Latvia (13.08.) ? ? - 1 ? ? ? ?
17. Liechtenstein (21.10.) ? ? ? ? ? ? ? ?
18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (23.10.) ? 54 ? 205 ? 7 ? 31
22. Norway (22.10.) ? 15 ? 142 ? 4 ? 27
23. Poland (23.10.) ? ? ? ? ? ? ? ..
24. Portugal (21.10.) - 15 ? ? - 2 ? ?
25. Romania (26.10) ? ? ? ? ? ? ? ?
26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (22.10.) ? ? - 303 ? ? ? 137
29. Sweden (22.10.) ? 13 - 145 ? ? ? ?
30. Switzerland (21.10.) ? ? - 24 ? ? ? 3
31. United Kingdom (a) (22.10.) - 506 ? ? - 99 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (380 cumulative hospitalisations), Wales (126) and Northern Ireland (346).


Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 27 October 2009, 09:00 hours CEST, and in the rest of the world by country, as of 26 October 2009, 16:00 hours CEST.


[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Belgium ? ? 5
  • Bulgaria ? ? 1
  • Czech Republic 1 ? 1
  • Finland 1 ? 1
  • France ? ? 36 (a)
  • Germany ? ? 3
  • Greece ? ? 3
  • Hungary ? ? 4
  • Iceland ? ? 1
  • Ireland 1 ? 9
  • Italy ? ? 4
  • Luxembourg ? ? 1
  • Malta ? ? 5
  • Netherlands ? ? 6
  • Norway 1 ? 11
  • Portugal ? ? 3
  • Spain ? ? 54
  • Sweden ? ? 2
  • United Kingdom 2 ? 130
    
    • Total 6 ? 280
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Serbia ? ? 1
  • Moldova ? ? 1
    
    • Total ? ? 2
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Bahrain ? ? 6
  • Egypt ? ? 3
  • Iran ? ? 16
  • Iraq 1 ? 4
  • Israel 2 ? 34
  • Jordan ? ? 3
  • Kuwait 2 ? 12
  • Lebanon 1 ? 3
  • Occupied Palestinian Territory ? - 1
  • Oman 1 ? 24
  • Qatar ? ? 3
  • Saudi Arabia ? ? 39
  • Syria ? ? 2
  • Turkey ? ? 1
  • United Arab Emirates ? ? 6
  • Yemen ? ? 13
    
    • Total 7 ? 170
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 1
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 91
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 108
• NORTH AMERICA
  
  • Canada ? ? 86
  • Mexico 36 ? 314
  • USA (b) ? ? 1004
    
    • Total 36 ? 1404
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 38
  • Cuba ? ? 7
  • Dominican Republic ? ? 22
  • El Salvador ? ? 22
  • Guatemala ? ? 13
  • Honduras ? ? 16
  • Jamaica ? ? 5
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? - 5
    
    • Total ? ? 161
• SOUTH AMERICA
  
  • Argentina ? ? 585
  • Bolivia ? ? 56
  • Brazil ? ? 1368
  • Chile ? ? 136
  • Colombia ? ? 118
  • Ecuador ? ? 70
  • Paraguay ? ? 52
  • Peru ? ? 162
  • Uruguay ? ? 33
  • Venezuela ? ? 93
    
    • Total ? ? 2673
• NORTH-EAST & SOUTH ASIA
  
  • Bangladesh ? ? 6
  • China (Mainland) 1 ? 3
  • Hong Kong SAR China ? ? 33
  • India 14 ? 444
  • Japan ? ? 27
  • Macao SAR China ? ? 1
  • Mongolia ? ? 1
  • South Korea 5 ? 25
  • Taiwan ? ? 25
    
    • Total 20 ? 565
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 3
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines 2 ? 30
  • Singapore ? ? 18
  • Thailand ? ? 176
  • Vietnam 1 ? 32
    
    • Total 3 ? 348
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 186
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? - 19
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 211
• TOTAL 72 ? 5922

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 9 in mainland France.
(b) Update today includes reported laboratory-confirmed influenza-associated U.S. fatal cases since August 1.
(?)
-
-------

[Giuseppe]

Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

Pandemic (H1N1) 2009 Update 28 October 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 28 October 2009, 09:00 hours CEST



Main developments in past 24 hours

• Total of 280 fatal cases in Europe and EFTA countries and 5 658 in the rest of the world have been reported up to date.

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases, as of 27 October 2009 16:00 hours CEST, for the world, and 28 October 09:00 hours CEST, for Europe is presented in Table 2.


Epidemiologic update


All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 280 deaths have been reported; the information is available in Table 2. The latest available updates as of October 27, 2009, at 16:00, on new and on confirmed fatal pandemic (H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.


Daily Update contents


ECDC has now stopped publishing numbers of confirmed cases reported from EU/EFTA member states ? as well as from other countries around the world ? in its Daily Update. This is due to the fact that most European countries are now recommending laboratory confirmation only in certain population groups, such as the risk groups.


The World Health Organization has also recommended that countries verify only the first few hundred cases; after that exhaustive sampling is not recommended any more. We will continue to monitor the evolution of the pandemic within Europe mirrored by the number of fatal cases by country and through the Weekly Influenza Surveillance Overview which is published on Fridays. For the countries outside of Europe, we will monitor the number of fatal cases by country and monitor the surveillance reports of selected non-European countries.


It must be emphasized that the numbers of fatal cases per country associated with pandemic influenza are likely to be gross underestimates. Access to healthcare, the quality of the laboratory network in the country, the quality of the surveillance system and the case definition used for identifying fatal cases all affect these figures and will vary from country to country.


Daily Updates will be produced by 09:00hrs every morning Monday to Friday. No updates will be produced during weekends and the Daily Update published on Monday includes the weekend?s information. The production cycle will be reviewed as needed.


Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 28 October 2009, 09:00 hours (CEST) in the EU and EFTA countries


[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (16.10.) ? ? ? ? ? ? ? ?
2. Belgium (16.10.) ? ? ? ? ? ? ? ?
3. Bulgaria ? ? ? ? ? ? ? ?
4. Cyprus ? ? ? ? ? ? ? ?
5. Czech Republic (15.10.) ? ? ? ? ? ? ? ?
6. Denmark (21.10.) ? ? ? ? ? ? ? ?
7. Estonia (23.10.) ? ? - 11 ? ? ? ?
8. Finland (26.10.) ? ? ? ? ? ? ? ?
9. France (20.10.) ? 37 ? 317 ? 13 ? 43
10. Germany (21.10.) ? ? ? ? ? ? ? ?
11. Greece (21.10.) ? ? ? ? ? ? ? ?
12. Hungary (22.10.) ? ? ? ? ? ? ? ?
13. Iceland (21.10.) ? 31 ? 80 - 6 ? ?
14. Ireland (18.10.) ? ? - 325 ? ? ? 26
15. Italy (18.10) ? ? - 1494 ? ? ? ?
16. Latvia (13.08.) ? ? - 1 ? ? ? ?
17. Liechtenstein (21.10.) ? ? ? ? ? ? ? ?
18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? - 1
21. Netherlands (23.10.) ? 54 ? 205 ? 7 ? 31
22. Norway (22.10.) ? 15 ? 142 ? 4 ? 27
23. Poland (27.10.) ? ? ? ? ? ? ? ?
24. Portugal (21.10.) - 15 ? ? - 2 ? ?
25. Romania (26.10) ? ? ? ? ? ? ? ?
26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (22.10.) ? ? - 303 ? ? ? 137
29. Sweden (22.10.) ? 13 - 145 ? ? ? ?
30. Switzerland (21.10.) ? ? - 24 ? ? ? 3
31. United Kingdom (a) (22.10.) - 506 ? ? - 99 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (380 cumulative hospitalisations), Wales (126) and Northern Ireland (346).


Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 28 October 2009, 09:00 hours CEST, and in the rest of the world by country, as of 27 October 2009, 16:00 hours CEST.


[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Belgium ? ? 5
  • Bulgaria ? ? 1
  • Czech Republic ? ? 1
  • Finland ? ? 1
  • France ? ? 36 (a)
  • Germany ? ? 3
  • Greece ? ? 3
  • Hungary ? ? 4
  • Iceland ? ? 1
  • Ireland ? ? 9
  • Italy ? ? 4
  • Luxembourg ? ? 1
  • Malta ? ? 5
  • Netherlands ? ? 6
  • Norway ? ? 11
  • Portugal ? ? 3
  • Spain ? ? 54
  • Sweden ? ? 2
  • United Kingdom ? ? 130
    
    • Total ? ? 280
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Serbia ? ? 1
  • Moldova ? ? 1
  • Russia 3 ? 3
    
    • Total 3 ? 5
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Bahrain ? ? 6
  • Egypt ? ? 3
  • Iran ? ? 16
  • Iraq ? ? 4
  • Israel 1 ? 35
  • Jordan ? ? 3
  • Kuwait 1 ? 13
  • Lebanon ? - 3
  • Occupied Palestinian Territory ? ? 1
  • Oman ? ? 24
  • Qatar ? ? 3
  • Saudi Arabia ? ? 39
  • Syria ? ? 2
  • Turkey ? ? 1
  • United Arab Emirates ? ? 6
  • Yemen ? ? 13
    
    • Total 2 ? 172
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 1
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 91
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 108
• NORTH AMERICA
  
  • Canada ? ? 86
  • Mexico ? ? 314
  • USA (b) ? ? 1004
    
    • Total ? ? 1404
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 38
  • Cuba ? ? 7
  • Dominican Republic ? ? 22
  • El Salvador ? ? 22
  • Guatemala ? ? 13
  • Honduras ? ? 16
  • Jamaica ? ? 5
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Suriname ? - 2
  • Trinidad-Tobago ? ? 5
    
    • Total ? ? 161
• SOUTH AMERICA
  
  • Argentina ? ? 585
  • Bolivia ? ? 56
  • Brazil ? ? 1368
  • Chile ? ? 136
  • Colombia ? ? 118
  • Ecuador ? ? 70
  • Paraguay ? ? 52
  • Peru ? ? 162
  • Uruguay ? ? 33
  • Venezuela 2 ? 95
    
    • Total 2 ? 2675
• NORTH-EAST & SOUTH ASIA
  
  • Bangladesh ? ? 6
  • China (Mainland) ? ? 3
  • Hong Kong SAR China ? ? 33
  • India 3 - 447
  • Japan ? ? 27
  • Macao SAR China ? ? 1
  • Mongolia 3 ? 4
  • South Korea 3 ? 28
  • Taiwan ? ? 25
    
    • Total 9 ? 574
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 3
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 18
  • Thailand ? ? 176
  • Vietnam ? ? 32
    
    • Total ? ? 348
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 186
  • Cook Islands ? ? 1
  • Marshall Islands ? - 1
  • New Zealand ? ? 19
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 211
• TOTAL 16 ? 5938

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 9 in mainland France.
(b) Update today includes reported laboratory-confirmed influenza-associated U.S. fatal cases since August 1.
(?)
-
-------

[Giuseppe]

Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

Pandemic (H1N1) 2009 Update 29 October 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]
ECDC DAILY UPDATE
Pandemic (H1N1) 2009 Update 29 October 2009, 09:00 hours CEST

Main developments in past 24 hours

• Study on U.S. prevalence estimates for Pandemic (H1N1) 2009 published;
• Total of 292 fatal cases in Europe and EFTA countries and 5 729 in the rest of the world have been reported up to date.

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases, as of 28 October 2009 16:00 hours CEST, for the world, and 29 October 09:00 hours CEST, for Europe is presented in Table 2.

Scientific update
Study on prevalence estimates for Pandemic (H1N1) 2009 published
U.S. CDC and Harvard School of Public Health researchers published a study estimating the number of cases of pandemic (H1N1) 2009 influenza by end of July. This study, published in Emerging Infectious Diseases, used a multiplier method to correct for under-ascertainment of cases and came up with an estimate of 1.8 million to 5.7 million cases with 9 000 to 21 000 hospitalisations occurring.
The full article is available at: LINK

Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 292 deaths have been reported; the information is available in Table 2. The latest available updates as of October 28, 2009, at 16:00, on new and on confirmed fatal pandemic (H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.

Daily Update contents
ECDC has now stopped publishing numbers of confirmed cases reported from EU/EFTA member states ? as well as from other countries around the world ? in its Daily Update. This is due to the fact that most European countries are now recommending laboratory confirmation only in certain population groups, such as the risk groups.
The World Health Organization has also recommended that countries verify only the first few hundred cases; after that exhaustive sampling is not recommended any more. We will continue to monitor the evolution of the pandemic within Europe mirrored by the number of fatal cases by country and through the Weekly Influenza Surveillance Overview which is published on Fridays. For the countries outside of Europe, we will monitor the number of fatal cases by country and monitor the surveillance reports of selected non-European countries.
It must be emphasized that the numbers of fatal cases per country associated with pandemic influenza are likely to be gross underestimates. Access to healthcare, the quality of the laboratory network in the country, the quality of the surveillance system and the case definition used for identifying fatal cases all affect these figures and will vary from country to country.
Daily Updates will be produced by 09:00hrs every morning Monday to Friday. No updates will be produced during weekends and the Daily Update published on Monday includes the weekend?s information. The production cycle will be reviewed as needed.

Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 29 October 2009, 09:00 hours (CEST) in the EU and EFTA countries
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (16.10.) ? ? ? ? ? ? ? ?
2. Belgium (16.10.) ? ? ? ? ? ? ? ?
3. Bulgaria (25.10) ? ? ? ? ? ? ? ?
4. Cyprus ? ? ? ? ? ? ? ?
5. Czech Republic (15.10.) ? ? ? ? ? ? ? ?
6. Denmark (28.10.) ? ? ? ? ? ? ? ?
7. Estonia (23.10.) ? ? - 11 ? ? ? ?
8. Finland (26.10.) ? ? ? ? ? ? ? ?
9. France (25.10.) ? 99 ? 447 ? 36 ? 73
10. Germany (21.10.) ? ? ? ? ? ? ? ?
11. Greece (21.10.) ? ? ? ? ? ? ? ?
12. Hungary (22.10.) ? ? ? ? ? ? ? ?
13. Iceland (21.10.) ? 31 ? 80 - 6 ? ?
14. Ireland (18.10.) ? ? - 325 ? ? ? 26
15. Italy (18.10) ? ? - 1494 ? ? ? ?
16. Latvia (13.08.) ? ? - 1 ? ? ? ?
17. Liechtenstein (21.10.) ? ? ? ? ? ? ? ?
18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (23.10.) ? 54 ? 205 ? 7 ? 31
22. Norway (22.10.) ? 15 ? 142 ? 4 ? 27
23. Poland (28.10.) ? ? ? ? ? ? ? ?
24. Portugal (28.10.) - 47 ? ? - 4 ? ?
25. Romania (26.10) ? ? ? ? ? ? ? ?
26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (22.10.) ? ? - 303 ? ? ? 137
29. Sweden (22.10.) ? 13 - 145 ? ? ? ?
30. Switzerland (25.10.) ? 3 - 27 ? ? ? ?
31. United Kingdom (a) (22.10.) - 506 ? ? - 99 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (380 cumulative hospitalisations), Wales (126) and Northern Ireland (346).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 29 October 2009, 09:00 hours CEST, and in the rest of the world by country, as of 28 October 2009, 16:00 hours CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Belgium ? ? 5
  • Bulgaria 1 ? 2
  • Czech Republic ? ? 1
  • Finland ? ? 1
  • France 8 ? 44 (a)
  • Germany ? ? 3
  • Greece ? ? 3
  • Hungary ? ? 4
  • Iceland ? ? 1
  • Ireland 1 ? 10
  • Italy ? ? 4
  • Luxembourg ? ? 1
  • Malta ? ? 5
  • Netherlands ? ? 6
  • Norway 2 ? 13
  • Portugal ? ? 3
  • Spain ? ? 54
  • Sweden ? ? 2
  • United Kingdom ? ? 130
    
    • Total 12 ? 292
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Serbia ? ? 1
  • Moldova ? ? 1
  • Russia 1 ? 4
    
    • Total 1 ? 6
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Bahrain ? ? 6
  • Egypt ? ? 3
  • Iran 6 ? 22
  • Iraq ? ? 4
  • Israel ? ? 35
  • Jordan ? ? 3
  • Kuwait ? ? 13
  • Lebanon ? - 3
  • Occupied Palestinian Territory ? ? 1
  • Oman ? ? 24
  • Qatar ? ? 3
  • Saudi Arabia ? ? 39
  • Syria ? ? 2
  • Turkey ? ? 1
  • United Arab Emirates ? ? 6
  • Yemen 3 ? 16
    
    • Total 9 ? 181
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 1
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 91
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 108
• NORTH AMERICA
  
  • Canada 3 ? 89
  • Mexico 14 ? 328
  • USA ? ? 1004
    
    • Total 17 ? 1421
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 38
  • Cuba ? ? 7
  • Dominican Republic ? ? 22
  • El Salvador ? ? 22
  • Guatemala 5 ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 5
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Suriname ? - 2
  • Trinidad-Tobago ? ? 5
    
    • Total 5 ? 166
• SOUTH AMERICA
  
  • Argentina ? ? 585
  • Bolivia ? ? 56
  • Brazil ? ? 1368
  • Chile ? ? 136
  • Colombia 13 ? 131
  • Ecuador 5 ? 75
  • Paraguay ? ? 52
  • Peru ? ? 162
  • Uruguay ? ? 33
  • Venezuela ? ? 95
    
    • Total 18 ? 2693
• NORTH-EAST & SOUTH ASIA
  
  • Afghanistan 1 ? 1
  • Bangladesh ? ? 6
  • China (Mainland) ? ? 3
  • Hong Kong SAR China ? ? 33
  • India 4 ? 451
  • Japan ? ? 27
  • Macao SAR China ? ? 1
  • Mongolia ? ? 4
  • South Korea 5 ? 33
  • Taiwan 2 ? 27
    
    • Total 12 ? 586
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 3
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 18
  • Thailand 6 ? 182
  • Vietnam 3 ? 35
    
    • Total 9 ? 357
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 186
  • Cook Islands ? - 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 19
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 211
• TOTAL 83 ? 6021

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 17 in mainland France.
(?)
-
-------

[Giuseppe]

Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

Pandemic (H1N1) 2009 Update 30 October 2009, 09:00 hours CEST (ECDC, edited)

[Source PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 30 October 2009, 09:00 hours CEST


Main developments in past 24 hours

• Total of 302 fatal cases in Europe and EFTA countries and 5 749 in the rest of the world have been reported up to date.

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases, as of 29 October 2009 16:00 hours CEST, for the world, and 30 October 09:00 hours CEST, for Europe is presented in Table 2.


Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 302 deaths have been reported; the information is available in Table 2. The latest available updates as of October 28, 2009, at 16:00, on new and on confirmed fatal pandemic (H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.


Daily Update contents
ECDC has now stopped publishing numbers of confirmed cases reported from EU/EFTA member states ? as well as from other countries around the world ? in its Daily Update. This is due to the fact that most European countries are now recommending laboratory confirmation only in certain population groups, such as the risk groups.
The World Health Organization has also recommended that countries verify only the first few hundred cases; after that exhaustive sampling is not recommended any more. We will continue to monitor the evolution of the pandemic within Europe mirrored by the number of fatal cases by country and through the Weekly Influenza Surveillance Overview which is published on Fridays. For the countries outside of Europe, we will monitor the number of fatal cases by country and monitor the surveillance reports of selected non-European countries.
It must be emphasized that the numbers of fatal cases per country associated with pandemic influenza are likely to be gross underestimates. Access to healthcare, the quality of the laboratory network in the country, the quality of the surveillance system and the case definition used for identifying fatal cases all affect these figures and will vary from country to country.
Daily Updates will be produced by 09:00hrs every morning Monday to Friday. No updates will be produced during weekends and the Daily Update published on Monday includes the weekend?s information. The production cycle will be reviewed as needed.


Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 30 October 2009, 09:00 hours (CEST) in the EU and EFTA countries


[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (23.10.) ? ? ? ? ? ? ? ?
2. Belgium (29.10.) ? ? ? ? ? ? ? ?
3. Bulgaria (25.10) ? ? ? ? ? ? ? ?
4. Cyprus ? ? ? ? ? ? ? ?
5. Czech Republic (29.10.) ? ? ? ? ? ? ? ?
6. Denmark (28.10.) ? ? ? ? ? ? ? ?
7. Estonia (23.10.) ? ? - 11 ? ? ? ?
8. Finland (29.10.) ? ? ? ? ? ? ? ?
9. France (25.10.) ? 99 ? 447 ? 36 ? 73
10. Germany (21.10.) ? ? ? ? ? ? ? ?
11. Greece (21.10.) ? ? ? ? ? ? ? ?
12. Hungary (25.10.) ? ? - 64 ? ? ? ?
13. Iceland (29.10.) ? ? ? 100 - 14 ? ?
14. Ireland (25.10.) ? ? - 438 ? ? ? 38
15. Italy (18.10) ? ? - 1494 ? ? ? ?
16. Latvia (13.08.) ? ? - 1 ? ? ? ?
17. Liechtenstein (25.10.) ? ? ? ? ? ? ? ?
18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (23.10.) ? 54 ? 205 ? 7 ? 31
22. Norway (28.10.) ? 18 ? 144 ? 3 ? 27
23. Poland (29.10.) ? ? ? ? ? ? ? ?
24. Portugal (28.10.) - 47 ? ? - 4 ? ?
25. Romania (26.10) ? ? ? ? ? ? ? ?
26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (22.10.) ? ? - 303 ? ? ? 137
29. Sweden (25.10.) ? 26 - 174 ? ? ? ?
30. Switzerland (25.10.) ? 3 - 27 ? ? ? ?
31. United Kingdom (a) (29.10.) - 751 ? ?- 157 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (580 cumulative hospitalisations), Wales (192) and Northern Ireland (437).


Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 30 October 2009, 09:00 hours CEST, and in the rest of the world by country, as of 29 October 2009, 16:00 hours CEST.


[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Belgium 2 ? 7
  • Bulgaria ? ? 2
  • Czech Republic ? ? 1
  • Finland ? ? 1
  • France ? ? 44 (a)
  • Germany ? ? 3
  • Greece ? ? 3
  • Hungary ? ? 4
  • Iceland ? ? 1
  • Ireland ? ? 10
  • Italy ? ? 4
  • Luxembourg ? ? 1
  • Malta ? ? 5
  • Netherlands ? ? 6
  • Norway ? ? 13
  • Portugal 1 ? 4
  • Spain ? ? 54
  • Sweden ? ? 2
  • United Kingdom 7 ? 137
    
    • Total 10 ? 302
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Serbia ? ? 1
  • Moldova ? ? 1
  • Russia 1 ? 5
    
    • Total 1 ? 7
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Bahrain ? ? 6
  • Egypt ? ? 3
  • Iran ? ? 22
  • Iraq ? ? 4
  • Israel ? ? 35
  • Jordan 1 ? 4
  • Kuwait ? ? 13
  • Lebanon ? - 3
  • Occupied Palestinian Territory ? ? 1
  • Oman ? ? 24
  • Qatar ? ? 3
  • Saudi Arabia ? ? 39
  • Syria 4 ? 6
  • Turkey ? ? 1
  • United Arab Emirates ? ? 6
  • Yemen ? ? 16
    
    • Total 5 ? 186
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 1
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 91
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 108
• NORTH AMERICA
  
  • Canada ? ? 89
  • Mexico ? ? 328
  • USA ? ? 1004
    
    • Total ? ? 1421
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 38
  • Cuba ? ? 7
  • Dominican Republic ? ? 22
  • El Salvador ? ? 22
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 5
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Suriname ? - 2
  • Trinidad-Tobago ? ? 5
    
    • Total ? ? 166
• SOUTH AMERICA
  
  • Argentina ? ? 585
  • Bolivia ? ? 56
  • Brazil ? ? 1368
  • Chile ? ? 136
  • Colombia ? ? 131
  • Ecuador ? ? 75
  • Paraguay ? ? 52
  • Peru ? ? 162
  • Uruguay ? ? 33
  • Venezuela ? ? 95
    
    • Total ? ? 2693
• NORTH-EAST & SOUTH ASIA
  
  • Afghanistan ? ? 1
  • Bangladesh ? ? 6
  • China (Mainland) 1 ? 4
  • Hong Kong SAR China 4 ? 37
  • India 6 ? 457
  • Japan ? ? 27
  • Macao SAR China 1 ? 2
  • Mongolia ? ? 4
  • South Korea ? ? 33
  • Taiwan ? ? 27
    
    • Total 12 ? 598
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia 1 ? 4
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 18
  • Thailand ? ? 182
  • Vietnam 1 ? 36
    
    • Total 2 ? 359
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 186
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 19
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 211
• TOTAL 30 ? 6051

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 17 in mainland France.
(?)
-
------

[Giuseppe]

Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

Pandemic (H1N1) 2009 Update 02 November 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 02 November 2009, 09:00 hours CEST


Main developments in past 72 hours

-- WHO SAGE Committee advises on pandemic vaccines October 30th , 2009 Outbreaks of Severe Acute Respiratory Infection in the Ukraine ? late October
-- The latest report from the European Influenza Surveillance network for week 43/2009 shows the steadily increasing appearance of the pandemic in EU-EEA countries
-- Total of 317 fatal cases in Europe and EFTA countries and 6 153 in the rest of the world have been reported up to date.



This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases, as of 01 November 2009 -16:00 hours CEST, for the world, and 02 November 2009 - 09:00 hours CEST, for Europe is presented in Table 2.


New Developments

WHO SAGE Committee advises on pandemic vaccines October 30th 2009


The WHO Strategic Advisory Group of Experts met last week and among other issues considered its position on pandemic vaccines; specifically on the status of vaccine availability, results from clinical trials on vaccine immunogenicity, and early results from safety monitoring in countries immunisation had started.
This is reported on the WHO web-site


Notable conclusions with relevance for European countries were:

• SAGE recommended use of a single dose of vaccine in adults and adolescents starting at age 10 years provided such use is consistent with indications from regulatory authorities;
• Data are not yet available for making recommendations on younger persons or immunocompromised persons but where national authorities have decided to vaccinate children they should start with single doses;
• That seasonal and pandemic vaccines can be administered simultaneously and there is no evidence that co-administration of vaccines, as recommended, would increase the risk of adverse events;
• Early results from the monitoring of people who have received pandemic vaccines was encouraging. Though there were side effects they were in the range seen for seasonal influenza vaccines and there was no indication of unusual adverse reactions. However monitoring for adverse events should continue. Concerning Pregnancy studies in experimental animals using live attenuated vaccines and non-adjuvanted or adjuvanted inactivated vaccines found no evidence of direct or indirect harmful effects. Because of the substantially elevated risk for a severe outcome in pregnant women infected with the pandemic virus, SAGE recommended that any licensed vaccine can be used in pregnant women, provided no specific contraindication has been identified by the regulatory authority.

Severe Acute Respiratory Infection in the Ukraine ? Late October


ECDC has become aware of outbreaks of Acute Respiratory Infection and Severe Acute Respiratory Infection in the Ukraine, notably in Western Provinces bordering the EU. Working with WHO Regional Office for Europe and the European Commission ECDC is monitoring the situation.
There are some reports of influenza A(H1N1) being detected through PCR. The most likely explanation is that this is a manifestation of the pandemic but further investigations are needed to confirm this and exclude other infections.
Neighbouring European Union countries are not yet seeing such acute outbreaks though levels of influenza like illness has been rising recently in Poland, Slovakia and Latvia.


EISN (European Influenza Surveillance Network) Weekly Influenza surveillance Output - October 30th


Weekly Influenza Surveillance Report Published for the EU/EEA Countries Week 43/2009 October 30th

• The number of countries with medium to very high intensity influenza activity continues to increase.
• Seventeen out of 27 countries report a rising trend.
• In sentinel samples, the proportion of influenza-like illness that tested positive for influenza has risen to 40%?a remarkably high percentage.
• Among positive sentinel isolates, influenza A(H1N1)v accounts for 82%.
• In 18?59 year-old patients with severe acute respiratory infection (SARI), females were overrepresented.
• In almost 40% of reported SARI cases, no underlying condition was identified.

(LINK)


Epidemiologic update


All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 317 deaths have been reported; the information is available in Table 2. The latest available updates as of November 01, 2009, at 16:00, on new and on confirmed fatal pandemic A(H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.


Daily Update contents


ECDC has now stopped publishing numbers of confirmed cases reported from EU/EFTA member states ? as well as from other countries around the world ? in its Daily Update. This is due to the fact that most European countries are now recommending laboratory confirmation only in certain population groups, such as the risk groups.
The World Health Organization has also recommended that countries verify only the first few hundred cases; after that exhaustive sampling is not recommended any more. We will continue to monitor the evolution of the pandemic within Europe mirrored by the number of fatal cases by country and through the Weekly Influenza Surveillance Overview which is published on Fridays. For the countries outside of Europe, we will monitor the number of fatal cases by country and monitor the surveillance reports of selected non-European countries.
It must be emphasized that the numbers of fatal cases per country associated with pandemic influenza are likely to be gross underestimates. Access to healthcare, the quality of the laboratory network in the country, the quality of the surveillance system and the case definition used for identifying fatal cases all affect these figures and will vary from country to country.
Daily Updates will be produced by 09:00hrs every morning Monday to Friday. No updates will be produced during weekends and the Daily Update published on Monday includes the weekend?s information. The production cycle will be reviewed as needed.


Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 02 November 2009, 09:00 hours (CEST) in the EU and EFTA countries


[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (23.10.) ? ? ? ? ? ? ? ?
2. Belgium (29.10.) ? ? ? ? ? ? ? ?
3. Bulgaria (25.10) ? ? ? ? ? ? ? ?
4. Cyprus ? ? ? ? ? ? ? ?
5. Czech Republic (29.10.) ? ? ? ? ? ? ? ?
6. Denmark (28.10.) ? ? ? ? ? ? ? ?
7. Estonia (23.10.) ? ? - 11 ? ? ? ?
8. Finland (29.10.) ? ? ? ? ? ? ? ?
9. France (25.10.) ? 99 ? 447 ? 36 ? 73
10. Germany (21.10.) ? ? ? ? ? ? ? ?
11. Greece (29.10.) ? ? ? ? ? ? ? ?
12. Hungary (25.10.) ? ? - 64 ? ? ? ?
13. Iceland (29.10.) ? ? ? 100 - 14 ? ?
14. Ireland (25.10.) ? ? - 438 ? ? ? 38
15. Italy (18.10) ? ? - 1494 ? ? ? ?
16. Latvia (13.08.) ? ? - 1 ? ? ? ?
17. Liechtenstein (25.10.) ? ? ? ? ? ? ? ?
18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (30.10.) ? 131 ? 335 ? 7 ? 39
22. Norway (28.10.) ? 18 ? 144 ? 3 ? 27
23. Poland (29.10.) ? ? ? ? ? ? ? ?
24. Portugal (28.10.) - 47 ? ? - 4 ? ?
25. Romania (26.10) ? ? ? ? ? ? ? ?
26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (29.10.) ? ? ? ? ? ? ? ?
29. Sweden (25.10.) ? 26 - 174 ? ? ? ?
30. Switzerland (25.10.) ? 3 - 27 ? ? ? ?
31. United Kingdom (a) (29.10.) - 751 ? ? - 157 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (580 cumulative hospitalisations), Wales (192) and Northern Ireland (437).


Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 02 November 2009, 09:00 hours CEST, and in the rest of the world by country, as of 01 November 2009, 16:00 hours CEST.


[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Belgium ? ? 7
  • Bulgaria ? ? 2
  • Czech Republic ? ? 1
  • Finland ? ? 1
  • France ? ? 44 (a)
  • Germany 2 ? 5
  • Greece ? ? 3
  • Hungary ? ? 4
  • Iceland ? ? 1
  • Ireland ? ? 10
  • Italy ? ? 4
  • Luxembourg ? ? 1
  • Malta ? ? 5
  • Netherlands 4 ? 10
  • Norway ? ? 13
  • Portugal ? ? 4
  • Spain 9 ? 63
  • Sweden ? ? 2
  • United Kingdom ? ? 137
    
    • Total 15 ? 317
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Serbia ? ? 1
  • Moldova ? ? 1
  • Russia ? ? 5
    
    • Total ? ? 7
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Bahrain ? ? 6
  • Egypt 1 ? 4
  • Iran ? ? 22
  • Iraq ? ? 4
  • Israel ? ? 35
  • Jordan ? ? 4
  • Kuwait 3 ? 16
  • Lebanon ? - 3
  • Occupied Palestinian Territory ? ? 1
  • Oman ? ? 24
  • Qatar 1 ? 4
  • Saudi Arabia 23 ? 62
  • Syria 1 ? 7
  • Turkey 2 ? 3
  • United Arab Emirates ? ? 6
  • Yemen ? ? 16
    
    • Total 31 ? 217
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 1
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 91
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 108
• NORTH AMERICA
  
  • Canada 6 ? 95
  • Mexico 26 ? 354
  • USA ? ? 1004
    
    • Total 32 ? 1453
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 38
  • Cuba ? ? 7
  • Dominican Republic ? ? 22
  • El Salvador ? ? 22
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 5
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Suriname ? - 2
  • Trinidad-Tobago ? ? 5
    
    • Total ? ? 166
• SOUTH AMERICA
  
  • Argentina 8 ? 593
  • Bolivia ? ? 56
  • Brazil ? ? 1368
  • Chile ? ? 136
  • Colombia ? ? 131
  • Ecuador ? ? 75
  • Paraguay ? ? 52
  • Peru ? ? 162
  • Uruguay ? ? 33
  • Venezuela ? ? 95
    
    • Total 8 ? 2701
• NORTH-EAST & SOUTH ASIA
  
  • Afghanistan ? ? 1
  • Bangladesh ? ? 6
  • China (Mainland) ? ? 4
  • Hong Kong SAR China ? ? 37
  • India 15 ? 472
  • Japan ? ? 27
  • Macao SAR China ? ? 2
  • Mongolia ? ? 4
  • South Korea 1 ? 34
  • Taiwan ? ? 27
    
    • Total 16 ? 614
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 4
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 18
  • Thailand ? ? 182
  • Vietnam ? ? 36
    
    • Total ? ? 359
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 186
  • Cook Islands ? - 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 19
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 211
• TOTAL 102 ? 6153

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 17 in mainland France.
(?)
-
--------

[Giuseppe]

Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

Pandemic (H1N1) 2009 Update 03 November 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 03 November 2009, 09:00 hours CEST


Main developments in past 24 hours

• Updates from U.S.A. and Canada;
• WHO Report on the situation in the Ukraine;
• Total of 325 fatal cases in Europe and EFTA countries and 5 846 in the rest of the world have been reported up to date.

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases is presented in Table 2 - as of 02 November 2009 -16:00 hours CEST, for the world, and 03 November 2009 - 09:00 hours CEST, for Europe.


Updates from U.S.A. and Canada

United States Update

Data as of 30 October 2009 16:00 CEST, for week ending 24 October, 2009 (Week 42)

• Virology:
  
  • 100% of all subtyped influenza A viruses reported to CDC were 2009 influenza A (H1N1) viruses.
  • 99.7% of all specimens were type A and 0.3% were type B.
  • Antigenic character of 99.4% of 2009 influenza A (H1N1) viruses were similar to the strain chosen for the vaccine; 0.6% (one virus) showed reduced titers with antisera produced against A/California/07/2009.
  • Since September 1, 2009, five infections with oseltamivir resistant 2009 influenza A (H1N1) viruses have been identified in the United States. Since the emergence of the 2009 influenza A (H1N1), all isolates tested have been resistant to the adamantanes (amantadine and rimantadine).
• Mortality Surveillance:
  
  • Pneumonia and Influenza Hospitalization and Deaths:
    
    • From August 30 ? October 24, 2009, 12,466 laboratory-confirmed influenza associated hospitalizations, 530 laboratory-confirmed influenza associated deaths, 25,985pneumonia and influenza syndrome-based hospitalizations, and 2,916 pneumonia and influenza syndrome-based deaths, were reported to CDC.
  • Pneumonia and Influenza (P&I) Mortality Surveillance:
    
    • During week 42, 7.1% of all deaths reported through the 122-Cities Mortality Reporting System were due to P&I. This percentage was above the epidemic threshold of 6.6% for week 42 and the percentage has been above the threshold for four weeks.
  • Influenza-associated Pediatric Mortality:
    
    • Influenza-Associated Pediatric Mortality: Twenty-two influenza-associated pediatric deaths were reported to CDC during week 42. Nineteen of these deaths were associated with 2009 influenza A (H1N1) virus infection and three were associated with an influenza A virus for which the subtype is undetermined. These deaths occurred between 23 August and 24 October 2009. One death reported during week 42 occurred during the 2008-09 season.
    • Since 30 August 2009, CDC has received 74 reports of influenza-associated pediatric deaths that occurred during the current influenza season (4657 due to 2009 influenza A(H1N1) and 9 due to undetermined subtype influenza A).
    • Among the 74 deaths in children, 47 children had specimens collected for bacterial culture from normally sterile sites and 16 (34%) of the 47 were positive; Staphylococcus aureus was identified in 7 (43.8%) of the 16 children.
    • A total of 114 deaths in children associated with 2009 H1N1 virus have been reported to CDC.
• Influenza-associated hospitalizations:
  
  • Laboratory-confirmed influenza-associated hospitalizations are monitored in the U.S. using a population-based surveillance network comprising 10 Emerging Infections Program sites and 6 new sites.
  • Laboratory-confirmed influenza-associated hospitalization rates were reported during 01 September ? 17 October 2009 (rates include influenza A, influenza B, and 2009 influenza A (H1N1)).
    
    • Rates [EIP (new sites)] for children aged 0-4 years and 5-17 years were 2.7 (4.9) and 1.3 (2.5) per 10,000, respectively.
    • Rates [EIP (new sites)] for adults aged 18-49 years, 50-64 years, and ≥ 65 years were 0.9 (0.8), 1.0 (0.9) and 0.8 (0.7) per 10,000, respectively.
• Influenza-like Illness (ILI):
  
  • Nationwide during week 42, 8.0% of patient visits reported through the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) were due to influenza-like illness (ILI). This percentage is above the national baseline of 2.3%. On a regional level, the percentage of outpatient visits for ILI ranged from 4.7% to 12.0% during week 42.
• Geographic spread:
  
  • Widespread influenza activity was reported by 48 states. Regional influenza activity was reported by Guam and 2 states. Local influenza activity was reported by the District of Columbia and Puerto Rico. The U.S. Virgin Islands did not report.
• Other information:
  
  • The 2009-2010 U.S. Influenza Season (for purposes of surveillance and reporting) began 4 October 2009.
  • For more information:
    
    • U.S. Centers for Disease Control and Prevention ?What's New on the H1N1 Flu Site? LINK
    • U.S. Centers for Disease Control and Prevention Weekly Influenza Surveillance Report LINK
    • Overview of Influenza Surveillance in the United States LINK

Canada Update

Data as of 30 October 2009 17:00 CEST, for week ending 24 October, 2009 (Week 42)


Striking increases in overall influenza activity were reported this week. All indicators (proportion of positive influenza tests, national ILI consultation rate, number of regions reporting widespread activity and number of influenza outbreaks) were considerably higher this week compared to the previous weeks.

• Virology:
  
  • 99.7% of all subtyped influenza A viruses being reported to Public Health Agency of Canada (PHAC) were 2009 influenza A (H1N1) viruses; the remainder were A(H3).
  • The proportion of tests that were positive for influenza was 29% which was a significant increase to the previous weeks.
  • 2009 influenza A (H1N1) viruses continue to be similar to the strain chosen for the vaccine.
  • No viruses resistant to Oseltamivir were detected in week 42.
• Hospitalizations and Deaths:
  
  • 175 hospitalizations and 9 deaths were reported for week 42.
• Paediatric Influenza Hospitalizations and Deaths:
  
  • In week 42, 48 laboratory-confirmed influenza-associated paediatric hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network.
  • Since the beginning of the pandemic, four deaths due to Pandemic (H1N1) 2009 had been reported through the IMPACT network among children under 16 years of age.
• Influenza-like Illness (ILI):
  
  • The national ILI consultation rate increased to 59 consultations per 1,000 patient visits this week which was an increase for a sixth consecutive week and was above the expected range for this time of the year.
• Geographic spread:
  
  • Ten regions reported widespread activity and 14 regions reported localized activity, while 23 regions reported sporadic activity and 7 regions reported no activity. 226 influenza outbreaks in schools, 6 outbreaks in hospitals and 3 outbreaks in long-term care facilities were reported.
• Other information:
  
  • The Minister of Health announced on October 23, 2009, that Canada has officially entered the second wave of Pandemic (H1N1) 2009.
  • For more information:
    
    • Public Health Agency of Canada LINK
    • Public Health Agency of Canada FluWatch LINK

Other Updates

WHO Report on the situation in the Ukraine


WHO has issued a report (dated November 1st) concerning outbreaks of severe acute respiratory infection in the Ukraine available here. This traces back the first reports of epidemic acute respiratory illness in the Western part of the country (Chernivtsi, Ivano-Frankivsk, Lviv, and Ternopil regions) to WHO on October 28th and the next day the first reports of confirmed pandemic A(H1N1) 2009 infection by in-country RT-PCR tests from some affected patients.


Specimens have yet to be tested at a WHO Collaborating Centre.
The report cites there having been over 2,300 individuals been admitted to hospital, including over 1,100 children by October 31st. As of 31 October 2009 it reports a total of 38 fatalities associated with severe acute respiratory infection. Fatal and severe cases are reported to have only sought medical attention 5 to 7 days after onset of symptoms and the report emphasises the importance of persons with acute respiratory infection seeking care at an early stage and lists the public health measures which the Ministry of Health of the Ukraine has recommended for the country.


In response to the request from the Minister of Health of the Ukraine, WHO has deployed a multi-disciplinary team of experts to assist the national authorities which includes experts from EU countries and ECDC.


Finally it notes that as WHO's earlier communication in May 2009, there is no rationale for travel restrictions because such measures will not prevent the spread of the disease.


Reviewing the reports of the situation in the adjoining EU countries as of week 43 (see the relevant Weekly Influenza Surveillance Overview) there were no reports to ECDC or WHO of anything such as is being seen in the Ukraine, though as in many EU/EEA countries rates of influenza like illness seen in primary care were rising in Poland and Slovakia.


Epidemiologic update


All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 325 deaths have been reported; the information is available in Table 2. The latest available updates as of November 02, 2009, at 16:00, on new and on confirmed fatal pandemic A(H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.


Daily Update contents


ECDC has now stopped publishing numbers of confirmed cases reported from EU/EFTA member states ? as well as from other countries around the world ? in its Daily Update. This is due to the fact that most European countries are now recommending laboratory confirmation only in certain population groups, such as the risk groups.


The World Health Organization has also recommended that countries verify only the first few hundred cases; after that exhaustive sampling is not recommended any more. We will continue to monitor the evolution of the pandemic within Europe mirrored by the number of fatal cases by country and through the Weekly Influenza Surveillance Overview which is published on Fridays. For the countries outside of Europe, we will monitor the number of fatal cases by country and monitor the surveillance reports of selected non-European countries.


It must be emphasized that the numbers of fatal cases per country associated with pandemic influenza are likely to be gross underestimates. Access to healthcare, the quality of the laboratory network in the country, the quality of the surveillance system and the case definition used for identifying fatal cases all affect these figures and will vary from country to country.


Daily Updates will be produced by 09:00hrs every morning Monday to Friday. No updates will be produced during weekends and the Daily Update published on Monday includes the weekend?s information. The production cycle will be reviewed as needed.


Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 02 November 2009, 09:00 hours (CEST) in the EU and EFTA countries


[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (23.10.) ? ? ? ? ? ? ? ?
2. Belgium (29.10.) ? ? ? ? ? ? ? ?
3. Bulgaria (25.10) ? ? ? ? ? ? ? ?
4. Cyprus ? ? ? ? ? ? ? ?
5. Czech Republic (29.10.) ? ? ? ? ? ? ? ?
6. Denmark (28.10.) ? ? ? ? ? ? ? ?
7. Estonia (23.10.) ? ? - 11 ? ? ? ?
8. Finland (29.10.) ? ? ? ? ? ? ? ?
9. France (25.10.) ? 99 ? 447 ? 36 ? 73
10. Germany (21.10.) ? ? ? ? ? ? ? ?
11. Greece (29.10.) ? ? ? ? ? ? ? ?
12. Hungary (25.10.) ? ? - 64 ? ? ? ?
13. Iceland (29.10.) ? ? ? 100 - 14 ? ?
14. Ireland (25.10.) ? ? - 438 ? ? ? 38
15. Italy (18.10) ? ? - 1494 ? ? ? ?
16. Latvia (13.08.) ? ? - 1 ? ? ? ?
17. Liechtenstein (25.10.) ? ? ? ? ? ? ? ?
18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
19. Luxembourg (21.10.) ? ? ? ? - 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (30.10.) ? 131 ? 335 ? 7 ? 39
22. Norway (28.10.) ? 18 ? 144 ? 3 ? 27
23. Poland (29.10.) ? ? ? ? ? ? ? ?
24. Portugal (28.10.) - 47 ? ? - 4 ? ?
25. Romania (26.10) ? ? ? ? ? ? ? ?
26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (29.10.) ? ? ? ? ? ? ? ?
29. Sweden (25.10.) ? 26 - 174 ? ? ? ?
30. Switzerland (25.10.) ? 3 - 27 ? ? ? ?
31. United Kingdom (a) (29.10.) - 751 ? ? - 157 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (580 cumulative hospitalisations), Wales (192) and Northern Ireland (437).


Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 03 November 2009, 09:00 hours CEST, and in the rest of the world by country, as of 02 November 2009, 16:00 hours CEST.


[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Austria 1 ? 1
  • Belgium ? ? 7
  • Bulgaria ? ? 2
  • Czech Republic ? 1
  • Finland ? ? 1
  • France ? ? 44 (a)
  • Germany 1 ? 6
  • Greece ? ? 3
  • Hungary ? ? 4
  • Iceland ? ? 1
  • Ireland ? ? 10
  • Italy ? ? 4
  • Luxembourg ? ? 1
  • Malta ? ? 5
  • Netherlands ? ? 10
  • Norway 2 ? 15
  • Portugal 1 ? 5
  • Spain ? ? 63
  • Sweden ? ? 2
  • United Kingdom 3 ? 140
    
    • Total 8 ? 325
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Croatia 1 ? 1
  • Moldova ? ? 1
  • Russia ? ? 5
  • Serbia ? ? 1
    
    • Total 1 ? 8
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Bahrain ? ? 6
  • Egypt ? ? 4
  • Iran ? ? 22
  • Iraq 3 ? 7
  • Israel ? ? 35
  • Jordan 1 ? 5
  • Kuwait 1 ? 17
  • Lebanon ? ? 3
  • Occupied Palestinian Territory ? ? 1
  • Oman 1 ? 25
  • Qatar ? ? 4
  • Saudi Arabia ? ? 62
  • Syria ? ? 7
  • Turkey ? ? 3
  • United Arab Emirates ? ? 6
  • Yemen ? ? 16
    
    • Total 6 ? 223
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 1
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 91
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 108
• NORTH AMERICA
  
  • Canada ? ? 95
  • Mexico ? ? 354
  • USA ? ? 1004
    
    • Total ? ? 1453
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 38
  • Cuba ? ? 7
  • Dominican Republic ? ? 22
  • El Salvador ? ? 22
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 5
  • Nicaragua ? ? 11
  • Panama ? - 11
  • Saint Kitts and Nevis ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total ? ? 166
• SOUTH AMERICA
  
  • Argentina ? ? 593
  • Bolivia ? ? 56
  • Brazil ? ? 1368
  • Chile ? ? 136
  • Colombia ? ? 131
  • Ecuador ? ? 75
  • Paraguay ? ? 52
  • Peru ? ? 162
  • Uruguay ? ? 33
  • Venezuela ? ? 95
    
    • Total ? ? 2701
• NORTH-EAST & SOUTH ASIA
  
  • Afghanistan ? ? 1
  • Bangladesh ? ? 6
  • China (Mainland) 2 ? 6
  • Hong Kong SAR China ? ? 37
  • India 1 ? 473
  • Japan ? ? 27
  • Macao SAR China ? ? 2
  • Mongolia ? ? 4
  • South Korea ? ? 34
  • Taiwan ? ? 27
    
    • Total 3 ? 617
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 4
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 18
  • Thailand ? ? 182
  • Vietnam ? ? 36
    
    • Total ? ? 359
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 186
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 19
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 211
• TOTAL 18 - 6171

(?)
-
-----

[Giuseppe]

Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

Pandemic (H1N1) 2009 Update 04 November 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]
ECDC DAILY UPDATE
Pandemic (H1N1) 2009 Update 04 November 2009, 09:00 hours CEST

Main developments in past 24 hours

• Situation update from Ukraine;
• Study on hospitalized cases in California published;
• An influenza A/H9 infection identified in a patient in Hong Kong;
• Total of 340 fatal cases in Europe and EFTA countries and 5 915 in the rest of the world have been reported up to date.

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases is presented in Table 2 - as of 03 November 2009 -16:00 hours CEST, for the world, and 04 November 2009 - 09:00 hours CEST, for Europe.

Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 340 deaths have been reported; the information is available in Table 2. The latest available updates as of November 03, 2009, at 16:00, on new and on confirmed fatal pandemic A(H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.

Other updates
Situation update from Ukraine
According to the WHO update from yesterday, referring to the Ministry of Health in Ukraine, more than 250 000 cases of acute respiratory illness have been reported in the country with 235 cases requiring intensive care. Seventy fatal outcomes from acute respiratory illness have also been reported. A multi-disciplinary team of nine experts has been deployed by WHO to assess the situation and related patient samples have been already sent to the WHO collaborating centre in London.
WHO update is available at: LINK

Study on hospitalized cases in California published
A study describing the clinical and epidemiologic features of the pandemic (H1N1) 2009 cases by the California Pandemic Research group was published in the Journal of the American Medical Association. Among the 1088 cases identified, 118 had a fatal outcome, most commonly due to viral pneumonitis or acute respiratory distress syndrome.
The article can be found at: LINK

An influenza A/H9 infection identified in a patient in Hong Kong
The ministry of health in Hong Kong reports of an influenza A/H9 infection in a 47-year old female patient from Guangdong with respiratory symptoms.

Daily Update contents
ECDC has now stopped publishing numbers of confirmed cases reported from EU/EFTA member states ? as well as from other countries around the world ? in its Daily Update. This is due to the fact that most European countries are now recommending laboratory confirmation only in certain population groups, such as the risk groups.
The World Health Organization has also recommended that countries verify only the first few hundred cases; after that exhaustive sampling is not recommended any more. We will continue to monitor the evolution of the pandemic within Europe mirrored by the number of fatal cases by country and through the Weekly Influenza Surveillance Overview which is published on Fridays. For the countries outside of Europe, we will monitor the number of fatal cases by country and monitor the surveillance reports of selected non-European countries.
It must be emphasized that the numbers of fatal cases per country associated with pandemic influenza are likely to be gross underestimates. Access to healthcare, the quality of the laboratory network in the country, the quality of the surveillance system and the case definition used for identifying fatal cases all affect these figures and will vary from country to country.
Daily Updates will be produced by 09:00hrs every morning Monday to Friday. No updates will be produced during weekends and the Daily Update published on Monday includes the weekend?s information. The production cycle will be reviewed as needed.

Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 04 November 2009, 09:00 hours (CEST) in the EU and EFTA countries
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (23.10.) ? ? ? ? ? ? ? ?
2. Belgium (29.10.) ? ? ? ? ? ? ? ?
3. Bulgaria (25.10) ? ? ? ? ? ? ? ?
4. Cyprus ? ? ? ? ? ? ? ?
5. Czech Republic (29.10.) ? ? ? ? ? ? ? ?
6. Denmark (28.10.) ? ? ? ? ? ? ? ?
7. Estonia (23.10.) ? ? - 11 ? ? ? ?
8. Finland (03.11.) ? ? ? ? ? ? ? ?
9. France (25.10.) ? 99 ? 447 ? 36 ? 73
10. Germany (29.10.) ? ? ? ? ? ? ? ?
11. Greece (29.10.) ? ? ? ? ? ? ? ?
12. Hungary (25.10.) ? ? - 64 ? ? ? ?
13. Iceland (30.10.) - 43 ? ? - 11 ? ?
14. Ireland (29.10.) ? 109 ? 492 ? 23 ? 45
15. Italy (18.10) ? ? - 1494 ? ? ? ?
16. Latvia (13.08.) ? ? - 1 ? ? ? ?
17. Liechtenstein (25.10.) ? ? ? ? ? ? ? ?
18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
19. Luxembourg (21.10.) ? ? ? ?- 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (30.10.) ? 131 ? 335 ? 7 ? 39
22. Norway (28.10.) ? 18 ? 144 ? 3 ? 27
23. Poland (03.11.) ? ? ? ? ? ? ? ?
24. Portugal (28.10.) - 47 ? ? - 4 ? ?
25. Romania (02.11) ? ? ? ? ? ? ? ?
26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (29.10.) ? ? ? ? ? ? ? ?
29. Sweden (25.10.) ? 26 - 174 ? ? ? ?
30. Switzerland (25.10.) ? 3 - 27 ? ? ? ?
31. United Kingdom (a) (29.10.) - 751 ? ? - 157 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (580 cumulative hospitalisations), Wales (192) and Northern Ireland (437).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 04 November 2009, 09:00 hours CEST, and in the rest of the world by country, as of 03 November 2009, 16:00 hours CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Austria ? ? 1
  • Belgium ? ? 7
  • Bulgaria 2 ? 4
  • Czech Republic ? ? 1
  • Finland ? ? 1
  • France ? ? 44 (a)
  • Germany ? ? 6
  • Greece ? ? 3
  • Hungary ? ? 4
  • Iceland ? ? 1
  • Ireland ? ? 10
  • Italy 13 ? 17
  • Luxembourg ? ? 1
  • Malta ? ? 3
  • Netherlands ? ? 10
  • Norway ? ? 15
  • Portugal ? ? 5
  • Spain ? ? 63
  • Sweden ? ? 2
  • United Kingdom 2 ? 142
    
    • Total 17 ? 340
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Croatia ? ? 1
  • Moldova ? ? 1
  • Russia 9 ? 14
  • Serbia ? ? 1
    
    • Total 9 ? 17
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Bahrain ? ? 6
  • Egypt 1 ? 5
  • Iran 6 ? 28
  • Iraq ? ? 7
  • Israel 4 - 39
  • Jordan 2 ? 7
  • Kuwait 4 ? 21
  • Lebanon ? ? 3
  • Occupied Palestinian Territory ? ? 1
  • Oman ? ? 25
  • Qatar ? ? 4
  • Saudi Arabia ? ? 62
  • Syria ? ? 7
  • Turkey 8 ? 11
  • United Arab Emirates ? ? 6
  • Yemen ? ? 16
    
    • Total 25 ? 248
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 1
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 91
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 108
• NORTH AMERICA
  
  • Canada ? ? 95
  • Mexico 23 ? 377
  • USA ? ? 1004
    
    • Total 23 ? 1476
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 38
  • Cuba ? ? 7
  • Dominican Republic ? ? 22
  • El Salvador ? ? 22
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 5
  • Nicaragua ? - 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total ? ? 166
• SOUTH AMERICA
  
  • Argentina ? ? 593
  • Bolivia ? ? 56
  • Brazil ? ? 1368
  • Chile ? ? 136
  • Colombia ? ? 131
  • Ecuador ? ? 75
  • Paraguay ? ? 52
  • Peru ? ? 162
  • Uruguay ? ? 33
  • Venezuela ? ? 95
    
    • Total ? ? 2701
• NORTH-EAST & SOUTH ASIA
  
  • Afghanistan ? ? 1
  • Bangladesh ? ? 6
  • China (Mainland) 1 ? 7
  • Hong Kong SAR China ? ? 37
  • India 2 ? 475
  • Japan ? ? 27
  • Macao SAR China ? ? 2
  • Mongolia ? ? 4
  • South Korea 8 ? 42
  • Taiwan ? ? 27
    
    • Total 11 ? 628
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 4
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 18
  • Thailand ? ? 182
  • Vietnam 1 ? 37
    
    • Total 1 - 360
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 186
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 19
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 211
• TOTAL 86 - 6255

(?)
-
------

[Giuseppe]

Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

Pandemic (H1N1) 2009 Update 05 November 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]
ECDC DAILY UPDATE
Pandemic (H1N1) 2009 Update 05 November 2009, 09:00 hours CEST

Main developments in past 24 hours

• Scientific advance on background rates for adverse events following immunizations published;
• Update on events in Ukraine included;
• Norway relaxes prescription requirements for antivirals;
• Total of 352 fatal cases in Europe and EFTA countries and 5 952 in the rest of the world have been reported up to date.

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases is presented in Table 2 - as of 04 November 2009 -16:00 hours CEST, for the world, and 05 November 2009 - 09:00 hours CEST, for Europe.

Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 352 deaths have been reported; the information is available in Table 2. The latest available updates as of November 04, 2009, at 16:00, on new and on confirmed fatal pandemic A(H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.

Scientific Advance
An international group including WHO has published an evidence based review of what are the background rates of key health events that are occurring continuously in the background, miscarriages, sudden unexpected deaths, Guillain Barre Syndrome etc.
This is important as a reminder that when many people are being immunised with influenza vaccines, especially people perhaps at higher risk of these events anyway they will occur in temporal association with immunisation and that such event (so-called Adverse Events Following Immunisation; AEFI) will be mostly or entirely due to coincidence.
The article and an ECDC comment goes onto to explain how though these events are taken very seriously by national and EU regulatory agencies so that real causative associations are considered and investigated.
The full ECDC review will be available today at: LINK

Other updates
Update on Ukraine
The ministry of health has reported yesterday almost 500 000 cases of acute respiratory illness and 86 deaths related to acute respiratory illness, which are clear increases to the report on the previous day. Influenza A (H1N1) has been identified in a number of samples in domestic laboratories.
A 9-person WHO outbreak assessment team, including experts from ECDC and EU memberstates has been deployed at the request of the ministry of health in Ukraine and are presently in Kiev and Lviv.
Samples have been sent for verification to the WHO collaborating centre laboratory in Mill Hill, London.
It is clear that the pandemic (H1N1) 2009 has established itself in Ukraine and it is likely that the rapidly evolving situation in Ukraine is mainly related to the pandemic.
However, at this stage, others causes for clusters of respiratory illness, specifically in the western oblasts cannot be ruled out.

Norway decided to relax prescription requirement for antivirals
In Norway, the Department of Health and Care services announced that temporary arrangements will be made to make the antivirals oseltamivir and zanamivir accessible in the pharmacies without prescriptions from 5th November.
Full press release available at: LINK

Daily Update contents
ECDC has now stopped publishing numbers of confirmed cases reported from EU/EFTA member states ? as well as from other countries around the world ? in its Daily Update. This is due to the fact that most European countries are now recommending laboratory confirmation only in certain population groups, such as the risk groups.
The World Health Organization has also recommended that countries verify only the first few hundred cases; after that exhaustive sampling is not recommended any more. We will continue to monitor the evolution of the pandemic within Europe mirrored by the number of fatal cases by country and through the Weekly Influenza Surveillance Overview which is published on Fridays. For the countries outside of Europe, we will monitor the number of fatal cases by country and monitor the surveillance reports of selected non-European countries.
It must be emphasized that the numbers of fatal cases per country associated with pandemic influenza are likely to be gross underestimates. Access to healthcare, the quality of the laboratory network in the country, the quality of the surveillance system and the case definition used for identifying fatal cases all affect these figures and will vary from country to country.
Daily Updates will be produced by 09:00hrs every morning Monday to Friday. No updates will be produced during weekends and the Daily Update published on Monday includes the weekend?s information. The production cycle will be reviewed as needed.

Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 05 November 2009, 09:00 hours (CEST) in the EU and EFTA countries
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (23.10.) ? ? ? ? ? ? ? ?
2. Belgium (29.10.) ? ? ? ? ? ? ? ?
3. Bulgaria (25.10) ? ? ? ? ? ? ? ?
4. Cyprus ? ? ? ? ? ? ? ?
5. Czech Republic (29.10.) ? ? ? ? ? ? ? ?
6. Denmark (04.11.) ? ? ? ? ? ? ? ?
7. Estonia (23.10.) ? ? - 11 ? ? ? ?
8. Finland (03.11.) ? ? ? ? ? ? ? ?
9. France (04.11.) ? 203 ? 625 ? 36 ? 131
10. Germany (29.10.) ? ? ? ? ? ? ? ?
11. Greece (29.10.) ? ? ? ? ? ? ? ?
12. Hungary (25.10.) ? ? - 64 ? ? ? ?
13. Iceland (30.10.) - 43 ? ? - 11 ? ?
14. Ireland (29.10.) ? 109 ? 492 ? 23 ? 45
15. Italy (04.11) ? ? ? ? ? ? ? ?
16. Latvia (13.08.) ? ? - 1 ? ? ? ?
17. Liechtenstein (25.10.) ? ? ? ? ? ? ? ?
18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (30.10.) ? 131 ? 335 ? 7 ? 39
22. Norway (04.11.) ? 69 ? 497 ? 4 ? 69
23. Poland (04.11.) ? ? ? ? ? ? ? ?
24. Portugal (04.11.) - 63 ? ? - 9 ? ?
25. Romania (04.11) ? ? ? ? ? ? ? ?
26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (29.10.) ? ? ? ? ? ? ? ?
29. Sweden (25.10.) ? 26 - 174 ? ? ? ?
30. Switzerland (25.10.) ? 3 - 27 ? ? ? ?
31. United Kingdom (a) (29.10.) - 751 ? ? - 157 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (580 cumulative hospitalisations), Wales (192) and Northern Ireland (437).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 05 November 2009, 09:00 hours CEST, and in the rest of the world by country, as of 04 November 2009, 16:00 hours CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Austria ? ? 1
  • Belgium 1 ? 8
  • Bulgaria 1 ? 5
  • Czech Republic ? ? 1
  • Finland ? ? 1
  • France 5 ? 49 (a)
  • Germany ? ? 6
  • Greece ? ? 3
  • Hungary ? ? 4
  • Iceland ? ? 1
  • Ireland ? ? 10
  • Italy 4 ? 21
  • Luxembourg ? ? 1
  • Malta ? ? 3
  • Netherlands ? ? 10
  • Norway ? ? 15
  • Portugal ? ? 5
  • Spain ? ? 63
  • Sweden ? ? 2
  • United Kingdom 1 ? 143
    
    • Total 12 ? 352
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Belarus 1 ? 1
  • Croatia ? ? 1
  • Moldova 1 ? 2
  • Russia ? ? 14
  • Serbia 1 ? 2
  • Ukraine 1 ? 1
    
    • Total 4 ? 21
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Bahrain ? ? 6
  • Egypt 1 ? 6
  • Iran ? - 28
  • Iraq ? ? 7
  • Israel ? ? 39
  • Jordan ? ? 7
  • Kuwait ? ? 21
  • Lebanon ? ? 3
  • Occupied Palestinian Territory ? ? 1
  • Oman ? ? 25
  • Qatar ? ? 4
  • Saudi Arabia 4 ? 66
  • Syria ? ? 7
  • Turkey 4 ? 15
  • United Arab Emirates ? ? 6
  • Yemen 1 ? 17
    
    • Total 10 ? 258
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 1
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 91
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 108
• NORTH AMERICA
  
  • Canada 6 ? 101
  • Mexico ? ? 377
  • USA ? ? 1004
    
    • Total 6 ? 1482
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 38
  • Cuba ? ? 7
  • Dominican Republic ? ? 22
  • El Salvador ? ? 22
  • Guatemala ? ? 18
  • Honduras ? - 16
  • Jamaica ? ? 5
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total ? ? 166
• SOUTH AMERICA
  
  • Argentina ? ? 593
  • Bolivia ? ? 56
  • Brazil ? ? 1368
  • Chile ? ? 136
  • Colombia 5 ? 136
  • Ecuador ? ? 75
  • Paraguay ? ? 52
  • Peru ? ? 162
  • Uruguay ? ? 33
  • Venezuela ? ? 95
    
    • Total 5 ? 2706
• NORTH-EAST & SOUTH ASIA
  
  • Afghanistan ? ? 1
  • Bangladesh ? ? 6
  • China (Mainland) 1 ? 8
  • Hong Kong SAR China ? ? 37
  • India 3 ? 478
  • Japan 1 ? 28
  • Macao SAR China ? ? 2
  • Mongolia 2 ? 6
  • South Korea 3 ? 45
  • Taiwan ? ? 27
    
    • Total 10 ? 638
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 4
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 18
  • Thailand 2 - 184
  • Vietnam ? ? 37
    
    • Total 2 ? 362
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 186
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 19
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 211
• TOTAL 49 ? 6304

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 22 in mainland France.
(?)
-
------

[Giuseppe]

Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

Pandemic (H1N1) 2009 Update 06 November 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 06 November 2009, 09:00 hours CEST


Main developments in past 24 hours

• Update on events in Ukraine included;
• Weekly Influenza Surveillance Overview to be published today;
• Eurosurveillance updates published;
• Total of 389 fatal cases in Europe and EFTA countries and 6 005 in the rest of the world have been reported up to date.

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases is presented in Table 2 - as of 05 November 2009 -16:00 hours CEST, for the world, and 06 November 2009 - 09:00 hours CEST, for Europe.


Other updates

Pandemic H1N1 outbreak, Ukraine
The Ministry of Health has reported yesterday 633,877 cases of acute respiratory illness and 95 deaths related to acute respiratory illness, which represents a significant increase compared to the previous day (+32% for the number of cases and + 10% for the number of deaths). Influenza A (H1N1) has been identified in a number of samples in domestic laboratories and confirmed by the WHO?s reference laboratory in London. A 9-person WHO outbreak assessment team, including experts from ECDC and EU Member States has been deployed at the request of the ministry of health in Ukraine and are presently in Kiev and Lviv. It is clear that the pandemic (H1N1) 2009 has established itself in Ukraine and it is likely that the rapidly evolving situation in Ukraine is mainly related to the pandemic. However, at this stage, others causes for clusters of respiratory illness, specifically in the western oblasts cannot be ruled out. Ukraine called on the EU through the Community Civil Protection Mechanism on 31 October for help to deal with this situation. The European Commission's Monitoring and Information Centre (MIC), is today dispatching a coordination and assessment team of experts. Adding to that, several countries has already offered their help to control this outbreak.

Cumulative number of reported ARI cases in Ukraine, by day, since 29th of October 2009 (data MOH)
[ARI ? HOSPITALISATIONS ? DEATHS]

• 29-Oct ? 37923 ? 951 ? 30
• 30-Oct ? 81487 ? 2341 ? 33
• 31-Oct ? 165192 ? 5239 ? 39
• 01-Nov ? 191431 ? 7524 ? 60
• 02-Nov ? 255516 ? 15810 ? 70
• 03-Nov ? 255516 ? 15810 ? 71
• 04-Nov ? 478456 ? 24003 ? 81
• 05-Nov ? 633877 ? 28836 - 95

Weekly Influenza Surveillance Overview


The ECDC Weekly Influenza Surveillance Overview will be published this afternoon and will be available at: LINK


Eurosurveillance update


In the eurosurveillance editorial this week, Alex J Elliot reviews the tools being used for monitoring the spread of the pandemic worldwide: sentinel based systems, syndromic surveillance systems, telephone health line monitoring, as well as novel trends in pandemic surveillance such as the Google flu trends approach.

Syndromic surveillance: The next phase of public health monitoring during the H1N1 influenza pandemic? LINK


Ireland presents this week a review of 205 cases of confirmed pandemic H1N1 influenza who were hospitalised in Ireland. This review confirms highest rates of admission among the 15 to 19 age group, while 51% of admitted cases did not belong to risk groups.

Surveillance of the first 205 confirmed hospitalised cases of pandemic H1N1 influenza in Ireland, 28 April ? 3 October 2009. LINK


Authors from Japan are presenting results of modelling applied for the evaluation of social distancing measures. They indicate that post-exposure prophylaxis combined with isolation at home and school closure significantly decreases the total number of cases in the community and can mitigate the spread of pandemic H1N1 influenza, even when there is a delay in the availability of vaccine.

Measures against transmission of pandemic H1N1 influenza in Japan

in 2009: Simulation model. LINK


Authors from New Zealand are reporting that Google Flu Trends appears to provide a useful free surveillance system but should probably be seen as supplementary rather than as an alternative monitoring tool.

Interpreting ?Google Flu Trends? data for pandemic H1N1 influenza: The New Zealand experience. LINK


Authors from Australia are reporting that using deputising medical service provides low cost and timely ILI surveillance.

Influenza-like illness surveillance using a deputising medical service corresponds to surveillance from sentinel general practices. LINK

?I-MOVE? towards monitoring seasonal and pandemic influenza vaccine effectiveness: lessons learnt from a pilot multi-centric case-control study in Europe, 2008-9. LINK


Epidemiologic update


All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 389 deaths have been reported; the information is available in Table 2. The latest available updates as of November 05, 2009, at 16:00, on new and on confirmed fatal pandemic A(H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.


Daily Update contents


ECDC has now stopped publishing numbers of confirmed cases reported from EU/EFTA member states ? as well as from other countries around the world ? in its Daily Update. This is due to the fact that most European countries are now recommending laboratory confirmation only in certain population groups, such as the risk groups.
The World Health Organization has also recommended that countries verify only the first few hundred cases; after that exhaustive sampling is not recommended any more. We will continue to monitor the evolution of the pandemic within Europe mirrored by the number of fatal cases by country and through the Weekly Influenza Surveillance Overview which is published on Fridays. For the countries outside of Europe, we will monitor the number of fatal cases by country and monitor the surveillance reports of selected non-European countries.
It must be emphasized that the numbers of fatal cases per country associated with pandemic influenza are likely to be gross underestimates. Access to healthcare, the quality of the laboratory network in the country, the quality of the surveillance system and the case definition used for identifying fatal cases all affect these figures and will vary from country to country.
Daily Updates will be produced by 09:00hrs every morning Monday to Friday. No updates will be produced during weekends and the Daily Update published on Monday includes the weekend?s information. The production cycle will be reviewed as needed.


Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 06 November 2009, 09:00 hours (CEST) in the EU and EFTA countries


[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (23.10.) ? ? ? ? ? ? ? ?
2. Belgium (05.11.) ? ? ? ? ? ? ? ?
3. Bulgaria (04.11) ? ? ? ? ? ? ? ?
4. Cyprus ? ? ? ? ? ? ? ?
5. Czech Republic (05.11.) ? ? ? ? ? ? ? ?
6. Denmark (04.11.) ? ? ? ? ? ? ? ?
7. Estonia (23.10.) ? ? - 11 ? ? ? ?
8. Finland (04.11.) ? ? ? ? ? ? ? ?
9. France (04.11.) ? 203 ? 625 ? 36 ? 131
10. Germany (29.10.) ? ? ? ? ? ? ? ?
11. Greece (04.11.) ? ? ? ? ? ? ? ?
12. Hungary (01.11.) ? ? - 68 ? ? ? ?
13. Iceland (30.10.) - 43 ? ? - 11 ? ?
14. Ireland (05.11.) ? 165 ? 665 ? 19 ? 54
15. Italy (05.11) ? ? ? ? ? ? ? ?
16. Latvia (13.08.) ? ? - 1 ? ? ? ?
17. Liechtenstein (05.11.) ? ? ? ? ? ? ? ?
18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (30.10.) ? 131 ? 335 ? 7 ? 39
22. Norway (04.11.) ? 69 ? 497 ? 4 ? 69
23. Poland (05.11.) ? ? ? ? ? ? ? ?
24. Portugal (04.11.) - 63 ? ? - 9 ? ?
25. Romania (05.11) ? ? ? ? ? ? ? ?
26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
27. Slovenia (10.08.) ? ? ? ? ? ? ? ...
28. Spain (05.11.) ? ? ? ? ? ? ? ?
29. Sweden (01.11.) ? 51 - 241 ? ? ? ?
30. Switzerland (01.11.) ? 6 - 33 ? ? ? ?
31. United Kingdom (a) (05.11.) - 848 ? ? - 172 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (691 cumulative hospitalisations), Wales (251) and Northern Ireland (495).


Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 06 November 2009, 09:00 hours CEST, and in the rest of the world by country, as of 05 November 2009, 16:00 hours CEST.


[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Austria ? ? 1
  • Belgium ? ? 8
  • Bulgaria ? ? 5
  • Czech Republic ? ? 1
  • Finland 1 ? 2
  • France ? ? 49 (a)
  • Germany 3 ? 9
  • Greece 2 ? 5
  • Hungary 1 ? 5
  • Iceland ? ? 1
  • Ireland 4 ? 14
  • Italy 4 ? 25
  • Luxembourg ? ? 1
  • Malta ? ? 3
  • Netherlands ? ? 10
  • Norway ? ? 15
  • Portugal ? ? 5
  • Spain 10 ? 73
  • Sweden 1 ? 3
  • United Kingdom 11 ? 154
    
    • Total 37 ? 389
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Belarus 6 ? 7
  • Croatia ? ? 1
  • Moldova ? ? 2
  • Russia ? ? 14
  • Serbia 1 ? 3
  • Ukraine ? ? 1
    
    • Total 7 ? 28
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Bahrain ? ? 6
  • Egypt ? ? 6
  • Iran 5 - 33
  • Iraq ? ? 7
  • Israel ? ? 39
  • Jordan ? ? 7
  • Kuwait ? ? 21
  • Lebanon ? ? 3
  • Occupied Palestinian Territory ? ? 1
  • Oman ? ? 25
  • Qatar 1 ? 5
  • Saudi Arabia ? ? 66
  • Syria ? ? 7
  • Turkey 4 ? 19
  • United Arab Emirates ? ? 6
  • Yemen ? ? 17
    
    • Total 10 ? 268
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 1
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 91
  • Sudan ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 108
• NORTH AMERICA
  
  • Canada ? ? 101
  • Mexico ? ? 377
  • USA ? ? 1004
    
    • Total ? ? 1482
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 38
  • Cuba ? ? 7
  • Dominican Republic ? ? 22
  • El Salvador 1 ? 23
  • Guatemala ? ? 18
  • Honduras ? - 16
  • Jamaica ? ? 5
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total 1 ? 167
• SOUTH AMERICA
  
  • Argentina ? ? 593
  • Bolivia ? ? 56
  • Brazil ? ? 1368
  • Chile ? ? 136
  • Colombia ? ? 136
  • Ecuador 5 ? 80
  • Paraguay ? ? 52
  • Peru 18 ? 180
  • Uruguay ? ? 33
  • Venezuela ? ? 95
    
    • Total 23 ? 2729
• NORTH-EAST & SOUTH ASIA
  
  • Afghanistan 8 ? 9
  • Bangladesh ? ? 6
  • China (Mainland) ? ? 8
  • Hong Kong SAR China 2 ? 39
  • India ? ? 478
  • Japan ? ? 28
  • Macao SAR China ? ? 2
  • Mongolia ? ? 6
  • South Korea ? ? 45
  • Taiwan ? ? 27
    
    • Total 10 ? 648
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 4
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 18
  • Thailand ? - 184
  • Vietnam 2 ? 39
    
    • Total 2 ? 364
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 186
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 19
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ?- 1
    
    • Total ? ? 211
• TOTAL 90 ? 6394

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 22 in mainland France.
(?)
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[Giuseppe]

Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

Pandemic (H1N1) 2009 Update 09 November 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 09 November 2009, 09:00 hours CEST


Main developments in past 72 hours

• ECDC updated its Pandemic Risk Assessment November 6th including recommended European planning assumptions for hospital care;
• WHO note concerning the detection of pandemic and other influenzas in animals;
• Deaths reported by EU/EEA countries as specifically due to the pandemic virus rose steeply in Week 45;
• Reports from European Influenza Surveillance Network show that pandemic activity is increasing in fifteen out of twenty one counties reporting a trend;
• Total of 401 fatal cases in Europe and EFTA countries and 6 082 in the rest of the world have been reported up to date.

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases is presented in Table 2 - as of 08 November 2009 -16:00 hours CEST, for the world, and 09 November 2009 - 09:00 hours CEST, for Europe.


ECDC Pandemic Risk Assessment updated


ECDC on Friday updated its Pandemic Risk Assessment which is the main repository of its scientific analyses of the epidemiology and experience of the pandemic in Europe and elsewhere. The update is informed by the first experiences from this autumn in Europe and North America as well as further analyses from the Southern Hemisphere?s temperate countries during their winter season.
It includes details of

• the clinical experience of people who are becoming severely ill;
• the first adjusted planning assumptions for European countries not significantly affected by the earlier wave;
• the basic parameters of the pandemic, drawing on work undertaken with WHO and ECDC Advisory Forum;
• European confirmation that many older people possess prior immunity, but that those who are not immune are more at risk of severe disease than any other age group;
• more information on the extent of asymptomatic and very mild cases and estimates of the relative risk for those who, if they have certain risk factors, become severely ill with this infection (pregnant women, people with asthma and other chronic respiratory diseases and massively obese people).

The Risk Assessment is available at LINK


Other updates

A(H1N1) detected in animals


After consultation with international bodies dealing with animals (FAO & OIE) WHO on November 5th issued a short note concerning pandemic influenza A(H1N1) occurring in animals. Since the pandemic virus emerged, a small number of infections have been reported in herds of pigs probably following direct transmission of the virus from infected humans to swine.



These isolated events have had no impact on the dynamics of the pandemic, which is spreading readily via human-to-human transmission. As human infections become increasingly widespread, transmission of the virus from humans to swine and other animals is likely to occur with greater frequency. This has already occurred with infections have been reported in turkeys in Chile and Canada and in a few pet animals in the USA. Again, these infections were isolated events and pose no special risks to human health.



However close monitoring and prompt official notification is needed in WHO?s view since these recent findings and the detection of a seemingly new A(H3N2) virus in mink in Denmark further suggest that influenza A viruses in animals and humans increasingly behave like a pool of genes circulating among multiple hosts. Hence there is a potential for novel influenza viruses to be generated in animals other than swine. This situation reinforces the need for close monitoring and close collaboration between public health and veterinary authorities.



When influenza infections are detected in farmed animals, WHO recommends monitoring of farm workers for signs of respiratory illness, and testing for H1N1 infection should such signs appear. FAO and OIE recommend that animals that are showing signs of illness be examined and properly managed, and allowed to fully recover before being transported or marketed.



In addition, samples from infected animals and humans should be taken for full genome sequencing of the influenza viruses to determine if mutations have occurred that could lead to changes in virulence, host range or antiviral resistance. Such sequencing is also important to assess the possible origin of the case or outbreak.


Full WHO note available at: LINK


Epidemiologic update


All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 401 deaths have been reported; the information is available in Table 2. The latest available updates as of November 08, 2009, at 16:00, on new and on confirmed fatal pandemic A(H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.


Surveillance Trends weeks 44 and 45


Today ECDC reports that deaths announced by EU national authorities as being due to the pandemic rose steeply in week 45 (see Figure 1 and Table 2). The Weekly Influenza Surveillance Overview for Week 44 published on November 6th recorded how on pandemic influenza continues to spread and increase across Europe with pandemic activity increasing in fifteen out of twenty one counties reporting a trend.



Of the six countries reporting rising influenza activity four (Austria, Estonia, Portugal and Romania) did so for the first time. Pandemic A(H1N1) remains the dominant strain circulating, while seasonal strains, mostly A(H3N2) and influenza B, are occurring only sporadically only sporadically.



The percentage of influenza positive sentinel specimens further increased since last week and is now at 48%.



Of nearly five hundred patients with Severe Acute Respiratory Infection patients reported by five countries to ECDC between weeks 40 and 44/2009, 60% needed ventilator support and 50% had no underlying chronic condition.


ECDC Weekly Influenza Surveillance Overview: LINK


Update contents


ECDC has now stopped publishing numbers of confirmed cases reported from EU/EFTA member states ? as well as from other countries around the world ? in its Daily Update. This is due to the fact that most European countries are now recommending laboratory confirmation only in certain population groups, such as the risk groups.


The World Health Organization has also recommended that countries verify only the first few hundred cases; after that exhaustive sampling is not recommended any more. We will continue to monitor the evolution of the pandemic within Europe mirrored by the number of fatal cases by country and through the Weekly Influenza Surveillance Overview which is published on Fridays. For the countries outside of Europe, we will monitor the number of fatal cases by country and monitor the surveillance reports of selected non-European countries.


It must be emphasized that the numbers of fatal cases per country associated with pandemic influenza are likely to be gross underestimates. Access to healthcare, the quality of the laboratory network in the country, the quality of the surveillance system and the case definition used for identifying fatal cases all affect these figures and will vary from country to country. Daily Updates will be produced by 09:00hrs every morning Monday to Friday. No updates will be produced during weekends and the Daily Update published on Monday includes the weekend?s information. The production cycle will be reviewed as needed.


Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 09 November 2009, 09:00 hours (CEST) in the EU and EFTA countries


[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (02.11.) ? ? ? ? ? ? ? ?
2. Belgium (05.11.) ? ? ? ? ? ? ? ?
3. Bulgaria (04.11) ? ? ? ? ? ? ? ?
4. Cyprus ? ? ? ? ? ? ? ?
5. Czech Republic (05.11.) ? ? ? ? ? ? ? ?
6. Denmark (04.11.) ? ? ? ? ? ? ? ?
7. Estonia (23.10.) ? ? - 11 ? ? ? ?
8. Finland (04.11.) ? ? ? ? ? ? ? ?
9. France (04.11.) ? 203 ? 625 ? 36 ? 131
10. Germany (29.10.) ? ? ? ? ? ? ? ?
11. Greece (04.11.) ? ? ? ? ? ? ? ?
12. Hungary (01.11.) ? ? - 68 ? ? ? ?
13. Iceland (30.10.) - 43 ? ? - 11 ? ?
14. Ireland (05.11.) ? 165 ? 665 ? 19 ? 54
15. Italy (07.11) ? ? ? ? ? ? ? ?
16. Latvia (13.08.) ? ? - 1 ? ? ? ?
17. Liechtenstein (05.11.) ? ? ? ? ? ? ? ?
18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (06.11.) ? 273 ? 611 ? 28 ? 69
22. Norway (04.11.) ? 69 ? 497 ? 4 ? 69
23. Poland (05.11.) ? ? ? ? ? ? ? ?
24. Portugal (04.11.) - 63 ? ? - 9 ? ?
25. Romania (08.11) ? ? ? ? ? ? ? ?
26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (05.11.) ? ? ? ? ? ? ? ?
29. Sweden (01.11.) ? 51 - 241 ? ? ? ?
30. Switzerland (01.11.) ? 6 - 33 ? ? ? ?
31. United Kingdom (a) (05.11.) - 848 ? ? - 172 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (691 cumulative hospitalisations), Wales (251) and Northern Ireland (495).


Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 09 November 2009, 09:00 hours CEST, and in the rest of the world by country, as of 08 November 2009, 16:00 hours CEST.


[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Austria ? ? 1
  • Belgium ? ? 8
  • Bulgaria ? ? 5
  • Czech Republic ? ? 1
  • Finland ? ? 2
  • France ? ? 49 (a)
  • Germany ? ? 9
  • Greece ? ? 5
  • Hungary ? ? 5
  • Iceland ? ? 1
  • Ireland ? ? 14
  • Italy 4 ? 29
  • Luxembourg ? ? 1
  • Malta ? ? 3
  • Netherlands 7 ? 17
  • Norway ? ? 15
  • Portugal ? ? 5
  • Spain ? ? 73
  • Sweden ? ? 3
  • United Kingdom 1 ? 155
    
    • Total 12 ? 401
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Belarus ? ? 7
  • Croatia ? ? 1
  • Moldova 1 ? 3
  • Russia 1 ? 15
  • Serbia 1 ? 4
  • Ukraine ? ? 1
    
    • Total 3 ? 31
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Bahrain ? ? 6
  • Egypt ? ? 6
  • Iran ? ? 33
  • Iraq ? - 7
  • Israel ? ? 39
  • Jordan ? ? 7
  • Kuwait 1 ? 22
  • Lebanon ? ? 3
  • Occupied Palestinian Territory 1 ? 2
  • Oman ? ? 25
  • Qatar ? ? 5
  • Saudi Arabia ? ? 66
  • Syria ? ? 7
  • Turkey 4 ? 23
  • United Arab Emirates ? ? 6
  • Yemen ? ? 17
    
    • Total 6 ? 274
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 1
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 91
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 108
• NORTH AMERICA
  
  • Canada 14 ? 115
  • Mexico 21 ? 398
  • USA ? ? 1004
    
    • Total 35 ? 1517
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 38
  • Cuba ? ? 7
  • Dominican Republic ? ? 22
  • El Salvador ? ? 23
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? - 5
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total ? ? 167
• SOUTH AMERICA
  
  • Argentina 7 ? 600
  • Bolivia ? ? 56
  • Brazil ? ? 1368
  • Chile 4 ? 140
  • Colombia ? ? 136
  • Ecuador ? ? 80
  • Paraguay ? ? 52
  • Peru ? ? 180
  • Uruguay ? ? 33
  • Venezuela 2 ? 97
    
    • Total 13 ? 2742
• NORTH-EAST & SOUTH ASIA
  
  • Afghanistan ? ? 9
  • Bangladesh ? ? 6
  • China (Mainland) 8 ? 16
  • Hong Kong SAR China ? ? 39
  • India 6 ? 484
  • Japan ? ? 28
  • Macao SAR China ? ? 2
  • Mongolia 2 ? 8
  • South Korea 3 ? 48
  • Taiwan ? ? 27
    
    • Total 19 ? 667
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 4
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 18
  • Thailand ? ? 184
  • Vietnam ? - 39
    
    • Total ? ? 364
• AUSTRALIA & PACIFIC
  
  • Australia 1 ? 187
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 19
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total 1 ? 212
• TOTAL 89 ? 6483

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 22 in mainland France.
(?)
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[JJackson]

Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

For those trying to understand what is going on in Europe and, more generally, it is more than a little disturbing that the table which starts all of these European CDC reports is largely empty or more accurately populated with ...'s which the legend defines as

(...) denotes no information readily available in official sources.

and we are not just talking about Liechtenstein & Lithuania. Of the four categories - 'Hospitalisations' and 'in ICU' plus their cumulative totals - there is no data in any of the boxes from Germany, Italy or Spain. Of the 31 countries listed only the Norwegians, Dutch, French and Irish have ticked every box. This is not esoteric data or tricky to estimate - like total case numbers - if some one gets as far as being hospitalised or given an ICU bed one would expect a G8 country to be able to count them and report same to the body overseeing data collection - we have had this pandemic in europe for over 6 months now let's see if we can get the counting sorted out.

Scores: Europe C- (Should do better)