Announcement

**Giuseppe** · December 16, 2009, 03:15 PM

Italy - Influenza A/H1N1 - Situation Update as for 16 December 2009 - Updated at 17.00 Hours CEST (Min Health, edited) - CASES: ILI (Cum.) 3,650,000, Hospitalized 811, in ICU 439, Deaths (Cum.) 153

Influenza A/H1N1 - Situation Update as for 16 December 2009 - Updated at 17.00 Hours CEST (Min Health, edited)

[Source RTF Document (in Italian): LINK. Edited. Warning: Google Machine Translation.]
Press Release No 606 - 16 December 2009 - Ministry of Health - PRESS OFFICE

Updates

- The estimated new cases of the flu syndrome in the 49th week (November 30 to December 6) is 224,000, for a total of 3,650,000 cases from 19 October when it began monitoring Influnet current season.
- It is confirmed for the third consecutive week the reduction of access to the emergency room and the number of hospitalizations for acute respiratory syndrome, for all age groups.
- Cases which have necessitated ventilatory support at 14 December: 439
- Percentage of cases that require respiratory assistance in relation to the total of patients: 0.012
- In the 49th week (November 30 to December 6) were administered 52,662 doses. Start of the vaccination campaign, were administered a total, 689,172 first doses and 5730 second doses
- A total of 7,423,851 doses of vaccine distributed. On December 4, started the seventh deployment to the Regions and Autonomous Provinces of vaccines.
- Total estimated cases of pandemic influenza beginning at 6 December: 3,650,000
- Total deaths related to the new influenza A/H1N1 to 16 December: 153

Epidemic surveillance

Cases and incidence

Thursday, December 10th were released weekly updates about the incidence of the flu syndrome in week 49.

The estimated new cases of the flu syndrome in the 49th week 224,000, for a total of 3,650,000 cases from the beginning of the surveillance Influnet (43 weeks: 19-25 October). For a total count since last May, these should be added about 17,000 cases reported previously by other surveillance systems for a total of 3,667,000 cases.

The total value of the impact of the flu syndrome in week 49 is equal to 3.73 cases per thousand attended, sharp downturn compared to the value observed in the previous week (6.68 cases per thousand power). The regions where in week 49 has the highest number of cases in the population under observation are Sardinia with an incidence of 2.0 per cent, Marche (1.1%), Friuli Venezia Giulia (0.6%), Provincia Autonoma Trento (0.6%).

The age group most affected is always the pediatric (0-14 years), with an incidence equal to 9.63 cases per thousand in the assisted group of younger children of 0-4 years and 7.94 per thousand in the range 5-14 years. In the age group 15-64 years the incidence is equal to 2.88 and between individuals aged 65 years and over to 0.84 cases per thousand clients.

There is a decline in the incidence in all age groups although more accentuated in pediatric fields in which the incidence has almost halved.

Cases that require respiratory assistance

The regions have reported so far at the Ministry of 811 hospital admissions for severe cases of influenza, of which 439 have required ventilatory support: a quota of 0,012 percent of the estimated total of people who contract the new flu A.

Victims related to influenza A

To date the total number of deaths stood at 153.

Tomorrow, along with a weekly update of the impact of flu syndrome, will also be provided an overall figure of deaths according to a reclassification made by the regions. The table with data for individual regions will be restored tomorrow

Situation in Europe (source ECDC)

Total casualties in 1393
in

- Great Britain 284
- Spain 208
- France 177

World situation (source ECDC)

Total victims 11188
of which:

- United States of America 1929
- Brazil 1632
- Mexico 732
- Argentina 616

Access to emergency

The network of sentinel emergency rooms reported that in the 49th week (November 30 to December 6), 5.4% of all persons who have turned to the emergency room was visited by acute respiratory syndrome. Of these, 26% had been hospitalized

It is confirmed for the third consecutive week the reduction of access to the emergency room and the number of hospitalizations for acute respiratory syndrome, for all age groups. The analysis of national data is based on information from 49 of the 56 emergency room that joined the surveillance. While reflecting the different modes of access to the emergency room, the system can be readily detected the trend of accesses for respiratory syndrome, an indirect indicator of increased activity of influenza viruses.

Vaccination of the population

In the 49th week (November 30 to December 6) were administered 52,662 doses. Start of the vaccination campaign, were administered a total for the categories as priorities for the first phase of vaccination, 689,172 first doses of 5730 and second doses.

Health professionals, social and health that have been vaccinated 153,852, representing 14.64% of the total.

20,491 women were vaccinated in the second and third trimesters of pregnancy (coverage estimated at 11.4%), while people aged between 6 months and 65 years with risk conditions were administered 438,204 doses (10.4%).

Some regions have also begun to vaccinate children and young adults aged between six months and 27 years without risk conditions and the holders of at least one of the conditions of risk over the age of 65 years for a total of 11,468 doses administered.

Currently, each region was asked to vaccinate as rapidly as women in the second and third trimesters of pregnancy and those aged 6 months to 64 years belonging to those at risk for pre-existing conditions, with priority for children belonging to these categories.

Vaccine distribution

Ended on 8 December, the seventh deployment to the Regions and Autonomous Provinces of pandemic vaccines. The doses delivered to the Regions and Autonomous Provinces as of 12 October were 7,423,851. By the end of December it will reach about 10 million doses: it is expected to further delivery, from 18 December to approximately additional 2,600,000 doses or in part in unit-dose packaging.

Government Actions

Updates

- 20 November 2009: it was disseminated to the Regions and Autonomous Provinces Ministerial Circular "Distribution antiviral drugs to assist Territorial reaffirming the guidance for the administration of antiviral drugs and methods of distribution on the territory of the competent local firms .

- 20 November 2009: it was disseminated to the Regions and Autonomous Provinces the ministerial circular "Supervision of hospitalizations, the serious and complicated and deaths of New Avian influenza virus A (H1N1) viruses and detection of vaccine coverage for the pandemic vaccine," updating the reporting form and procedures for its transmission.

Background

The World Health Organization on 11 June 2009 has declared a state of pandemic influenza with the transition to the phase of maximum alert.

The infection is caused by a new influenza virus H1N1 that has spread from Mexico in March 2009 from around the world.

The government immediately took all measures to counter the spread of new influenza A and protect the health of citizens.

The Ministry has set April 24 a special Crisis Unit headed by Deputy Ferruccio Fazio. Here are the main actions:

Control and containment stage

In the first phase of the spread of the disease were applied to all measures of infection control and containment measures to limit the spread of the virus. This avoided in our country a first wave of summer 2009 epidemic first hand that occurred in other European countries. Among the preventive measures more effective, please note the early identification of cases in travelers from affected areas, prophylaxis of their close contacts, promotion of hygiene rules and protective equipment such as hand washing.

Vaccination of the population

The Government has set up a vaccination strategy to cope with the new wave of epidemic influenza A (H1N1) in place in the 2009-2010 influenza season and eradicate the epidemic of new virus A (H1N1) in our country. E 'planned vaccination of 40% of the Italian population from the employees of essential services like health care personnel, and groups at risk of complications (children and adults with chronic diseases in the age group 6 months to 64 years, women pregnancy in the second and third quarter). E 'active monitoring of the vaccination campaign.

Stocks of antivirals

The Ministry has forty million doses of antiviral drugs, including three in the form of the active powder which, as they have gradually become encapsulated Military Chemical Pharmaceutical Institute in Florence, are distributed to the regions. The Ministry has also issued specific recommendations for proper use of antivirals.

Management of severe cases

The Ministry has provided a first guide to operators in the management of serious and complicated by new influenza virus A (H1N1) and promoted by the regions and autonomous provinces to identify the centers that make for prospective patients suffering from acute respiratory failure. It also defines the criteria for the management of patients, particularly regarding access to the ICU and the next location within the intensive care centers that make up regional networks.

Epidemic surveillance

Starting from 19 October 2009, the influenza surveillance system is based on Influnet, which collects the cases of the network of sentinel physicians reported among its clients as well as data on viruses circulating the network of accredited laboratories. The ISS also conducts random confirmation of clinical cases of serious and deepening virologic to monitor the possible emergence of resistance to antiviral drugs and record any changes in the pandemic virus.

The Ministry also conducts monitoring of hospitalized cases, of serious and deaths.

Sentinel surveillance of access to Emergency

The Ministry of Higher Health Institute have launched in collaboration with the Regional Monitoring of accesses to a specific emergency room. The data will be transmitted on a weekly basis.

Pharmacovigilance

Part of action coordinated by the crisis, the Italian Drug Agency (AIFA) has prepared a National Plan of Pharmacovigilance for monitoring the safety of pandemic vaccines and antivirals. The system has been running since October.

International Epidemiological updates

The World Health Organization November 20 reported that in Norway there was a mutation of the virus in some samples of the new AH1N1 influenza virus isolated in three patients, of whom two died. The mutation is charged with the hemagglutinin (viral protein surface) of the new influenza virus A/H1N1, and causes the substitution of a single amino acid (a glycine instead of aspartic acid). The same mutation was observed in sporadic cases, since last April, in several countries around the world both in patients with severe pneumonia and patients with benign course of disease. Following these reports, the National Institute of Health has reassessed the sequences of more than 100 strains identified by as many patients diagnosed in recent months in various Italian regions. The mutation has been found so far in only one patient suffering from a severe form of pneumonia resolved following treatment with ECMO performed in intensive care. None of the other patients examined, including those with serious or life-threatening events, showed that mutation. The Italian data confirmed that the mutation in question is not to be currently predominant in cases of serious or deadly new flu in addition, the same mutation has a sporadic and does not seem at this stage in the process of diffusion.

Read more

All information on government, the questions and answers, rules and documentation for operators on www.ministerosalute.it, games and interactive tests to understand and better combat the virus A/H1N1al site www.fermailvirus . com.

Information also via phone by calling the call center 1500 of the Ministry, available every day of the week, from 8.00 to 18.00.

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------

**Giuseppe** · December 18, 2009, 03:26 AM

Italy - Influenza A/H1N1 - Situation Update as for 17 December 2009 - Updated at 17.00 Hours CEST (Min Health, edited) - CASES: ILI (Cum.) 3,777,000, Hospitalized 811, in ICU 439, Deaths (Cum.) 163

Influenza A/H1N1 - Situation Update as for 17 December 2009 - Updated at 17.00 Hours CEST (Min Health, edited)

[Source RTF Document (in Italian): LINK. Edited. Warning: Google Machine Translation.]
Press Release No 607 - 17 December 2009 - Ministry of Health - PRESS OFFICE

Updates

- The estimated new cases of the flu syndrome in the 50th week (December 7 to 13) were 132,000, for a total of 3,777,000 cases from 19 October when it began monitoring Influnet current season.
- Determined the number of accesses to the emergency room and that of hospitalizations for acute respiratory syndrome, for all age groups.
- Cases which have necessitated ventilatory support at 17 December: 439
- Percentage of cases that require respiratory assistance in relation to the total of patients: 0.012
- In the 50th week (December 7 to 13) were administered 35,305 doses. Start of the vaccination campaign, a total of 749,842 first doses were administered, and 12,257 second doses
- A total of 7,423,851 doses of vaccine distributed. It is scheduled from 18 December, the distribution of additional 2.6 million doses of vaccines to the Regions and Autonomous Provinces.
- Total estimated cases of influenza since the beginning of the pandemic at 17 December: 3,777,000
- Total deaths related to the new influenza A/H1N1 to 17 December: 163
- Percentage of victims in relation to the total of patients with new influenza A: 0.0043 percent

Epidemic surveillance

Cases and incidence

Today, Thursday, December 17th were released weekly updates about the incidence of flu syndrome in week 50.

The estimated new cases of the flu syndrome in the 50th week is 132,000, for a total of 3,777,000 cases from the beginning of the surveillance Influnet (43 weeks: 19-25 October). For a total count since last May, these should be added about 17,000 cases reported previously by other surveillance systems for a total of 3,794,000 cases.

The total value of the impact of the flu syndrome in week 50 is equal to 2.20 cases per thousand assisted, down to the value observed in the previous week (3.78 cases per thousand power). The regions where in week 50 has the highest number of cases in the population under observation are Sardinia with an incidence of 1.1 per cent, Marche (0.5%), Autonomous Province of Trento (0.3%) .

The age group most affected is always the pediatric (0-14 years), with an incidence equal to 5.10 cases per milleassistiti (6.62 per thousand in the range of very young children of 0-4 years and 4.32 per thousand in the range 5-14 years).

There is a decline in the incidence in each age group, although more marked in the pediatric fields in which the incidence has almost halved

Cases that require respiratory assistance

The regions have reported so far at the Ministry of 811 hospital admissions for severe cases of influenza, of which 439 have required ventilatory support: a quota of 0,012 percent of the estimated total of people who contract the new flu A.

Victims related to influenza A

The percentage of victims related to influenza A has been updated compared to the total number of cases estimated by Influnet and is equal to 0.0043 percent of patients, compared with 0.2 percent of the victims related to the normal flu. Must be considered that the percentage of victims being calculated considering the clinical cases reported to the surveillance system, because these are most likely underestimated, the value might be even lower than the estimate above.
At 17.00 hours on 17 December the overall figure of deaths according to a reclassification made by the regions is equal to 163.

This number includes cases for which the regional health authorities have confirmed the finding of infection by the new A/H1N1.

Situation in Italy

Total casualties 163

- Region
- Abruzzi 3
- Basilicata 1
- Calabria 12
- Campania 45
- Emilia Romagna 11
- Friuli Venezia Giulia 1
- Lazio 10
- Liguria 3
- Lombardy 12
- Marches 2
- Molise 4
- Piedmont 10
- Puglia 25
- Sicily 10
- Tuscany * 2
- Umbria 3
- Veneto 8
- P.a. Bolzano 1

* The data relating to Tuscany are being updated by the local authorities

Situation in Europe (source ECDC)

Total casualties in 1470
in

- Great Britain 284
- Spain 208
- France 181

World situation (source ECDC)

Total victims 11749
of which:

- United States of America 2038
- Brazil 1632
- Mexico 770
- Argentina 616

Access to emergency

The network of sentinel emergency rooms reported that in the 50th week (December 7 to 13), 5.4% of all persons who have turned to the emergency room was visited by acute respiratory syndrome. Of these, 24% had been hospitalized And specified the number of accesses to the emergency room and that of hospitalizations for acute respiratory syndrome, for all age groups. The analysis of national data is based on information from 52 of the 59 emergency room that joined the surveillance.

While reflecting the different modes of access to the emergency room, the system can be readily detected the trend of accesses for respiratory syndrome, an indirect indicator of increased activity of influenza viruses.

Vaccination of the population

In the 50th week (December 7 to 13) were administered 35,305 doses. Start of the vaccination campaign, were administered a total for the categories as priorities for the first phase of vaccination, first 749,842 second doses and 12,257 doses.

Health professionals, social and health that have vaccinated 156,309, equal to 15% of the total.

Women in the second and third trimester of pregnancy were administered 21,376 doses (equal to 11% of total), people aged between 6 months and 65 years with risk conditions were administered 470,514 doses (11%) while children 1378 born preterm doses (7%).

Some regions have started to vaccinate children and young adults between 6 months and 17 years without risk conditions (9,773 doses) and the holders of at least one of the conditions of risk over the age of 65 years (6,305 doses).

Currently, each region was asked to vaccinate as rapidly as women in the second and third trimesters of pregnancy and those aged 6 months to 64 years belonging to those at risk for pre-existing conditions, with priority for children belonging to these categories.

Vaccine distribution

Ended on 8 December, the seventh deployment to the Regions and Autonomous Provinces of pandemic vaccines. The doses delivered to the Regions and Autonomous Provinces as of 12 October were 7,423,851. By the end of December it will reach about 10 million doses: it is expected to further delivery, from 18 December to approximately additional 2,600,000 doses or in part in unit-dose packaging.

Government Actions

Updates

- 20 November 2009: it was disseminated to the Regions and Autonomous Provinces Ministerial Circular "Distribution antiviral drugs to assist Territorial reaffirming the guidance for the administration of antiviral drugs and methods of distribution on the territory of the competent local firms .

- 20 November 2009: it was disseminated to the Regions and Autonomous Provinces the ministerial circular "Supervision of hospitalizations, the serious and complicated and deaths of New Avian influenza virus A (H1N1) viruses and detection of vaccine coverage for the pandemic vaccine," updating the reporting form and procedures for its transmission.

Background

The World Health Organization on 11 June 2009 has declared a state of pandemic influenza with the transition to the phase of maximum alert.

The infection is caused by a new influenza virus H1N1 that has spread from Mexico in March 2009 from around the world.

The government immediately took all measures to counter the spread of new influenza A and protect the health of citizens.

The Ministry has set April 24 a special Crisis Unit headed by Deputy Ferruccio Fazio. Here are the main actions:

Control and containment stage

In the first phase of the spread of the disease were applied to all measures of infection control and containment measures to limit the spread of the virus. This avoided in our country a first wave of summer 2009 epidemic first hand that occurred in other European countries. Among the preventive measures more effective, please note the early identification of cases in travelers from affected areas, prophylaxis of their close contacts, promotion of hygiene rules and protective equipment such as hand washing.

Vaccination of the population

The Government has set up a vaccination strategy to cope with the new wave of epidemic influenza A (H1N1) in place in the 2009-2010 influenza season and eradicate the epidemic of new virus A (H1N1) in our country. E 'planned vaccination of 40% of the Italian population from the employees of essential services like health care personnel, and groups at risk of complications (children and adults with chronic diseases in the age group 6 months to 64 years, women pregnancy in the second and third quarter). E 'active monitoring of the vaccination campaign.

Stocks of antivirals

The Ministry has forty million doses of antiviral drugs, including three in the form of the active powder which, as they have gradually become encapsulated Military Chemical Pharmaceutical Institute in Florence, are distributed to the regions. The Ministry has also issued specific recommendations for proper use of antivirals.

Management of severe cases

The Ministry has provided a first guide to operators in the management of serious and complicated by new influenza virus A (H1N1) and promoted by the regions and autonomous provinces to identify the centers that make for prospective patients suffering from acute respiratory failure. It also defines the criteria for the management of patients, particularly regarding access to the ICU and the next location within the intensive care centers that make up regional networks.

Epidemic surveillance

Starting from 19 October 2009, the influenza surveillance system is based on Influnet, which collects the cases of the network of sentinel physicians reported among its clients as well as data on viruses circulating the network of accredited laboratories. The ISS also conducts random confirmation of clinical cases of serious and deepening virologic to monitor the possible emergence of resistance to antiviral drugs and record any changes in the pandemic virus.

The Ministry also conducts monitoring of hospitalized cases, of serious and deaths.

Sentinel surveillance of access to Emergency

The Ministry of Higher Health Institute have launched in collaboration with the Regional Monitoring of accesses to a specific emergency room. The data will be transmitted on a weekly basis.

Pharmacovigilance

Part of action coordinated by the crisis, the Italian Drug Agency (AIFA) has prepared a National Plan of Pharmacovigilance for monitoring the safety of pandemic vaccines and antivirals. The system has been running since October.

International Epidemiological updates

The World Health Organization November 20 reported that in Norway there was a mutation of the virus in some samples of the new AH1N1 influenza virus isolated in three patients, of whom two died. The mutation is charged with the hemagglutinin (viral protein surface) of the new influenza virus A/H1N1, and causes the substitution of a single amino acid (a glycine instead of aspartic acid). The same mutation was observed in sporadic cases, since last April, in several countries around the world both in patients with severe pneumonia and patients with benign course of disease. Following these reports, the National Institute of Health has reassessed the sequences of more than 100 strains identified by as many patients diagnosed in recent months in various Italian regions. The mutation has been found so far in only one patient suffering from a severe form of pneumonia resolved following treatment with ECMO performed in intensive care. None of the other patients examined, including those with serious or life-threatening events, showed that mutation. The Italian data confirmed that the mutation in question is not to be currently predominant in cases of serious or deadly new flu in addition, the same mutation has a sporadic and does not seem at this stage in the process of diffusion.

Read more

All information on government, the questions and answers, rules and documentation for operators on www.ministerosalute.it, games and interactive tests to understand and better combat the virus A/H1N1al site www.fermailvirus . com.

Information also via phone by calling the call center 1500 of the Ministry, available every day of the week, from 8.00 to 18.00.

--
-----

**Giuseppe** · December 18, 2009, 03:34 PM

Italy - Influenza A/H1N1 - Situation Update as for 18 December 2009 - Updated at 17.00 Hours CEST (Min Health, edited) - CASES: ILI (Cum.) 3,794,000, Hospitalized 832, in ICU 448, Deaths (Cum.) 178

Influenza A/H1N1 - Situation Update as for 18 December 2009 - Updated at 17.00 Hours CEST (Min Health, edited)

[Source RTF Document (in Italian): LINK. Edited. Warning: Google Machine Translation.]

Press Release No 609 - 18 December 2009 - Ministry of Health - PRESS OFFICE

Updates

- The estimated new cases of the flu syndrome in the 50th week (December 7 to 13) were 132,000, for a total of 3,777,000 cases from 19 October when it began monitoring Influnet current season.
- Determined the number of accesses to the emergency room and that of hospitalizations for acute respiratory syndrome, for all age groups.
- Cases which have necessitated ventilatory support to 18 December: 448
- Percentage of cases that require respiratory assistance in relation to the total of patients: 0.012
- In the 50th week (December 7 to 13) were administered 35,305 doses. Start of the vaccination campaign, a total of 749,842 first doses were administered, and 12,257 second doses
- A total of 7,423,851 doses of vaccine distributed. It is scheduled from 18 December, the distribution of additional 2.6 million doses of vaccines to the Regions and Autonomous Provinces.
- Total estimated cases of influenza since the beginning of the pandemic at 18 December: 3,777,000
- Total deaths related to the new influenza A/H1N1 to 18 December: 178
- Percentage of victims in relation to the total of patients with new influenza A: 0.0047 percent

Epidemic surveillance

Cases and incidence

Thursday, December 17th were released weekly updates about the incidence of the flu syndrome in week 50.

The estimated new cases of the flu syndrome in the 50th week is 132,000, for a total of 3,777,000 cases from the beginning of the surveillance Influnet (43 weeks: 19-25 October). For a total count since last May, these should be added about 17,000 cases reported previously by other surveillance systems for a total of 3,794,000 cases.

The total value of the impact of the flu syndrome in week 50 is equal to 2.20 cases per thousand assisted, down to the value observed in the previous week (3.78 cases per thousand power). The regions where in week 50 has the highest number of cases in the population under observation are Sardinia with an incidence of 1.1 per cent, Marche (0.5%), Autonomous Province of Trento (0.3%) . The age group most affected is always the pediatric (0-14 years), with an incidence equal to 5.10 cases per milleassistiti (6.62 per thousand in the range of very young children of 0-4 years and 4.32 per thousand in the range 5-14 years).

There is a decline in the incidence in each age group, although more marked in the pediatric fields in which the incidence has almost halved

Cases that require respiratory assistance

The regions have reported so far at the Ministry of 832 hospital admissions for severe cases of influenza, of which 448 have required ventilatory support: a quota of 0,012 percent of the estimated total of people who contract the new flu A.

Victims related to influenza A

The percentage of victims related to influenza A has been updated compared to the total number of cases estimated by Influnet and is equal to 0.0047 percent of patients, compared with 0.2 percent of the victims related to the normal flu. Must be considered that the percentage of victims being calculated considering the clinical cases reported to the surveillance system, because these are most likely underestimated, the value might be even lower than the estimate above.

At 17.00 hours of December 18, the overall figure of deaths following a reclassification, still in work, by the regions is equal to 178.

This number includes cases for which the regional health authorities have confirmed the finding of infection by the new A/H1N1.

Situation in Italy

Total casualties 178

- Region
- Abruzzi 3
- Basilicata 1
- Calabria 13
- Campania 46
- Emilia Romagna 12
- Friuli Venezia Giulia 2
- Lazio 13
- Liguria 3
- Lombardy 12
- Marches 3
- Molise 4
- Piedmont 12
- Puglia 25
- Sicily 12
- Tuscany * 4
- Umbria 3
- Veneto 8
- P.a. Bolzano 1
- P.a. Trent 1

Situation in Europe (source ECDC)

Total casualties in 1570
in

- Great Britain 298
- Spain 298
- France 182

World situation (source ECDC)

Total victims 11877
of which:

- United States of America 2038
- Brazil 1632
- Mexico 770
- Argentina 616

Access to emergency

The network of sentinel emergency rooms reported that in the 50th week (December 7 to 13), 5.4% of all persons who have turned to the emergency room was visited by acute respiratory syndrome. Of these, 24% had been hospitalized

And specified the number of accesses to the emergency room and that of hospitalizations for acute respiratory syndrome, for all age groups. The analysis of national data is based on information from 52 of the 59 emergency room that joined the surveillance.

While reflecting the different modes of access to the emergency room, the system can be readily detected the trend of accesses for respiratory syndrome, an indirect indicator of increased activity of influenza viruses.

Vaccination of the population

In the 50th week (December 7 to 13) were administered 35,305 doses. Start of the vaccination campaign, were administered a total for the categories as priorities for the first phase of vaccination, first 749,842 second doses and 12,257 doses.

Health professionals, social and health that have vaccinated 156,309, equal to 15% of the total. Women in the second and third trimester of pregnancy were administered 21,376 doses (equal to 11% of total), people aged between 6 months and 65 years with risk conditions were administered 470,514 doses (11%) while children 1378 born preterm doses (7%).

Some regions have already begun to vaccinate children and young adults between 6 months and 17 years without risk conditions (9,773 doses) and the holders of at least one of the conditions of risk over the age of 65 years (6,305 doses).

Vaccine distribution

Ended on 8 December, the seventh deployment to the Regions and Autonomous Provinces of pandemic vaccines. The doses delivered to the Regions and Autonomous Provinces as of 12 October were 7,423,851. By the end of December it will reach about 10 million doses: it is expected to further delivery, from 18 December to approximately additional 2,600,000 doses or in part in unit-dose packaging.

Government Actions

Updates

- 20 November 2009: it was disseminated to the Regions and Autonomous Provinces Ministerial Circular "Distribution antiviral drugs to assist Territorial reaffirming the guidance for the administration of antiviral drugs and methods of distribution on the territory of the competent local firms .

- 20 November 2009: it was disseminated to the Regions and Autonomous Provinces the ministerial circular "Supervision of hospitalizations, the serious and complicated and deaths of New Avian influenza virus A (H1N1) viruses and detection of vaccine coverage for the pandemic vaccine," updating the reporting form and procedures for its transmission.

Background

The World Health Organization on 11 June 2009 has declared a state of pandemic influenza with the transition to the phase of maximum alert.

The infection is caused by a new influenza virus H1N1 that has spread from Mexico in March 2009 from around the world.

The government immediately took all measures to counter the spread of new influenza A and protect the health of citizens.

The Ministry has set April 24 a special Crisis Unit headed by Deputy Ferruccio Fazio. Here are the main actions:

Control and containment stage

In the first phase of the spread of the disease were applied to all measures of infection control and containment measures to limit the spread of the virus. This avoided in our country a first wave of summer 2009 epidemic first hand that occurred in other European countries. Among the preventive measures more effective, please note the early identification of cases in travelers from affected areas, prophylaxis of their close contacts, promotion of hygiene rules and protective equipment such as hand washing.

Vaccination of the population

The Government has set up a vaccination strategy to cope with the new wave of epidemic influenza A (H1N1) in place in the 2009-2010 influenza season and eradicate the epidemic of new virus A (H1N1) in our country. E 'planned vaccination of 40% of the Italian population from the employees of essential services like health care personnel, and groups at risk of complications (children and adults with chronic diseases in the age group 6 months to 64 years, women pregnancy in the second and third quarter). E 'active monitoring of the vaccination campaign.

Stocks of antivirals

The Ministry has forty million doses of antiviral drugs, including three in the form of the active powder which, as they have gradually become encapsulated Military Chemical Pharmaceutical Institute in Florence, are distributed to the regions. The Ministry has also issued specific recommendations for proper use of antivirals.

Management of severe cases

The Ministry has provided a first guide to operators in the management of serious and complicated by new influenza virus A (H1N1) and promoted by the regions and autonomous provinces to identify the centers that make for prospective patients suffering from acute respiratory failure. It also defines the criteria for the management of patients, particularly regarding access to the ICU and the next location within the intensive care centers that make up regional networks.

Epidemic surveillance

Starting from 19 October 2009, the influenza surveillance system is based on Influnet, which collects the cases of the network of sentinel physicians reported among its clients as well as data on viruses circulating the network of accredited laboratories. The ISS also conducts random confirmation of clinical cases of serious and deepening virologic to monitor the possible emergence of resistance to antiviral drugs and record any changes in the pandemic virus.

The Ministry also conducts monitoring of hospitalized cases, of serious and deaths.

Sentinel surveillance of access to Emergency

The Ministry of Higher Health Institute have launched in collaboration with the Regional Monitoring of accesses to a specific emergency room. The data will be transmitted on a weekly basis.

Pharmacovigilance

Part of action coordinated by the crisis, the Italian Drug Agency (AIFA) has prepared a National Plan of Pharmacovigilance for monitoring the safety of pandemic vaccines and antivirals. The system has been running since October.

International Epidemiological updates

The World Health Organization November 20 reported that in Norway there was a mutation of the virus in some samples of the new AH1N1 influenza virus isolated in three patients, of whom two died. The mutation is charged with the hemagglutinin (viral protein surface) of the new influenza virus A/H1N1, and causes the substitution of a single amino acid (a glycine instead of aspartic acid). The same mutation was observed in sporadic cases, since last April, in several countries around the world both in patients with severe pneumonia and patients with benign course of disease. Following these reports, the National Institute of Health has reassessed the sequences of more than 100 strains identified by as many patients diagnosed in recent months in various Italian regions. The mutation has been found so far in only one patient suffering from a severe form of pneumonia resolved following treatment with ECMO performed in intensive care. None of the other patients examined, including those with serious or life-threatening events, showed that mutation. The Italian data confirmed that the mutation in question is not to be currently predominant in cases of serious or deadly new flu in addition, the same mutation has a sporadic and does not seem at this stage in the process of diffusion.

Read more

All information on government, the questions and answers, rules and documentation for operators on www.ministerosalute.it, games and interactive tests to understand and better combat the virus A/H1N1al site www.fermailvirus . com.

Information also via phone by calling the call center 1500 of the Ministry, available every day of the week, from 8.00 to 18.00.

--
------

**Giuseppe** · December 19, 2009, 03:16 PM

Italy - Influenza A/H1N1 - Situation Update as for 19 December 2009 - Updated at 17.00 Hours CEST (Min Health, edited) - CASES: ILI (Cum.) 3,794,000, Hospitalized 832, in ICU 448, Deaths (Cum.) 178

Influenza A/H1N1 - Situation Update as for 19 December 2009 - Updated at 17.00 Hours CEST (Min Health, edited)

[Source RTF Document (in Italian): LINK. Edited. Warning: Google Machine Translation.]

Press Release No 610 - 19 December 2009 - Ministry of Health - PRESS OFFICE

Updates

- The estimated new cases of the flu syndrome in the 50th week (December 7 to 13) were 132,000, for a total of 3,777,000 cases from 19 October when it began monitoring Influnet current season.
- Determined the number of accesses to the emergency room and that of hospitalizations for acute respiratory syndrome, for all age groups.
- Cases which have necessitated ventilatory support at 19 December: 448
- Percentage of cases that require respiratory assistance in relation to the total of patients: 0.012
- In the 50th week (December 7 to 13) were administered 35,305 doses. Start of the vaccination campaign, a total of 749,842 first doses were administered, and 12,257 second doses
- A total of 7,423,851 doses of vaccine distributed. By the end of December it will reach about 10 million doses.
- Total estimated cases of influenza since the beginning of the pandemic to 19 December: 3,777,000
- Total deaths related to the new influenza A/H1N1 to December 19: 178
- Percentage of victims in relation to the total of patients with new influenza A: 0.0047 percent

Epidemic surveillance

Cases and incidence

Thursday, December 17th were released weekly updates about the incidence of the flu syndrome in week 50.

The estimated new cases of the flu syndrome in the 50th week is 132,000, for a total of 3,777,000 cases from the beginning of the surveillance Influnet (43 weeks: 19-25 October). For a total count since last May, these should be added about 17,000 cases reported previously by other surveillance systems for a total of 3,794,000 cases.

The total value of the impact of the flu syndrome in week 50 is equal to 2.20 cases per thousand assisted, down to the value observed in the previous week (3.78 cases per thousand power). The regions where in week 50 has the highest number of cases in the population under observation are Sardinia with an incidence of 1.1 per cent, Marche (0.5%), Autonomous Province of Trento (0.3%) .

The age group most affected is always the pediatric (0-14 years), with an incidence equal to 5.10 cases per milleassistiti (6.62 per thousand in the range of younger children of 0-4 years and 4.32 per thousand in the range 5-14 years).

There is a decline in the incidence in each age group, although more marked in the pediatric fields in which
the incidence has almost halved

Cases that require respiratory assistance

The regions have reported so far at the Ministry of 832 hospital admissions for severe cases of influenza, of which 448 have required ventilatory support: a quota of 0,012 percent of the estimated total of people who contract the new flu A.

Victims related to influenza A

The percentage of victims related to influenza A has been updated compared to the total number of cases estimated by Influnet and is equal to 0.0047 percent of patients, compared with 0.2 percent of the victims related to the normal flu. Must be considered that the percentage of victims being calculated considering the clinical cases reported to the surveillance system, because these are most likely underestimated, the value might be even lower than the estimate above.

At 17.00 hours on 19 December the overall figure of deaths following a reclassification, still in work, by the regions is equal to 178.

This number includes cases for which the regional health authorities have confirmed the finding of infection by the new A/H1N1.

Situation in Italy

Total casualties 178

- Region
- Abruzzi 3
- Basilicata 1
- Calabria 13
- Campania 46
- Emilia Romagna 12
- Friuli Venezia Giulia 2
- Lazio 13
- Liguria 3
- Lombardy 12
- Marches 3
- Molise 4
- Piedmont 12
- Puglia 25
- Sicily 12
- Tuscany * 4
- Umbria 3
- Veneto 8
- P.a. Bolzano 1
- P.a. Trent 1

Situation in Europe (source ECDC)

Total casualties in 1570
in

- Great Britain 298
- Spain 298
- France 182

World situation (source ECDC)

Total victims 11877
of which:

- United States of America 2038
- Brazil 1632
- Mexico 770
- Argentina 616

Access to emergency

The network of sentinel emergency rooms reported that in the 50th week (December 7 to 13), 5.4% of all persons who have turned to the emergency room was visited by acute respiratory syndrome. Of these, 24% had been hospitalized

And specified the number of accesses to the emergency room and that of hospitalizations for acute respiratory syndrome, for all age groups. The analysis of national data is based on information from 52 of the 59 emergency room that joined the surveillance. While reflecting the different modes of access to the emergency room, the system can be readily detected the trend of accesses for respiratory syndrome, an indirect indicator of increased activity of influenza viruses.

Vaccination of the population

In the 50th week (December 7 to 13) were administered 35,305 doses. Start of the vaccination campaign, were administered a total for the categories as priorities for the first phase of vaccination, first 749,842 second doses and 12,257 doses.

Health professionals, social and health that have vaccinated 156,309, equal to 15% of the total.

Women in the second and third trimester of pregnancy were administered 21,376 doses (equal to 11% of total), people aged between 6 months and 65 years with risk conditions were administered 470,514 doses (11%) while children 1378 born preterm doses (7%).

Some regions have already begun to vaccinate children and young adults between 6 months and 17 years without risk conditions (9,773 doses) and the holders of at least one of the conditions of risk over the age of 65 years (6,305 doses).

Vaccine distribution

Ended on 8 December, the seventh deployment to the Regions and Autonomous Provinces of pandemic vaccines. The doses delivered to the Regions and Autonomous Provinces as of 12 October were 7,423,851. By the end of December it will reach about 10 million doses.

Government Actions

Updates

- 20 November 2009: it was disseminated to the Regions and Autonomous Provinces Ministerial Circular "Distribution antiviral drugs to assist Territorial reaffirming the guidance for the administration of antiviral drugs and methods of distribution on the territory of the competent local firms .

- 20 November 2009: it was disseminated to the Regions and Autonomous Provinces the ministerial circular "Supervision of hospitalizations, the serious and complicated and deaths of New Avian influenza virus A (H1N1) viruses and detection of vaccine coverage for the pandemic vaccine," updating the reporting form and procedures for its transmission.

Background

The World Health Organization on 11 June 2009 has declared a state of pandemic influenza with the transition to the phase of maximum alert.

The infection is caused by a new influenza virus H1N1 that has spread from Mexico in March 2009 from around the world.

The government immediately took all measures to counter the spread of new influenza A and protect the health of citizens.

The Ministry has set April 24 a special Crisis Unit headed by Deputy Ferruccio Fazio. Here are the main actions:

Control and containment stage

In the first phase of the spread of the disease were applied to all measures of infection control and containment measures to limit the spread of the virus. This avoided in our country a first wave of summer 2009 epidemic first hand that occurred in other European countries. Among the preventive measures more effective, please note the early identification of cases in travelers from affected areas, prophylaxis of their close contacts, promotion of hygiene rules and protective equipment such as hand washing.

Vaccination of the population

The Government has set up a vaccination strategy to cope with the new wave of epidemic influenza A (H1N1) in place in the 2009-2010 influenza season and eradicate the epidemic of new virus A (H1N1) in our country. E 'planned vaccination of 40% of the Italian population from the employees of essential services like health care personnel, and groups at risk of complications (children and adults with chronic diseases in the age group 6 months to 64 years, women pregnancy in the second and third quarter). E 'active monitoring of the vaccination campaign.

Stocks of antivirals

The Ministry has forty million doses of antiviral drugs, including three in the form of the active powder which, as they have gradually become encapsulated Military Chemical Pharmaceutical Institute in Florence, are distributed to the regions. The Ministry has also issued specific recommendations for proper use of antivirals.

Management of severe cases

The Ministry has provided a first guide to operators in the management of serious and complicated by new influenza virus A (H1N1) and promoted by the regions and autonomous provinces to identify the centers that make for prospective patients suffering from acute respiratory failure. It also defines the criteria for the management of patients, particularly regarding access to the ICU and the next location within the intensive care centers that make up regional networks.

Epidemic surveillance

Starting from 19 October 2009, the influenza surveillance system is based on Influnet, which collects the cases of the network of sentinel physicians reported among its clients as well as data on viruses circulating the network of accredited laboratories. The ISS also conducts random confirmation of clinical cases of serious and deepening virologic to monitor the possible emergence of resistance to antiviral drugs and record any changes in the pandemic virus.

The Ministry also conducts monitoring of hospitalized cases, of serious and deaths.

Sentinel surveillance of access to Emergency

The Ministry of Higher Health Institute have launched in collaboration with the Regional Monitoring of accesses to a specific emergency room. The data will be transmitted on a weekly basis.

Pharmacovigilance

Part of action coordinated by the crisis, the Italian Drug Agency (AIFA) has prepared a National Plan of Pharmacovigilance for monitoring the safety of pandemic vaccines and antivirals. The system has been running since October.

International Epidemiological updates

The World Health Organization November 20 reported that in Norway there was a mutation of the virus in some samples of the new AH1N1 influenza virus isolated in three patients, of whom two died. The mutation is charged with the hemagglutinin (viral protein surface) of the new influenza virus A/H1N1, and causes the substitution of a single amino acid (a glycine instead of aspartic acid). The same mutation was observed in sporadic cases, since last April, in several countries around the world both in patients with severe pneumonia and patients with benign course of disease. Following these reports, the National Institute of Health has reassessed the sequences of more than 100 strains identified by as many patients diagnosed in recent months in various Italian regions. The mutation has been found so far in only one patient suffering from a severe form of pneumonia resolved following treatment with ECMO performed in intensive care. None of the other patients examined, including those with serious or life-threatening events, showed that mutation. The Italian data confirmed that the mutation in question is not to be currently predominant in cases of serious or deadly new flu in addition, the same mutation has a sporadic and does not seem at this stage in the process of diffusion.

Read more

All information on government, the questions and answers, rules and documentation for operators on www.ministerosalute.it, games and interactive tests to understand and better combat the virus A/H1N1al site www.fermailvirus . com.

Information also via phone by calling the call center 1500 of the Ministry, available every day of the week, from 8.00 to 18.00.

--
------

**estacion** · December 21, 2009, 09:57 AM

Re: Italy - Influenza A/H1N1 - Situation Update as for 19 December 2009 - Updated at 17.00 Hours CEST (Min Health, edited) - CASES: ILI (Cum.) 3,794,000, Hospitalized 832, in ICU 448, Deaths (Cum.) 178

Situation in Europe (source ECDC)

Total casualties in 1570
in

- Great Britain 298
- Spain 298
- France 182

ironorehopper

May be Italian Ministry of Health has slipped a typo in Spain death figure at this report.
If a recall well, at that moment there were 230 A/H1N1 fatalities in Spain.

**Giuseppe** · December 21, 2009, 10:16 AM

Re: Italy - Influenza A/H1N1 - Situation Update as for 19 December 2009 - Updated at 17.00 Hours CEST (Min Health, edited) - CASES: ILI (Cum.) 3,794,000, Hospitalized 832, in ICU 448, Deaths (Cum.) 178

Originally posted by estacion View Post

ironorehopper

May be Italian Ministry of Health has slipped a typo in Spain death figure at this report.
If a recall well, at that moment there were 230 A/H1N1 fatalities in Spain.

Unfortunately, as you correctly noted, Italian Ministry of Health lacks of accuracy when reporting foreign fatal pandemic H1N1 2009 virus infection cases, as well national cases, especially about hospitalized and intensive care unit patients.

**Giuseppe** · December 22, 2009, 03:02 AM

Italy - Influenza A/H1N1 - Situation Update as for 21 December 2009 - Updated at 17.00 Hours CEST (Min Health, edited) - CASES: ILI (Cum.) 3,794,000, Hospitalized 832, in ICU 448, Deaths (Cum.) 182

Influenza A/H1N1 - Situation Update as for 21 December 2009 - Updated at 17.00 Hours CEST (Min Health, edited)

[Source RTF Document (in Italian): LINK. Edited. Warning: Google Machine Translation.]
Press Release - No 612 - 21 December 2009 - Ministry of Health - PRESS OFFICE

Updates

- The estimated new cases of the flu syndrome in the 50th week (December 7 to 13) were 132,000, for a total of 3,777,000 cases from 19 October when it began monitoring Influnet current season.
- Determined the number of accesses to the emergency room and that of hospitalizations for acute respiratory syndrome, for all age groups.
- Cases which have necessitated ventilatory support at 21 December: 448
- Percentage of cases that require respiratory assistance in relation to the total of patients: 0.012
- In the 50th week (December 7 to 13) were administered 35,305 doses. Start of the vaccination campaign, a total of 749,842 first doses were administered, and 12,257 second doses
- A total of 7,423,851 doses of vaccine distributed. By the end of December it will reach about 10 million doses.
- Total estimated cases of influenza since the beginning of the pandemic at 21 December: 3,777,000
- Total deaths related to the new influenza A/H1N1 to 21 December: 182
- Percentage of victims in relation to the total of patients with new influenza A: 0.0047 percent

Epidemic surveillance

Cases and incidence

Thursday, December 17th were released weekly updates about the incidence of the flu syndrome in week 50.

The estimated new cases of the flu syndrome in the 50th week is 132,000, for a total of 3,777,000 cases from the beginning of the surveillance Influnet (43 weeks: 19-25 October). For a total count since last May, these should be added about 17,000 cases reported previously by other surveillance systems for a total of 3,794,000 cases.

The total value of the impact of the flu syndrome in week 50 is equal to 2.20 cases per thousand assisted, down to the value observed in the previous week (3.78 cases per thousand power). The regions where in week 50 has the highest number of cases in the population under observation are Sardinia with an incidence of 1.1 per cent, Marche (0.5%), Autonomous Province of Trento (0.3%) .

The age group most affected is always the pediatric (0-14 years), with an incidence equal to 5.10 cases per milleassistiti (6.62 per thousand in the range of younger children of 0-4 years and 4.32 per thousand in the range 5-14 years).

There is a decline in the incidence in each age group, although more marked in the pediatric fields in which the incidence has almost halved

Cases that require respiratory assistance

The regions have reported so far at the Ministry of 832 hospital admissions for severe cases of influenza, of which 448 have required ventilatory support: a quota of 0,012 percent of the estimated total of people who contract the new flu A.

Victims related to influenza A

The percentage of victims related to influenza A has been updated compared to the total number of cases estimated by Influnet and is equal to 0.0047 percent of patients, compared with 0.2 percent of the victims related to the normal flu. Must be considered that the percentage of victims being calculated considering the clinical cases reported to the surveillance system, because these are most likely underestimated, the value might be even lower than the estimate above.

At 17.00 hours on 21 December the overall figure of deaths following a reclassification, still in work, by the regions is equal to 182.

This number includes cases for which the regional health authorities have confirmed the finding of infection by the new A/H1N1.

Situation in Italy

Total casualties 182

- Region
- Abruzzi 3
- Basilicata 1
- Calabria 14
- Campania 46
- Emilia Romagna 12
- Friuli Venezia Giulia 2
- Lazio 13
- Liguria 3
- Lombardy 12
- Marches 3
- Molise 4
- Piedmont 12
- Puglia 26
- Sicily 13
- Tuscany 4
- Umbria 3
- Veneto 9
- P.a. Bolzano 1
- P.a. Trent 1

Situation in Europe (source ECDC)

Total casualties in 1652
in

- Great Britain 298
- Spain 232
- France 196

World situation (source ECDC)

Total victims 12040
of which:

- United States of America 2038
- Brazil 1632
- Mexico 780
- Argentina 617

Access to emergency

The network of sentinel emergency rooms reported that in the 50th week (December 7 to 13), 5.4% of all persons who have turned to the emergency room was visited by acute respiratory syndrome. Of these, 24% had been hospitalized

And specified the number of accesses to the emergency room and that of hospitalizations for acute respiratory syndrome, for all age groups. The analysis of national data is based on information from 52 of the 59 emergency room that joined the surveillance. While reflecting the different modes of access to the emergency room, the system can be readily detected the trend of accesses for respiratory syndrome, an indirect indicator of increased activity of influenza viruses.

Vaccination of the population

In the 50th week (December 7 to 13) were administered 35,305 doses. Start of the vaccination campaign, were administered a total for the categories as priorities for the first phase of vaccination, first 749,842 second doses and 12,257 doses.

Health professionals, social and health that have vaccinated 156,309, equal to 15% of the total.

Women in the second and third trimester of pregnancy were administered 21,376 doses (equal to 11% of total), people aged between 6 months and 65 years with risk conditions were administered 470,514 doses (11%) while children 1378 born preterm doses (7%).

Some regions have already begun to vaccinate children and young adults between 6 months and 17 years without risk conditions (9,773 doses) and the holders of at least one of the conditions of risk over the age of 65 years (6,305 doses).

Vaccine distribution

Ended on 8 December, the seventh deployment to the Regions and Autonomous Provinces of pandemic vaccines. The doses delivered to the Regions and Autonomous Provinces as of 12 October were 7,423,851. By the end of December it will reach about 10 million doses.

Government Actions

Updates

- 20 November 2009: it was disseminated to the Regions and Autonomous Provinces Ministerial Circular "Distribution antiviral drugs to assist Territorial reaffirming the guidance for the administration of antiviral drugs and methods of distribution on the territory of the competent local firms .

- 20 November 2009: it was disseminated to the Regions and Autonomous Provinces the ministerial circular "Supervision of hospitalizations, the serious and complicated and deaths of New Avian influenza virus A (H1N1) viruses and detection of vaccine coverage for the pandemic vaccine," updating the reporting form and procedures for its transmission.

Background

The World Health Organization on 11 June 2009 has declared a state of pandemic influenza with the transition to the phase of maximum alert.

The infection is caused by a new influenza virus H1N1 that has spread from Mexico in March 2009 from around the world.

The government immediately took all measures to counter the spread of new influenza A and protect the health of citizens.

The Ministry has set April 24 a special Crisis Unit headed by Deputy Ferruccio Fazio. Here are the main actions:

Control and containment stage

In the first phase of the spread of the disease were applied to all measures of infection control and containment measures to limit the spread of the virus. This avoided in our country a first wave of summer 2009 epidemic first hand that occurred in other European countries. Among the preventive measures more effective, please note the early identification of cases in travelers from affected areas, prophylaxis of their close contacts, promotion of hygiene rules and protective equipment such as hand washing.

Vaccination of the population

The Government has set up a vaccination strategy to cope with the new wave of epidemic influenza A (H1N1) in place in the 2009-2010 influenza season and eradicate the epidemic of new virus A (H1N1) in our country. E 'planned vaccination of 40% of the Italian population from the employees of essential services like health care personnel, and groups at risk of complications (children and adults with chronic diseases in the age group 6 months to 64 years, women pregnancy in the second and third quarter). E 'active monitoring of the vaccination campaign.

Stocks of antivirals

The Ministry has forty million doses of antiviral drugs, including three in the form of the active powder which, as they have gradually become encapsulated Military Chemical Pharmaceutical Institute in Florence, are distributed to the regions. The Ministry has also issued specific recommendations for proper use of antivirals.

Management of severe cases

The Ministry has provided a first guide to operators in the management of serious and complicated by new influenza virus A (H1N1) and promoted by the regions and autonomous provinces to identify the centers that make for prospective patients suffering from acute respiratory failure. It also defines the criteria for the management of patients, particularly regarding access to the ICU and the next location within the intensive care centers that make up regional networks.

Epidemic surveillance

Starting from 19 October 2009, the influenza surveillance system is based on Influnet, which collects the cases of the network of sentinel physicians reported among its clients as well as data on viruses circulating the network of accredited laboratories. The ISS also conducts random confirmation of clinical cases of serious and deepening virologic to monitor the possible emergence of resistance to antiviral drugs and record any changes in the pandemic virus.

The Ministry also conducts monitoring of hospitalized cases, of serious and deaths.

Sentinel surveillance of access to Emergency

The Ministry of Higher Health Institute have launched in collaboration with the Regional Monitoring of accesses to a specific emergency room. The data will be transmitted on a weekly basis.

Pharmacovigilance

Part of action coordinated by the crisis, the Italian Drug Agency (AIFA) has prepared a National Plan of Pharmacovigilance for monitoring the safety of pandemic vaccines and antivirals. The system has been running since October.

International Epidemiological updates

The World Health Organization November 20 reported that in Norway there was a mutation of the virus in some samples of the new AH1N1 influenza virus isolated in three patients, of whom two died. The mutation is charged with the hemagglutinin (viral protein surface) of the new influenza virus A/H1N1, and causes the substitution of a single amino acid (a glycine instead of aspartic acid). The same mutation was observed in sporadic cases, since last April, in several countries around the world both in patients with severe pneumonia and patients with benign course of disease. Following these reports, the National Institute of Health has reassessed the sequences of more than 100 strains identified by as many patients diagnosed in recent months in various Italian regions. The mutation has been found so far in only one patient suffering from a severe form of pneumonia resolved following treatment with ECMO performed in intensive care. None of the other patients examined, including those with serious or life-threatening events, showed that mutation. The Italian data confirmed that the mutation in question is not to be currently predominant in cases of serious or deadly new flu in addition, the same mutation has a sporadic and does not seem at this stage in the process of diffusion.

Read more

All information on government, the questions and answers, rules and documentation for operators on www.ministerosalute.it, games and interactive tests to understand and better combat the virus A/H1N1al site www.fermailvirus . com.

Information also via phone by calling the call center 1500 of the Ministry, available every day of the week, from 8.00 to 18.00.

--
------

**Giuseppe** · December 22, 2009, 04:29 PM

Italy - Influenza A/H1N1 - Situation Update as for 22 December 2009 - Updated at 17.00 Hours CEST (Min Health, edited) - CASES: ILI (Cum.) 3,794,000, Hospitalized 832, in ICU 448, Deaths (Cum.) 187

Influenza A/H1N1 - Situation Update as for 22 December 2009 - Updated at 17.00 Hours CEST (Min Health, edited)

[Source RTF Document (in Italian): LINK. Edited. Warning: Google Machine Translation.]
Press Release No 613 - 22 December 2009 - Ministry of Health - PRESS OFFICE

Updates

- The estimated new cases of the flu syndrome in the 50th week (December 7 to 13) were 132,000, for a total of 3,777,000 cases from 19 October when it began monitoring Influnet current season.
- Determined the number of accesses to the emergency room and that of hospitalizations for acute respiratory syndrome, for all age groups.
- Cases which have necessitated ventilatory support at 22 December: 448
- Percentage of cases that require respiratory assistance in relation to the total of patients: 0.012
- In the 50th week (December 7 to 13) were administered 35,305 doses. Start of the vaccination campaign, a total of 749,842 first doses were administered, and 12,257 second doses
- A total of 7,423,851 doses of vaccine distributed. By the end of December it will reach about 10 million doses.
- Total estimated cases of influenza since the beginning of the pandemic at 22 December: 3,777,000
- Total deaths related to the new influenza A/H1N1 to 22 December: 187
- Percentage of victims in relation to the total of patients with new influenza A: 0.0050 percent

Epidemic surveillance

Cases and incidence

Thursday, December 17th were released weekly updates about the incidence of the flu syndrome in week 50.

The estimated new cases of the flu syndrome in the 50th week is 132,000, for a total of 3,777,000 cases from the beginning of the surveillance Influnet (43 weeks: 19-25 October). For a total count since last May, these should be added about 17,000 cases reported previously by other surveillance systems for a total of 3,794,000 cases.

The total value of the impact of the flu syndrome in week 50 is equal to 2.20 cases per thousand assisted, down to the value observed in the previous week (3.78 cases per thousand power). The regions where in week 50 has the highest number of cases in the population under observation are Sardinia with an incidence of 1.1 per cent, Marche (0.5%), Autonomous Province of Trento (0.3%) .

The age group most affected is always the pediatric (0-14 years), with an incidence equal to 5.10 cases per thousand assisted (6.62 per thousand in the range of younger children of 0-4 years and 4 32 per thousand in the range 5-14 years).

There is a decline in the incidence in each age group, although more marked in the pediatric fields in which
the incidence has almost halved

Cases that require respiratory assistance

The regions have reported so far at the Ministry of 832 hospital admissions for severe cases of influenza, of which 448 have required ventilatory support: a quota of 0,012 percent of the estimated total of people who contract the new flu A.

Victims related to influenza A

The percentage of victims related to influenza A has been updated compared to the total number of cases estimated by Influnet and is equal to 0.0050 percent of patients, compared with 0.2 percent of the victims related to the normal flu. Must be considered that the percentage of victims being calculated considering the clinical cases reported to the surveillance system, because these are most likely underestimated, the value might be even lower than the estimate above.

At 17.00 hours of December 22, the overall figure of deaths following a reclassification, still in work, by the regions is equal to 187.

This number includes cases for which the regional health authorities have confirmed the finding of infection by the new A/H1N1.

Situation in Italy

Total casualties 187

- Region
- Abruzzi 3
- Basilicata 1
- Calabria 14
- Campania 47
- Emilia Romagna 12
- Friuli Venezia Giulia 3
- Lazio 13
- Liguria 3
- Lombardy 12
- Marches 3
- Molise 4
- Piedmont 12
- Puglia 29
- Sicily 13
- Tuscany 4
- Umbria 3
- Veneto 9
- P.a. Bolzano 1
- P.a. Trent 1

Situation in Europe (source ECDC)

Total casualties in 1671
in

- Great Britain 298
- Spain 232
- France 200

World situation (source ECDC)

Total victims 12121
of which:

- United States of America 2038
- Brazil 1632
- Mexico 780
- Argentina 617

Access to emergency

The network of sentinel emergency rooms reported that in the 50th week (December 7 to 13), 5.4% of all persons who have turned to the emergency room was visited by acute respiratory syndrome. Of these, 24% had been hospitalized

And specified the number of accesses to the emergency room and that of hospitalizations for acute respiratory syndrome, for all age groups. The analysis of national data is based on information from 52 of the 59 emergency room that joined the surveillance.

While reflecting the different modes of access to the emergency room, the system can be readily detected the trend of accesses for respiratory syndrome, an indirect indicator of increased activity of influenza viruses.

Vaccination of the population

In the 50th week (December 7 to 13) were administered 35,305 doses. Start of the vaccination campaign, were administered a total for the categories as priorities for the first phase of vaccination, first 749,842 second doses and 12,257 doses.

Health professionals, social and health that have vaccinated 156,309, equal to 15% of the total.

Women in the second and third trimester of pregnancy were administered 21,376 doses (equal to 11% of total), people aged between 6 months and 65 years with risk conditions were administered 470,514 doses (11%) while children 1378 born preterm doses (7%).

Some regions have already begun to vaccinate children and young adults between 6 months and 17 years without risk conditions (9,773 doses) and the holders of at least one of the conditions of risk over the age of 65 years (6,305 doses).

Vaccine distribution

Ended on 8 December, the seventh deployment to the Regions and Autonomous Provinces of pandemic vaccines. The doses delivered to the Regions and Autonomous Provinces as of 12 October were 7,423,851. By the end of December it will reach about 10 million doses.

Government Actions

Updates

- 20 November 2009: it was disseminated to the Regions and Autonomous Provinces Ministerial Circular "Distribution antiviral drugs to assist Territorial reaffirming the guidance for the administration of antiviral drugs and methods of distribution on the territory of the competent local firms .

- 20 November 2009: it was disseminated to the Regions and Autonomous Provinces the ministerial circular "Supervision of hospitalizations, the serious and complicated and deaths of New Avian influenza virus A (H1N1) viruses and detection of vaccine coverage for the pandemic vaccine," updating the reporting form and procedures for its transmission.

Background

The World Health Organization on 11 June 2009 has declared a state of pandemic influenza with the transition to the phase of maximum alert.

The infection is caused by a new influenza virus H1N1 that has spread from Mexico in March 2009 from around the world.

The government immediately took all measures to counter the spread of new influenza A and protect the health of citizens.

The Ministry has set April 24 a special Crisis Unit headed by Deputy Ferruccio Fazio. Here are the main actions:

Control and containment stage

In the first phase of the spread of the disease were applied to all measures of infection control and containment measures to limit the spread of the virus. This avoided in our country a first wave of summer 2009 epidemic first hand that occurred in other European countries. Among the preventive measures more effective, please note the early identification of cases in travelers from affected areas, prophylaxis of their close contacts, promotion of hygiene rules and protective equipment such as hand washing.

Vaccination of the population

The Government has set up a vaccination strategy to cope with the new wave of epidemic influenza A (H1N1) in place in the 2009-2010 influenza season and eradicate the epidemic of new virus A (H1N1) in our country. E 'planned vaccination of 40% of the Italian population from the employees of essential services like health care personnel, and groups at risk of complications (children and adults with chronic diseases in the age group 6 months to 64 years, women pregnancy in the second and third quarter). E 'active monitoring of the vaccination campaign.

Stocks of antivirals

The Ministry has forty million doses of antiviral drugs, including three in the form of the active powder which, as they have gradually become encapsulated Military Chemical Pharmaceutical Institute in Florence, are distributed to the regions. The Ministry has also issued specific recommendations for proper use of antivirals.

Management of severe cases

The Ministry has provided a first guide to operators in the management of serious and complicated by new influenza virus A (H1N1) and promoted by the regions and autonomous provinces to identify the centers that make for prospective patients suffering from acute respiratory failure. It also defines the criteria for the management of patients, particularly regarding access to the ICU and the next location within the intensive care centers that make up regional networks.

Epidemic surveillance

Starting from 19 October 2009, the influenza surveillance system is based on Influnet, which collects the cases of the network of sentinel physicians reported among its clients as well as data on viruses circulating the network of accredited laboratories. The ISS also conducts random confirmation of clinical cases of serious and deepening virologic to monitor the possible emergence of resistance to antiviral drugs and record any changes in the pandemic virus.

The Ministry also conducts monitoring of hospitalized cases, of serious and deaths.

Sentinel surveillance of access to Emergency

The Ministry of Higher Health Institute have launched in collaboration with the Regional Monitoring of accesses to a specific emergency room. The data will be transmitted on a weekly basis.

Pharmacovigilance

Part of action coordinated by the crisis, the Italian Drug Agency (AIFA) has prepared a National Plan of Pharmacovigilance for monitoring the safety of pandemic vaccines and antivirals. The system has been running since October.

International Epidemiological updates

The World Health Organization November 20 reported that in Norway there was a mutation of the virus in some samples of the new AH1N1 influenza virus isolated in three patients, of whom two died. The mutation is charged with the hemagglutinin (viral protein surface) of the new influenza virus A/H1N1, and causes the substitution of a single amino acid (a glycine instead of aspartic acid). The same mutation was observed in sporadic cases, since last April, in several countries around the world both in patients with severe pneumonia and patients with benign course of disease. Following these reports, the National Institute of Health has reassessed the sequences of more than 100 strains identified by as many patients diagnosed in recent months in various Italian regions. The mutation has been found so far in only one patient suffering from a severe form of pneumonia resolved following treatment with ECMO performed in intensive care. None of the other patients examined, including those with serious or life-threatening events, showed that mutation. The Italian data confirmed that the mutation in question is not to be currently predominant in cases of serious or deadly new flu in addition, the same mutation has a sporadic and does not seem at this stage in the process of diffusion.

Read more

All information on government, the questions and answers, rules and documentation for operators on www.ministerosalute.it, games and interactive tests to understand and better combat the virus A/H1N1al site www.fermailvirus . com.

Information also via phone by calling the call center 1500 of the Ministry, available every day of the week, from 8.00 to 18.00.

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**Giuseppe** · December 23, 2009, 04:36 AM

FluNews - Italy: Reporting period epiweek 50 (7-13 December 2009) (excerpts, edited)

FluNews - Italy: Reporting period epiweek 50 (7-13 December 2009) (excerpts, edited)

[Source Full PDF Document: LINK. EDITED.]

FLUNEWS - ITALY

Reporting period epiweek 50 (7-13 December 2009)

ILI surveillance methodology:

The Italian surveillance system for influenza is based on a network of sentinel community based physicians in the 21 regions and autonomous provinces of the country. Incidence rates are therefore not based on consultations but on the served population of each reporting physician each week. Incidence data per 1,000 patients is provided globally and by age group.

For more information on the Influnet surveillance system consult the website LINK (in Italian).

This bulletin is a translation of FluNews, the official report combining the information of all the epidemiological surveillance systems monitoring the influenza pandemic in Italy. The original version in Italian is produced by the National Centre of Epidemiology (CNESPS) of the Italian National Institute of Health (LINK)

Influenza Like Illness (ILI) sentinel surveillance: (LINK)

Completeness of reporting in epiweek 50 was 95% (20/21 regions reporting).

The incidence of ILI, as detected through sentinel surveillance, was 2.20 cases per 1,000, decreased compared with the previous epiweek. In the age group 0-4 years the incidence was 6.62?. Among patients aged 5-14 years the incidence was 4.32?, among
those aged 15-64 years it was 1.71?, while the incidence among patients 65 years or more, was 0.65?. After having peaked in epiweek 46 (incidence 12.89?), the ILI epicurve is still descending.

HIGHLIGHTS:

The epidemic curve for ILI cases in Italy is decreasing sharply.
The number of deaths due to H1N1 is decreasing.
Emergency room admissions for ARS are not breaching alarm/alert thresholds.
Purchase of pain killers, antibiotics and antivirals was decreasing in epiweek 49.

(...)
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Attached Files

epiweek_50.pdf (1.10 MB, 112 views)

**Giuseppe** · December 24, 2009, 12:25 PM

Italy - Influenza A/H1N1 - Situation Update - week 51/2009 (14-20 December) (Min Health, edited) - CASES: ILI (Cum.) 3,889,000, Hospitalized 934, in ICU 452, Deaths (Cum.) 188

Influenza A/H1N1 - Situation Update - week 51/2009 (14-20 December) (Min Health, edited)

[Source RTF Document (in Italian): LINK. Edited. Warning: Google Machine Translation.]
Press Release No 615 - 24 December 2009 - Ministry of Health - PRESS OFFICE

Updates

- The estimated new cases of the flu syndrome in the 51st week (December 14 to 20) were 107,000, for a total of 3,872,000 cases from 19 October when it began monitoring Influnet current season.
- Determined the number of accesses to the emergency room and that of hospitalizations for acute respiratory syndrome, for all age groups.
- Cases which have necessitated ventilatory support at 21 December 452
- Percentage of cases that require respiratory assistance in relation to the total of patients: 0.011 for 100
- In the 51st week (December 14 to 20) were administered 34,904 doses (26,361 first and 8543 second doses). Start of the vaccination campaign, a total of 798,414 first doses were administered, and 22,042 second doses.
- A total of 7,423,851 doses of vaccine distributed. By the end of December it will reach about 10 million doses.
- Total deaths related to the new influenza A/H1N1 to 20 December: 188
- Percentage of victims in relation to the total of patients with new influenza A: 0.0048 percent

Epidemic surveillance

Cases and incidence

Thursday, December 24th were released weekly updates about the incidence of the flu syndrome in week 51.

The estimated new cases of the flu syndrome in the 51st week is 107,000, for a total of 3,872,000 cases from the beginning of the surveillance Influnet (43 weeks: 19-25 October). For a total count since last May, these should be added about 17,000 cases reported previously by other surveillance systems for a total of 3,889,000 cases.

The total value of the impact of the flu syndrome in week 51 is equal to 1.79 cases per thousand assisted, slightly less than the value observed in the previous week (2.16 cases per thousand power). The regions where in week 51 has the highest number of cases in the population under observation are Sardinia with an incidence of 7.68 per thousand assisted, Marche (3.96 per 1000), Piemonte (2.47 per 1000) .

The age group most affected is always the pediatric (0-14 years), with an incidence equal to 3.69 cases per thousand assisted (5.04 per thousand in the range of younger children of 0-4 years and 3 00 per thousand in the range 5-14 years). There is a decline in the incidence in all age groups although more accentuated in pediatric

Cases that require respiratory assistance

The regions have reported so far at the Ministry of 934 hospital admissions for severe cases of influenza, of which 452 have required ventilatory support: a fee equal to 0.011 percent of the estimated total of people who contract the new flu A.

Victims related to influenza A

The percentage of victims related to the influence A/H1N1v has been updated compared to the total number of cases estimated by Influnet and is equal to 0.0048 percent of patients, compared with 0.2 percent of the victims related to the normal flu. Must be considered that the percentage of victims being calculated considering the clinical cases reported to the surveillance system, because these are most likely underestimated, the value might be even lower than the estimate above.

At week 51 the overall figure of deaths is equal to 188. This number includes cases for which the regional health authorities have confirmed the finding of infection by the new A/H1N1.

Situation in Italy

Total casualties 188

- Region
- Abruzzi 3
- Basilicata 1
- Calabria 14
- Campania 47
- Emilia Romagna 12
- Friuli 3
- Lazio 14
- Liguria 3
- Lombardy 12
- Marche 3
- Molise 4
- P.a. Bolzano 1
- P.a. Trento 1
- Piedmont 12
- Puglia 29
- Sicily 13
- Tuscany 4

Situation in Europe (source ECDC)

Total casualties in 1671
in

- Great Britain 298
- Spain 232
- France 200

World situation (source ECDC)

Total victims 12121
of which:

- United States of America 2038
- Brazil 1632
- Mexico 780
- Argentina 617

Access to emergency

The network of sentinel emergency rooms reported that in the 51 th week (14-20 December) to 4.5% of all people who have turned to the emergency room was visited by acute respiratory syndrome. Of these, 28.3% were hospitalized.

Decreased access to emergency and the number of hospitalizations for acute respiratory syndrome, for all age groups. The analysis of national data is based on information from 53 of the 59 emergency room that joined the surveillance. While reflecting the different modes of access to the emergency room, the system can be readily detected the trend of accesses for respiratory syndrome, an indirect indicator of increased activity of influenza viruses.

Vaccination of the population

In the 51 weeks were administered 34,904 doses (26,361 first and 8543 second doses). Start of the vaccination campaign, a total of 798,414 first doses were administered, and 22,042 second doses.

Health personnel, social and health has received 158,429 doses, for a coverage of 15%. Women in the second and third trimester of pregnancy were administered 22,082 doses (12% of total), people aged between 6 months and 65 years with risk conditions were administered 501,970 doses (12%) and children 1462 born preterm doses (7%).

Some regions have also begun to vaccinate children and young people aged between 6 months and 17 years without risk conditions (14,447 doses) and the holders of at least one of the conditions of risk over the age of 65 years (8,474 doses).

Vaccine distribution

Ended on 8 December, the seventh deployment to the Regions and Autonomous Provinces of pandemic vaccines. The doses delivered to the Regions and Autonomous Provinces as of 12 October were 7,423,851. By the end of December it will reach about 10 million doses.

Government Actions

Updates

- 20 November 2009: it was disseminated to the Regions and Autonomous Provinces Ministerial Circular "Distribution antiviral drugs to assist Territorial reaffirming the guidance for the administration of antiviral drugs and methods of distribution on the territory of the competent local firms .

- 20 November 2009: it was disseminated to the Regions and Autonomous Provinces the ministerial circular "Supervision of hospitalizations, the serious and complicated and deaths of New Avian influenza virus A (H1N1) viruses and detection of vaccine coverage for the pandemic vaccine," updating the reporting form and procedures for its transmission.

Background

The World Health Organization on 11 June 2009 has declared a state of pandemic influenza with the transition to the phase of maximum alert.

The infection is caused by a new influenza virus H1N1 that has spread from Mexico in March 2009 from around the world.

The government immediately took all measures to counter the spread of new influenza A and protect the health of citizens.

The Ministry has set April 24 a special Crisis Unit headed by Deputy Ferruccio Fazio. Here are the main actions:

Control and containment stage

In the first phase of the spread of the disease were applied to all measures of infection control and containment measures to limit the spread of the virus. This avoided in our country a first wave of summer 2009 epidemic first hand that occurred in other European countries. Among the preventive measures more effective, please note the early identification of cases in travelers from affected areas, prophylaxis of their close contacts, promotion of hygiene rules and protective equipment such as hand washing.

Vaccination of the population

The Government has set up a vaccination strategy to cope with the new wave of epidemic influenza A (H1N1) in place in the 2009-2010 influenza season and eradicate the epidemic of new virus A (H1N1) in our country. E 'planned vaccination of 40% of the Italian population from the employees of essential services like health care personnel, and groups at risk of complications (children and adults with chronic diseases in the age group 6 months to 64 years, women pregnancy in the second and third quarter). E 'active monitoring of the vaccination campaign.

Stocks of antivirals

The Ministry has forty million doses of antiviral drugs, including three in the form of the active powder which, as they have gradually become encapsulated Military Chemical Pharmaceutical Institute in Florence, are distributed to the regions. The Ministry has also issued specific recommendations for proper use of antivirals.

Management of severe cases

The Ministry has provided a first guide to operators in the management of serious and complicated by new influenza virus A (H1N1) and promoted by the regions and autonomous provinces to identify the centers that make for prospective patients suffering from acute respiratory failure. It also defines the criteria for the management of patients, particularly regarding access to the ICU and the next location within the intensive care centers that make up regional networks.

Epidemic surveillance

Starting from 19 October 2009, the influenza surveillance system is based on Influnet, which collects the cases of the network of sentinel physicians reported among its clients as well as data on viruses circulating the network of accredited laboratories. The ISS also conducts random confirmation of clinical cases of serious and deepening virologic to monitor the possible emergence of resistance to antiviral drugs and record any changes in the pandemic virus.

The Ministry also conducts monitoring of hospitalized cases, of serious and deaths.

Sentinel surveillance of access to Emergency

The Ministry of Higher Health Institute have launched in collaboration with the Regional Monitoring of accesses to a specific emergency room. The data will be transmitted on a weekly basis.

Pharmacovigilance

Part of action coordinated by the crisis, the Italian Drug Agency (AIFA) has prepared a National Plan of Pharmacovigilance for monitoring the safety of pandemic vaccines and antivirals. The system has been running since October.

International Epidemiological updates

The World Health Organization November 20 reported that in Norway there was a mutation of the virus in some samples of the new AH1N1 influenza virus isolated in three patients, of whom two died. The mutation is charged with the hemagglutinin (viral protein surface) of the new influenza virus A/H1N1, and causes the substitution of a single amino acid (a glycine instead of aspartic acid). The same mutation was observed in sporadic cases, since last April, in several countries around the world both in patients with severe pneumonia and patients with benign course of disease. Following these reports, the National Institute of Health has reassessed the sequences of more than 100 strains identified by as many patients diagnosed in recent months in various Italian regions. The mutation has been found so far in only one patient suffering from a severe form of pneumonia resolved following treatment with ECMO performed in intensive care. None of the other patients examined, including those with serious or life-threatening events, showed that mutation. The Italian data confirmed that the mutation in question is not to be currently predominant in cases of serious or deadly new flu in addition, the same mutation has a sporadic and does not seem at this stage in the process of diffusion.

Read more

All information on government, the questions and answers, rules and documentation for operators on www.ministerosalute.it, games and interactive tests to understand and better combat the virus A/H1N1al site www.fermailvirus . com.

Information also via phone by calling the call center 1500 of the Ministry, operating every day of the week (except holidays) from 8.00 to 18.00.

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**Giuseppe** · December 30, 2009, 01:21 PM

Italy - Influenza A/H1N1 2009 - Ministry of Health Situation Updates - December 15-31, 2009 Archive.

This thread contains Italian Ministry of Health Press Releases with 2009 H1N1 Pandemic Influenza situation updates.

Announcement

Italy - Influenza A/H1N1 2009 - Ministry of Health Situation Updates - December 15-31, 2009 Archive.

Italy - Influenza A/H1N1 2009 - Ministry of Health Situation Updates - December 15-31, 2009 Archive.

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