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

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC): Pandemic Influenza H1N1 2009, Situation Updates (Since August 4, 2009)

Pandemic (H1N1) 2009 - Update 16 August 2009, 17:00 hours CEST (ECDC, edited)

[Original Full Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 - Update 16 August 2009, 17:00 hours CEST


Main developments in past 24 hours

• 188 new cases reported in the EU and EFTA countries, reaching a total of 38 187 cases, 60 of which have died of the infection;
• 1 171 new cases including 11 fatal cases, were reported from non-EU and EFTA countries, reaching a cumulative total of 190 734 cases;

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 cases as of 16 August 2009, 16:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer:

Several countries have now announced recommendations on treatment on clinical signs only and focused laboratory testing only for specific population groups or in outbreaks. For these countries, the reported numbers of cases presented in this report will severely underestimate the true incidence in the country and will not be comparable to countries still recommending laboratory tests of all suspected influenza cases.


Epidemiologic update

Out of the 27 EU and 4 EFTA countries, all countries have reported a total of 38 187 confirmed cases of influenza A(H1N1)v infection, including 60 deaths (Table 1). In the past 24 hours, 188 new cases were reported from the EU and EFTA countries. Currently, the majority of the cases are being reported from the UK, Netherlands, Greece and Germany. During this week, we have identified reports of currently hospitalised cases from 6 countries. The majority of the hospitalized cases have been reported from UK, specifically from England.

Outside of the EU and EFTA countries, a total of 1 171 new cases have been reported within the last 24 hours. 11 fatal cases were also reported (Table 3). In total, 190 734 cases including 2 024 fatal cases have been reported from non-EU and EFTA countries.

Media reports discuss increasing numbers of cases being reported in countries on the northern and eastern side of the Indian Ocean. Many Central and South American countries have passed the peak incidence period, according to media reports and supported by the official reports.

Globally, the total number of confirmed and reported influenza A (H1N1)v cases to date is 228 921 including 2 084 deaths.


Other developments

Extension of the pandemic

The pandemic continues to affect an increasing number of countries. Over this past week, the Democratic Republic of the Congo, Cameroon, Madagascar, East Timor and Zambia reported their first confirmed cases of influenza A (H1N1)v.

During the same period Japan, South Korea, Nicaragua, Mauritius, Iraq, Samoa, Ghana, Occupied Palestine Territory and Ireland all confirmed their first death due to this virus.


Changing the format of the daily report

As the influenza pandemic evolves, new types of data become increasingly important, whereas other may become less interesting. ECDC has refreshed the format of the Situation Update to better accommodate current and anticipated information needs. The name of this report changed to "Daily Update" and some changes have been made in the data reported.

Table 1 ? reported cases by the EU/EFTA countries remains as before. In addition, we are publishing a new Table 2 on the number of current and cumulative hospitalisations and admission to intensive care in EU/EFTA Member States. The source of the information is official statements or surveillance reports published by national health authorities. It should be noted that indications and thresholds for hospitalisations vary by country, so the figures quoted may not be directly comparable between countries.

Assuming no changes in the national reporting system, trends of hospitalisations over time should give an accurate representation of the evolution of the pandemic. This might change if countries are faced with capacity issues within the healthcare system at a later stage of this evolving pandemic.

Table 3 lists only reported deaths for countries outside the EU/EFTA area; we have discontinued reporting the case numbers for these countries. The main reason for this is that more and more countries have stopped the reporting of new cases, and these figures no longer give a representative picture of the situation.

The two graphs now show number of reported deaths by week of report ? one graph for EU/EFTA, one for the entire world. The two maps depict cumulative deaths by country, one for EU/EFTA, one for the world.


Table 1: Reported new confirmed cases and cumulative number of influenza A(H1N1)v and cumulative deaths among confirmed cases by country as of 16 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Deaths among confirmed cases*]

1. Austria ... - 222 - ...
2. Belgium ... - 126 - 1
3. Bulgaria ... - 51 - ...
4. Cyprus ... - 297 - ...
5. Czech Republic ... - 201 - ...
6. Denmark ... - 444 - ...
7. Estonia ... - 56 - ...
8. Finland ... - 196 - ...
9. France** ... - 1125 - 1
10. Germany ... - 11493 - ...
11. Greece ... - 1424 - ...
12. Hungary ... - 133 - 1
13. Iceland ... - 118 - ...
14. Ireland ... - 574 - 1
15. Italy ... - 1238 - ...
16. Latvia ... - 23 - ...
17. Liechtenstein ... - 13 - ...
18. Lithuania ... - 40 - ...
19. Luxemburg ... - 113 - ...
20. Malta ... - 204 - ...
21. Netherlands*** ... - 1473 - 1
22. Norway ... - 868 - ...
23. Poland ... - 143 - ...
24. Portugal 173 - 1268 - ...
25. Romania 15 - 253 - ...
26. Slovakia ... - 96 - ...
27. Slovenia ... - 200 - ...
28. Spain ... - 1538 - 11
29. Sweden ... - 602 - ...
30. Switzerland ... - 752 - ...
31. United Kingdom**** ... - 12903 - 44

• Total 188 - 38187 - 60

Note:
cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites. Countries shaded with gray are not recommending laboratory tests for all suspect cases, therefore comparisons in time or between these countries should not be made at present.

(*) Deaths are included in the cumulative number of confirmed cases
(**) Cases reported from France include those reported from the overseas territories (434)
(***) Cases from the Netherlands include those reported from Aruba and the Dutch Antilles
(****) Cases reported from the United Kingdom include the number of individual cases from the following overseas territories: Anguilla, The Falklands, Gibraltar, Sovereign Base Area Cyprus, Turks and Caicos Islands (78)


Table 2: Reported number of confirmed influenza A(H1N1)v cases admitted to hospitals and intensive care by country as of 16 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - (date of report) - Most recent number of cases admitted in hospitals - Cumulative number of cases admitted in hospitals - Most recent number of cases admitted to intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (7.8.) - 0 - ... - 0 - ...
2. Belgium (7.8.) - 0 - ... - 0 - ...
3. Bulgaria - ... - ... - ... - ...
4. Cyprus - ... - ... - ... - ...
5. Czech Republic (5.8.) - 0 - ... - 0 - ...
6. Denmark (13.8.) - ... - ... - ... - ...
7. Estonia (12.8.) - 0 - 0 - 0 - 0
8. Finland (4.8.) - ... - ... - ... - ...
9. France(a) (12.8.) - 5 - 53 - 4 - 10
10. Germany (13.8.) - ... - ... - ... - ...
11. Greece (3.8.) - 4 - ... - 2 - ...
12. Hungary (7.8.) - ... - ... - ... - ...
13. Iceland (7.8.) - 0 - 0 - 0 - 0
14. Ireland (7.8.) - 3 - 23 - ... - ...
15. Italy (17.7.) - ... - ... - ... - ...
16. Latvia (11.8.) - ... - 1 - ... - ...
17. Liechtenstein (13.8.) - ... - ... - ... - ...
18. Lithuania (5.8.) - ... - ... - ... - ...
19. Luxemburg (30.7.) - 0 - 0 - 0 - 0
20. Malta - ... - ... - ... - ...
21. Netherlands (14.8.) - ... - 28 - ... - ...
22. Norway (5.8.) - ... - ... - ... - ...
23. Poland (4.8.) - ... - ... - ... - ...
24. Portugal (15.8.) - 20 - ... - ... - ...
25. Romania - ... - 18 - ... - ...
26. Slovakia (12.8.) - 2 - 33 - 0 - 0
27. Slovenia (10.8.) - ... - ... - ... - ...
28. Spain (14.8.) - ... - ... - 29 - 77
29. Sweden (6.8.) - ... - ... - ... - ...
30. Switzerland (13.8.) - ... - 11 - ... - 1
31. United Kingdom(b) (13.8.) - 371 - ... - 55 - ...

Note:
Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites. New updates are shaded in yellow. (-) denotes no information readily available in official sources.

(a) Cases reported from France include those reported from the overseas territories.
(b) Data for England only. Does not include Scotland (94 cumulative hospitalisations), Wales (33) and Northern Ireland (14 ).


Table 3. Reported number of new and cumulative confirmed fatal pandemic influenza (H1N1) 2009 cases by country as of 16 August 2009, 16:00 hours (CEST) outside of the EU/EFTA area

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

• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA

1. No deaths reported - ... - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Egypt ... - 1
2. Iraq ... - 1
3. Israel ... - 7
4. Lebanon ... - 1
5. Occupied Palestinian Territory ... - 1
6. Qatar ... - 1
7. Saudi Arabia ... - 11

• AFRICA

1. Ghana ... - 1
2. Mauritius ... - 1
3. South Africa ... - 3

• NORTH AMERICA

1. Canada ... - 66
2. Mexico ... - 163
3. USA ... - 477

• CENTRAL AMERICA & CARIBBEAN

1. Cayman Islands ... - 1
2. Costa Rica ... - 28
3. Dominican Republic ... - 5
4. El Salvador ... - 12
5. Guatemala ... - 10
6. Honduras ... - 7
7. Jamaica ... - 4
8. Nicaragua ... - 1
9. Panama ... - 4
10. Saint Kitts and Nevis ... - 1

• SOUTH AMERICA

1. Argentina ... - 404
2. Bolivia ... - 14
3. Brazil ... - 192
4. Chile ... - 112
5. Colombia ... - 18
6. Ecuador ... - 23
7. Paraguay ... - 39
8. Peru ... - 45
9. Uruguay ... - 22
10. Venezuela ... - 12

• NORTH-EAST & SOUTH ASIA

1. Hong Kong SAR China ... - 4
2. India ... - 17
3. Japan ... - 1
4. South Korea 1 - 2
5. Taiwan 1 - 2

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 1
2. Indonesia ... - 3
3. Laos Peoples Democratic Republic ... - 1
4. Malaysia 3 - 62
5. Philippines ... - 8
6. Singapore ... - 11
7. Thailand ... - 97
8. Vietnam ... - 2

• AUSTRALIA & PACIFIC

1. Australia 6 - 108
2. New Zealand ... - 14
3. Samoa ... - 2
4. Tonga ... - 1

• TOTAL 11 - 2024

Note:
cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated. Yellow shading indicates a new update has been recorded for the country during the past 24 hours.


(...)
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[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC): Pandemic Influenza H1N1 2009, Situation Updates (Since August 4, 2009)

Pandemic (H1N1) 2009 - Update 17 August 2009, 17:00 hours CEST (ECDC, edited)

[Original Full Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 - Update 17 August 2009, 17:00 hours CEST


Main developments in past 24 hours

• 762 new cases reported in the EU and EFTA countries, reaching a total of 38 936 cases, no new deaths reported;
• 1 683 new cases including 23 fatal cases, were reported from non-EU and EFTA countries, reaching a cumulative total of 192 417 cases;
• Report on oseltamivir-resistance developing in two immune suppressed patients published;
• HPA issues letter to neurologist to raise awareness of Guillain-Barr? syndrome.

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 cases as of 17 August 2009, 16:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer:

Several countries have now announced recommendations on treatment on clinical signs only and focused laboratory testing only for specific population groups or in outbreaks. For these countries, the reported numbers of cases presented in this report will severely underestimate the true incidence in the country and will not be comparable to countries still recommending laboratory tests of all suspected influenza cases.


Epidemiologic update

Out of the 27 EU and 4 EFTA countries, all countries have reported a total of 38 936 confirmed cases of influenza A(H1N1)v infection, including 60 deaths (Table 1). In the past 24 hours, 762 new cases were reported from the EU and EFTA countries. Currently, the majority of the cases are being reported from Germany. During this week, we have identified public reports of currently hospitalised cases from 5 countries (Table 2). The majority of the hospitalized cases have been reported from UK, specifically from England.

Outside of the EU and EFTA countries, a total of 1 683 new cases have been reported within the last 24 hours. 23 fatal cases were also reported (Table 3). In total, 192 417 cases including 2 047 fatal cases have been reported from non-EU and EFTA countries.

Media reports discuss increasing numbers of cases being reported in countries on the northern and eastern side of the Indian Ocean, as well as South Africa. Most North, Central and South American countries have passed the peak incidence period, according to media reports and supported by the official reports.

Globally, the total number of confirmed and reported influenza A (H1N1)v cases to date is 231 353 including 2 107 deaths.


Updates from Eurosurveillance

In Eurosurveillance, Volume 14, Issue 32, an article from Turkey reports on the first 128 cases of influenza A(H1N1)v identified in Turkey and on the control measures taken by the Ministry of Health for containment of the epidemic from 27 April to 17 July 2009. Of the 128 cases, 17 were from the Turkish Cypriot community and the remaining 111 from various provinces in Turkey. The number of cases increased remarkably from June onward. Of the 111 confirmed cases in Turkey, 25 were domestic secondary cases. Of the 17 confirmed cases in the Turkish Cypriot community, 13 were indigenous. http://www.eurosurveillance.org/View...rticleId=19304

A report from Peru presents a preliminary analysis of 1,771 cases of influenza A(H1N1)v confirmed in Peru by 17 July 2009, including the frequency of the clinical characteristics, the geographic and age distribution of the cases and the estimate of the transmission potential. Age-specific frequency of cases was highest among school age children and young adults, and the lowest frequency of cases was registered among seniors. Estimates of the reproduction number lie in the range of 1.2 to 1.7, which is broadly consistent with previous estimates for this pandemic in other regions. http://www.eurosurveillance.org/View...rticleId=19299

An article analysing the German influenza surveillance data gives estimates of the chances of seasonal influenza to circulate during the upcoming season, using data of the German influenza sentinel scheme from 1992 to 2009. The authors calculated type and subtype-specific indices for past exposure and the corresponding morbidity indices for each season. For 2009-10, the model used by the authors suggests that it is unlikely that influenza A(H3N2) will circulate with more than a low intensity, seasonal A(H1N1) with more than a low to moderate intensity, and influenza B with more than a low to median intensity. The probability of a competitive circulation of seasonal influenza A with the new A(H1N1)v is low, increasing the chance for the latter to dominate the next influenza season in Germany. http://www.eurosurveillance.org/View...rticleId=19303


Other developments

Report of two cases of oseltamivir-resistance among immune suppressed patients

A report in the US CDC publication MMWR described two independent cases of oseltamivir-resistant strains of influenza A(H1N1)v developing in two severely immune suppressed patients. Both cases were leukemia patients on immunosuppressive drugs. No secondary transmission was documented. Full report available at: http://www.cdc.gov/mmwr/preview/mmwr...=mm58d0814a1_e


UK HPA issued a letter to neurologist to be alert for signs and symptoms of Guillain- Barr? Syndrome

British press discussed two letters sent by the UK Health Protection Agency (HPA) and the Surveillance unit of the Association of Brittish Neurologists (BNSU) to neurologists in the country raising the awareness for signs and symptoms of Guillain-Barr? syndrome (GBS) among population groups vaccinated against influenza A(H1N1)v. These letters relate to the 1976 abandonment of the US Swine flu vaccination program based on fears of increased risk of GBS among vaccinated people.

Guillain-Barr? syndrome is a rare peripheral neuropathic disease. Typical symptoms include progressive proximal and distal limb weakness over a four-week period, loss of reflexes and variable sensory symptoms. The autonomic nervous system is also often affected. A high frequency of respiratory failure seen in patients contributes to the 10% mortality seen in prospective studies. However, early treatment is effective. European studies estimate annual incidence at 1.2 per 100 000 to 1.6 per 100 000 persons. A large proportion of GBS patients have a history of a preceding infection. Link to recent BMJ clinical review article on Guillain-Barr?: http://www.bmj.com/cgi/content/extract/337/jul17_1/a671


Changing the format of the daily report

As the influenza pandemic evolves, new types of data become increasingly important, whereas other may become less interesting. ECDC has refreshed the format of the Situation Update to better accommodate current and anticipated information needs. The name of this report changed to "Daily Update" and some changes have been made in the data reported.

Table 1 ? reported cases by the EU/EFTA countries remains as before. In addition, we are publishing a new Table 2 on the number of current and cumulative hospitalisations and admission to intensive care in EU/EFTA Member States. The source of the information is official statements or surveillance reports published by national health authorities. It should be noted that indications and thresholds for hospitalisations vary by country, so the figures quoted may not be directly comparable between countries.

Assuming no changes in the national reporting system, trends of hospitalisations over time should give an accurate representation of the evolution of the pandemic. This might change if countries are faced with capacity issues within the healthcare system at a later stage of this evolving pandemic.

Table 3 lists only reported deaths for countries outside the EU/EFTA area; we have discontinued reporting the case numbers for these countries. The main reason for this is that more and more countries have stopped the reporting of new cases, and these figures no longer give a representative picture of the situation.

The two graphs now show number of reported deaths by week of report ? one graph for EU/EFTA, one for the entire world. The two maps depict cumulative deaths by country, one for EU/EFTA, one for the world.


Table 1: Reported new confirmed cases and cumulative number of influenza A(H1N1)v and cumulative deaths among confirmed cases by country as of 17 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Deaths among confirmed cases(a)]

1. Austria ... - 222 - ...
2. Belgium ... - 126 - 1
3. Bulgaria ... - 51 - ...
4. Cyprus ... - 297 - ...
5. Czech Republic ... - 201 - ...
6. Denmark ... - 444 - ...
7. Estonia ... - 56 - ...
8. Finland ... - 196 - ...
9. France(b) ... - 1125 - 1
10. Germany 627 - 12120 - ...
11. Greece ... - 1424 - ...
12. Hungary ... - 133 - 1
13. Iceland 17 - 135 - ...
14. Ireland ... - 574 - 1
15. Italy ... - 1238 - ...
16. Latvia ... - 23 - ...
17. Liechtenstein ... - 5 - ...
18. Lithuania ... - 40 - ...
19. Luxemburg 5 - 118 - ...
20. Malta ... - 204 - ...
21. Netherlands(c) ... - 1473 - 1
22. Norway ... - 868 - ...
23. Poland ... - 143 - ...
24. Portugal 109 - 1377 - ...
25. Romania 3 - 256 - ...
26. Slovakia ... - 96 - ...
27. Slovenia 1 - 201 - ...
28. Spain ... - 1538 - 11
29. Sweden ... - 602 - ...
30. Switzerland ... - 747 - ...
31. United Kingdom(d) ... - 12903 - 44

• Total 762 - 38936 - 60

Note:
cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites. Countries shaded with gray are not recommending laboratory tests for all suspect cases, therefore comparisons in time or between these countries should not be made at present.

(a) Deaths are included in the cumulative number of confirmed cases
(b) Cases reported from France include those reported from the overseas territories (434)
(c) Cases from the Netherlands include those reported from Aruba and the Dutch Antilles
(d) Cases reported from the United Kingdom include the number of individual cases from the following overseas territories: Anguilla, The Falklands, Gibraltar, Sovereign Base Area Cyprus, Turks and Caicos Islands (78)


Table 2: Reported number of confirmed influenza A(H1N1)v cases admitted to hospitals and intensive care by country as of 17 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - (date of report) - Most recent number of cases admitted in hospitals - Cumulative number of cases admitted in hospitals - Most recent number of cases admitted to intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (7.8.) - 0 - ... - 0 - ...
2. Belgium (7.8.) - 0 - ... - 0 - ...
3. Bulgaria - ... - ... - ... - ...
4. Cyprus - ... - ... - ... - ...
5. Czech Republic (5.8.) - 0 - ... - 0 - ...
6. Denmark (13.8.) - ... - ... - ... - ...
7. Estonia (14.8.) - 0 - 0 - 0 - 0
8. Finland (4.8.) - ... - ... - ... - ...
9. France(a) (12.8.) - 5 - 53 - 4 - 10
10. Germany (17.8.) - ... - ... - ... - ...
11. Greece (13.8.) - ... - ... - 1 - ...
12. Hungary (7.8.) - ... - ... - ... - ...
13. Iceland (7.8.) - 0 - 0 - 0 - 0
14. Ireland (13.8.) - 4 - 41 - ... - ...
15. Italy (17.7.) - ... - ... - ... - ...
16. Latvia (13.8.) - ... - 1 - ... - ...
17. Liechtenstein (13.8.) - ... - ... - ... - ...
18. Lithuania (13.8.) - ... - ... - ... - ...
19. Luxemburg (14.8.) - ... - ... - 0 - 0
20. Malta - ... - ... - ... - ...
21. Netherlands (14.8.) - ... - 28 - ... - ...
22. Norway (5.8.) - ... - ... - ... - ...
23. Poland (4.8.) - ... - ... - ... - ...
24. Portugal (16.8.) - 17 - ... - ... - ...
25. Romania - ... - 18 - ... - ...
26. Slovakia (12.8.) - 2 - 33 - 0 - 0
27. Slovenia (10.8.) - ... - ... - ... - ...
28. Spain (14.8.) - ... - ... - 29 - 77
29. Sweden (6.8.) - ... - ... - ... - ...
30. Switzerland (13.8.) - ... - 11 - ... - 1
31. United Kingdom(b) (13.8.) - 371 - ... - 55 - ...

Note:
Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites. New updates are shaded in yellow. (-) denotes no information readily available in official sources.

(a) Cases reported from France include those reported from the overseas territories.
(b) Data for England only. Does not include Scotland (94 cumulative hospitalisations), Wales (33) and Northern Ireland (14 ).


Table 3. Reported number of new and cumulative confirmed fatal pandemic influenza (H1N1) 2009 cases by country as of 17 August 2009, 16:00 hours (CEST) outside of the EU/EFTA area

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

• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA

1. No deaths reported - ... - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Egypt ... - 1
2. Iraq ... - 1
3. Israel 1 - 8
4. Lebanon ... - 1
5. Occupied Palestinian Territory ... - 1
6. Qatar ... - 1
7. Saudi Arabia 3 - 14

• AFRICA

1. Ghana ... - 1
2. Mauritius ... - 1
3. South Africa 3 - 6

• NORTH AMERICA

1. Canada ... - 66
2. Mexico ... - 163
3. USA ... - 477

• CENTRAL AMERICA & CARIBBEAN

1. Cayman Islands ... - 1
2. Costa Rica 1 - 29
3. Dominican Republic ... - 5
4. El Salvador ... - 12
5. Guatemala ... - 10
6. Honduras ... - 7
7. Jamaica ... - 4
8. Nicaragua ... - 1
9. Panama ... - 4
10. Saint Kitts and Nevis ... - 1

• SOUTH AMERICA

1. Argentina ... - 404
2. Bolivia ... - 14
3. Brazil(a) ... - 192
4. Chile ... - 112
5. Colombia ... - 18
6. Ecuador ... - 23
7. Paraguay ... - 39
8. Peru ... - 45
9. Uruguay ... - 22
10. Venezuela ... - 12

• NORTH-EAST & SOUTH ASIA

1. Hong Kong SAR China ... - 4
2. India 8 - 25
3. Japan ... - 1
4. South Korea ... - 2
5. Taiwan ... - 2

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 1
2. Indonesia 1 - 4
3. Laos Peoples Democratic Republic ... - 1
4. Malaysia 2 - 64
5. Philippines ... - 8
6. Singapore ... - 11
7. Thailand ... - 97
8. Vietnam ... - 2

• AUSTRALIA & PACIFIC

1. Australia 4 - 112
2. New Zealand ... - 14
3. Samoa ... - 2
4. Tonga ... - 1

• TOTAL 23 - 2047

Note:
cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated. Yellow shading indicates a new update has been recorded for the country during the past 24 hours.

(a) Brazil is repoting only confirmed cases among patients with Severe Acute Respiratory Infections (SARI)

(...)
-
------

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC): Pandemic Influenza H1N1 2009, Situation Updates (Since August 4, 2009)

Pandemic (H1N1) 2009 - Update 18 August 2009, 17:00 hours CEST (ECDC, edited)

[Original Full Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 - Update 18 August 2009, 17:00 hours CEST


Main developments in past 24 hours

• 491 new cases reported in the EU and EFTA countries, reaching a total of 39 427 cases; Spain and Ireland reported one new death each; Malta reported its first death;
• 5 285 new cases including 34 fatal cases, were reported from non-EU and EFTA countries, reaching a cumulative total of 197 702 cases.

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 cases as of 18 August 2009, 16:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer:

Several countries have now announced recommendations on treatment on clinical signs only and focused laboratory testing only for specific population groups or in outbreaks. For these countries, the reported numbers of cases presented in this report will severely underestimate the true incidence in the country and will not be comparable to countries still recommending laboratory tests of all suspected influenza cases.


Epidemiologic update

Out of the 27 EU and 4 EFTA countries, all countries have reported cases of influenza A(H1N1)v. A total of 39 427 confirmed cases of influenza A(H1N1)v infection, including 63 deaths have been reported since April 2009 (Table 1). In the past 24 hours, 491 new cases, including 3 new fatal cases from Spain, Ireland and Malta, were reported from the EU and EFTA countries. Currently, the majority of the cases are being reported from Germany. During this week, we have identified public reports of currently hospitalised cases from 5 countries (Table 2). The majority of the hospitalized cases have been reported from UK, specifically from England.

Outside of the EU and EFTA countries, a total of 5 285 new cases have been reported within the last 24 hours. 34 fatal cases were also reported (Table 3). In total, 197 702 cases including 2 081 fatal cases have been reported from non-EU and EFTA countries.

Media reports discuss increasing numbers of cases being reported in countries on the northern and eastern side of the Indian Ocean, as well as South Africa. Most North, Central and South American countries have passed the peak incidence period, according to media reports and supported by the official reports.

Globally, the total number of confirmed and reported influenza A (H1N1)v cases to date is 237 129 including 2 144 deaths.


Other developments

Retraction: Switzerland yet to publish the priority groups for vaccination

In the Daily Update 14 August we reported that Switzerland and UK had published their priority groups for vaccination. The report on Switzerland was based on a media source and Swiss authorities have now clarified that this news item was referring to the recommendations of an advisory group, the experts commission, and is not the official position of the government. The final decision will be made by the Federal Office of Public Health at a later stage.


Changing the format of the daily report

As the influenza pandemic evolves, new types of data become increasingly important, whereas other may become less interesting. ECDC has refreshed the format of the Situation Update to better accommodate current and anticipated information needs. The name of this report changed to "Daily Update" and some changes have been made in the data reported.

Table 1 ? reported cases by the EU/EFTA countries remains as before. In addition, we are publishing a new Table 2 on the number of current and cumulative hospitalisations and admission to intensive care in EU/EFTA Member States. The source of the information is official statements or surveillance reports published by national health authorities. It should be noted that indications and thresholds for hospitalisations vary by country, so the figures quoted may not be directly comparable between countries.

Assuming no changes in the national reporting system, trends of hospitalisations over time should give an accurate representation of the evolution of the pandemic. This might change if countries are faced with capacity issues within the healthcare system at a later stage of this evolving pandemic.

Table 3 lists only reported deaths for countries outside the EU/EFTA area; we have discontinued reporting the case numbers for these countries. The main reason for this is that more and more countries have stopped the reporting of new cases, and these figures no longer give a representative picture of the situation.

The two graphs now show number of reported deaths by week of report ? one graph for EU/EFTA, one for the entire world. The two maps depict cumulative deaths by country, one for EU/EFTA, one for the world.


Table 1: Reported new confirmed cases and cumulative number of influenza A(H1N1)v and cumulative deaths among confirmed cases by country as of 18 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Deaths among confirmed cases(a)]

1. Austria ... - 222 - ...
2. Belgium ... - 126 - 1
3. Bulgaria ... - 51 - ...
4. Cyprus ... - 297 - ...
5. Czech Republic 8 - 209 - ...
6. Denmark ... - 444 - ...
7. Estonia ... - 56 - ...
8. Finland 4 - 200 - ...
9. France (b) ... - 1125 - 1
10. Germany 373 - 12493 - ...
11. Greece ... - 1424 - ...
12. Hungary 10 - 143 - 1
13. Iceland ... - 135 - ...
14. Ireland ... - 574 - 2
15. Italy ... - 1238 - ...
16. Latvia ... - 23 - ...
17. Liechtenstein ... - 5 - ...
18. Lithuania ... - 40 - ...
19. Luxemburg ... - 118 - ...
20. Malta 27 - 231 - 1
21. Netherlands (c) ... - 1473 - 1
22. Norway ... - 868 - ...
23. Poland 7 - 150 - ...
24. Portugal ... - 1377 - ...
25. Romania 6 - 262 - ...
26. Slovakia 2 - 98 - ...
27. Slovenia 1 - 202 - ...
28. Spain ... - 1538 - 12
29. Sweden ... - 602 - ...
30. Switzerland 53 - 800 - ...
31. United Kingdom (d) ... - 12903 - 44

• Total 491 - 39427 - 63

Note:
cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites. Countries shaded with gray are not recommending laboratory tests for all suspect cases, therefore comparisons in time or between these countries should not be made at present.

(a) Deaths are included in the cumulative number of confirmed cases
(b) Cases reported from France include those reported from the overseas territories (434)
(c) Cases from the Netherlands include those reported from Aruba and the Dutch Antilles
(d) Cases reported from the United Kingdom include the number of individual cases from the following overseas territories: Anguilla, The Falklands, Gibraltar, Sovereign Base Area Cyprus, Turks and Caicos Islands (78)


Table 2: Reported number of confirmed influenza A(H1N1)v cases admitted to hospitals and intensive care by country as of 18 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - (date of report) - Most recent number of cases admitted in hospitals - Cumulative number of cases admitted in hospitals - Most recent number of cases admitted to intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (7.8.) - 0 - ... - 0 - ...
2. Belgium (7.8.) - 0 - ... - 0 - ...
3. Bulgaria - ... - ... - ... - ...
4. Cyprus - ... - ... - ... - ...
5. Czech Republic (17.8.) - 0 - ... - 0 - ...
6. Denmark (13.8.) - ... - ... - ... - ...
7. Estonia (14.8.) - 0 - 0 - 0 - 0
8. Finland (4.8.) - ... - ... - ... - ...
9. France(a) (12.8.) - 5 - 53 - 4 - 10
10. Germany (17.8.) - ... - ... - ... - ...
11. Greece (13.8.) - ... - ... - 1 - ...
12. Hungary (7.8.) - ... - ... - ... - ...
13. Iceland (7.8.) - 0 - 0 - 0 - 0
14. Ireland (13.8.) - 4 - 41 - ... - ...
15. Italy (17.7.) - ... - ... - ... - ...
16. Latvia (13.8.) - ... - 1 - ... - ...
17. Liechtenstein (13.8.) - ... - ... - ... - ...
18. Lithuania (13.8.) - ... - ... - ... - ...
19. Luxemburg (14.8.) - ... - ... - 0 - 0
20. Malta - ... - ... - ... - ...
21. Netherlands (14.8.) - ... - 28 - ... - ...
22. Norway (12.8.) - ... - ... - ... - ...
23. Poland (4.8.) - ... - ... - ... - ...
24. Portugal (17.8.) 9 - ... - 4 - ...
25. Romania - ... - 18 - ... - ...
26. Slovakia (12.8.) - 2 - 33 - 0 - 0
27. Slovenia (10.8.) - ... - ... - ... - ...
28. Spain (14.8.) - ... - ... - 29 - 77
29. Sweden (6.8.) - ... - ... - ... - ...
30. Switzerland (17.8.) - ... - 11 - ... - 1
31. United Kingdom(b) (13.8.) - 371 - ... - 55 - ...

Note:
Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites. New updates are shaded in yellow.

(...) denotes no information readily available in official sources.
(a) Cases reported from France include those reported from the overseas territories.
(b) Data for England only. Does not include Scotland (94 cumulative hospitalisations), Wales (33) and Northern Ireland (14 ).


Table 3. Reported number of new and cumulative confirmed fatal pandemic influenza (H1N1) 2009 cases by country as of 18 August 2009, 16:00 hours (CEST) outside of the EU/EFTA area

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

• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA

1. No deaths reported - ... - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Egypt ... - 1
2. Iraq ... - 1
3. Israel 2 - 10
4. Lebanon ... - 1
5. Occupied Palestinian Territory ... - 1
6. Qatar ... - 1
7. Saudi Arabia ... - 14

• AFRICA

1. Ghana ... - 1
2. Mauritius 2 - 3
3. South Africa ... - 6

• NORTH AMERICA

1. Canada ... - 66
2. Mexico ... - 163
3. USA ... - 477

• CENTRAL AMERICA & CARIBBEAN

1. Cayman Islands ... - 1
2. Costa Rica ... - 29
3. Dominican Republic ... - 5
4. El Salvador ... - 12
5. Guatemala ... - 10
6. Honduras ... - 7
7. Jamaica ... - 4
8. Nicaragua ... - 1
9. Panama 2 - 6
10. Saint Kitts and Nevis ... - 1

• SOUTH AMERICA

1. Argentina ... - 404
2. Bolivia ... - 14
3. Brazil ... - 192
4. Chile ... - 112
5. Colombia ... - 18
6. Ecuador ... - 23
7. Paraguay ... - 39
8. Peru 17 - 62
9. Uruguay ... - 22
10. Venezuela ... - 12

• NORTH-EAST & SOUTH ASIA

1. Hong Kong SAR China ... - 4
2. India ... - 25
3. Japan ... - 1
4. South Korea ... - 2
5. Taiwan ... - 2

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 1
2. Indonesia ... - 4
3. Laos Peoples Democratic Republic ... - 1
4. Malaysia 3 - 67
5. Philippines ... - 8
6. Singapore ... - 11
7. Thailand ... - 97
8. Vietnam ... - 2

• AUSTRALIA & PACIFIC

1. Australia 6 - 118
2. Cook Islands 1 - 1
3. New Zealand 1 - 15
4. Samoa ... - 2
5. Tonga ... - 1

• TOTAL 34 - 2081

Note:
cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated. Yellow shading indicates a new update has been recorded for the country during the past 24 hours.

(...)
-
------

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC): Pandemic Influenza H1N1 2009, Situation Updates (Since August 4, 2009)

Pandemic (H1N1) 2009 - Update 19 August 2009, 17:00 hours CEST (ECDC, edited)

[Original Full Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 - Update 19 August 2009, 17:00 hours CEST


Main developments in past 24 hours

• 729 new cases reported in the EU and EFTA countries, reaching a total of 40 156 cases;
• 5 729 new cases including 205 fatal cases, were reported from non-EU and EFTA countries, reaching a cumulative total of 203 431 cases;
• Preliminary estimate for reproductive number from New Zealand published last week.

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 cases as of 19 August 2009, 16:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer:

Several countries have now announced recommendations on treatment on clinical signs only and focused laboratory testing only for specific population groups or in outbreaks. For these countries, the reported numbers of cases presented in this report will severely underestimate the true incidence in the country and will not be comparable to countries still recommending laboratory tests of all suspected influenza cases.


Epidemiologic update

Out of the 27 EU and 4 EFTA countries, all countries have reported cases of influenza A(H1N1)v. A total of 40 156 confirmed cases of influenza A(H1N1)v infection, including 63 deaths have been reported since April 2009 (Table 1). In the past 24 hours, 729 new cases, from the EU and EFTA countries. Currently, the majority of the cases are being reported from Germany. During this week, we have identified public reports of currently hospitalised cases from 5 countries (Table 2). The majority of the hospitalized cases have been reported from UK, specifically from England.

Outside of the EU and EFTA countries, a total of 5 729 new cases have been reported within the last 24 hours. 205 fatal cases were also reported (Table 3). In total, 203 431 cases including 2 286 fatal cases have been reported from non-EU and EFTA countries.

Media reports discuss increasing numbers of cases being reported in countries on the northern and eastern side of the Indian Ocean, as well as South Africa. Most North, Central and South American countries have passed the peak incidence period, according to media reports and supported by the official reports.

Globally, the total number of confirmed and reported influenza A (H1N1)v cases to date is 243 587 including 2 349 deaths.


Other developments

UK MHRA issued a letter to healthcare personnel alerting them to possible interactions between oseltamivir and warfarin.

The UK Medicines and healthcare products regulatory agency (MHRA) issued a letter to healthcare personnel in the country alerting them to possibility of interactions between oseltamivir and warfarin. These possible interactions were identified through a signal in the adverse effects monitoring system. Warfarin is an anticoagulant used by approximately 600 000 cardiovascular patients in the UK and is known or suspected to have interactions with several medicines and food products. Other signals identified through the adverse events monitoring systems included hepatic adverse events and reports on convulsions and hallucinations. At present there is no change to the UK product information for Tamiflu and patients should continue to take Tamiflu as advised by their healthcare provider. The MHRA assessment is that the benefitrisk balance for Tamiflu remains positive.


Scientific Advance: Preliminary estimate for the reproduction number of influenza A(H1N1)v in New Zealand.

Nishiura H, Wilson N, Baker M. Estimating the reproduction number of the novel influenza A virus (H1N1) in a Southern Hemisphere setting: preliminary estimate in New Zealand New Zealand Med J 2009; 122, No. 1299

A recent study has estimated the early effective reproduction number R in New Zealand by analyzing early national data. The authors estimated a value of R of 1.96 (95% confidence interval 1.80 ? 2.15), when assuming a generation time of 2.8 days. This would correspond to a final cumulative attack rate of 78.6 % (including both clinical and asymptomatic infections) of the total population. The authors acknowledge this is almost certainly an over-estimate as it assumes homogenous mixing, that countermeasures were ineffective and there was a wholly susceptible population. The methodology used is also very sensitive to ?noise?, that is random deviations on the data. The full original article is available at: http://www.nzma.org.nz/journal/122-1299/3722/

The ECDC Scientific Advance commentary is available at: http://ecdc.europa.eu/en/activities/...rm.aspx?ID=639


Changing the format of the daily report

As the influenza pandemic evolves, new types of data become increasingly important, whereas other may become less interesting. ECDC has refreshed the format of the Situation Update to better accommodate current and anticipated information needs. The name of this report changed to "Daily Update" and some changes have been made in the data reported.

Table 1 ? reported cases by the EU/EFTA countries remains as before. In addition, we are publishing a new Table 2 on the number of current and cumulative hospitalisations and admission to intensive care in EU/EFTA Member States. The source of the information is official statements or surveillance reports published by national health authorities. It should be noted that indications and thresholds for hospitalisations vary by country, so the figures quoted may not be directly comparable between countries.

Assuming no changes in the national reporting system, trends of hospitalisations over time should give an accurate representation of the evolution of the pandemic. This might change if countries are faced with capacity issues within the healthcare system at a later stage of this evolving pandemic.

Table 3 lists only reported deaths for countries outside the EU/EFTA area; we have discontinued reporting the case numbers for these countries. The main reason for this is that more and more countries have stopped the reporting of new cases, and these figures no longer give a representative picture of the situation.

The two graphs now show number of reported deaths by week of report ? one graph for EU/EFTA, one for the entire world. The two maps depict cumulative deaths by country, one for EU/EFTA, one for the world.


Table 1: Reported new confirmed cases and cumulative number of influenza A(H1N1)v and cumulative deaths among confirmed cases by country as of 19 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Deaths among confirmed cases(a)]

1. Austria ... - 222 - ...
2. Belgium ... - 126 - 1
3. Bulgaria 6 - 57 - ...
4. Cyprus ... - 297 - ...
5. Czech Republic ... - 209 - ...
6. Denmark ... - 444 - ...
7. Estonia 1 - 57 - ...
8. Finland 4 - 204 - ...
9. France (b) ... - 1125 - 1
10. Germany 337 - 12830 - ...
11. Greece ... - 1424 - ...
12. Hungary 2 - 145 - 1
13. Iceland ... - 135 - ...
14. Ireland ... - 574 - 2
15. Italy ... - 1238 - ...
16. Latvia ... - 23 - ...
17. Liechtenstein ... - 5 - ...
18. Lithuania ... - 40 - ...
19. Luxemburg ... - 118 - ...
20. Malta ... - 231 - 1
21. Netherlands (c) ... - 1473 - 1
22. Norway ... - 868 - ...
23. Poland 2 - 152 - ...
24. Portugal 257 - 1634 - ...
25. Romania 7 - 269 - ...
26. Slovakia 1 - 99 - ...
27. Slovenia 1 - 203 - ...
28. Spain ... - 1538 - 12
29. Sweden 70 - 672 - ...
30. Switzerland 41 - 841 - ...
31. United Kingdom (d) ... - 12903 - 44

• Total 729 - 40156 - 63

Note:
cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites. Countries shaded with gray are not recommending laboratory tests for all suspect cases, therefore comparisons in time or between these countries should not be made at present.

(a) Deaths are included in the cumulative number of confirmed cases
(b) Cases reported from France include those reported from the overseas territories (434)
(c) Cases from the Netherlands include those reported from Aruba and the Dutch Antilles
(d) Cases reported from the United Kingdom include the number of individual cases from the following overseas territories: Anguilla, The Falklands, Gibraltar, Sovereign Base Area Cyprus, Turks and Caicos Islands (78)


Table 2: Reported number of confirmed influenza A(H1N1)v cases admitted to hospitals and intensive care by country as of 18 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - (date of report) - Most recent number of cases admitted in hospitals - Cumulative number of cases admitted in hospitals - Most recent number of cases admitted to intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (7.8.) - 0 - ... - 0 - ...
2. Belgium (7.8.) - 0 - ... - 0 - ...
3. Bulgaria - ... - ... - ... - ...
4. Cyprus - ... - ... - ... - ...
5. Czech Republic (17.8.) - 0 - ... - 0 - ...
6. Denmark (13.8.) - ... - ... - ... - ...
7. Estonia (14.8.) - 0 - 0 - 0 - 0
8. Finland (18.8.) - ... - ... - ... - ...
9. France(a) (12.8.) - 5 - 53 - 4 - 10
10. Germany (19.8.) - ... - ... - ... - ...
11. Greece (13.8.) - ... - ... - 1 - ...
12. Hungary (7.8.) - ... - ... - ... - ...
13. Iceland (7.8.) - 0 - 0 - 0 - 0
14. Ireland (13.8.) - 4 - 41 - ... - ...
15. Italy (17.7.) - ... - ... - ... - ...
16. Latvia (13.8.) - ... - 1 - ... - ...
17. Liechtenstein (13.8.) - ... - ... - ... - ...
18. Lithuania (13.8.) - ... - ... - ... - ...
19. Luxemburg (14.8.) - ... - ... - 0 - 0
20. Malta - ... - ... - ... - ...
21. Netherlands (14.8.) - ... - 28 - ... - ...
22. Norway (12.8.) - ... - ... - ... - ...
23. Poland (18.8.) - ... - ... - ... - ...
24. Portugal (18.8.) - 9 - ... - 4 - ...
25. Romania - ... - 18 - ... - ...
26. Slovakia (12.8.) - 2 - 33 - 0 - 0
27. Slovenia (10.8.) - ... - ... - ... - ...
28. Spain (14.8.) - ... - ... - 29 - 77
29. Sweden (6.8.) - ... - ... - ... - ...
30. Switzerland (18.8.) - ... - 11 - ... - 1
31. United Kingdom(b) (13.8.) - 371 - ... - 55 - ...

Note:
Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites. New updates are shaded in yellow. (-) denotes no information readily available in official sources.

(a) Cases reported from France include those reported from the overseas territories.
(b) Data for England only. Does not include Scotland (94 cumulative hospitalisations), Wales (33) and Northern Ireland (14 ).


Table 3. Reported number of new and cumulative confirmed fatal pandemic influenza (H1N1) 2009 cases by country as of 19 August 2009, 16:00 hours (CEST) outside of the EU/EFTA area

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

• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA

1. No deaths reported - ... - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Egypt ... - 1
2. Iraq ... - 1
3. Israel ... - 10
4. Lebanon ... - 1
5. Occupied Palestinian Territory ... - 1
6. Qatar ... - 1
7. Saudi Arabia ... - 14
8. Yemen 1 - 1

• AFRICA

1. Ghana ... - 1
2. Mauritius ... - 3
3. South Africa ... - 6

• NORTH AMERICA

1. Canada 1 - 67
2. Mexico 1 - 164
3. USA ... - 477

• CENTRAL AMERICA & CARIBBEAN

1. Cayman Islands ... - 1
2. Costa Rica ... - 29
3. Dominican Republic ... - 5
4. El Salvador ... - 12
5. Guatemala ... - 10
6. Honduras ... - 7
7. Jamaica ... - 4
8. Nicaragua ... - 1
9. Panama ... - 6
10. Saint Kitts and Nevis ... - 1

• SOUTH AMERICA

1. Argentina ... - 404
2. Bolivia 2 - 16
3. Brazil 176 - 368
4. Chile ... - 112
5. Colombia 5 - 23
6. Ecuador ... - 23
7. Paraguay ... - 39
8. Peru ... - 62
9. Uruguay ... - 22
10. Venezuela ... - 12

• NORTH-EAST & SOUTH ASIA

1. Hong Kong SAR China ... - 4
2. India ... - 25
3. Japan 2 - 3
4. South Korea ... - 2
5. Taiwan ... - 2

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 1
2. Indonesia ... - 4
3. Laos Peoples Democratic Republic ... - 1
4. Malaysia ... - 67
5. Philippines ... - 8
6. Singapore ... - 11
7. Thailand 14 - 111
8. Vietnam ... - 2

• AUSTRALIA & PACIFIC

1. Australia 3 - 121
2. Cook Islands ... - 1
3. New Zealand ... - 15
4. Samoa ... - 2
5. Tonga ... - 1

• TOTAL 205 - 2286

Note:
cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated. Yellow shading indicates a new update has been recorded for the country during the past 24 hours.


(...)
-
------

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC): Pandemic Influenza H1N1 2009, Situation Updates (Since August 4, 2009)

Pandemic (H1N1) 2009 - Update 20 August 2009, 17:00 hours CEST (ECDC, edited)

[Original Full Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 - Update 20 August 2009, 17:00 hours CEST


Main developments in past 24 hours

• 782 new cases reported in the EU and EFTA countries, reaching a total of 40 938 cases;
• 2 579 new cases including 37 fatal cases, were reported from non-EU and EFTA countries, reaching a cumulative total of 206 010 cases;
• First intravenous use of zanamivir reported.

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 cases as of 20 August 2009, 16:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer:

Several countries have now announced recommendations on treatment on clinical signs only and focused laboratory testing only for specific population groups or in outbreaks. For these countries, the reported numbers of cases presented in this report will severely underestimate the true incidence in the country and will not be comparable to countries still recommending laboratory tests of all suspected influenza cases.


Epidemiologic update

All 27 EU and 4 EFTA countries are reporting cases of influenza A(H1N1)v. A total of 40 938 confirmed cases of influenza A(H1N1)v infection, including 73 deaths have been reported since April 2009 (Table 1). In the past 24 hours, 782 new cases from the EU and EFTA countries were confirmed. Currently, the majority of cases are being reported from Germany and the UK. The latest available updates on hospital admissions per Member State are presented in Table 2. The majority of recent hospitalized cases are reported from the UK, and from England in particular.

Outside of the EU and EFTA countries, a total of 2 579 new cases have been reported within the last 24 hours, among whom 37 were fatal (Table 3). In total, 206 010 cases including 2 323 fatal cases have been reported from non-EU and EFTA countries.

Globally, the total number of confirmed and reported influenza A (H1N1)v cases to date is 246 948 including 2 396 deaths.


Pandemic updates from outside of Europe

Introduction

Each Thursday, ECDC publishes a special section on the evolution of the pandemic influenza H1N1 2009 in selected countries outside Europe. For the time being, this selection is preliminary and may vary in the future.

Countries were selected based on the following criteria: they are currently in the winter influenza season, represent different geographical regions, have adequately large population sizes and have accessible and reliable public health data.

The objective of this addendum 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.

Disclaimer:

This report aims to increase awareness of seasonal influenza in countries outside Europe by providing an analysis of various surveillance data sources dealing with those selected countries. Please note, this report is based on data available at the date of publishing. Delays in the reporting of data may cause data to change retrospectively. For further details about information contained in this report please contact the H1N1 Influenza team


Australia

As of 20 August, Australia has 32 799 confirmed cases of pandemic (H1N1) 2009, and a total of 128 deaths. There are currently 455 people in hospital around Australia with pandemic (H1N1) 2009 and 95 of these are in intensive care units. The total number of hospitalisations in Australia since pandemic (H1N1) 2009 was identified is 3802.

http://www.healthemergency.gov.au/internet/healthemergency/publishing.nsf/Content/F998919755CCCD32CA25761500153B8A/$FileUpdate%20bulletin%2012noon%2019082009.pdf

Australian Government-Department of Health and Ageing: http://www.healthemergency.gov.au/in...ontent/updates


New Zealand

There are a total of 3086 confirmed cases of pandemic (H1N1) 09, up from 3021 last week, and 951 cases were hospitalised cases. Pneumonia was recorded for 233 of them, and acute respiratory distress syndrome (ARDS) for 38. The number of deaths from pandemic (H1N1) 09 in New Zealand, is 15.

http://www.moh.govt.nz/moh.nsf/indexmh/influenza-a-h1n1-update-133-130809

There has been a slight increase in consultations for influenza-like illness (ILI) through sentinel surveillance in week 33 (10-16 August 2009), with the highest notification rates seen in the under-one-year age group. The weekly ILI consultation rate is still higher than previous years for the same week. Among 26 influenza virus isolates reported, 21 (81%) were influenza A (H1N1)v.

http://www.surv.esr.cri.nz/PDF_surveillance/Virology/FluWeekRpt/2009/FluWeekRpt200933.pdf

Chile

A total of 12 104 cases of pandemic (H1N1) 09 were notified as of 19th of July in Chile, 1212 of whom presented with severe respiratory distress syndrome (SRDS). Of these, 46% had a history of chronic illness. So far, 105 deaths were attributed to pandemic (H1N1) 09, corresponding to a case fatality of 0.6%. The age of all cases varies from 11 days to 94 years, with the most affected age groups being 10-14 years and 5-9 years. The under-4 year olds represent 15% of cases; their proportion has been rising in the last weeks.

In week 27, 98% of isolated influenza type A strains were attributed to influenza A (H1N1)v. A total of 78 samples were tested for H274Y mutation but no positive sample was found.

http://www.sochinf.cl/sitio/templates/sochinf2008/documentos/comunicado_influenza.pdf

Brazil

Since the beginning of monitoring SRDS on of July 16th, 20 820 cases were notified, of which 3087 were subsequently linked to influenza A (H1N1)v. Of these, 368 have deceased. The reported mortality due to influenza A (H1N1)v is currently 0,19/100.000 inhabitants.

Of the 3087 SRDS cases linked to influenza A (H1N1)v, 1308 (42,4%) presented al least one of the following risk factors: metabolic or respiratory disease, or chronic cardiopathy. In SRDS cases presenting at least one these risk factors, the mortality was 1,38 times higher than in cases without an associated risk factor (CI 1,14 ? 1,67).

Of the 368 deceased, 185 (50,3%) presented at least one of the abovementioned risk factors, including pregnancy.

Out of 8519 PCR tests conducted up to week 32, 5767 (67,7%) tested positive for influenza A (H1N1)v, 1958 (23%) tested positive for seasonal influenza type A, 14 (0,2%) for seasonal influenza type B and 780 (9,2%) for other infectious agents. From week 27 onward there is a rising frequency of influenza A (H1N1)v diagnosis within the samples collected.

For entire epidemiological update for week 32 (Portuguese) see: http://portal.saude.gov.br/portal/ar..._18ago2009.pdf

H1N1 website of the ministry of health: http://dtr2001.saude.gov.br/ascom/sv...uenza_site.htm


South Africa

As of 17 August, South Africa has confirmed 3 485 cases of pandemic (H1N1) 09, with 1 576 new cases being confirmed since the previous update. The number of deaths related to the pandemic is six, four of whom had no underlying conditions, one patient was pregnant and another was a pregnant woman with diabetes.

The provinces with most people affected are Gauteng, which is leading with 1 818 cases, followed by Western Cape with 810 cases and 359 in KwaZulu-Natal.

http://www.nicd.ac.za/

Other developments

First intra-venous use of zanamivir

Media reported on a 20-year-old Australian with asthma, who survived severe pandemic (H1N1) 09, after being treated with an experimental intravenous form of zanamivir (Relenza). The drug is normally taken with an inhaler.

http://www.news.com.au/adelaidenow/story/0,22606,25950004-5006301,00.html

Changing the format of the daily report

As the influenza pandemic evolves, new types of data become increasingly important, whereas other may become less interesting. ECDC has refreshed the format of the Situation Update to better accommodate current and anticipated information needs. The name of this report changed to "Daily Update" and some changes have been made in the data reported.

Table 1 ? reported cases by the EU/EFTA countries remains as before. In addition, we are publishing a new Table 2 on the number of current and cumulative hospitalisations and admission to intensive care in EU/EFTA Member States. The source of the information is official statements or surveillance reports published by national health authorities. It should be noted that indications and thresholds for hospitalisations vary by country, so the figures quoted may not be directly comparable between countries.

Assuming no changes in the national reporting system, trends of hospitalisations over time should give an accurate representation of the evolution of the pandemic. This might change if countries are faced with capacity issues within the healthcare system at a later stage of this evolving pandemic.

Table 3 lists only reported deaths for countries outside the EU/EFTA area; we have discontinued reporting the case numbers for these countries. The main reason for this is that more and more countries have stopped the reporting of new cases, and these figures no longer give a representative picture of the situation.

The two graphs now show number of reported deaths by week of report ? one graph for EU/EFTA, one for the entire world. The two maps depict cumulative deaths by country, one for EU/EFTA, one for the world.


Table 1: Reported new confirmed cases and cumulative number of influenza A(H1N1)v and cumulative deaths among confirmed cases by country as of 20 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Deaths among confirmed cases (a)]

1. Austria 42 - 264 - ...
2. Belgium ... - 126 - 1
3. Bulgaria ... - 57 - ...
4. Cyprus ... - 297 - ...
5. Czech Republic ... - 209 - ...
6. Denmark 43 - 487 - ...
7. Estonia ... - 57 - ...
8. Finland ... - 204 - ...
9. France (b) ... - 1125 - 1
10. Germany 350 - 13180 - ...
11. Greece ... - 1424 - ...
12. Hungary 3 - 148 - 1
13. Iceland ... - 135 - ...
14. Ireland 104 - 678 - 2
15. Italy ... - 1238 - ...
16. Latvia ... - 23 - ...
17. Liechtenstein ... - 5 - ...
18. Lithuania 7 - 47 - ...
19. Luxemburg 11 - 129 - ...
20. Malta ... - 231 - 1
21. Netherlands (c) ... - 1473 - 1
22. Norway ... - 868 - ...
23. Poland 1 - 153 - ...
24. Portugal 199 - 1833 - ...
25. Romania 4 - 273 - ...
26. Slovakia ... - 99 - ...
27. Slovenia 2 - 205 - ...
28. Spain ... - 1538 - 12
29. Sweden ... - 672 - ...
30. Switzerland 16 - 857 - ...
31. United Kingdom (d) ... - 12903 - 54

• Total 782 - 40938 - 73

Note:
cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites. Countries shaded with gray are not recommending laboratory tests for all suspect cases, therefore comparisons in time or between these countries should not be made at present.

(a) Deaths are included in the cumulative number of confirmed cases
(b) Cases reported from France include those reported from the overseas territories (434)
(c) Cases from the Netherlands include those reported from Aruba and the Dutch Antilles
(d) Cases reported from the United Kingdom include the number of individual cases from the following overseas territories: Anguilla, The Falklands, Gibraltar, Sovereign Base Area Cyprus, Turks and Caicos Islands (78)


Table 2: Reported number of confirmed influenza A(H1N1)v cases admitted to hospitals and intensive care by country as of 20 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - (date of report) - Most recent number of cases admitted in hospitals - Cumulative number of cases admitted in hospitals - Most recent number of cases admitted to intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (7.8.) - 0 - ... - 0 - ...
2. Belgium (7.8.) - 0 - ... - 0 - ...
3. Bulgaria - ... - ... - ... - ...
4. Cyprus - ... - ... - ... - ...
5. Czech Republic (17.8.) - 0 - ... - 0 - ...
6. Denmark (13.8.) - ... - ... - ... - ...
7. Estonia (14.8.) - 0 - 0 - 0 - 0
8. Finland (18.8.) - ... - ... - ... - ...
9. France(a) (18.8.) - 6 - 65 - 5 - 11
10. Germany (20.8.) - ... - ... - ... - ...
11. Greece (13.8.) - ... - ... - 1 - ...
12. Hungary (19.8.) - ... - 27 - ... - ...
13. Iceland (19.8.) - 0 - 0 - 0 - 0
14. Ireland (13.8.) - 4 - 41 - ... - ...
15. Italy (17.7.) - ... - ... - ... - ...
16. Latvia (13.8.) - ... - 1 - ... - ...
17. Liechtenstein (19.8.) - ... - ... - ... - ...
18. Lithuania (13.8.) - ... - ... - ... - ...
19. Luxemburg (14.8.) - ... - ... - 0 - 0
20. Malta - ... - ... - ... - ...
21. Netherlands (14.8.) - ... - 28 - ... - ...
22. Norway (12.8.) - ... - ... - ... - ...
23. Poland (18.8.) - ... - ... - ... - ...
24. Portugal (19.8.) - 8 - ... - ... - ...
25. Romania - ... - 18 - ... - ...
26. Slovakia (12.8.) - 2 - 33 - 0 - 0
27. Slovenia (10.8.) - ... - ... - ... - ...
28. Spain (14.8.) - ... - ... - 29 - 77
29. Sweden (6.8.) - ... - ... - ... - ...
30. Switzerland (19.8.) - ... - 11 - ... - 1
31. United Kingdom(b) (20.8.) - 263 - ... - ... - ...

Note:
Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites. New updates are shaded in yellow.

(...) denotes no information readily available in official sources.
(a) Cases reported from France include those reported from the overseas territories.
(b) Data for England only. Does not include Scotland (94 cumulative hospitalisations), Wales (33) and Northern Ireland (14 ).


Table 3. Reported number of new and cumulative confirmed fatal pandemic influenza A(H1N1)v 2009 cases by country as of 20 August 2009, 16:00 hours (CEST) outside of the EU/EFTA area

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

• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA

1. No deaths reported - ... - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Egypt ... - 1
2. Iraq ... - 1
3. Israel ... - 10
4. Kuwait 1 - 1
5. Lebanon ... - 1
6. Occupied Palestinian Territory ... - 1
7. Qatar ... - 1
8. Saudi Arabia ... - 14
9. Yemen ... - 1

• AFRICA

1. Ghana ... - 1
2. Mauritius 2 - 5
3. South Africa ... - 6

• NORTH AMERICA

1. Canada ... - 67
2. Mexico ... - 164
3. USA ... - 477

• CENTRAL AMERICA & CARIBBEAN

1. Cayman Islands ... - 1
2. Costa Rica 2 - 31
3. Dominican Republic ... - 5
4. El Salvador 3 - 15
5. Guatemala ... - 10
6. Honduras ... - 7
7. Jamaica ... - 4
8. Nicaragua ... - 1
9. Panama ... - 6
10. Saint Kitts and Nevis ... - 1

• SOUTH AMERICA

1. Argentina ... - 404
2. Bolivia 1 - 17
3. Brazil ... - 368
4. Chile 16 - 128
5. Colombia ... - 23
6. Ecuador ... - 23
7. Paraguay ... - 39
8. Peru ... - 62
9. Uruguay ... - 22
10. Venezuela ... - 12

• NORTH-EAST & SOUTH ASIA

1. Hong Kong SAR China ... - 4
2. India 3 - 28
3. Japan ... - 3
4. South Korea ... - 2
5. Taiwan ... - 2

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 1
2. Indonesia ... - 4
3. Laos Peoples Democratic Republic ... - 1
4. Malaysia 1 - 68
5. Philippines ... - 8
6. Singapore ... - 11
7. Thailand ... - 111
8. Vietnam ... - 2

• AUSTRALIA & PACIFIC

1. Australia 7 - 128
2. Cook Islands ... - 1
3. New Zealand ... - 15
4. Samoa ... - 2
5. Tonga ... - 1

• TOTAL 37 - 2323

Note:
cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated. Yellow shading indicates a new update has been recorded for the country during the past 24 hours.

(...)
-
------

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC): Pandemic Influenza H1N1 2009, Situation Updates (Since August 4, 2009)

Pandemic (H1N1) 2009 - Update 21 August 2009, 17:00 hours CEST (ECDC, edited)

[Original Full Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 - Update 21 August 2009, 17:00 hours CEST


Main developments in past 24 hours

• 850 new cases reported in the EU and EFTA countries, reaching a total of 41 788 cases; the Netherlands reported 1 new fatal case and the United Kingdom 5 new fatal cases;
• 2 351 new cases including 28 fatal cases, were reported from non-EU and EFTA countries, reaching a cumulative total of 207 153 cases;
• Sweden publishes recommendation for pandemic vaccination priority groups;
• The weekly influenza surveillance bulletin is published on the ECDC website.

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 cases as of 21 August 2009, 16:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer:

Several countries have now announced recommendations on treatment on clinical signs only and focused laboratory testing only for specific population groups or in outbreaks. For these countries, the reported numbers of cases presented in this report will severely underestimate the true incidence in the country and will not be comparable to countries still recommending laboratory tests of all suspected influenza cases.


Epidemiologic update

All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 41 788 confirmed cases, including 79 deaths, have been reported since April 2009 (Table 1). In the past 24 hours, 850 new cases from the EU and EFTA countries were confirmed, including one new fatal case from the Netherlands (with confirmed underlying illness) and five from the United Kingdom. Currently, the majority of cases are being reported from Germany and the UK. The latest available updates on hospital admissions per Member State are presented in Table 2. The majority of recent hospitalized cases are reported from the UK, and from England in particular.

Outside of the EU and EFTA countries, a total of 2 351 new cases have been reported within the last 24 hours, among which 28 were fatal (Table 3). In total, 207 153 cases including 2 351 fatal cases have been reported from non-EU and EFTA countries.

Globally, the total number of confirmed and reported pandemic (H1N1) 2009 influenza cases to date is 248 941, including 2 430 deaths.


ECDC weekly influenza surveillance bulletin

The weekly influenza surveillance bulletin has been published on the ECDC website: http://ecdc.europa.eu/en/activities/...2009week33.pdf

Ireland and the UK (Northern Ireland) are the only countries in Europe currently reporting medium levels of influenza activity, while the UK (England) now reports low levels. The intensity appears to be rising in Bulgaria, Ireland, Poland and Sweden and to be declining in the UK (England and Northern Ireland). In week 33, for the third week in a row, the proportion of sentinel specimens positive for influenza virus continued to decrease, reaching 13% after peaking at 27% during week 30.


Updates from Eurosurveillance

In this week's edition of Eurosurveillance, an article from France describes the characteristics of 574 deaths associated with pandemic H1N1 influenza up to 16 July 2009. Data (except from Canada and Australia) suggest that the elderly may to some extent be protected from infection. Underlying diseases were present in at least half of the fatal cases. There are two risk factors that seem to be of particular importance: pregnancy and metabolic condition (including obesity, which has not been considered as risk factor in previous pandemics or seasonal influenza). http://www.eurosurveillance.org/View...rticleId=19309

A report from the United Kingdom presents the importance of school and social activities in the transmission of influenza A(H1N1)v. During the containment phase in the United Kingdom (April to June 2009), a cluster of influenza A(H1N1)v cases was identified, prompting further investigation and public health action by the Health Protection Agency. The first confirmed case, a pupil at a school in England, was imported. During the following two weeks, 16 further cases were confirmed with epidemiological links to the first imported case. In this cluster, findings show that significant transmission occurred in two classes, with attack rates of 17% and 7%. Other settings included a party (with minimum and maximum attack rates of 14% and 25%) and a choir (where both the minimum and the maximum attack rate was 4%). No evidence of transmission was found on two school bus trips, despite exposure over 50 minutes to a symptomatic case and over two periods of 30 minutes to a case during the prodromal phase (i.e. within 12 hours of symptom onset). Nor was there onward transmission in another school despite exposure over several hours to two cases, both of whom attended school during the prodromal phase.

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19311

An article analysing the epidemiological and clinical characteristics of influenza A(H1N1)v infection in children, describes the first 45 cases confirmed in children in Cyprus. Fever, cough, rhinorrhoea and sore throat were the most common symptoms of infection. Half of the children had fever for one day or only for a few hours. Five children were hospitalised, and overall their symptoms were mild. Adherence to oseltamivir treatment was very high, with low frequency of gastrointestinal side effects such as nausea and vomiting. Camping places and summer schools played a significant role in spreading the infection among children of school age. http://www.eurosurveillance.org/View...rticleId=19312


Other developments

Sweden publishes recommendations for vaccination

The priority for vaccination with the pandemic (H1N1) 2009 influenza vaccine in Sweden will be given to pregnant women, and persons with chronic illness, including chronic lung disease, extreme obesity or neuromuscular disorders affecting respiration, chronic cardiovascular disease, immuno-suppression, chronic liver or renal dysfunction, diabetes, severe asthma, or severe neuromuscular disease. Also health professionals are included in the priority group.
More information is available from: http://www.socialstyrelsen.se/Aktuel...yhet090820.htm


ECDC publishes health education guidance on the use of influenza antivirals

A new guidance document on the public health use of influenza antivirals during influenza pandemics, with particular reference to the pandemic (H1N1) 2009, is now available from ECDC?s website:

http://ecdc.europa.eu/en/healthtopics/Documents/0908_Influenza_AH1N1_On_Public_Health_Use_of_Influenza_Antivirals_during_Influenza_Pandemics.pdf

Changing the format of the daily report

As the influenza pandemic evolves, new types of data become increasingly important, whereas other may become less interesting. ECDC has refreshed the format of the Situation Update to better accommodate current and anticipated information needs. The name of this report changed to "Daily Update" and some changes have been made in the data reported.

Table 1 ? reported cases by the EU/EFTA countries remains as before. In addition, we are publishing a new Table 2 on the number of current and cumulative hospitalisations and admission to intensive care in EU/EFTA Member States. The source of the information is official statements or surveillance reports published by national health authorities. It should be noted that indications and thresholds for hospitalisations vary by country, so the figures quoted may not be directly comparable between countries.

Assuming no changes in the national reporting system, trends of hospitalisations over time should give an accurate representation of the evolution of the pandemic. This might change if countries are faced with capacity issues within the healthcare system at a later stage of this evolving pandemic.

Table 3 lists only reported deaths for countries outside the EU/EFTA area; we have discontinued reporting the case numbers for these countries. The main reason for this is that more and more countries have stopped the reporting of new cases, and these figures no longer give a representative picture of the situation.

The two graphs now show number of reported deaths by week of report ? one graph for EU/EFTA, one for the entire world. The two maps depict cumulative deaths by country, one for EU/EFTA, one for the world.


Table 1: Reported new confirmed cases and cumulative number of influenza A(H1N1)v infections and cumulative deaths among confirmed cases by country as of 21 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Deaths among confirmed cases (a)]

1. Austria 6 - 270 - ...
2. Belgium ... - 126 - 1
3. Bulgaria ... - 57 - ...
4. Cyprus ... - 297 - ...
5. Czech Republic 8 - 217 - ...
6. Denmark 33 - 520 - ...
7. Estonia ... - 57 - ...
8. Finland 3 - 207 - ...
9. France (b) ... - 1125 - 1
10. Germany 560 - 13740 - ...
11. Greece ... - 1424 - ...
12. Hungary 1 - 149 - 1
13. Iceland 17 - 152 - ...
14. Ireland ... - 678 - 2
15. Italy ... - 1238 - ...
16. Latvia ... - 23 - ...
17. Liechtenstein ... - 5 - ...
18. Lithuania ... - 47 - ...
19. Luxemburg ... - 129 - ...
20. Malta 6 - 237 - 1
21. Netherlands (c) ... - 1473 - 2
22. Norway ... - 868 - ...
23. Poland ... - 153 - ...
24. Portugal 154 - 1987 - ...
25. Romania ... - 273 - ...
26. Slovakia 4 - 103 - ...
27. Slovenia 4 - 209 - ...
28. Spain ... - 1538 - 12
29. Sweden ... - 672 - ...
30. Switzerland ... - 857 - ...
31. United Kingdom (d) 54 - 12957 - 59

• Total 850 - 41788 - 79

Note:
cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites. Countries shaded with gray are not recommending laboratory tests for all suspect cases, therefore comparisons in time or between these countries should not be made at present.

(a) Deaths are included in the cumulative number of confirmed cases
(b) Cases reported from France include those reported from the overseas territories (434)
(c) Cases from the Netherlands include those reported from Aruba and the Dutch Antilles
(d) Cases reported from the United Kingdom include the number of individual cases from the following overseas territories: Anguilla, The Falklands, Gibraltar, Sovereign Base Area Cyprus, Turks and Caicos Islands (78)


Table 2: Reported number of confirmed influenza A(H1N1)v cases admitted to hospitals and intensive care by country as of 21 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - (date of report) - Most recent number of cases admitted in hospitals - Cumulative number of cases admitted in hospitals - Most recent number of cases admitted to intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (7.8.) - 0 - ... - 0 - ...
2. Belgium (7.8.) - 0 - ... - 0 - ...
3. Bulgaria - ... - ... - ... - ...
4. Cyprus - ... - ... - ... - ...
5. Czech Republic (17.8.) - 0 - ... - 0 - ...
6. Denmark (20.8) - ... - ... - ... - ...
7. Estonia (14.8.) - 0 - 0 - 0 - 0
8. Finland (18.8.) - ... - ... - ... - ...
9. France(a) (18.8.) - 6 - 65 - 5 - 11
10. Germany (21.8.) - ... - ... - ... - ...
11. Greece (13.8.) - ... - ... - 1 - 2
12. Hungary (19.8.) - ... - 27 - ... - ...
13. Iceland (20.8.) - 0 - 0 - 0 - 0
14. Ireland (13.8.) - 4 - 41 - ... - ...
15. Italy (17.7.) - ... - ... - ... - ...
16. Latvia (13.8.) - ... - 1 - ... - ...
17. Liechtenstein (19.8.) - ... - ... - ... - ...
18. Lithuania (13.8.) - ... - ... - ... - ...
19. Luxemburg (14.8.) - ... - ... - 0 - 0
20. Malta - ... - ... - ... - ...
21. Netherlands (14.8.) - ... - 28 - ... - ...
22. Norway (19.8.) - ... - ... - ... - ...
23. Poland (18.8.) - ... - ... - ... - ...
24. Portugal (20.8.) - 8 - ... - ... - ...
25. Romania - ... - 18 - ... - ...
26. Slovakia (12.8.) - 2 - 33 - 0 - 0
27. Slovenia (10.8.) - ... - ... - ... - ...
28. Spain (20.8.) - ... - ... - 32 - 92
29. Sweden (20.8.) - ... - ... - ... - ...
30. Switzerland (20.8.) - ... - 11 - ... - 1
31. United Kingdom(b) (20.8.) - 263 - ... - 30 - ...

Note:
Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites. New updates are shaded in yellow.

(...) denotes no information readily available in official sources.
(a) Cases reported from France include those reported from the overseas territories.
(b) Data for England only. Does not include Scotland (114 cumulative hospitalisations), Wales (38) and Northern Ireland (36).


Table 3. Reported number of new and cumulative confirmed fatal pandemic influenza (H1N1) 2009 cases by country as of 21 August 2009, 16:00 hours (CEST) outside of the EU/EFTA area

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

• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA

1. No deaths reported - ... - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Egypt ... - 1
2. Iraq ... - 1
3. Israel ... - 11
4. Kuwait ... - 1
5. Lebanon ... - 1
6. Occupied Palestinian Territory ... - 1
7. Qatar ... - 1
8. Saudi Arabia 2 - 16
9. United Arab Emirates 1 - 1
10. Yemen ... - 1

• AFRICA

1. Ghana ... - 1
2. Mauritius ... - 5
3. South Africa 2 - 8

• NORTH AMERICA

1. Canada 4 - 71
2. Mexico ... - 164
3. USA ... - 477

• CENTRAL AMERICA & CARIBBEAN

1. Cayman Islands ... - 1
2. Costa Rica ... - 31
3. Dominican Republic ... - 5
4. El Salvador ... - 15
5. Guatemala ... - 10
6. Honduras ... - 7
7. Jamaica ... - 4
8. Nicaragua ... - 1
9. Panama ... - 6
10. Saint Kitts and Nevis ... - 1

• SOUTH AMERICA

1. Argentina ... - 404
2. Bolivia 2 - 19
3. Brazil ... - 368
4. Chile ... - 128
5. Colombia ... - 23
6. Ecuador ... - 23
7. Paraguay ... - 39
8. Peru ... - 62
9. Uruguay ... - 22
10. Venezuela 5 - 17

• NORTH-EAST & SOUTH ASIA

1. Hong Kong SAR China ... - 4
2. India 8 - 36
3. Japan ... - 3
4. South Korea ... - 2
5. Taiwan 1 - 3

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 1
2. Indonesia ... - 4
3. Laos Peoples Democratic Republic ... - 1
4. Malaysia ... - 68
5. Philippines ... - 8
6. Singapore ... - 11
7. Thailand ... - 111
8. Vietnam ... - 2

• AUSTRALIA & PACIFIC

1. Australia 3 - 131
2. Cook Islands ... - 1
3. New Zealand ... - 15
4. Samoa ... - 2
5. Tonga ... - 1

• TOTAL 28 - 2351

Note:
cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated. Yellow shading indicates a new update has been recorded for the country during the past 24 hours.

(...)
-
------

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC): Pandemic Influenza H1N1 2009, Situation Updates (Since August 4, 2009)

Pandemic (H1N1) 2009 - Update 22 August 2009, 17:00 hours CEST (ECDC, edited)

[Original Full Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 - Update 22 August 2009, 17:00 hours CEST


Main developments in past 24 hours

• 311 new cases reported in the EU and EFTA countries, reaching a total of 42 099 cases; Spain reported 1 new fatal case;
• 1 343 new cases including 108 fatal cases, were reported from non-EU and EFTA countries, reaching a cumulative total of 208 496 cases;
• Updated ECDC Interim Risk assessment ?Pandemic (H1N1) 2009 influenza? published on the ECDC website;
• WHO recommendations on the use of antivirals in the management of patients infected with the H1N1 pandemic virus published on WHO website;
• U.S. CDC ACIP recommendations on the use of influenza A(H1N1) 2009 monovalent vaccines published on the CDC Website ECDC website.

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 cases as of 22 August 2009, 16:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer:

Several countries have now announced recommendations on treatment on clinical signs only and focused laboratory testing only for specific population groups or in outbreaks. For these countries, the reported numbers of cases presented in this report will severely underestimate the true incidence in the country and will not be comparable to countries still recommending laboratory tests of all suspected influenza cases.


Epidemiologic update

All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 42 099 confirmed cases, including 80 deaths, have been reported since April 2009 (Table 1). In the past 24 hours, 311 new cases from the EU and EFTA countries were confirmed, including one new fatal case from Spain. Currently, the majority of cases are being reported from Germany and the UK. The latest available updates on hospital admissions per Member State are presented in Table 2. The majority of recent hospitalized cases are reported from the UK and from England in particular.

Outside of the EU and EFTA countries, a total of 1 343 new cases have been reported within the last 24 hours, among which 108 were fatal (Table 3). In total, 208 496 cases including 2 459 fatal cases have been reported from non-EU and EFTA countries.

Globally, the total number of confirmed and reported pandemic (H1N1) 2009 influenza cases to date is 250595, including 2 539 deaths.


Updated ECDC Interim Risk Assessment

Updated ECDC Interim Risk Assessment ?Pandemic (H1N1) 2009 influenza? has been published on the ECDC website: http://ecdc.europa.eu/en/healthtopic...Assessment.pdf


Other developments

WHO Recommendations on the Use of Antivirals

WHO Recommendations on the use of antivirals in the management of patients infected with the H1N1 pandemic virus (pandemic (H1N1) 2009 briefing note 8) have been published on WHO website. The guidelines represent the consensus reached by an international panel of experts who reviewed all available studies on the safety and effectiveness of these drugs.

Emphasis was placed on the use of oseltamivir and zanamivir to prevent severe illness and deaths, reduce the need for hospitalization, and reduce the duration of hospital stays. The document states that on an individual patient basis, initial treatment decisions should be based on clinical assessment and knowledge about the presence of the virus in the community.

For patients who initially present with severe illness or whose condition begins to deteriorate, WHO recommends treatment with oseltamivir as soon as possible. For patients with underlying medical conditions that increase the risk of more severe disease, WHO recommends treatment with either oseltamivir or zanamivir. These patients should also receive treatment as soon as possible after symptom onset, without waiting for the results of laboratory tests. As pregnant women are included among groups at increased risk, WHO recommends that pregnant women receive antiviral treatment as soon as possible after symptom onset.

WHO recommends prompt antiviral treatment for children with severe or deteriorating illness, and those at risk of more severe or complicated illness. This recommendation includes all children under the age of five years, as this age group is at increased risk of more severe illness.

The full text of the recommendations is available at the link below. http://www.who.int/csr/resources/pub.../en/index.html


Recommendations of the Advisory Committee on Immunization Practices (ACIP) on the use of influenza A (H1N1) 2009 monovalent vaccine

U.S. CDC's Advisory Committee on Immunization Practices (ACIP) recommendations on the use of influenza A (H1N1) 2009 monovalent vaccine have been published on CDC website. They are based on the review of epidemiologic and clinical data to determine which population groups should be targeted initially for vaccination and considerations of the projected vaccine supply likely to be available when vaccine is first available and the expected increase in vaccine availability during the following 6 months.

The document states that licensed vaccines against pandemic influenza A (H1N1) 2009 virus are expected to be available in the U.S. by mid-October 2009. The guiding principle of ACIP recommendations is to vaccinate as many persons as possible as quickly as possible.

Highlights of these recommendations include 1) the identification of five initial target groups for vaccination efforts (pregnant women, persons who live with or provide care for infants aged <6 months, health-care and emergency medical services personnel, children and young adults aged 6 months--24 years, and persons aged 25--64 years who have medical conditions that put them at higher risk for influenza-related complications), 2) establishment of priority for a subset of persons within the initial target groups in the event that initial vaccine availability is unable to meet demand, and 3) guidance on use of vaccine in other adult population groups as vaccine availability increases.

The full text of the recommendations is available at the link below. http://www.cdc.gov/mmwr/preview/mmwr...=rr58e0821a1_e


Other Updates from the U.S. CDC

CDC also issued recently three other documents related to influenza A(H1N1) 2009:

• CDC Guidance for Businesses and Employers To Plan and Respond to the 2009?2010 Influenza Season http://www.cdc.gov/h1n1flu/business/guidance/
• CDC Guidance for Responses to Influenza for Inst itut ions of Higher Educat ion during the2009-2010 Academic Year http://www.cdc.gov/h1n1flu/institutions/guidance/
• Key Flu Indicators http://www.cdc.gov/h1n1flu/

Changing the format of the daily report

As the influenza pandemic evolves, new types of data become increasingly important, whereas other may become less interesting. ECDC has refreshed the format of the Situation Update to better accommodate current and anticipated information needs. The name of this report changed to "Daily Update" and some changes have been made in the data reported.

Table 1 ? reported cases by the EU/EFTA countries remains as before. In addition, we are publishing a new Table 2 on the number of current and cumulative hospitalisations and admission to intensive care in EU/EFTA Member States. The source of the information is official statements or surveillance reports published by national health authorities. It should be noted that indications and thresholds for hospitalisations vary by country, so the figures quoted may not be directly comparable between countries.

Assuming no changes in the national reporting system, trends of hospitalisations over time should give an accurate representation of the evolution of the pandemic. This might change if countries are faced with capacity issues within the healthcare system at a later stage of this evolving pandemic.

Table 3 lists only reported deaths for countries outside the EU/EFTA area; we have discontinued reporting the case numbers for these countries. The main reason for this is that more and more countries have stopped the reporting of new cases, and these figures no longer give a representative picture of the situation.

The two graphs now show number of reported deaths by week of report ? one graph for EU/EFTA, one for the entire world. The two maps depict cumulative deaths by country, one for EU/EFTA, one for the world.


Table 1: Reported new confirmed cases and cumulative number of influenza A(H1N1)v and cumulative deaths among confirmed cases by country as of 22 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Deaths among confirmed cases (a)]

1. Austria ... - 270 - ...
2. Belgium ... - 126 - 1
3. Bulgaria ... - 57 - ...
4. Cyprus ... - 297 - ...
5. Czech Republic ... - 217 - ...
6. Denmark ... - 520 - ...
7. Estonia ... - 57 - ...
8. Finland ... - 207 - ...
9. France (b) ... - 1125 - 1
10. Germany ... - 13740 - ...
11. Greece ... - 1424 - ...
12. Hungary ... - 149 - 1
13. Iceland ... - 152 - ...
14. Ireland ... - 678 - 2
15. Italy 279 - 1517 - ...
16. Latvia ... - 23 - ...
17. Liechtenstein ... - 5 - ...
18. Lithuania ... - 47 - ...
19. Luxemburg ... - 129 - ...
20. Malta ... - 237 - 1
21. Netherlands (c) ... - 1473 - 2
22. Norway ... - 868 - ...
23. Poland ... - 153 - ...
24. Portugal ... - 1987 - ...
25. Romania ... - 273 - ...
26. Slovakia 5 - 108 - ...
27. Slovenia 1 - 210 - ...
28. Spain ... - 1538 - 13
29. Sweden ... - 672 - ...
30. Switzerland 26 - 883 - ...
31. United Kingdom (d) ... - 12957 - 59

• Total 311 - 42099 - 80

Note:
cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites. Countries shaded with gray are not recommending laboratory tests for all suspect cases, therefore comparisons in time or between these countries should not be made at present.

(a) Deaths are included in the cumulative number of confirmed cases
(b) Cases reported from France include those reported from the overseas territories (434)
(c) Cases from the Netherlands include those reported from Aruba and the Dutch Antilles
(d) Cases reported from the United Kingdom include the number of individual cases from the following overseas territories: Anguilla, The Falklands, Gibraltar, Sovereign Base Area Cyprus, Turks and Caicos Islands (78)


Table 2: Reported number of confirmed influenza A(H1N1)v cases admitted to hospitals and intensive care by country as of 22 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - (date of report) - Most recent number of cases admitted in hospitals - Cumulative number of cases admitted in hospitals - Most recent number of cases admitted to intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (7.8.) - 0 - ... - 0 - ...
2. Belgium (7.8.) - 0 - ... - 0 - ...
3. Bulgaria - ... - ... - ... - ...
4. Cyprus - ... - ... - ... - ...
5. Czech Republic (17.8.) - 0 - ... - 0 - ...
6. Denmark (20.8) - ... - ... - ... - ...
7. Estonia (14.8.) - 0 - 0 - 0 - 0
8. Finland (18.8.) - ... - ... - ... - ...
9. France(a) (18.8.) - 6 - 65 - 5 - 11
10. Germany (21.8.) - ... - ... - ... - ...
11. Greece (13.8.) - ... - ... - 1 - 2
12. Hungary (19.8.) - ... - 27 - ... - ...
13. Iceland (20.8.) - 0 - 0 - 0 - 0
14. Ireland (20.8.) - 14 - 55 - ... - ...
15. Italy (17.7.) - ... - ... - ... - ...
16. Latvia (13.8.) - ... - 1 - ... - ...
17. Liechtenstein (19.8.) - ... - ... - ... - ...
18. Lithuania (13.8.) - ... - ... - ... - ...
19. Luxemburg (14.8.) - ... - ... - 0 - 0
20. Malta - ... - ... - ... - ...
21. Netherlands (20.8.) - 18 - 46 - ... - ...
22. Norway (19.8.) - ... - ... - ... - ...
23. Poland (18.8.) - ... - ... - ... - ...
24. Portugal (20.8.) - 8 - ... - ... - ...
25. Romania - ... - 18 - ... - ...
26. Slovakia (12.8.) - 2 - 33 - 0 - 0
27. Slovenia (10.8.) - ... - ... - ... - ...
28. Spain (20.8.) - ... - ... - 32 - 91
29. Sweden (20.8.) - ... - ... - ... - ...
30. Switzerland (20.8.) - ... - 11 - ... - 1
31. United Kingdom(b) (20.8.) - 263 - ... - 30 - ...

Note:
Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites. New updates are shaded in yellow.

(...) denotes no information readily available in official sources.
(a) Cases reported from France include those reported from the overseas territories.
(b) Data for England only. Does not include Scotland (114 cumulative hospitalisations), Wales (38) and Northern Ireland (36).


Table 3. Reported number of new and cumulative confirmed fatal pandemic influenza (H1N1) 2009 cases by country as of 22 August 2009, 16:00 hours (CEST) outside of the EU/EFTA area

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

• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA

1. No deaths reported - ... - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Egypt ... - 1
2. Iraq ... - 1
3. Israel ... - 11
4. Kuwait ... - 1
5. Lebanon ... - 1
6. Occupied Palestinian Territory ... - 1
7. Oman 2 - 2
8. Qatar ... - 1
9. Saudi Arabia ... - 16
10. United Arab Emirates ... - 1
11. Yemen ... - 1

• AFRICA

1. Ghana ... - 1
2. Mauritius ... - 5
3. South Africa ... - 8

• NORTH AMERICA

1. Canada ... - 71
2. Mexico 6 - 170
3. USA 45 - 522

• CENTRAL AMERICA & CARIBBEAN

1. Cayman Islands ... - 1
2. Costa Rica ... - 31
3. Dominican Republic ... - 5
4. El Salvador ... - 15
5. Guatemala ... - 10
6. Honduras ... - 7
7. Jamaica ... - 4
8. Nicaragua ... - 1
9. Panama ... - 6
10. Saint Kitts and Nevis ... - 1

• SOUTH AMERICA

1. Argentina 35 - 439
2. Bolivia ... - 19
3. Brazil ... - 368
4. Chile ... - 128
5. Colombia ... - 23
6. Ecuador 4 - 27
7. Paraguay 2 - 41
8. Peru ... - 62
9. Uruguay ... - 22
10. Venezuela ... - 17

• NORTH-EAST & SOUTH ASIA

1. Hong Kong SAR China ... - 4
2. India 12 - 48
3. Japan ... - 3
4. South Korea ... - 2
5. Taiwan ... - 3

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 1
2. Indonesia ... - 4
3. Laos Peoples Democratic Republic ... - 1
4. Malaysia ... - 68
5. Philippines ... - 8
6. Singapore 1 - 12
7. Thailand ... - 111
8. Vietnam ... - 2

• AUSTRALIA & PACIFIC

1. Australia 1 - 132
2. Cook Islands ... - 1
3. New Zealand ... - 15
4. Samoa ... - 2
5. Tonga ... - 1

• TOTAL 108 - 2459

Note:
cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated. Yellow shading indicates a new update has been recorded for the country during the past 24 hours.

(...)
-
------

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC): Pandemic Influenza H1N1 2009, Situation Updates (Since August 4, 2009)

Pandemic (H1N1) 2009 - Update 24 August 2009, 17:00 hours CEST (ECDC, edited)

[Original Full Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 - Update 24 August 2009, 17:00 hours CEST


Main developments in past 24 hours

• 1 048 new cases reported in the EU and EFTA countries, reaching a total of 43 152 cases; Spain reported one new fatal case; France reported 9 new fatal cases;
• Deaths reported from France include 5 in New Caledonia, 3 in the French Polynesia and 2 in mainland France;
• 720 new cases including 17 fatal cases, were reported from non-EU and EFTA countries, reaching a cumulative total of 210 017 cases;
• Early report suggests influenza A(H1N1)v isolated from turkeys in Chile;
• Sweden announced the priority groups for pandemic influenza vaccination.

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 cases as of 24 August 2009, 16:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer:

Several countries have now announced recommendations on treatment on clinical signs only and focused laboratory testing only for specific population groups or in outbreaks. For these countries, the reported numbers of cases presented in this report will severely underestimate the true incidence in the country and will not be comparable to countries still recommending laboratory tests of all suspected influenza cases.


Epidemiologic update

All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 43 152 confirmed cases, including 93 deaths, have been reported since April 2009 (Table 1). In the past 24 hours, 1048 new cases from the EU and EFTA countries were confirmed, including one new fatal case from Spain and nine from France. Deaths reported from France include 5 in New Caledonia, 3 in the French Polynesia and 2 in mainland France.

Currently, the majority of cases have been reported from Germany and the UK. The latest available updates on hospital admissions per Member State are presented in Table 2. The majority of recent hospitalized cases have been reported from the UK and from England in particular.

Outside of the EU and EFTA countries, a total of 720 new cases have been reported within the last 24 hours, among which 17 were fatal (Table 3). In total, 210 017 cases including 2 479 fatal cases have been reported from non-EU and EFTA countries.

Globally, the total number of confirmed and reported pandemic (H1N1) 2009 influenza cases to date is 253169 including 2 572 deaths.


Other Updates

Sweden published the national priority groups for pandemic vaccines

The National Board of Health and Welfare in Sweden adopted national recommendations on vaccination strategies for the pandemic (H1N1) 2009 influenza. Vaccination of two groups are recommended in parallel, whenever possible:

1. Persons at risk of severe disease:
   • a. Initially all individuals above 3 years of age and soon after all individuals above 6 months of age with the following chronic underlying diseases:
     • i. Chronic lung disease
     • ii. Conditions that cause breathing difficulties like extreme obesity or neuromuscular diseases
     • iii. Chronic cardiovascular diseases (excluding hypertension only)
     • iv. Immune suppressed (incl HIV)
     • v. Chronic liver or renal failure (GFR<30ml/min)
     • vi. Diabetes mellitus, when a febrile illness can lead to complications
     • vii. Asthma under medication for the past three years
   • b. Pregnant women
2. Healthcare personnel

The press release and attached documentation can be accessed in swedish through: http://www.socialstyrelsen.se/Aktuel...yhet090820.htm


Influenza A(H1N1)v isolated from turkeys in Chile

Researchers from the public health institute of Chile published a short and early report on the ProMed newsletter suggesting that they have isolated influenza A(H1N1)v in turkeys involved in an outbreak in Chile. Further confirmation of these results is awaited. The full report can be found at: http://www.promedmail.org/pls/otn/f?..._ID:1000,78910


Changing the format of the daily report

As the pandemic (H1N1) 2009 evolves, new types of data become increasingly important, whereas other may become less interesting. ECDC has refreshed the format of the Situation Update to better accommodate current and anticipated information needs.

The name of this report changed to "Daily Update" and some changes have been made in the data reported.

Table 1 ? reported cases by the EU/EFTA countries remains as before. In addition, we are publishing a new Table 2 on the number of current and cumulative hospitalisations and admission to intensive care in EU/EFTA Member States. The source of the information is official statements or surveillance reports published by national health authorities. It should be noted that indications and thresholds for hospitalisations vary by country, so the figures quoted may not be directly comparable between countries.

Assuming no changes in the national reporting system, trends of hospitalisations over time should give an accurate representation of the evolution of the pandemic. This might change if countries are faced with capacity issues within the healthcare system at a later stage of this evolving pandemic.

Table 3 lists only reported deaths for countries outside the EU/EFTA area; we have discontinued reporting the case numbers for these countries. The main reason for this is that more and more countries have stopped the reporting of new cases, and these figures no longer give a representative picture of the situation.

The two graphs now show number of reported deaths by week of report ? one graph for EU/EFTA, one for the entire world. The two maps depict cumulative deaths by country, one for EU/EFTA, one for the world.


Table 1: Reported new confirmed cases and cumulative number of Pandemic (H1N1) 2009 influenza and cumulative deaths among confirmed cases by country as of 24 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Deaths among confirmed cases (a)]

1. Austria ... - 270 - ...
2. Belgium ... - 126 - 1
3. Bulgaria 6 - 63 - ...
4. Cyprus ... - 297 - ...
5. Czech Republic 20 - 237 - ...
6. Denmark ... - 520 - ...
7. Estonia ... - 57 - ...
8. Finland 1 - 208 - ...
9. France (b) ... - 1125 - 10 (e)
10. Germany 585 - 14325 - ...
11. Greece 207 - 1631 - 1
12. Hungary ... - 149 - 1
13. Iceland ... - 152 - ...
14. Ireland ... - 678 - 2
15. Italy ... - 1517 - ...
16. Latvia ... - 23 - ...
17. Liechtenstein ... - 5 - ...
18. Lithuania ... - 47 - ...
19. Luxemburg ... - 129 - ...
20. Malta ... - 237 - 1
21. Netherlands (c) ... - 1473 - 2
22. Norway ... - 868 - ...
23. Poland ... - 153 - ...
24. Portugal 223 - 2210 - ...
25. Romania 6 - 284 - ...
26. Slovakia ... - 108 - ...
27. Slovenia ... - 210 - ...
28. Spain ... - 1538 - 16
29. Sweden ... - 672 - ...
30. Switzerland ... - 883 - ...
31. United Kingdom (d) ... - 12957 - 59

• Total 1048 - 43152 - 93

Note:
cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites. Countries shaded with gray are not recommending laboratory tests for all suspect cases, therefore comparisons in time or between these countries should not be made at present.

(a) Deaths are included in the cumulative number of confirmed cases
(b) Cases reported from France include those reported from the overseas territories (434).
(c) Cases from the Netherlands include those reported from Aruba and the Dutch Antilles
(d) Cases reported from the United Kingdom include the number of individual cases from the following overseas territories: Anguilla, The Falklands, Gibraltar, Sovereign Base Area Cyprus, Turks and Caicos Islands (78)
(e) Deaths reported from France include 5 in New Caledonia, 3 in the French Polynesia and 2 in mainland France.


Table 2: Reported number of confirmed influenza A(H1N1)v cases admitted to hospitals and intensive care by country as of 24 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - (date of report) - Most recent number of cases admitted in hospitals - Cumulative number of cases admitted in hospitals - Most recent number of cases admitted to intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (7.8.) - 0 - ... - 0 - ...
2. Belgium (7.8.) - 0 - ... - 0 - ...
3. Bulgaria - ... - ... - ... - ...
4. Cyprus - ... - ... - ... - ...
5. Czech Republic (17.8.) - 0 - ... - 0 - ...
6. Denmark (20.8) - ... - ... - ... - ...
7. Estonia (14.8.) - 0 - 0 - 0 - 0
8. Finland (18.8.) - ... - ... - ... - ...
9. France(a) (18.8.) - 6 - 65 - 5 - 11
10. Germany (21.8.) - ... - ... - ... - ...
11. Greece (13.8.) - ... - ... - 1 - 2
12. Hungary (19.8.) - ... - 27 - ... - ...
13. Iceland (20.8.) - 0 - 0 - 0 - 0
14. Ireland (20.8.) - 14 - 55 - ... - ...
15. Italy (17.7.) - ... - ... - ... - ...
16. Latvia (13.8.) - ... - 1 - ... - ...
17. Liechtenstein (19.8.) - ... - ... - ... - ...
18. Lithuania (13.8.) - ... - ... - ... - ...
19. Luxemburg (14.8.) - ... - ... - 0 - 0
20. Malta - ... - ... - ... - ...
21. Netherlands (20.8.) - 18 - 46 - ... - ...
22. Norway (19.8.) - ... - ... - ... - ...
23. Poland (18.8.) - ... - ... - ... - ...
24. Portugal (20.8.) - 8 - ... - ... - ...
25. Romania - ... - 18 - ... - ...
26. Slovakia (12.8.) - 2 - 33 - 0 - 0
27. Slovenia (10.8.) - ... - ... - ... - ...
28. Spain (20.8.) - ... - ... - 32 - 91
29. Sweden (20.8.) - ... - ... - ... - ...
30. Switzerland (20.8.) - ... - 11 - ... - 1
31. United Kingdom(b) (20.8.) - 263 - ... - 30 - ...

Note:
Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites. New updates are shaded in yellow.

(...) denotes no information readily available in official sources.
(a) Cases reported from France include those reported from the overseas territories.
(b) Data for England only. Does not include Scotland (114 cumulative hospitalisations), Wales (38) and Northern Ireland (36).


Table 3. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases by country as of 24 August 2009, 16:00 hours (CEST) outside of the EU/EFTA area

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

• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA

1. No deaths reported - ... - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Egypt ... - 1
2. Iraq ... - 1
3. Israel ... - 11
4. Kuwait ... - 2
5. Lebanon ... - 1
6. Occupied Palestinian Territory ... - 1
7. Oman ... - 4
8. Qatar ... - 1
9. Saudi Arabia ... - 16
10. United Arab Emirates ... - 1
11. Yemen ... - 1

• AFRICA

1. Ghana ... - 1
2. Mauritius ... - 5
3. South Africa ... - 8

• NORTH AMERICA

1. Canada ... - 71
2. Mexico ... - 170
3. USA ... - 522

• CENTRAL AMERICA & CARIBBEAN

1. Cayman Islands ... - 1
2. Costa Rica ... - 31
3. Dominican Republic ... - 5
4. El Salvador ... - 15
5. Guatemala ... - 10
6. Honduras ... - 7
7. Jamaica ... - 4
8. Nicaragua ... - 1
9. Panama ... - 6
10. Saint Kitts and Nevis ... - 1

• SOUTH AMERICA

1. Argentina ... - 439
2. Bolivia ... - 19
3. Brazil ... - 368
4. Chile ... - 128
5. Colombia ... - 23
6. Ecuador ... - 27
7. Paraguay ... - 41
8. Peru ... - 62
9. Uruguay ... - 22
10. Venezuela ... - 17

• NORTH-EAST & SOUTH ASIA

1. Hong Kong SAR China ... - 4
2. India 12 - 60
3. Japan ... - 3
4. South Korea ... - 2
5. Taiwan 2 - 5

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 1
2. Indonesia 1 - 5
3. Laos Peoples Democratic Republic ... - 1
4. Malaysia 1 - 69
5. Philippines ... - 8
6. Singapore ... - 12
7. Thailand ... - 111
8. Vietnam ... - 2

• AUSTRALIA & PACIFIC

1. Australia ... - 132
2. Cook Islands ... - 1
3. New Zealand 1 - 16
4. Samoa ... - 2
5. Tonga ... - 1

• TOTAL 17 - 2479

Note:
cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated. Yellow shading indicates a new update has been recorded for the country during the past 24 hours.

(...)
-
------

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC): Pandemic Influenza H1N1 2009, Situation Updates (Since August 4, 2009)

Pandemic (H1N1) 2009 - Update 25 August 2009, 17:00 hours CEST (ECDC, edited)

[Original Full Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 - Update 25 August 2009, 17:00 hours CEST


Main developments in past 24 hours

• 93 new cases reported in the EU and EFTA countries, reaching a total of 43 245 cases;
• 1 685 new cases including 22 fatal cases, were reported from non-EU and EFTA countries, reaching a cumulative total of 211 702 cases;
• ECDC Scientific Advance review published;
• US president?s advisors release report assessing pandemic influenza preparedness;
• ECDC summary of weekly media monitoring included.

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 cases as of 25 August 2009, 16:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer:

Several countries have now announced recommendations on treatment on clinical signs only and focused laboratory testing only for specific population groups or in outbreaks. For these countries, the reported numbers of cases presented in this report will severely underestimate the true incidence in the country and will not be comparable to countries still recommending laboratory tests of all suspected influenza cases.


Epidemiologic update

All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 43 245 confirmed cases, including 93 deaths, have been reported since April 2009 (Table 1). In the past 24 hours, 93 new cases from the EU and EFTA countries were confirmed.

Currently, the majority of cases have been reported from Germany and the UK. The latest available updates on hospital admissions per Member State are presented in Table 2. The majority of recent hospitalized cases have been reported from the UK and from England in particular.

Outside of the EU and EFTA countries, a total of 1 685 new cases have been reported within the last 24 hours, among which 22 were fatal (Table 3). In total, 211 702 cases including 2 501 fatal cases have been reported from non-EU and EFTA countries.

Globally, the total number of confirmed and reported pandemic (H1N1) 2009 influenza cases to date is 254947 including 2 594 deaths.


Other Updates

ECDC publishes a Scientific Advance on reproductive numbers and generation times for this pandemic

Following a review of a study from New Zealand last week ECDC this week publishes a review explaining what is meant by Reproductive Numbers (R) and Generation Time in general, how these values are estimated and lists what have been the findings of various studies so far outside Europe and within Europe. This table will be updated as new data become available.

The full Scientific Advance review can be found at: http://ecdc.europa.eu/en/activities/...rm.aspx?ID=641


US president?s advisors release report assessing pandemic influenza preparedness

The US President?s Council of Advisors on Science and Technology (PCAST) released a report assessing pandemic influenza preparedness in the US. Several media sources discussing report. Full press release and report available through: http://www.whitehouse.gov/the_press_...-preparations/


Short summary of the media monitoring of the past week for the ECDC Daily Updates

ECDC?s media section collects articles of particular interest with regard to the H1N1 pandemic 2009?s development by 10:00 am every morning. It is by no means exhaustive. The purpose of the ECDC daily strategic media monitoring is to raise awareness of present key media stories across Europe, and it should not be seen as representing the views of ECDC. This strategic media monitoring is intended for internal use in ECDC and for our communication network.

Media continue to report on new vaccine developments. A number of articles reported concerns over the safety of the vaccine and over antiviral resistance. Articles also reported on the costs of vaccines in various European countries. Various media outlets reported on secondary economic effects of the pandemic (H1N1) 2009. According to media, some of the EU Member States are still discussing measures such as school closures and, in Swedish schools, to avoid shaking hands.

Media also reported about Chile where the influenza A(H1N1)v virus was detected in turkeys. This is the first time the virus has been found outside humans and pigs, continues the reports. Chile's turkey meat remains safe to eat, according to the reporting.

In international news, in an attempt to prevent influenza A(H1N1)v spread, Muslims under 25 or over 65 years of age planning on participating in the pilgrimage to Mecca were stopped at the Cairo airport, leading to protests.


Changing the format of the daily report

As the pandemic (H1N1) 2009 evolves, new types of data become increasingly important, whereas other may become less interesting. ECDC has refreshed the format of the Situation Update to better accommodate current and anticipated information needs. The name of this report changed to "Daily Update" and some changes have been made in the data reported.

Table 1 ? reported cases by the EU/EFTA countries remains as before. In addition, we are publishing a new Table 2 on the number of current and cumulative hospitalisations and admission to intensive care in EU/EFTA Member States. The source of the information is official statements or surveillance reports published by national health authorities. It should be noted that indications and thresholds for hospitalisations vary by country, so the figures quoted may not be directly comparable between countries.

Assuming no changes in the national reporting system, trends of hospitalisations over time should give an accurate representation of the evolution of the pandemic. This might change if countries are faced with capacity issues within the healthcare system at a later stage of this evolving pandemic.

Table 3 lists only reported deaths for countries outside the EU/EFTA area; we have discontinued reporting the case numbers for these countries. The main reason for this is that more and more countries have stopped the reporting of new cases, and these figures no longer give a representative picture of the situation.

The two graphs now show number of reported deaths by week of report ? one graph for EU/EFTA, one for the entire world. The two maps depict cumulative deaths by country, one for EU/EFTA, one for the world.


Table 1: Reported new confirmed cases and cumulative number of Pandemic (H1N1) 2009 influenza and cumulative deaths among confirmed cases by country as of 25 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Deaths among confirmed cases (a)]

1. Austria ... - 270 - ...
2. Belgium ... - 126 - 1
3. Bulgaria ... - 63 - ...
4. Cyprus ... - 297 - ...
5. Czech Republic ... - 237 - ...
6. Denmark 8 - 528 - ...
7. Estonia 1 - 58 - ...
8. Finland 2 - 210 - ...
9. France (b) ... - 1125 - 10 (e)
10. Germany ... - 14325 - ...
11. Greece ... - 1631 - 1
12. Hungary 2 - 151 - 1
13. Iceland ... - 152 - ...
14. Ireland ... - 678 - 2
15. Italy ... - 1517 - ...
16. Latvia ... - 23 - ...
17. Liechtenstein ... - 5 - ...
18. Lithuania ... - 47 - ...
19. Luxemburg ... - 129 - ...
20. Malta 5 - 242 - 1
21. Netherlands (c) ... - 1473 - 2
22. Norway ... - 868 - ...
23. Poland ... - 153 - ...
24. Portugal ... - 2210 - ...
25. Romania 8 - 292 - ...
26. Slovakia 4 - 112 - ...
27. Slovenia ... - 210 - ...
28. Spain ... - 1538 - 16
29. Sweden ... - 672 - ...
30. Switzerland 63 - 946 - ...
31. United Kingdom (d) ... - 12957 - 59

• Total 93 - 43245 - 93

Note:
cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites. Countries shaded with gray are not recommending laboratory tests for all suspect cases, therefore comparisons in time or between these countries should not be made at present.

(a) Deaths are included in the cumulative number of confirmed cases
(b) Cases reported from France include those reported from the overseas territories (434).
(c) Cases from the Netherlands include those reported from Aruba and the Dutch Antilles
(d) Cases reported from the United Kingdom include the number of individual cases from the following overseas territories: Anguilla, The Falklands, Gibraltar, Sovereign Base Area Cyprus, Turks and Caicos Islands (78)
(e) Deaths reported from France include 5 in New Caledonia, 3 in the French Polynesia and 2 in mainland France.


Table 2: Reported number of confirmed influenza A(H1N1)v cases admitted to hospitals and intensive care by country as of 25 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - (date of report) - Most recent number of cases admitted in hospitals - Cumulative number of cases admitted in hospitals - Most recent number of cases admitted to intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (7.8.) - 0 - ... - 0 - ...
2. Belgium (7.8.) - 0 - ... - 0 - ...
3. Bulgaria - ... - ... - ... - ...
4. Cyprus - ... - ... - ... - ...
5. Czech Republic (17.8.) - 0 - ... - 0 - ...
6. Denmark (20.8) - ... - ... - ... - ...
7. Estonia (14.8.) - 0 - 0 - 0 - 0
8. Finland (18.8.) - ... - ... - ... - ...
9. France(a) (18.8.) - 6 - 65 - 5 - 11
10. Germany (21.8.) - ... - ... - ... - ...
11. Greece (13.8.) - ... - ... - 1 - 2
12. Hungary (19.8.) - ... - 27 - ... - ...
13. Iceland (20.8.) - 0 - 0 - 0 - 0
14. Ireland (20.8.) - 14 - 55 - ... - ...
15. Italy (17.7.) - ... - ... - ... - ...
16. Latvia (13.8.) - ... - 1 - ... - ...
17. Liechtenstein (19.8.) - ... - ... - ... - ...
18. Lithuania (13.8.) - ... - ... - ... - ...
19. Luxemburg (14.8.) - ... - ... - 0 - 0
20. Malta - ... - ... - ... - ...
21. Netherlands (20.8.) - 18 - 46 - ... - ...
22. Norway (19.8.) - ... - ... - ... - ...
23. Poland (18.8.) - ... - ... - ... - ...
24. Portugal (20.8.) - 8 - ... - ... - ...
25. Romania - ... - 18 - ... - ...
26. Slovakia (12.8.) - 2 - 33 - 0 - 0
27. Slovenia (10.8.) - ... - ... - ... - ...
28. Spain (20.8.) - ... - ... - 32 - 91
29. Sweden (20.8.) - ... - ... - ... - ...
30. Switzerland (24.8.) - ... - 20 - ... - 1
31. United Kingdom(b) (20.8.) - 263 - ... - 30 - ...

Note:
Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites. New updates are shaded in yellow.

(...) denotes no information readily available in official sources.
(a) Cases reported from France include those reported from the overseas territories.
(b) Data for England only. Does not include Scotland (114 cumulative hospitalisations), Wales (38) and Northern Ireland (36).


Table 3. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases by country as of 25 August 2009, 16:00 hours (CEST) outside of the EU/EFTA area

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

• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA

1. No deaths reported - ... - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Egypt ... - 1
2. Iraq ... - 1
3. Israel ... - 11
4. Kuwait ... - 2
5. Lebanon ... - 1
6. Occupied Palestinian Territory ... - 1
7. Oman ... - 4
8. Qatar ... - 1
9. Saudi Arabia ... - 16
10. United Arab Emirates ... - 1
11. Yemen ... - 1

• AFRICA

1. Ghana ... - 1
2. Mauritius ... - 5
3. South Africa ... - 8

• NORTH AMERICA

1. Canada ... - 71
2. Mexico ... - 170
3. USA ... - 522

• CENTRAL AMERICA & CARIBBEAN

1. Cayman Islands ... - 1
2. Costa Rica ... - 31
3. Dominican Republic ... - 5
4. El Salvador ... - 15
5. Guatemala ... - 10
6. Honduras ... - 7
7. Jamaica ... - 4
8. Nicaragua ... - 1
9. Panama ... - 6
10. Saint Kitts and Nevis ... - 1

• SOUTH AMERICA

1. Argentina ... - 439
2. Bolivia ... - 19
3. Brazil ... - 368
4. Chile ... - 128
5. Colombia ... - 23
6. Ecuador ... - 27
7. Paraguay ... - 41
8. Peru 18 - 80
9. Uruguay ... - 22
10. Venezuela ... - 17

• NORTH-EAST & SOUTH ASIA

1. Hong Kong SAR China ... - 4
2. India 3 - 63
3. Japan ... - 3
4. South Korea ... - 2
5. Taiwan ... - 5

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 1
2. Indonesia ... - 5
3. Laos Peoples Democratic Republic ... - 1
4. Malaysia ... - 69
5. Philippines ... - 8
6. Singapore 1 - 13
7. Thailand ... - 111
8. Vietnam ... - 2

• AUSTRALIA & PACIFIC

1. Australia ... - 132
2. Cook Islands ... - 1
3. New Zealand ... - 16
4. Samoa ... - 2
5. Tonga ... - 1

• TOTAL 22 - 2501

Note:
cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated. Yellow shading indicates a new update has been recorded for the country during the past 24 hours.

(...)
-
------

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC): Pandemic Influenza H1N1 2009, Situation Updates (Since August 4, 2009)

Pandemic (H1N1) 2009 - Update 26 August 2009, 17:00 hours CEST (ECDC, edited)

[Original Full Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 - Update 26 August 2009, 17:00 hours CEST


Main developments in past 24 hours

• 745 new cases reported in the EU and EFTA countries, reaching a total of 43 990 cases;
• European Commission policy statement on vaccination target and priority groups published;
• Public health development: WHO guidelines for the use of influenza antivirals published;
• New ECDC Health education document on vaccine use published.

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 cases as of 26 August 2009, 16:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer:

Several countries have now announced recommendations on treatment on clinical signs only and focused laboratory testing only for specific population groups or in outbreaks. For these countries, the reported numbers of cases presented in this report will severely underestimate the true incidence in the country and will not be comparable to countries still recommending laboratory tests of all suspected influenza cases.


Epidemiologic update

All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 43 990 confirmed cases, including 93 deaths, have been reported since April 2009 (Table 1). In the past 24 hours, 745 new cases from the EU and EFTA countries were confirmed.

Currently, the majority of cases have been reported from Germany and the UK. The latest available updates on hospital admissions per Member State are presented in Table 2. The majority of recent hospitalized cases have been reported from the UK and from England in particular.


Other Updates

European Commission policy statement on vaccination target and priority groups published

The European Union Health Security Committee and the Early Warning and Response authorities (HSC/EWRS) adopted a policy statement proposed by the European Commission which outlines a shared European approach towards identifying target and priority groups for A H1N1 vaccination.

The statement is available at: http://europa.eu/rapid/pressReleases...guiLanguage=en

The ECDC interim guidance on pandemic vaccines is available at: http://ecdc.europa.eu/en/publication...rm.aspx?ID=388


Public health development: WHO guidelines for the use of influenza antivirals published

The World Health Organization (WHO) has issued evidence-based guidelines for the use of influenza antivirals and recommendations concerning the use of the current antivirals in the management of patients infected or possibly infected with all kinds of influenza (seasonal, pandemic and animal influenzas). At present the major interest will be in their use concerning the A(H1N1) 2009 pandemic virus. Rather than claiming to be applicable to every country in the world (or even within Europe) these are designed to give a common understanding of the underlying evidence and are specifically to assist national or local public health authorities produce their own guidelines tailored to their own circumstances. The WHO guidelines especially emphasize the use of the neuraminidase inhibitors, oseltamivir and zanamivir for people in the risk-groups and with severe or progressive illness so as to prevent severe illness and deaths, reduce the need for hospitalization and reduce the duration of hospital stays. A description of the guidelines listing the 18 recommendations with a comment is posted as a public health development on the ECDC web-site.

The full ECDC review and links to the original document can be found at: http://ecdc.europa.eu/en/healthtopic...velopment.aspx


New ECDC Health education document on vaccine use published

ECDC?s HEALTH EDUCATION document ?On the use of specific pandemic influenza vaccines? was published today. The document is a short summary of information on the use of specific pandemic influenza vaccines during the pandemic (H1N1) 2009. It provides background information and guidance on pandemic vaccine use, along with options for prioritisation strategies based on the current scenario of the pandemic.

The full document is available from: http://ecdc.europa.eu/en/healthtopic...a_vaccines.pdf


Changing the format of the daily report

As the pandemic (H1N1) 2009 evolves, new types of data become increasingly important, whereas other may become less interesting. ECDC has refreshed the format of the Situation Update to better accommodate current and anticipated information needs. The name of this report changed to "Daily Update" and some changes have been made in the data reported.

Table 1 ? reported cases by the EU/EFTA countries remains as before. In addition, we are publishing a new Table 2 on the number of current and cumulative hospitalisations and admission to intensive care in EU/EFTA Member States. The source of the information is official statements or surveillance reports published by national health authorities. It should be noted that indications and thresholds for hospitalisations vary by country, so the figures quoted may not be directly comparable between countries.

Assuming no changes in the national reporting system, trends of hospitalisations over time should give an accurate representation of the evolution of the pandemic. This might change if countries are faced with capacity issues within the healthcare system at a later stage of this evolving pandemic.

Table 3 lists only reported deaths for countries outside the EU/EFTA area; we have discontinued reporting the case numbers for these countries. The main reason for this is that more and more countries have stopped the reporting of new cases, and these figures no longer give a representative picture of the situation.

The two graphs now show number of reported deaths by week of report ? one graph for EU/EFTA, one for the entire world. The two maps depict cumulative deaths by country, one for EU/EFTA, one for the world.


Table 1: Reported new confirmed cases and cumulative number of Pandemic (H1N1) 2009 influenza and cumulative deaths among confirmed cases by country as of 26 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Deaths among confirmed cases (a)]

1. Austria ... - 270 - ...
2. Belgium ... - 126 - 1
3. Bulgaria ... - 63 - ...
4. Cyprus ... - 297 - ...
5. Czech Republic ... - 237 - ...
6. Denmark 9 - 537 - ...
7. Estonia 1 - 59 - ...
8. Finland ... - 210 - ...
9. France (b) ... - 1125 - 10 (e)
10. Germany 615 - 14940 - ...
11. Greece ... - 1631 - 1
12. Hungary ... - 151 - 1
13. Iceland ... - 152 - ...
14. Ireland ... - 678 - 2
15. Italy ... - 1517 - ...
16. Latvia ... - 23 - ...
17. Liechtenstein ... - 5 - ...
18. Lithuania 1 - 48 - ...
19. Luxemburg 1 - 130 - ...
20. Malta 4 - 246 - 1
21. Netherlands (c) ... - 1473 - 2
22. Norway ... - 868 - ...
23. Poland 2 - 155 - ...
24. Portugal ... - 2210 - ...
25. Romania 2 - 294 - ...
26. Slovakia 1 - 113 - ...
27. Slovenia ... - 210 - ...
28. Spain ... - 1538 - 16
29. Sweden 84 - 756 - ...
30. Switzerland 25 - 971 - ...
31. United Kingdom (d) ... - 12957 - 59

• Total 745 - 43990 - 93

Note:
cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites. Countries shaded with gray are not recommending laboratory tests for all suspect cases, therefore comparisons in time or between these countries should not be made at present.

(a) Deaths are included in the cumulative number of confirmed cases
(b) Cases reported from France include those reported from the overseas territories (434).
(c) Cases from the Netherlands include those reported from Aruba and the Dutch Antilles
(d) Cases reported from the United Kingdom include the number of individual cases from the following overseas territories: Anguilla, The Falklands, Gibraltar, Sovereign Base Area Cyprus, Turks and Caicos Islands (78)
(e) Deaths reported from France include 5 in New Caledonia, 3 in the French Polynesia and 2 in mainland France.


Table 2: Reported number of confirmed influenza A(H1N1)v cases admitted to hospitals and intensive care by country as of 26 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - (date of report) - Most recent number of cases admitted in hospitals - Cumulative number of cases admitted in hospitals - Most recent number of cases admitted to intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (7.8.) - 0 - ... - 0 - ...
2. Belgium (7.8.) - 0 - ... - 0 - ...
3. Bulgaria - ... - ... - ... - ...
4. Cyprus - ... - ... - ... - ...
5. Czech Republic (17.8.) - 0 - ... - 0 - ...
6. Denmark (26.8) - ... - 4 - ... - ...
7. Estonia (14.8.) - 0 - 0 - 0 - 0
8. Finland (18.8.) - ... - ... - ... - ...
9. France (a) (18.8.) - 6 - 65 - 5 - 11
10. Germany (24.8.) - ... - ... - ... - ...
11. Greece (13.8.) - ... - ... - 1 - 2
12. Hungary (19.8.) - ... - 27 - ... - ...
13. Iceland (20.8.) - 0 - 0 - 0 - 0
14. Ireland (20.8.) - 14 - 55 - ... - ...
15. Italy (17.7.) - ... - ... - ... - ...
16. Latvia (13.8.) - ... - 1 - ... - ...
17. Liechtenstein (19.8.) - ... - ... - ... - ...
18. Lithuania (13.8.) - ... - ... - ... - ...
19. Luxemburg (14.8.) - ... - ... - 0 - 0
20. Malta - ... - ... - ... - ...
21. Netherlands (20.8.) - 18 - 46 - ... - ...
22. Norway (19.8.) - ... - ... - ... - ...
23. Poland (18.8.) - ... - ... - ... - ...
24. Portugal (20.8.) - 8 - ... - ... - ...
25. Romania - ... - 18 - ... - ...
26. Slovakia (12.8.) - 2 - 33 - 0 - 0
27. Slovenia (10.8.) - ... - ... - ... - ...
28. Spain (20.8.) - ... - ... - 32 - 91
29. Sweden (20.8.) - ... - ... - ... - ...
30. Switzerland (25.8.) - ... - 20 - ... - 1
31. United Kingdom (b) (20.8.) - 263 - ... - 30 - ...

Note:
Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites. New updates are shaded in yellow.

(...) denotes no information readily available in official sources.
(a) Cases reported from France include those reported from the overseas territories.
(b) Data includes all probable cases for England only. Does not include Scotland (114 cumulative hospitalisations), Wales (38) and Northern Ireland (36).


Table 3. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases by country as of 26 August 2009, 16:00 hours (CEST) outside of the EU/EFTA area

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

• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA

1. No deaths reported - ... - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Egypt ... - 1
2. Iran 1 - 1
3. Iraq ... - 1
4. Israel ... - 11
5. Kuwait ... - 2
6. Lebanon ... - 1
7. Occupied Palestinian Territory ... - 1
8. Oman ... - 4
9. Qatar ... - 1
10. Saudi Arabia ... - 16
11. United Arab Emirates ... - 1
12. Yemen ... - 1

• AFRICA

1. Ghana ... - 1
2. Mauritius ... - 5
3. South Africa 7 - 15

• NORTH AMERICA

1. Canada ... - 71
2. Mexico 9 - 179
3. USA ... - 522

• CENTRAL AMERICA & CARIBBEAN

1. Cayman Islands ... - 1
2. Costa Rica ... - 31
3. Dominican Republic ... - 5
4. El Salvador ... - 15
5. Guatemala ... - 10
6. Honduras ... - 7
7. Jamaica ... - 4
8. Nicaragua 1 - 2
9. Panama ... - 6
10. Saint Kitts and Nevis ... - 1

• SOUTH AMERICA

1. Argentina ... - 439
2. Bolivia ... - 19
3. Brazil ... - 368
4. Chile ... - 128
5. Colombia 6 - 29
6. Ecuador ... - 27
7. Paraguay ... - 41
8. Peru ... - 80
9. Uruguay ... - 22
10. Venezuela ... - 17

• NORTH-EAST & SOUTH ASIA

1. Hong Kong SAR China ... - 4
2. India 1 - 64
3. Japan ... - 3
4. South Korea ... - 2
5. Taiwan ... - 5

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 1
2. Indonesia ... - 5
3. Laos Peoples Democratic Republic ... - 1
4. Malaysia ... - 69
5. Philippines ... - 8
6. Singapore ... - 13
7. Thailand 8 - 119
8. Vietnam ... - 2

• AUSTRALIA & PACIFIC

1. Australia ... - 132
2. Cook Islands ... - 1
3. New Zealand ... - 16
4. Samoa ... - 2
5. Tonga ... - 1

• TOTAL 33 - 2534

Note:
cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated. Yellow shading indicates a new update has been recorded for the country during the past 24 hours.

(...)
-
------

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC): Pandemic Influenza H1N1 2009, Situation Updates (Since August 4, 2009)

Pandemic (H1N1) 2009 - Update 27 August 2009, 17:00 hours CEST (ECDC, edited)

[Original Full Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 - Update 27 August 2009, 17:00 hours CEST


Main developments in past 24 hours

• Update on countries outside EU included;
• Poland announces change in laboratory confirmation policy;
• Two new oseltamivir-resistant isolates identified in USA;
• 661 new cases reported in the EU and EFTA countries, reaching a total of 44 651 cases.

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 cases as of 27 August 2009, 16:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer:

Several countries have now announced recommendations on treatment on clinical signs only and focused laboratory testing only for specific population groups or in outbreaks. For these countries, the reported numbers of cases presented in this report will severely underestimate the true incidence in the country and will not be comparable to countries still recommending laboratory tests of all suspected influenza cases.


Updates from outside the EU

Australia (pop. 20.7 million)

In the national report for August 27th it was stated that the total number of deaths associated with the pandemic influenza (H1N1) 2009 is now 147. There are still relatively large numbers of cases hospitalised, currently 422 people of which due to (H1N1) 2009 and 86 (20.4%) of these are in Intensive Care Units. The total number of hospitalisations in Australia since the pandemic began is 4364. In most but not all of the jurisdictions of Australia the indications from clinical surveillance is that the peak of the first wave has been passed. However, the minister of health was quoted by media as saying the swine flu pandemic has not yet passed its peak.

The current Australian influenza report can be found at: http://www.healthemergency.gov.au/internet/healthemergency/publishing.nsf/Content/09FDF2052D820653CA25761C000CBC3D/$File/270809.pdf

A feature articles on what Europe can learn from Australia appeared in the British Medical Journal on August 22nd: http://www.bmj.com/cgi/content/full/339/aug18_1/b3317

Australian Government-Department of Health and Ageing: http://www.healthemergency.gov.au/in...ontent/updates


New Zealand (pop. 4.2 million)

The latest report (August 26th) indicates that the amount of influenza in the community continues to decline. The ILI consultation rate from a sentinel surveillance system has been deceasing since week 29, but are still at higher levels than during the past two years. The number of deaths from Pandemic Influenza (H1N1) 2009 is now 16. These are deaths where swine flu was a primary cause. There are a number of other deaths that are being investigated by the Coroner's office. As of August 26th only 10 people are reported to be in hospital with due to the influenza (H1N1) 2009 or its complications but this includes six people in intensive care. In general, schools are reporting usual levels of absence for this time of year. The majority of isolates received through the sentinel surveillance system have been influenza A(h1N1)v from week since week 27. Last week the proportion of A(H1N1)v dropped to 40% out of less than 20 samples collected.

NZ National influenza update is at: http://www.moh.govt.nz/moh.nsf/index...ate-146-260809

NZ Sentinel surveillance report is at: http://www.surv.esr.cri.nz/PDF_surve...kRpt200933.pdf


Brazil (pop. 192 million)

Since the beginning of the pandemic, 30 854 monitoring Severe Acute Respiratory Infection (SARI) cases were notified, of which 6100 were subsequently laboratory-confirmed as influenza A (H1N1)v infections. The number of confirmed cases as well as ILI cases appears to have been decreasing for the last two weeks. Of the confirmed SARI cases, 557 (10.7 %) have died. According to the health ministry, this is the highest number for a country in the world. However, Brazil has a large population and the reported mortality due to SARI cases with confirmed influenza A (H1N1)v is currently 0,29/100.000 inhabitants.

Out of the 5 206 SARI cases linked to influenza A (H1N1)v, 36.9 % presented with at least one of risk factor (including pregnancy). Among SARI cases in fertile age 29.7 were pregnant, which corresponds to the proportion of pregnant women among SARI cases due to seasonal influenza. In SARI cases presenting at least one these risk factors, the mortality was 1,38 times higher than in cases without an associated risk factor (CI 1,14 ? 1,67).

Out of 8 649 PCR tests conducted up to week 32, 5 864 (67,7%) tested positive for influenza A (H1N1)v.

This proportion has not changed much in the last four weeks.

For entire epidemiological update for week 32 (Portuguese) see: http://portal.saude.gov.br/portal/ar...25_08_2009.pdf

H1N1 website of the ministry of health: http://dtr2001.saude.gov.br/ascom/sv...uenza_site.htm


South Africa (pop. 48.6 million)

As of 24 August, South Africa has confirmed 5118 cases of pandemic (H1N1) 09, with 1633 new cases being confirmed since the previous update. The number of deaths related to the pandemic is 15. It appears that the number of confirmed cases and deaths are still increasing.

The recommended national strategy is laboratory confirmation only, however the national authorities believe it is likely that most cases are still being captured by the surveillance system.

South Africa has a large HIV-positive population, but thus far no information is available on severity of illness or changes in transmission patterns among this important group.

The minister of health said this week that South Africa has no choice but to develop its own production capacity for the pandemic influenza vaccine, citing concerns that vaccine may not be available after orders of developed countries have been fulfilled.

SA surveillance report available at: http://www.nicd.ac.za/


Other Updates

Poland announces change in laboratory confirmation policy

Poland announced that laboratory tests on suspected A(H1N1)v cases are no longer mandatory and a decision of testing a patient is left to the discretion of the treating doctor.


Two more oseltamivir-resistant isolates identified in US

Two more oseltamivir resistant cases of novel H1N1 flu have been identified in the US, bringing the US total to four, according to media reports quoting US CDC.


Epidemiologic update

All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 44 651 confirmed cases, including 94 deaths, have been reported since April 2009 (Table 1). In the past 24 hours, 661 new cases from the EU and EFTA countries were confirmed.

Currently, the majority of cases have been reported from Germany and the UK. The latest available updates on hospital admissions per Member State are presented in Table 2.


Changing the format of the daily update

As the pandemic (H1N1) 2009 evolves, new types of data become increasingly important, whereas other may become less interesting. ECDC has refreshed the format of the Situation Update to better accommodate current and anticipated information needs. The name of this report changed to "Daily Update" and some changes have been made in the data reported.

Table 1 ? reported cases by the EU/EFTA countries remains as before. In addition, we are publishing a new Table 2 on the number of current and cumulative hospitalisations and admission to intensive care in EU/EFTA Member States. The source of the information is official statements or surveillance reports published by national health authorities. It should be noted that indications and thresholds for hospitalisations vary by country, so the figures quoted may not be directly comparable between countries.

Assuming no changes in the national reporting system, trends of hospitalisations over time should give an accurate representation of the evolution of the pandemic. This might change if countries are faced with capacity issues within the healthcare system at a later stage of this evolving pandemic.

Table 3 lists only reported deaths for countries outside the EU/EFTA area; we have discontinued reporting the case numbers for these countries. The main reason for this is that more and more countries have stopped the reporting of new cases, and these figures no longer give a representative picture of the situation.

The two graphs now show number of reported deaths by week of report ? one graph for EU/EFTA, one for the entire world. The two maps depict cumulative deaths by country, one for EU/EFTA, one for the world.


Table 1: Reported new confirmed cases and cumulative number of Pandemic (H1N1) 2009 influenza and cumulative deaths among confirmed cases by country as of 26 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Deaths among confirmed cases (a)]

1. Austria 30 - 300 - ...
2. Belgium ... - 126 - 1
3. Bulgaria ... - 63 - ...
4. Cyprus ... - 297 - ...
5. Czech Republic ... - 237 - ...
6. Denmark 3 - 540 - ...
7. Estonia ... - 59 - ...
8. Finland 1 - 211 - ...
9. France (b) ... - 1125 - 10 (e)
10. Germany 319 - 15259 - ...
11. Greece ... - 1631 - 1
12. Hungary ... - 151 - 1
13. Iceland ... - 152 - ...
14. Ireland 89 - 767 - 2
15. Italy ... - 1517 - ...
16. Latvia 3 - 26 - ...
17. Liechtenstein ... - 5 - ...
18. Lithuania ... - 48 - ...
19. Luxemburg ... - 130 - ...
20. Malta ... - 246 - 1
21. Netherlands (c) ... - 1473 - 2
22. Norway 157 - 1025 - ...
23. Poland ... - 155 - ...
24. Portugal 34 - 2244 - ...
25. Romania 2 - 296 - ...
26. Slovakia 1 - 114 - ...
27. Slovenia ... - 210 - ...
28. Spain ... - 1538 - 17
29. Sweden ... - 756 - ...
30. Switzerland 22 - 993 - ...
31. United Kingdom (d) ... - 12957 - 59

• Total 661 - 44651 - 94

Note:
cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites. Countries shaded with gray are not recommending laboratory tests for all suspect cases, therefore comparisons in time or between these countries should not be made at present.

(a) Deaths are included in the cumulative number of confirmed cases
(b) Cases reported from France include those reported from the overseas territories (434).
(c) Cases from the Netherlands include those reported from Aruba and the Dutch Antilles
(d) Cases reported from the United Kingdom include the number of individual cases from the following overseas territories: Anguilla, The Falklands, Gibraltar, Sovereign Base Area Cyprus, Turks and Caicos Islands (78)
(e) Deaths reported from France include 5 in New Caledonia, 3 in the French Polynesia and 2 in mainland France.


Table 2: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 27 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - (date of report) - Most recent number of cases admitted in hospitals - Cumulative number of cases admitted in hospitals - Most recent number of cases admitted to intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (7.8.) - 0 - ... - 0 - ...
2. Belgium (27.8.) - ... - ... - ... - ...
3. Bulgaria - ... - ... - ... - ...
4. Cyprus - ... - ... - ... - ...
5. Czech Republic (17.8.) - 0 - ... - 0 - ...
6. Denmark (26.8) - ... - 4 - ... - ...
7. Estonia (14.8.) - 0 - 0 - 0 - 0
8. Finland (18.8.) - ... - ... - ... - ...
9. France (a) (25.8.) - 11 - 83 - 5 - 10
10. Germany (27.8.) - ... - ... - ... - ...
11. Greece (13.8.) - ... - ... - 1 - 2
12. Hungary (19.8.) - ... - 27 - ... - ...
13. Iceland (26.8.) - 0 - 0 - 0 - 0
14. Ireland (27.8.) - 18 - 61 - 4 - 6
15. Italy (17.7.) - ... - ... - ... - ...
16. Latvia (13.8.) - ... - 1 - ... - ...
17. Liechtenstein (19.8.) - ... - ... - ... - ...
18. Lithuania (13.8.) - ... - ... - ... - ...
19. Luxemburg (14.8.) - ... - ... - 0 - 0
20. Malta - ... - ... - ... - ...
21. Netherlands (20.8.) - 18 - 46 - ... - ...
22. Norway (26.8.) - ... - ... - ... - ...
23. Poland (26.8.) - ... - ... - ... - ...
24. Portugal (20.8.) - 8 - ... - ... - ...
25. Romania - ... - 18 - ... - ...
26. Slovakia (12.8.) - 2 - 33 - 0 - 0
27. Slovenia (10.8.) - ... - ... - ... - ...
28. Spain (20.8.) - ... - ... - 32 - 91
29. Sweden (27.8.) - ... - ... - ... - ...
30. Switzerland (26.8.) - ... - 16 - ... - 1
31. United Kingdom (b) (27.8.) - 218 - ... - 30 - ...

Note:
Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites. New updates are shaded in yellow.

(...) denotes no information readily available in official sources.
(a) Cases reported from France include those reported from the overseas territories.
(b) Data includes all probable cases for England only. Does not include Scotland (114 cumulative hospitalisations), Wales (38) and Northern Ireland (36).


Table 3. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases by country as of 26 August 2009, 16:00 hours (CEST) outside of the EU/EFTA area

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

• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA

1. No deaths reported - ... - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Egypt ... - 1
2. Iran ... - 1
3. Iraq ... - 1
4. Israel 3 - 14
5. Kuwait ... - 2
6. Lebanon ... - 1
7. Occupied Palestinian Territory ... - 1
8. Oman ... - 4
9. Qatar ... - 1
10. Saudi Arabia ... - 16
11. Syria 1 - 1
12. United Arab Emirates ... - 1
13. Yemen ... - 1

• AFRICA

1. Ghana ... - 1
2. Mauritius ... - 5
3. South Africa ... - 15

• NORTH AMERICA

1. Canada ... - 71
2. Mexico ... - 179
3. USA ... - 522

• CENTRAL AMERICA & CARIBBEAN

1. Cayman Islands ... - 1
2. Costa Rica ... - 31
3. Dominican Republic ... - 5
4. El Salvador 2 - 17
5. Guatemala 2 - 12
6. Honduras ... - 7
7. Jamaica ... - 4
8. Nicaragua ... - 2
9. Panama ... - 6
10. Saint Kitts and Nevis ... - 1

• SOUTH AMERICA

1. Argentina ... - 439
2. Bolivia ... - 19
3. Brazil 189 - 557
4. Chile ... - 128
5. Colombia ... - 29
6. Ecuador ... - 27
7. Paraguay ... - 41
8. Peru ... - 80
9. Uruguay ... - 22
10. Venezuela ... - 17

• NORTH-EAST & SOUTH ASIA

1. Hong Kong SAR China ... - 4
2. India 11 - 75
3. Japan ... - 3
4. South Korea ... - 2
5. Taiwan ... - 5

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 1
2. Indonesia ... - 5
3. Laos Peoples Democratic Republic ... - 1
4. Malaysia ... - 69
5. Philippines ... - 8
6. Singapore ... - 13
7. Thailand ... - 119
8. Vietnam ... - 2

• AUSTRALIA & PACIFIC

1. Australia 15 - 147
2. Cook Islands ... - 1
3. New Zealand ... - 16
4. Samoa ... - 2
5. Tonga ... - 1

• TOTAL 223 - 2757

Note:
cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated. Yellow shading indicates a new update has been recorded for the country during the past 24 hours.

(...)
-
------

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC): Pandemic Influenza H1N1 2009, Situation Updates (Since August 4, 2009)

Pandemic (H1N1) 2009 - Update 28 August 2009, 17:00 hours CEST (ECDC, edited)

[Original Full Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 - Update 28 August 2009, 17:00 hours CEST


Main developments in past 24 hours

• 974 new cases reported in the EU and EFTA countries, reaching a total of 45,625 cases;
• 1,223 new cases reported from non EU and EFTA countries reaching a total of 222,984 cases;
• 9 new fatal cases reported from EU and EFTA countries and 13 from non EU and EFTA countries;
• Updates in Eurosurveillance from Germany and New Zealand;
• The weekly influenza surveillance bulletin is published on the ECDC website.

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 cases as of 28 August 2009, 16:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer:

Several countries have now announced recommendations on treatment on clinical signs only and focused laboratory testing only for specific population groups or in outbreaks. For these countries, the reported numbers of cases presented in this report will severely underestimate the true incidence in the country and will not be comparable to countries still recommending laboratory tests of all suspected influenza cases.


Updates from Eurosurveillance

In this week's edition of Eurosurveillance, an article from Germany analyses the first 9,950 cases of influenza A(H1N1)v in Germany. This analysis confirms findings from other sources according to which the virus is currently mainly causing mild diseases, affecting mostly adolescents and young adults. Overall hospitalisation rate for influenza A(H1N1)v was low (7%). Only 3% of the cases had underlying conditions and pneumonia was rare (0.4%). Reporting and testing requirements have been adapted recently, taking into consideration the additional information available on influenza A(H1N1)v infections. http://www.eurosurveillance.org/View...rticleId=19318

A report analysing the cases of influenza A(H1N1)v detected in New Zealand from April to August 2009 describes the containment measures that have been implemented and that appeared to slow the establishment of the pandemic during May. The pandemic accelerated markedly in June, reaching a peak within four to six weeks, and has been declining since mid-July. By 23 August, there had been 3,179 recorded cases (97.8% reported as confirmed), including 972 hospitalisations, 114 intensive care admissions, and 16 deaths. Influenza-like illness (ILI) surveillance in general practice suggests that 7.5% (95% CI: 3.4?11.2) of the population of New Zealand had symptomatic infection, giving a case fatality ratio of 0.005%. Hospitalisations were markedly higher for Māori (age standardised relative risk (RR)=3.0, 95% CI: 2.9?3.2) and Pacific peoples (RR=6.7, 95% CI: 6.2?7.1) compared with Europeans and others. The apparent decline of the pandemic (shown by all surveillance systems) cannot be fully explained. New Zealand remains in the middle of its traditional influenza season, the influenza A(H1N1)v virus appears relatively infectious. About 11% of the population were estimated to have been infected.

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19319

ECDC weekly influenza surveillance bulletin

The weekly influenza surveillance bulletin has been published on the ECDC website: http://www.ecdc.europa.eu/en/activit...2009week34.pdf

Ireland, Norway and the UK (Northern Ireland) are the only countries in Europe currently reporting medium levels of influenza activity. What appears to have been an unusual summer peak of influenza activity in the UK and Ireland is on the decline and, apart from Bulgaria and Romania, no country is reporting an increasing trend.


Epidemiologic update

All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 45,625 confirmed cases, including 103 deaths, have been reported since April 2009 (Table 1). In the past 24 hours, 974 new cases from the EU and EFTA countries were confirmed. Nine new fatal cases reported in the last 24 hours: United Kingdom (6) and Spain (3).

Currently, the majority of cases have been reported from Germany and the UK. The latest available updates on hospital admissions per Member State are presented in Table 2.


Table 1: Reported new confirmed cases and cumulative number of Pandemic (H1N1) 2009 influenza and cumulative deaths among confirmed cases by country as of 28 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Deaths among confirmed cases (a)]

1. Austria (28.8.) - 2 - 302 - ...
2. Belgium (30.7.) ... - 126 - 1
3. Bulgaria (24.8.) ... - 63 - ...
4. Cyprus (14.7.) ... - 297 - ...
5. Czech Republic (28.8.) - 6 - 243 - ...
6. Denmark (28.8.) - 3 - 543 - ...
7. Estonia (28.8.) - 2 61 - ...
8. Finland (27.8.) ... - 211 - ...
9. France (b) (25.8.) ... - 1125 - 10 (e)
10. Germany (28.8.) - 308 - 15567 - ...
11. Greece (28.8.) - 208 - 1839 - 1
12. Hungary (25.8.) ... - 151 - 1
13. Iceland (20.8.) ... - 152 - ...
14. Ireland (26.8.) ... - 767 - 2
15. Italy (26.8.) - 283 - 1800 - ...
16. Latvia (27.8.) ... - 26 - ...
17. Liechtenstein (6.8.) ... - 5 - ...
18. Lithuania (26.8.) ... - 48 - ...
19. Luxemburg (26.8.) ... - 130 - ...
20. Malta (26.8.) - 11 - 257 - 1
21. Netherlands (c) (27.8.) ... - 1473 - 2
22. Norway (26.8.) ... - 1025 - ...
23. Poland (26.8.) ... - 155 - ...
24. Portugal (27.8.) ... - 2244 - ...
25. Romania (27.8.) ... - 296 - ...
26. Slovakia (27.8.) - 3 - 117 - ...
27. Slovenia (21.8.) ... - 210 - ...
28. Spain (26.8.) ... - 1538 - 20
29. Sweden (26.8.) ... - 756 - ...
30. Switzerland (27.8.) - 10 - 1003 - ...
31. United Kingdom (d) (27.8.) - 138 - 13095 - 65

• Total - 974 - 45625 - 103

Note:
cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites. Countries shaded with gray are not recommending laboratory tests for all suspect cases, therefore comparisons in time or between these countries should not be made at present.

(a) Deaths are included in the cumulative number of confirmed cases
(b) Cases reported from France include those reported from the overseas territories (434).
(c) Cases from the Netherlands include those reported from Aruba and the Dutch Antilles
(d) Cases reported from the United Kingdom include the number of individual cases from the following overseas territories: Anguilla, The Falklands, Gibraltar, Sovereign Base Area Cyprus, Turks and Caicos Islands (78)
(e) Deaths reported from France include 5 in New Caledonia, 3 in the French Polynesia and 2 in mainland France.


Table 2: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 28 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - (date of report) - Most recent number of cases admitted in hospitals - Cumulative number of cases admitted in hospitals - Most recent number of cases admitted to intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (7.8.) - 0 - ... - 0 - ...
2. Belgium (27.8.) - ... - ... - ... - ...
3. Bulgaria - ... - ... - ... - ...
4. Cyprus - ... - ... - ... - ...
5. Czech Republic (27.8.) - ... - ... - ... - ...
6. Denmark (26.8) - ... - 4 - ... - ...
7. Estonia (14.8.) - 0 - 0 - 0 - 0
8. Finland (18.8.) - ... - ... - ... - ...
9. France (a) (25.8.) - 11 - 83 - 5 - 10
10. Germany (28.8.) - ... - ... - ... - ...
11. Greece (13.8.) - ... - ... - 1 - 2
12. Hungary (19.8.) - ... - 27 - ... - ...
13. Iceland (26.8.) - 0 - 0 - 0 - 0
14. Ireland (27.8.) - 21 - 75 - 4 - 6
15. Italy (26.7.) - ... - ... - ... - ...
16. Latvia (13.8.) - ... - 1 - ... - ...
17. Liechtenstein (19.8.) - ... - ... - ... - ...
18. Lithuania (13.8.) - ... - ... - ... - ...
19. Luxemburg (14.8.) - ... - ... - 0 - 0
20. Malta - ... - ... - ... - ...
21. Netherlands (28.8.) - ... - 52 - ... - ...
22. Norway (26.8.) - ... - ... - ... - ...
23. Poland (26.8.) - ... - ... - ... - ...
24. Portugal (20.8.) - 8 - ... - ... - ...
25. Romania - ... - 18 - ... - ...
26. Slovakia (12.8.) - 2 - 33 - 0 - 0
27. Slovenia (10.8.) - ... - ... - ... - ...
28. Spain (27.8.) - ... - ... - 26 - 114
29. Sweden (27.8.) - ... - ... - ... - ...
30. Switzerland (27.8.) - ... - 18 - ... - 1
31. United Kingdom (b) (27.8.) - 218 - ... - 30 - ...

Note:
Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites. New updates are shaded in yellow.

(...) denotes no information readily available in official sources.
(a) Cases reported from France include those reported from the overseas territories.
(b) Data includes all probable cases for England only. Does not include Scotland (114 cumulative hospitalisations), Wales (38) and Northern Ireland (36).


Table 3. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases by country as of 28 August 2009, 16:00 hours (CEST) outside of the EU/EFTA area

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

• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA

1. No deaths reported - ... - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Egypt ... - 1
2. Iran ... - 1
3. Iraq ... - 1
4. Israel ... - 14
5. Kuwait ... - 2
6. Lebanon ... - 1
7. Occupied Palestinian Territory ... - 1
8. Oman 1 - 5
9. Qatar ... - 1
10. Saudi Arabia ... - 16
11. Syria ... - 1
12. United Arab Emirates ... - 1
13. Yemen ... - 1

• AFRICA

1. Ghana ... - 1
2. Mauritius ... - 5
3. South Africa ... - 15

• NORTH AMERICA

1. Canada 1 - 72
2. Mexico ... - 179
3. USA ... - 522

• CENTRAL AMERICA & CARIBBEAN

1. Cayman Islands ... - 1
2. Costa Rica ... - 31
3. Dominican Republic ... - 5
4. El Salvador ... - 17
5. Guatemala ... - 12
6. Honduras ... - 7
7. Jamaica ... - 4
8. Nicaragua 2 - 4
9. Panama ... - 6
10. Saint Kitts and Nevis ... - 1

• SOUTH AMERICA

1. Argentina ... - 439
2. Bolivia ... - 19
3. Brazil ... - 557
4. Chile ... - 128
5. Colombia ... - 29
6. Ecuador ... - 27
7. Paraguay ... - 41
8. Peru ... - 80
9. Uruguay ... - 22
10. Venezuela ... - 17

• NORTH-EAST & SOUTH ASIA

1. Hong Kong SAR China ... - 4
2. India 3 - 78
3. Japan ... - 3
4. South Korea 1 - 3
5. Taiwan ... - 5

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 1
2. Indonesia ... - 5
3. Laos Peoples Democratic Republic ... - 1
4. Malaysia 2 - 71
5. Philippines ... - 8
6. Singapore ... - 13
7. Thailand ... - 119
8. Vietnam ... - 2

• AUSTRALIA & PACIFIC

1. Australia 3 - 150
2. Cook Islands ... - 1
3. New Zealand ... - 16
4. Samoa ... - 2
5. Tonga ... - 1

• TOTAL 13 - 2770

Note:
cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated. Yellow shading indicates a new update has been recorded for the country during the past 24 hours.

(...)
-
------

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC): Pandemic Influenza H1N1 2009, Situation Updates (Since August 4, 2009)

Pandemic (H1N1) 2009 - Update 29 August 2009, 17:00 hours CEST (ECDC, edited)

[Original Full Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 - Update 29 August 2009, 17:00 hours CEST


Main developments in past 24 hours

• 48 new cases reported in the EU and EFTA countries;
• 1 new fatal case (Spain) reported from EU and EFTA countries

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 cases as of 29 August 2009, 16:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer:

Several countries have recently announced recommendations on treatment on clinical signs only and focused laboratory testing only for specific population groups or in outbreaks. For these countries, the reported numbers of cases presented in this report will severely underestimate the true incidence in the country and will not be comparable to countries still recommending laboratory tests of all suspected influenza cases.


Epidemiologic update

All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 45 673 confirmed cases, including 104 deaths, have been reported since April 2009 (Table 1). In the past 24 hours, 48 new cases from the EU and EFTA countries were confirmed. One new fatal case reported in the last 24 hours from Spain.

Currently, the majority of cases are being reported from Germany and the UK. The latest available updates on hospital admissions per Member State are presented in Table 2.


Table 1: Reported new confirmed cases and cumulative number of Pandemic (H1N1) 2009 influenza and cumulative deaths among confirmed cases by country as of 29 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Deaths among confirmed cases (a)]

1. Austria (28.8.) ... - 302 - ...
2. Belgium (30.7.) ... - 126 - 1
3. Bulgaria (24.8.) ... - 63 - ...
4. Cyprus (14.7.) ... - 297 - ...
5. Czech Republic (28.8.) ... - 243 - ...
6. Denmark (28.8.) ... - 543 - ...
7. Estonia (28.8.) ... - 61 - ...
8. Finland (27.8.) ... - 211 - ...
9. France (b) (25.8.) ... - 1125 - 10 (e)
10. Germany (28.8.) ... - 15567 - ...
11. Greece (28.8.) ... - 1839 - 1
12. Hungary (25.8.) ... - 151 - 1
13. Iceland (28.8.) - 13 - 165 - ...
14. Ireland (26.8.) ... - 767 - 2
15. Italy (26.8.) ... - 1800 - ...
16. Latvia (29.8.) - 1 - 27 - ...
17. Liechtenstein (6.8.) ... - 5 - ...
18. Lithuania (26.8.) ... - 48 - ...
19. Luxemburg (28.8.) - 14 - 144 - ...
20. Malta (26.8.) ... - 257 - 1
21. Netherlands (c) (27.8.) ... - 1473 - 2
22. Norway (26.8.) ... - 1025 - ...
23. Poland (26.8.) ... - 155 - ...
24. Portugal (27.8.) ... - 2244 - ...
25. Romania (29.8.) - 9 - 305 - ...
26. Slovakia (27.8.) ... - 117 - ...
27. Slovenia (21.8.) ... - 210 - ...
28. Spain (28.8.) ... - 1538 - 21
29. Sweden (26.8.) ... - 756 - ...
30. Switzerland (28.8.) - 11 - 1014 - ...
31. United Kingdom (d) (27.8.) ... - 13095 - 65

• Total 48 45673 104

Note:
cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites. Countries shaded with gray are not recommending laboratory tests for all suspect cases, therefore comparisons in time or between these countries should not be made at present.

(a) Deaths are included in the cumulative number of confirmed cases
(b) Cases reported from France include those reported from the overseas territories (434).
(c) Cases from the Netherlands include those reported from Aruba and the Dutch Antilles
(d) Cases reported from the United Kingdom include the number of individual cases from the following overseas territories: Anguilla, The Falklands, Gibraltar, Sovereign Base Area Cyprus, Turks and Caicos Islands (78)
(e) Deaths reported from France include 5 in New Caledonia, 3 in the French Polynesia and 2 in mainland France.


Table 2: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 28 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - (date of report) - Most recent number of cases admitted in hospitals - Cumulative number of cases admitted in hospitals - Most recent number of cases admitted to intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (7.8.) - 0 - ... - 0 - ...
2. Belgium (27.8.) - ... - ... - ... - ...
3. Bulgaria - ... - ... - ... - ...
4. Cyprus - ... - ... - ... - ...
5. Czech Republic (27.8.) - ... - ... - ... - ...
6. Denmark (26.8) - ... - 4 - ... - ...
7. Estonia (14.8.) - 0 - 0 - 0 - 0
8. Finland (18.8.) - ... - ... - ... - ...
9. France (a) (25.8.) - 11 - 83 - 5 - 10
10. Germany (28.8.) - ... - ... - ... - ...
11. Greece (13.8.) - ... - ... - 1 - 2
12. Hungary (19.8.) - ... - 27 - ... - ...
13. Iceland (26.8.) - 0 - 0 - 0 - 0
14. Ireland (27.8.) - 21 - 75 - 4 - 6
15. Italy (26.7.) - ... - ... - ... - ...
16. Latvia (13.8.) - ... - 1 - ... - ...
17. Liechtenstein (19.8.) - ... - ... - ... - ...
18. Lithuania (13.8.) - ... - ... - ... - ...
19. Luxemburg (14.8.) - ... - ... - 0 - 0
20. Malta - ... - ... - ... - ...
21. Netherlands (28.8.) - ... - 52 - ... - ...
22. Norway (26.8.) - ... - ... - ... - ...
23. Poland (26.8.) - ... - ... - ... - ...
24. Portugal (20.8.) - 8 - ... - ... - ...
25. Romania - ... - 18 - ... - ...
26. Slovakia (12.8.) - 2 - 33 - 0 - 0
27. Slovenia (10.8.) - ... - ... - ... - ...
28. Spain (27.8.) - ... - ... - 26 - 114
29. Sweden (27.8.) - ... - ... - ... - ...
30. Switzerland (27.8.) - ... - 18 - ... - 1
31. United Kingdom (b) (27.8.) - 218 - ... - 30 - ...

Note:
Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites. New updates are shaded in yellow.

(...) denotes no information readily available in official sources.
(a) Cases reported from France include those reported from the overseas territories.
(b) Data includes all probable cases for England only. Does not include Scotland (114 cumulative hospitalisations), Wales (38) and Northern Ireland (36).


Table 3. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases by country as of 29 August 2009, 16:00 hours (CEST) outside of the EU/EFTA area

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

• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA

1. No deaths reported - ... - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Egypt ... - 1
2. Iran ... - 1
3. Iraq ... - 1
4. Israel ... - 14
5. Kuwait ... - 2
6. Lebanon ... - 1
7. Occupied Palestinian Territory ... - 1
8. Oman ... - 5
9. Qatar ... - 1
10. Saudi Arabia ... - 16
11. Syria ... - 1
12. United Arab Emirates ... - 1
13. Yemen ... - 1

• AFRICA

1. Ghana ... - 1
2. Mauritius ... - 5
3. South Africa ... - 15

• NORTH AMERICA

1. Canada ... - 72
2. Mexico 5 - 184
3. USA 34 - 556

• CENTRAL AMERICA & CARIBBEAN

1. Cayman Islands ... - 1
2. Costa Rica 2 - 33
3. Dominican Republic ... - 5
4. El Salvador ... - 17
5. Guatemala ... - 12
6. Honduras ... - 7
7. Jamaica ... - 4
8. Nicaragua ... - 4
9. Panama 1 - 7
10. Saint Kitts and Nevis ... - 1

• SOUTH AMERICA

1. Argentina ... - 439
2. Bolivia ... - 19
3. Brazil ... - 557
4. Chile 2 - 130
5. Colombia ... - 29
6. Ecuador 9 - 36
7. Paraguay ... - 41
8. Peru ... - 80
9. Uruguay ... - 22
10. Venezuela 7 - 24

• NORTH-EAST & SOUTH ASIA

1. Hong Kong SAR China ... - 4
2. India ... - 78
3. Japan ... - 3
4. South Korea ... - 3
5. Taiwan ... - 5

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 1
2. Indonesia 1 - 6
3. Laos Peoples Democratic Republic ... - 1
4. Malaysia ... - 71
5. Philippines ... - 8
6. Singapore ... - 13
7. Thailand ... - 119
8. Vietnam ... - 2

• AUSTRALIA & PACIFIC

1. Australia ... - 150
2. Cook Islands ... - 1
3. New Zealand ... - 16
4. Samoa ... - 2
5. Tonga ... - 1

• TOTAL 61 - 2831

Note:
cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated. Yellow shading indicates a new update has been recorded for the country during the past 24 hours.

(...)
-
-----

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC): Pandemic Influenza H1N1 2009, Situation Updates (Since August 4, 2009)

Pandemic (H1N1) 2009 - Update 30 August 2009, 17:00 hours CEST (ECDC, edited)

[Original Full Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 - Update 30 August 2009, 17:00 hours CEST


Main developments in past 24 hours

• No new cases reported in the EU and EFTA countries;

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 cases as of 30 August 2009, 16:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer:

Several countries have recently announced recommendations on treatment on clinical signs only and focused laboratory testing only for specific population groups or in outbreaks. For these countries, the reported numbers of cases presented in this report will severely underestimate the true incidence in the country and will not be comparable to countries still recommending laboratory tests of all suspected influenza cases.


Epidemiologic update

All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 45 673 confirmed cases, including 104 deaths, have been reported since April 2009 (Table 1). In the past 24 hours, no new cases from the EU and EFTA countries were confirmed.

Currently, the majority of cases are being reported from Germany and the UK. The latest available updates on hospital admissions per Member State are presented in Table 2.


Table 1: Reported new confirmed cases and cumulative number of Pandemic (H1N1) 2009 influenza and cumulative deaths among confirmed cases by country as of 30 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Deaths among confirmed cases (a)]

1. Austria (28.8.) ... - 302 - ...
2. Belgium (30.7.) ... - 126 - 1
3. Bulgaria (24.8.) ... - 63 - ...
4. Cyprus (14.7.) ... - 297 - ...
5. Czech Republic (28.8.) ... - 243 - ...
6. Denmark (28.8.) ... - 543 - ...
7. Estonia (28.8.) ... - 61 - ...
8. Finland (27.8.) ... - 211 - ...
9. France (b) (25.8.) ... - 1125 - 10 (e)
10. Germany (28.8.) ... - 15567 - ...
11. Greece (28.8.) ... - 1839 - 1
12. Hungary (25.8.) ... - 151 - 1
13. Iceland (28.8.) ... - 165 - ...
14. Ireland (26.8.) ... - 767 - 2
15. Italy (26.8.) ... - 1800 - ...
16. Latvia (29.8.) ... - 27 - ...
17. Liechtenstein (6.8.) ... - 5 - ...
18. Lithuania (26.8.) ... - 48 - ...
19. Luxembourg (28.8.) ... - 144 - ...
20. Malta (26.8.) ... - 257 - 1
21. Netherlands (c) (27.8.) ... - 1473 - 2
22. Norway (26.8.) ... - 1025 - ...
23. Poland (26.8.) ... - 155 - ...
24. Portugal (27.8.) ... - 2244 - ...
25. Romania (29.8.) ... - 305 - ...
26. Slovakia (27.8.) ... - 117 - ...
27. Slovenia (21.8.) ... - 210 - ...
28. Spain (28.8.) ... - 1538 - 21
29. Sweden (26.8.) ... - 756 - ...
30. Switzerland (28.8.) ... - 1014 - ...
31. United Kingdom (d) (27.8.) ... - 13095 - 65

• Total ... - 45673 - 104

Note:
cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites. Countries shaded with gray are not recommending laboratory tests for all suspect cases, therefore comparisons in time or between these countries should not be made at present.

(a) Deaths are included in the cumulative number of confirmed cases
(b) Cases reported from France include those reported from the overseas territories (434).
(c) Cases from the Netherlands include those reported from Aruba and the Dutch Antilles
(d) Cases reported from the United Kingdom include the number of individual cases from the following overseas territories: Anguilla, The Falklands, Gibraltar, Sovereign Base Area Cyprus, Turks and Caicos Islands (78)
(e) Deaths reported from France include 5 in New Caledonia, 3 in the French Polynesia and 2 in mainland France.


Table 2: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 28 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - (date of report) - Most recent number of cases admitted in hospitals - Cumulative number of cases admitted in hospitals - Most recent number of cases admitted to intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (7.8.) - 0 - ... - 0 - ...
2. Belgium (27.8.) - ... - ... - ... - ...
3. Bulgaria - ... - ... - ... - ...
4. Cyprus - ... - ... - ... - ...
5. Czech Republic (27.8.) - ... - ... - ... - ...
6. Denmark (26.8) - ... - 4 - ... - ...
7. Estonia (14.8.) - 0 - 0 - 0 - 0
8. Finland (18.8.) - ... - ... - ... - ...
9. France (a) (25.8.) - 11 - 83 - 5 - 10
10. Germany (28.8.) - ... - ... - ... - ...
11. Greece (13.8.) - ... - ... - 1 - 2
12. Hungary (19.8.) - ... - 27 - ... - ...
13. Iceland (26.8.) - 0 - 0 - 0 - 0
14. Ireland (27.8.) - 21 - 75 - 4 - 6
15. Italy (26.7.) - ... - ... - ... - ...
16. Latvia (13.8.) - ... - 1 - ... - ...
17. Liechtenstein (19.8.) - ... - ... - ... - ...
18. Lithuania (13.8.) - ... - ... - ... - ...
19. Luxembourg (14.8.) - ... - ... - 0 - 0
20. Malta - ... - ... - ... - ...
21. Netherlands (28.8.) - ... - 52 - ... - ...
22. Norway (26.8.) - ... - ... - ... - ...
23. Poland (26.8.) - ... - ... - ... - ...
24. Portugal (20.8.) - 10 - ... - ... - ...
25. Romania - ... - 18 - ... - ...
26. Slovakia (12.8.) - 2 - 33 - 0 - 0
27. Slovenia (10.8.) - ... - ... - ... - ...
28. Spain (27.8.) - ... - ... - 26 - 114
29. Sweden (27.8.) - ... - ... - ... - ...
30. Switzerland (27.8.) - ... - 18 - ... - 1
31. United Kingdom (b) (27.8.) - 218 - ... - 30 - ...

Note:
Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites. New updates are shaded in yellow.

(...) denotes no information readily available in official sources.
(a) Cases reported from France include those reported from the overseas territories.
(b) Data includes all probable cases for England only. Does not include Scotland (114 cumulative hospitalisations), Wales (38) and Northern Ireland (36).


Table 3. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases by country as of 30 August 2009, 16:00 hours (CEST) outside of the EU/EFTA area

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

• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA

1. No deaths reported - ... - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Egypt ... - 1
2. Iran ... - 1
3. Iraq ... - 1
4. Israel ... - 14
5. Kuwait ... - 2
6. Lebanon ... - 1
7. Occupied Palestinian Territory ... - 1
8. Oman ... - 5
9. Qatar ... - 1
10. Saudi Arabia ... - 16
11. Syria ... - 1
12. United Arab Emirates ... - 1
13. Yemen ... - 1

• AFRICA

1. Ghana ... - 1
2. Mauritius ... - 5
3. South Africa 5 - 20

• NORTH AMERICA

1. Canada ... - 72
2. Mexico ... - 184
3. USA ... - 556

• CENTRAL AMERICA & CARIBBEAN

1. Cayman Islands ... - 1
2. Costa Rica ... - 33
3. Dominican Republic ... - 5
4. El Salvador ... - 17
5. Guatemala ... - 12
6. Honduras ... - 7
7. Jamaica ... - 4
8. Nicaragua ... - 4
9. Panama ... - 7
10. Saint Kitts and Nevis ... - 1

• SOUTH AMERICA

1. Argentina 26 - 465
2. Bolivia ... - 19
3. Brazil ... - 557
4. Chile ... - 130
5. Colombia ... - 29
6. Ecuador ... - 36
7. Paraguay ... - 41
8. Peru ... - 80
9. Uruguay ... - 22
10. Venezuela ... - 24

• NORTH-EAST & SOUTH ASIA

1. Hong Kong SAR China ... - 4
2. India ... - 78
3. Japan ... - 3
4. South Korea ... - 3
5. Taiwan ... - 5

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 1
2. Indonesia ... - 6
3. Laos Peoples Democratic Republic ... - 1
4. Malaysia 1 - 72
5. Philippines ... - 8
6. Singapore ... - 13
7. Thailand ... - 119
8. Vietnam ... - 2

• AUSTRALIA & PACIFIC

1. Australia ... - 150
2. Cook Islands ... - 1
3. New Zealand ... - 16
4. Samoa ... - 2
5. Tonga ... - 1

• TOTAL 32 - 2863

Note:
cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated. Yellow shading indicates a new update has been recorded for the country during the past 24 hours.

(...)
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[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC): Pandemic Influenza H1N1 2009, Situation Updates (Since August 4, 2009)

Pandemic (H1N1) 2009 - Update 31 August 2009, 17:00 hours CEST (ECDC, edited)

[Original Full Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 - Update 31 August 2009, 17:00 hours CEST


Main developments in past 24 hours

• ECDC strategic media monitoring review included;
• Colombian president diagnosed with pandemic influenza after South American summit;
• 343 new cases reported in the EU and EFTA countries, reaching a total of 46 016 cases.

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 cases as of 31 August 2009, 16:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer:

Several countries have now announced recommendations on treatment on clinical signs only and focused laboratory testing only for specific population groups or in outbreaks. For these countries, the reported numbers of cases presented in this report will severely underestimate the true incidence in the country and will not be comparable to countries still recommending laboratory tests of all suspected influenza cases.


Weekly strategic media monitoring

ECDC?s health communication unit screens and collects articles of particular interest with regard to the H1N1 pandemic?s development by 10:00 am every morning. It is by no means exhaustive. The purpose of the ECDC daily strategic media monitoring is to raise awareness of present key media stories across Europe, and it should not be seen as representing the views of ECDC. This strategic media monitoring is intended for internal use in ECDC and for our communication network.

Media highlights 24?28 August

Vaccine issues, such as concerns about availability, safety and effectiveness, are increasingly being covered by the media. Several newspapers reported that a significant number of healthcare professionals in different countries were unwilling to get vaccinated against influenza A(H1N1)v. Despite these safety concerns, US news reports say that the vaccine trials are on track and the only side-effects observed to date are those similar to other influenza vaccines.

The EU Health Security Committee has outlined target and priority groups for the A(H1N1)v vaccination and a number of Member States are preparing for mass vaccination campaigns. France and the UK received their first order of the vaccine on the 28 August, several media reported.

Media also reported this week that more deaths will be caused by acute viral respiratory problems due to the new influenza as compared to seasonal influenza, and that smokers are more prone developing lifethreatening complications from influenza (H1N1)v.

Brazil was reported to be the country in the world with the most deaths due to A(H1N1)v.

Media reports noticed that WHO warned that a second pandemic wave should be expected as the northern hemisphere enters the colder season. Meanwhile, the US CDC released a statement saying that there is no cause for panic over the pandemic, and several European newspapers reported that their countries were preparing for the pandemic.


Other Updates

Media reports indicate that the Colombian president has been diagnosed with pandemic (H1N1) 2009 influenza after attending a summit of South American leaders in Argentina.


Epidemiologic update

All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 46 016 confirmed cases, including 104 deaths, have been reported since April 2009 (Table 1). In the past 24 hours, 343 new cases from the EU and EFTA countries were confirmed.

Currently, the majority of cases have been reported from Germany. The latest available updates on hospital admissions per Member State are presented in Table 2.


Changing the format of the daily update

As the pandemic (H1N1) 2009 evolves, new types of data become increasingly important, whereas other may become less interesting. ECDC has refreshed the format of the Situation Update to better accommodate current and anticipated information needs. The name of this report changed to "Daily Update" and some changes have been made in the data reported.

Table 1 ? reported cases by the EU/EFTA countries remains as before. In addition, we are publishing a new Table 2 on the number of current and cumulative hospitalisations and admission to intensive care in EU/EFTA Member States. The source of the information is official statements or surveillance reports published by national health authorities. It should be noted that indications and thresholds for hospitalisations vary by country, so the figures quoted may not be directly comparable between countries.

Assuming no changes in the national reporting system, trends of hospitalisations over time should give an accurate representation of the evolution of the pandemic. This might change if countries are faced with capacity issues within the healthcare system at a later stage of this evolving pandemic.

Table 3 lists only reported deaths for countries outside the EU/EFTA area; we have discontinued reporting the case numbers for these countries. The main reason for this is that more and more countries have stopped the reporting of new cases, and these figures no longer give a representative picture of the situation.

The two graphs now show number of reported deaths by week of report ? one graph for EU/EFTA, one for the entire world. The two maps depict cumulative deaths by country, one for EU/EFTA, one for the world.


Table 1: Reported new confirmed cases and cumulative number of Pandemic (H1N1) 2009 influenza and cumulative deaths among confirmed cases by country as of 31 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Deaths among confirmed cases (a)]

1. Austria (31.8.) - 12 - 314 - ...
2. Belgium (30.7.) ... - 126 - 1
3. Bulgaria (24.8.) ... - 63 - ...
4. Cyprus (14.7.) ... - 297 - ...
5. Czech Republic (28.8.) ... - 243 - ...
6. Denmark (28.8.) ... - 543 - ...
7. Estonia (28.8.) ... - 61 - ...
8. Finland (27.8.) ... - 211 - ...
9. France (b) (25.8.) ... - 1125 - 10 (e)
10. Germany (31.8.) - 311 - 15878 - ...
11. Greece (28.8.) ... - 1839 - 1
12. Hungary (25.8.) ... - 151 - 1
13. Iceland (28.8.) ... - 165 - ...
14. Ireland (26.8.) ... - 767 - 2
15. Italy (26.8.) ... - 1800 - ...
16. Latvia (29.8.) ... - 27 - ...
17. Liechtenstein (6.8.) ... - 5 - ...
18. Lithuania (26.8.) ... - 48 - ...
19. Luxembourg (28.8.) ... - 144 - ...
20. Malta (31.8.) - 13 - 270 - 1
21. Netherlands (c) (27.8.) ... - 1473 - 2
22. Norway (26.8.) ... - 1025 - ...
23. Poland (26.8.) ... - 155 - ...
24. Portugal (27.8.) ... - 2244 - ...
25. Romania (29.8.) ... - 305 - ...
26. Slovakia (27.8.) ... - 117 - ...
27. Slovenia (31.8.) - 7 - 217 - ...
28. Spain (28.8.) ... - 1538 - 21
29. Sweden (26.8.) ... - 756 - ...
30. Switzerland (28.8.) ... - 1014 - ...
31. United Kingdom (d) (27.8.) ... - 13095 - 65

• Total 343 - 46016 - 104

Note:
cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites. Countries shaded with gray are not recommending laboratory tests for all suspect cases, therefore comparisons in time or between these countries should not be made at present.

(a) Deaths are included in the cumulative number of confirmed cases
(b) Cases reported from France include those reported from the overseas territories (434).
(c) Cases from the Netherlands include those reported from Aruba and the Dutch Antilles
(d) Cases reported from the United Kingdom include the number of individual cases from the following overseas territories: Anguilla, The Falklands, Gibraltar, Sovereign Base Area Cyprus, Turks and Caicos Islands (78)
(e) Deaths reported from France include 5 in New Caledonia, 3 in the French Polynesia and 2 in mainland France.


Table 2: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 31 August 2009, 16:00 hours (CEST) in the EU and EFTA countries

[Country - (date of report) - Most recent number of cases admitted in hospitals - Cumulative number of cases admitted in hospitals - Most recent number of cases admitted to intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (7.8.) - 0 - ... - 0 - ...
2. Belgium (27.8.) - ... - ... - ... - ...
3. Bulgaria - ... - ... - ... - ...
4. Cyprus - ... - ... - ... - ...
5. Czech Republic (17.8.) - 0 - ... - 0 - ...
6. Denmark (26.8) - ... - 4 - ... - ...
7. Estonia (14.8.) - 0 - 0 - 0 - 0
8. Finland (18.8.) - ... - ... - ... - ...
9. France (a) (25.8.) - 11 - 83 - 5 - 10
10. Germany (31.8.) - ... - ... - ... - ...
11. Greece (29.8.) - ... - ... - 1 - ...
12. Hungary (19.8.) - ... - 27 - ... - ...
13. Iceland (26.8.) - 0 - 0 - 0 - 0
14. Ireland (27.8.) - 18 - 61 - 4 - 6
15. Italy (29.8.) - ... - ... - 1 - ...
16. Latvia (13.8.) - ... - 1 - ... - ...
17. Liechtenstein (19.8.) - ... - ... - ... - ...
18. Lithuania (13.8.) - ... - ... - ... - ...
19. Luxemburg (14.8.) - ... - ... - 0 - 0
20. Malta - ... - ... - ... - ...
21. Netherlands (20.8.) - 18 - 46 - ... - ...
22. Norway (26.8.) - ... - ... - ... - ...
23. Poland (26.8.) - ... - ... - ... - ...
24. Portugal (20.8.) - 8 - ... - ... - ...
25. Romania - ... - 18 - ... - ...
26. Slovakia (12.8.) - 2 - 33 - 0 - 0
27. Slovenia (10.8.) - ... - ... - ... - ...
28. Spain (20.8.) - ... - ... - 32 - 91
29. Sweden (27.8.) - ... - ... - ... - ...
30. Switzerland (26.8.) - ... - 16 - ... - 1
31. United Kingdom (b) (27.8.) - 218 - ... - 30 - ...

Note:
Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites. New updates are shaded in yellow.

(...) denotes no information readily available in official sources.
(a) Cases reported from France include those reported from the overseas territories.
(b) Data includes all probable cases for England only. Does not include Scotland (114 cumulative hospitalisations), Wales (38) and Northern Ireland (36).


Table 3. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases by country as of 31 August 2009, 16:00 hours (CEST) outside of the EU/EFTA area

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

• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA

1. No deaths reported - ... - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Bahrain 1 - 1
2. Egypt ... - 1
3. Iran ... - 1
4. Iraq ... - 1
5. Israel 1 - 15
6. Kuwait 3 - 5
7. Lebanon ... - 1
8. Occupied Palestinian Territory ... - 1
9. Oman 1 - 6
10. Qatar ... - 1
11. Saudi Arabia 3 - 19
12. Syria 1 - 2
13. United Arab Emirates 1 - 2
14. Yemen ... - 1

• AFRICA

1. Ghana ... - 1
2. Mauritius ... - 5
3. South Africa 5 - 25

• NORTH AMERICA

1. Canada ... - 72
2. Mexico ... - 184
3. USA ... - 556

• CENTRAL AMERICA & CARIBBEAN

1. Cayman Islands ... - 1
2. Costa Rica ... - 33
3. Dominican Republic 3 - 8
4. El Salvador ... - 17
5. Guatemala ... - 12
6. Honduras 1 - 8
7. Jamaica ... - 4
8. Nicaragua ... - 4
9. Panama ... - 7
10. Saint Kitts and Nevis ... - 1

• SOUTH AMERICA

1. Argentina ... - 465
2. Bolivia ... - 19
3. Brazil ... - 557
4. Chile ... - 130
5. Colombia ... - 29
6. Ecuador 4 - 40
7. Paraguay ... - 41
8. Peru ... - 80
9. Uruguay ... - 22
10. Venezuela ... - 24

• NORTH-EAST & SOUTH ASIA

1. Hong Kong SAR China 2 - 6
2. India 15 - 93
3. Japan ... - 3
4. South Korea ... - 3
5. Taiwan ... - 5

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 1
2. Indonesia 2 - 8
3. Laos Peoples Democratic Republic ... - 1
4. Malaysia ... - 72
5. Philippines ... - 8
6. Singapore 2 - 15
7. Thailand ... - 119
8. Vietnam ... - 2

• AUSTRALIA & PACIFIC

1. Australia ... - 150
2. Cook Islands ... - 1
3. Marshall Islands 1 - 1
4. New Zealand 1 - 17
5. Samoa ... - 2
6. Tonga ... - 1

• TOTAL 47 - 2910

Note:
cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated. Yellow shading indicates a new update has been recorded for the country during the past 24 hours.

(...)
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