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

[Giuseppe]

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

Pandemic (H1N1) 2009 Update 01 December 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]
ECDC DAILY UPDATE
Pandemic (H1N1) 2009 Update 01 December 2009, 09:00 hours CEST

Main developments in past 24 hours

• Updates from U.S.A. and Canada included;
• World Aids Day: HIV-infection and pandemic Influenza A(H1N1)v
• Total of 881 fatal cases in Europe and EFTA countries and 7 770 in the rest of the world have been reported up to date.

This report is based on official information provided by national public health websites or through other official communication channels. Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 01 December 2009, 09:00 hours (CEST) in EU and EFTA countries are in Table 1. An update on the number of confirmed fatal cases is presented in Table 2 - as of 30 November 2009 - 16:00 hours CEST, for the world, and 01 December 2009 - 09:00 hours CEST, for Europe.

Updates from U.S.A. and Canada
From U.S. Center s for Disease Control and Prevention weekly influenza surveillance report: Week 46 (15-21 November 2009)
From U.S. Centers for Disease Control and Prevention (CDC) weekly influenza surveillance report:

• Influenza activity continued to decrease in the U.S.
• 1,880 (20.5%) of all specimens tested with results reported to CDC/Influenza Division were positive for influenza.
• Over 99% of all sub typed influenza A viruses being reported to CDC were 2009 influenza A (H1N1) viruses.
• The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold for the eighth consecutive week.
• 35 influenza-associated pediatric deaths were reported. 27 of these deaths were associated with 2009 influenza A (H1N1) virus infection, seven were associated with an influenza A virus for which the subtype was undetermined, and one was associated with a seasonal influenza A (H1) virus infection that occurred in March.
• The proportion of outpatient visits for influenza-like illness (ILI) was 4.3% which is above the national baseline of 2.3%.
• 32 states reported geographically widespread influenza activity, Puerto Rico and 17 states reported regional influenza activity, the District of Columbia and one state reported local influenza activity, and Guam and the U.S. Virgin Islands reported sporadic influenza activity.
• Other news:
  
  • The U.S. Food and Drug Administration approved on 27 November the influenza vaccine Agriflu for people ages 18 years and older to prevent disease caused by influenza virus subtypes A and B. Agriflu, manufactured by Novartis Vaccines and Diagnostics in Siena, Italy, was approved using the FDA?s accelerated approval pathway, which helps safe and effective medical products for serious or life-threatening diseases become available sooner. In this case, Novartis demonstrated that the vaccine induced levels of antibodies in the blood likely to be effective in preventing seasonal influenza.
• For more information:
  
  • U.S. Centers for Disease Control and Prevention ?What's New on the H1N1 Flu Site? : LINK
  • U.S. Centers for Disease Control and Prevention Weekly Influenza Surveillance Report: LINK
  • Overview of Influenza Surveillance in the United States: LINK

From the Public Health Agency of Canada:

• Influenza activity level decreased. All influenza indicators declined.
• Nearly 100% of the positive influenza A subtype specimens were 2009 influenza A (H1N1) viruses.
• The intensity of Pandemic (H1N1) 2009 in the population was high with 1,554 hospitalizations, 243 ICU admissions and 61 deaths reported. `
• 99 laboratory-confirmed influenza-associated pediatric hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network. Of these, 22 were reported as Pandemic (H1N1) 2009 and 77 were reported as unsubtyped influenza A.
• The number of hospitalizations was higher than the overall number of hospitalizations for the first wave.
• The proportion of severe cases (ICU admissions and deaths) among all hospitalized cases was lower in the second wave than in the first wave.
• ILI consultation rate was 57 consultations per 1,000 patient visits, significantly lower than the previous weeks.
• For more information:
  
  • Public Health Agency of Canada: LINK
  • Public Health Agency of Canada FluWatch: LINK

Epidemiologic update
The Weekly Influenza Surveillance Report
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 881 deaths have been reported since April 2009 (Table 2). Since week 41 the numbers of deaths each has shown a steady increase almost doubling every fortnight over the last six weeks, although there was only a 6% increase in week 47, compared to the previous week. While the most deaths have to date been in Western Europe there are increasing numbers of deaths being reported from Central and Eastern Europe. Latest new and confirmed fatal pandemic (H1N1) cases outside the EU/EFTA area are presented in Table 2 as well. Available updates on hospital admissions, per Member State, can be found in Table 1.

Other updates
HIV-infection and pandemic Influenza A(H1N1)v
December 1 is celebrated as World Aids Day. Today various events around the world highlight current challenges for fighting the global HIV/Aids pandemic and address the situation f the approximately 30 million persons living with the infection around the world. As HIV-infection diminishes the immune systems capability to fight other infections and may lead to a higher risk for complications due to influenza infection, HIV-infected individuals are among the recommended categories for receiving pandemic Influenza A(H1N1)v vaccination. As of yet there is little information available on the actual outcome of Influenza infection among individuals in differnt stages of HIV infection, but studies are underway.
Further information can be found at:

• ECDC and World Aids Day: LINK
• US CDC HIV and A(H1N1): LINK
• UNAIDS World Aids Day: LINK
• Eurosurveillance, Vaillant et al. LINK

Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 01 December 2009, 09:00 hours (CEST) in EU and EFTA countries
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (18.11.) ? ? ? ? ? ? ? ?
2. Belgium (26.11.) ? ? ? ? ? ? ? ?
3. Bulgaria (22.11) ? ? ? ? ? ? ? ?
4. Cyprus(23.11) ? ? ? ? ? ? ? 6
5. Czech Republic (26.11.) ? ? ? ? ? ? ? ?
6. Denmark (25.11.) ? ? ? ? ? ? ? ?
7. Estonia (25.11.) ? ? ? ? ? ? ? ?
8. Finland (30.11.) - 8 ? ? - 8 ? ?
9. France (30.11.) ? ? ? 461 - 137 ? ?
10. Germany (26.11.) ? ? ? ? ? ? ? ?
11. Greece (15.11.) ? ? ? ? ? ? ? ?
12. Hungary (22.11.) ? ? ? ? ? ? ? ?
13. Iceland (26.11.) ? 5 ? 180 ? 1 ? 20
14. Ireland (25.11.) ? 211 ? 941 ? 18 ? 77
15. Italy (27.11) ? ? - 600 ? ? ? 315
16. Latvia (25.11.) ? ? ? ? ? ? ? ?
17. Liechtenstein (26.11.) ? ? ? ? ? ? ? ?
18. Lithuania (04.11.) ? ? ? ? ? ? ? ?
19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (27.11.) ? 289 ? 1587 ? 29 ? 167
22. Norway (25.11.) ? 60 ? 1102 ? 13 ? 127
23. Poland (30.11.) ? ? ? ? ? ? ? ?
24. Portugal (25.11.) - 148 ? ? - 20 ? ?
25. Romania (23.11) - 10 ? ? - 5 ? ?
26. Slovakia (25.11.) ? 13 - 51 ? ? ? ?
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (26.11.) ? ? ? ? ? ? ? ?
29. Sweden (22.11.) ? 206 - 836 ? ? ? ?
30. Switzerland (26.11.) ? 23 - 127 ? ? ? 30
31. United Kingdom (a) (26.11.) - 753 ? ? - 154 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (1104 cumulative hospitalisations), Wales (411) and Northern Ireland (558).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 01 December 2009, 09:00 hours CEST, and in the rest of the world by country, as of 30 November 2009, 16:00 hours CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Austria ? ? 3
  • Belgium ? ? 13
  • Bulgaria ? ? 5
  • Czech Republic ? ? 8
  • Denmark 1 ? 6
  • Estonia ? ? 1
  • Finland ? ? 16
  • France 10 ? 114 (a)
  • Germany ? ? 59
  • Greece ? ? 12
  • Hungary ? ? 8
  • Iceland ? ? 2
  • Ireland ? ? 17
  • Italy ? ? 93
  • Latvia ? ? 5
  • Lithuania 2 ? 4
  • Luxembourg ? ? 2
  • Malta ? ? 3
  • Netherlands ? ? 36
  • Norway ? ? 25
  • Poland 6 ? 22
  • Portugal 3 ? 21
  • Romania ? ? 3
  • Slovakia ? ? 1
  • Slovenia ? ? 2
  • Spain ? ? 135
  • Sweden ? ? 15
  • Switzerland ? ? 3
  • United Kingdom 1 ? 247
    
    • Total 23 ? 881
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Azerbaijan ? ? 2
  • Belarus ? ? 20
  • Bosnia and Herzegovina ? ? 1
  • Croatia ? - 11
  • Former Yugoslav Republic of Macedonia ? ? 3
  • Kosovo ? ? 7
  • Moldova 1 ? 12
  • Russia ? ? 19
  • Serbia 5 ? 22
  • Ukraine ? ? 18
    
    • Total 6 ? 115
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Algeria ? ? 3
  • Bahrain ? ? 7
  • Egypt 1 ? 21
  • Iran ? ? 140
  • Iraq 5 ? 15
  • Israel 5 ? 60
  • Jordan ? ? 14
  • Kuwait ? ? 27
  • Lebanon ? ? 3
  • Morocco 2 ? 3
  • Occupied Palestinian Territory ? ? 9
  • Oman ? ? 27
  • Qatar ? ? 8
  • Saudi Arabia ? ? 81
  • Syria ? ? 50
  • Tunisia ? ? 2
  • Turkey 34 ? 195
  • United Arab Emirates ? ? 6
  • Yemen ? ? 22
    
    • Total 47 ? 693
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 1
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 91
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 108
• NORTH AMERICA
  
  • Canada ? ? 309
  • Mexico ? ? 610
  • USA ? ? 1265
    
    • Total ? ? 2184
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 40
  • Cuba ? ? 7
  • Dominican Republic ? ? 22
  • El Salvador ? ? 27
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 6
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Saint Lucia ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total ? ? 175
• SOUTH AMERICA
  
  • Argentina ? ? 613
  • Bolivia ? ? 58
  • Brazil ? ? 1528
  • Chile ? ? 148
  • Colombia ? ? 160
  • Ecuador ? ? 82
  • Paraguay ? ? 52
  • Peru ? ? 190
  • Uruguay ? ? 33
  • Venezuela ? ? 114
    
    • Total ? ? 2978
• NORTH-EAST & SOUTH ASIA
  
  • Afghanistan ? ? 14
  • Bangladesh ? ? 6
  • China (Mainland) ? ? 104
  • Hong Kong SAR China ? ? 41
  • India 4 - 573
  • Japan ? ? 28
  • Macao SAR China ? ? 2
  • Maldives ? ? 1
  • Mongolia ? ? 18
  • Pakistan ? ? 1
  • South Korea ? ? 104
  • Sri Lanka ? ? 5
  • Taiwan ? ? 30
    
    • Total 4 ? 927
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 5
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 19
  • Thailand ? ? 187
  • Vietnam 3 ? 44
    
    • Total 3 ? 374
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 190
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 20
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 216
• TOTAL 83 ? 8651

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 7 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 86 in mainland France.
(?)
-
-------

[Giuseppe]

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

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

[Source Full PDF Document: LINK. EDITED.]
ECDC DAILY UPDATE
Pandemic (H1N1) 2009 Update 02 December 2009, 09:00 hours CEST

Main developments in past 24 hours

• A total of 898 fatal cases in Europe and EFTA countries and 7 851 in the rest of the world have been reported up to date.
• Scientific Advance: studies suggest that seasonal influenza vaccination unlikely to protect from pandemic influenza A(H1N1)v infection

This report is based on official information provided by national public health websites or through other official communication channels. Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 02 December 2009, 09:00 hours (CEST) in EU and EFTA countries are in Table 1. An update on the number of confirmed fatal cases is presented in Table 2 - as of 01 December 2009 - 16:00 hours CEST, for the world, and 01 December 2009 - 09:00 hours CEST, for Europe.

Scientific Advance
A number of epidemiological and serological studies indicate that trivalent influenza seasonal vaccination is unlikely to confer any protection against pandemic influenza A(H1N1)v 2009 infection

• Hancock K, Veguilla V, Lu X, et al. Cross-reactive antibody responses to the 2009 pandemic H1N1 influenza virus. N Engl J Med 2009 Nov 12;361(20):1945-52.
  
  • The above study is reviewed in today?s Scientific Advance together with evidence from four observational studies investigating the effects of seasonal influenza vaccination on the risk of infection with 2009 pandemic influenza. This study shows that vaccination with recent seasonal influenza vaccines, even when formulated with adjuvants, provides hardly any protection against pandemic influenza (H1N1) 2009. Together, the information available from the four published epidemiological studies plus the serological study results do not support any change in the seasonal or pandemic influenza vaccination policies by EU Member States.
  • The full ECDC review is available at: LINK

Epidemiologic update
The Weekly Influenza Surveillance Report
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 898 deaths have been reported since April 2009 (Table 2). Since week 41 the numbers of deaths each has shown a steady increase almost doubling every fortnight over the last six weeks, although there was only a 6% increase in week 47, compared to the previous week. While the most deaths have to date been in Western Europe there are increasing numbers of deaths being reported from Central and Eastern Europe. Latest new and confirmed fatal pandemic (H1N1) cases outside the EU/EFTA area are presented in Table 2 as well. Available updates on hospital admissions, per Member State, can be found in Table 1.

Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 02 December 2009, 09:00 hours (CEST) in EU and EFTA countries
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (18.11.) ? ? ? ? ? ? ? ?
2. Belgium (26.11.) ? ? ? ? ? ? ? ?
3. Bulgaria (22.11) ? ? ? ? ? ? ? ?
4. Cyprus(23.11) ? ? ? ? ? ? ? 6
5. Czech Republic (26.11.) ? ? ? ? ? ? ? ?
6. Denmark (25.11.) ? ? ? ? ? ? ? ?
7. Estonia (25.11.) ? ? ? ? ? ? ? ?
8. Finland (01.12.) - 5 ? ? - 12 ? ?
9. France (30.11.) ? ? ? 461 - 137 ? ?
10. Germany (26.11.) ? ? ? ? ? ? ? ?
11. Greece (15.11.) ? ? ? ? ? ? ? ?
12. Hungary (22.11.) ? ? ? ? ? ? ? ?
13. Iceland (26.11.) ? 5 ? 180 ? 1 ? 20
14. Ireland (25.11.) ? 211 ? 941 ? 18 ? 77
15. Italy (28.11) ? ? - 600 ? ? ? 315
16. Latvia (25.11.) ? ? ? ? ? ? ? ?
17. Liechtenstein (26.11.) ? ? ? ? ? ? ? ?
18. Lithuania (04.11.) ? ? ? ? ? ? ? ?
19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (27.11.) ? 289 ? 1587 ? 29 ? 167
22. Norway (25.11.) ? 60 ? 1102 ? 13 ? 127
23. Poland (30.11.) ? ? ? ? ? ? ? ?
24. Portugal (25.11.) - 148 ? ? - 20 ? ?
25. Romania (23.11) - 10 ? ? - 5 ? ?
26. Slovakia (25.11.) ? 13 - 51 ? ? ? ?
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (26.11.) ? ? ? ? ? ? ? ?
29. Sweden (22.11.) ? 206 - 836 ? ? ? ?
30. Switzerland (26.11.) ? 23 - 127 ? ? ? 30
31. United Kingdom (a) (26.11.) - 753 ? ? - 154 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (1104 cumulative hospitalisations), Wales (411) and Northern Ireland (558).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 02 December 2009, 09:00 hours CEST, and in the rest of the world by country, as of 01 December 2009, 16:00 hours CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Austria ? ? 3
  • Belgium ? ? 13
  • Bulgaria ? ? 5
  • Czech Republic ? ? 8
  • Denmark ? ? 6
  • Estonia ? ? 1
  • Finland ? ? 16
  • France ? ? 114 (a)
  • Germany 2 ? 60
  • Greece ? ? 12
  • Hungary ? ? 8
  • Iceland ? ? 2
  • Ireland ? ? 17
  • Italy 2 ? 95
  • Latvia 3 ? 8
  • Lithuania 1 ? 5
  • Luxembourg ? ? 2
  • Malta ? ? 3
  • Netherlands ? ? 36
  • Norway ? ? 25
  • Poland 2 ? 24
  • Portugal ? ? 21
  • Romania ? ? 3
  • Slovakia ? ? 1
  • Slovenia 5 ? 7
  • Spain ? ? 135
  • Sweden ? ? 15
  • Switzerland ? ? 3
  • United Kingdom 3 ? 250
    
    • Total 18 ? 898
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Azerbaijan ? ? 2
  • Belarus ? ? 20
  • Bosnia and Herzegovina ? ? 1
  • Croatia ? - 11
  • Former Yugoslav Republic of Macedonia 1 ? 4
  • Kosovo ? ? 7
  • Moldova ? ? 12
  • Russia ? ? 19
  • Serbia ? ? 22
  • Ukraine 23 ? 41
    
    • Total 24 ? 139
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Algeria ? ? 3
  • Bahrain ? ? 7
  • Egypt ? ? 21
  • Iran ? ? 140
  • Iraq ? ? 15
  • Israel 3 ? 63
  • Jordan ? ? 14
  • Kuwait ? ? 27
  • Lebanon ? ? 3
  • Libya 1 ? 1
  • Morocco 1 ? 4
  • Occupied Palestinian Territory ? ? 9
  • Oman ? ? 27
  • Qatar ? ? 8
  • Saudi Arabia ? ? 81
  • Syria ? ? 50
  • Tunisia ? ? 2
  • Turkey ? ? 195
  • United Arab Emirates ? ? 6
  • Yemen ? ? 22
    
    • Total 5 ? 698
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 1
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa 1 ? 92
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total 1 ? 109
• NORTH AMERICA
  
  • Canada ? ? 309
  • Mexico 46 ? 656
  • USA ? ? 1265
    
    • Total 46 ? 2230
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 40
  • Cuba ? ? 7
  • Dominican Republic ? ? 22
  • El Salvador ? ? 27
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 6
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Saint Lucia ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total ? ? 175
• SOUTH AMERICA
  
  • Argentina ? ? 613
  • Bolivia ? ? 58
  • Brazil ? ? 1528
  • Chile ? ? 148
  • Colombia ? ? 160
  • Ecuador ? ? 82
  • Paraguay ? ? 52
  • Peru ? ? 190
  • Uruguay ? ? 33
  • Venezuela ? ? 114
    
    • Total ? ? 2978
• NORTH-EAST & SOUTH ASIA
  
  • Afghanistan 2 ? 16
  • Bangladesh ? ? 6
  • China (Mainland) ? ? 104
  • Hong Kong SAR China ? - 41
  • India 2 ? 575
  • Japan ? ? 28
  • Macao SAR China ? ? 2
  • Maldives ? ? 1
  • Mongolia ? ? 18
  • Pakistan ? ? 1
  • South Korea ? ? 104
  • Sri Lanka ? ? 5
  • Taiwan ? ? 30
    
    • Total 4 ? 931
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 5
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 19
  • Thailand ? ? 187
  • Vietnam ? ? 44
    
    • Total ? ? 374
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 190
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 20
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 216
• TOTAL 98 ? 8749

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 7 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 86 in mainland France.
(?)
-
--------

[Giuseppe]

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

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

[Source Full PDF Document: LINK. EDITED.]
ECDC DAILY UPDATE
Pandemic (H1N1) Update 03 December 2009 09:00 hours CEST

Main developments in past 24h

• A total of 947 fatal cases in Europe and EFTA countries been reported up to date.
• WHO update: Oseltamivir resistance in immunocompromised hospital patients

This report is based on official information provided by national public health websites or communication channels. Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country in Table 1. An update on the number of confirmed fatal cases is presented in Table 2, for the world.

WHO Updates
Oseltamivir resistance in immunocompromised hospital patients
The WHO released its Pandemic (H1N1) 2009 briefing note 18, commenting on the recent reports on Oseltamivir resistance among immunocompromised individuals. The agency modifies the treatment recommendations regarding this group of individuals and reaffirms its recommendations for resistance monitoring and vaccination of health care staff, carers and family contacts of patients against pandemic influenza.
More information available at: LINK

Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 947 deaths have been reported since April 2009 (Table 2). Since week 41 the numbers of deaths each has shown a steady increase almost doubling every fortnight over the last six weeks, although there was only a 6% increase in week 47, compared to the previous week. While the most deaths have to date been in Western Europe there are increasing numbers of deaths being reported from Central and Eastern Europe. Latest new and confirmed fatal pandemic (H1N1) cases outside the EU/EFTA area are presented in Table 2 as well. Available updates on hospital admissions, per Member State, can be found in Table 1.

Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 03 December 2009, 09:00 hours (CEST) in EU and EFTA countries
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (18.11.) ? ? ? ? ? ? ? ?
2. Belgium (26.11.) ? ? ? ? ? ? ? ?
3. Bulgaria (22.11) ? ? ? ? ? ? ? ?
4. Cyprus(23.11) ? ? ? ? ? ? ? 6
5. Czech Republic (26.11.) ? ? ? ? ? ? ? ?
6. Denmark (02.12.) ? ? ? ? ? ? ? ?
7. Estonia (25.11.) ? ? ? ? ? ? ? ?
8. Finland (02.12.) - 7 ? ? - 6 ? ?
9. France (30.11.) ? ? ? 461 - 137 ? ?
10. Germany (01.12.) ? ? ? ? ? ? ? ?
11. Greece (02.12.) ? ? ? ? ? ? ? ?
12. Hungary (22.11.) ? ? ? ? ? ? ? ?
13. Iceland (26.11.) ? 5 ? 180 ? 1 ? 20
14. Ireland (25.11.) ? 211 ? 941 ? 18 ? 77
15. Italy (02.12) ? ? - 674 ? ? ? 353
16. Latvia (25.11.) ? ? ? ? ? ? ? ?
17. Liechtenstein (26.11.) ? ? ? ? ? ? ? ?
18. Lithuania (04.11.) ? ? ? ? ? ? ? ?
19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (27.11.) ? 289 ? 1587 ? 29 ? 167
22. Norway (02.12.) ? 37 ? 1206 ? 19 ? 151
23. Poland (30.11.) ? ? ? ? ? ? ? ?
24. Portugal (25.11.) - 148 ? ? - 20 ? ?
25. Romania (23.11) - 10 ? ? - 5 ? ?
26. Slovakia (02.12.) ? 38 ? 81 ? 8 ? 31
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (26.11.) ? ? ? ? ? ? ? ?
29. Sweden (22.11.) ? 206 - 836 ? ? ? ?
30. Switzerland (26.11.) ? 23 - 127 ? ? ? 30
31. United Kingdom (a) (26.11.) - 753 ? ? - 154 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (1104 cumulative hospitalisations), Wales (411) and Northern Ireland (558).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 03 December 2009, 09:00 hours CEST, and in the rest of the world by country, as of 02 December 2009, 16:00 hours CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Austria ? ? 3
  • Belgium ? ? 13
  • Bulgaria ? ? 5
  • Czech Republic 12 ? 20
  • Denmark 3 ? 9
  • Estonia ? ? 1
  • Finland 1 ? 17
  • France ? ? 114 (a)
  • Germany 5 ? 61
  • Greece 9 ? 21
  • Hungary ? ? 8
  • Iceland ? ? 2
  • Ireland ? ? 17
  • Italy 12 ? 107
  • Latvia 1 ? 9
  • Lithuania 1 ? 6
  • Luxembourg ? ? 2
  • Malta ? ? 3
  • Netherlands ? ? 36
  • Norway ? ? 25
  • Poland ? ? 24
  • Portugal 2 ? 23
  • Romania 2 ? 5
  • Slovakia ? ? 1
  • Slovenia ? ? 7
  • Spain ? ? 135
  • Sweden ? ? 15
  • Switzerland ? ? 3
  • United Kingdom ? ? 250
    
    • Total 48 ? 947
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Azerbaijan ? ? 2
  • Belarus ? ? 20
  • Bosnia and Herzegovina 2 ? 3
  • Croatia 8 - 19
  • Former Yugoslav Republic of Macedonia ? ? 4
  • Kosovo ? ? 7
  • Moldova 1 ? 13
  • Russia ? ? 19
  • Serbia ? ? 22
  • Ukraine ? ? 18
    
    • Total 11 ? 150
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Algeria 1 ? 4
  • Bahrain ? ? 7
  • Egypt ? ? 21
  • Iran ? ? 140
  • Iraq ? ? 15
  • Israel ? ? 63
  • Jordan ? ? 14
  • Kuwait ? ? 27
  • Lebanon ? ? 3
  • Libya ? ? 1
  • Morocco ? ? 4
  • Occupied Palestinian Territory ? ? 9
  • Oman ? ? 27
  • Qatar ? ? 8
  • Saudi Arabia ? ? 81
  • Syria ? ? 50
  • Tunisia ? ? 2
  • Turkey ? ? 195
  • United Arab Emirates ? ? 6
  • Yemen ? ? 22
    
    • Total 1 ? 699
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar 1 ? 2
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 92
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total 1 ? 110
• NORTH AMERICA
  
  • Canada 20 ? 329
  • Mexico ? ? 656
  • USA 377 ? 1642
    
    • Total 397 ? 2627
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 40
  • Cuba 13 ? 20
  • Dominican Republic 1 ? 23
  • El Salvador ? ? 27
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 6
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Saint Lucia ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total 14 ? 189
• SOUTH AMERICA
  
  • Argentina ? ? 613
  • Bolivia ? ? 58
  • Brazil ? ? 1528
  • Chile ? ? 148
  • Colombia 3 ? 163
  • Ecuador 6 ? 88
  • Paraguay ? ? 52
  • Peru 10 ? 200
  • Uruguay ? ? 33
  • Venezuela ? ? 114
    
    • Total 19 ? 2997
• NORTH-EAST & SOUTH ASIA
  
  • Afghanistan ? ? 16
  • Bangladesh ? ? 6
  • China (Mainland) 74 ? 178
  • Hong Kong SAR China ? - 41
  • India 4 ? 579
  • Japan ? ? 28
  • Macao SAR China ? ? 2
  • Maldives ? ? 1
  • Mongolia 6 ? 24
  • Pakistan ? ? 1
  • South Korea ? ? 104
  • Sri Lanka ? ? 5
  • Taiwan ? ? 30
    
    • Total 84 ? 1015
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 5
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 19
  • Thailand ? ? 187
  • Vietnam ? ? 44
    
    • Total ? ? 374
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 190
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 20
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 216
• TOTAL 575 ? 9324

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 7 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 86 in mainland France.
(?)
-
-------

[Giuseppe]

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

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

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

Main developments in past 24 hours

• First European Medicines Agency weekly report on centrally authorized pandemic vaccines and antivirals published ECDC
• Weekly Influenza Surveillance Overview will be published this afternoon
• WHO: too early to judge if pandemic has peaked
• A total of 1 024 fatal cases in Europe and EFTA countries and 8 610 in the rest of the world have been reported up to date.

This report is based on official information provided by national public health websites or through other official communication channels. Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 04 December 2009, 09:00 hours (CEST) in EU and EFTA countries are in Table 1. An update on the number of confirmed fatal cases is presented in Table 2 - as of 03 December 2009 - 16:00 hours CEST, for the world, and 04 December 2009 - 09:00 hours CEST, for Europe.

Update from the European Medicines Agency
First European Medicines Agency weekly report on centrally authorized pandemic vaccines and antivirals published
The European Medicines Agency (EMA) reports on the use and benefits of pandemic vaccines and antivirals, as well as on adverse reactions reported to the Agency. The report includes information on the distribution of three centrally authorised vaccines and an estimate of the number of people vaccinated in EU member states. To date, no unexpected serious safety issues have been identified. The most frequent adverse reactions that have been reported are non-serious and as expected. This is the first issue of a new weekly report that the European agency launched on the 3rd of December.
More information can be found at: LINK or from the agency's website LINK

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

WHO: too early to judge if pandemic has peaked
The World Health Organisation said in a press conference on 3 of December that it's too soon to judge whether the H1N1 influenza pandemic has passed its peak, although signs of a drop in cases can be seen in some countries
More information can be found at: LINK

Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 1 024 deaths have been reported since April 2009 (Table 2). Since week 41 the numbers of deaths each has shown a steady increase almost doubling every fortnight over the last six weeks, although there was only a 6% increase in week 47, compared to the previous week. While the most deaths have to date been in Western Europe there are increasing numbers of deaths being reported from Central and Eastern Europe. Latest new and confirmed fatal pandemic (H1N1) cases outside the EU/EFTA area are presented in Table 2 as well. Available updates on hospital admissions, per Member State, can be found in Table 1

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

1. Austria (18.11.) ? ? ? ? ? ? ? ?
2. Belgium (03.12.) ? ? ? ? ? ? ? ?
3. Bulgaria (22.11) ? ? ? ? ? ? ? ?
4. Cyprus(23.11) ? ? ? ? ? ? ? 6
5. Czech Republic (26.11.) ? ? ? ? ? ? ? ?
6. Denmark (02.12.) ? ? ? ? ? ? ? ?
7. Estonia (02.12.) ? ? ? ? ? ? ? ?
8. Finland (02.12.) - 46 ? ? - 21 ? ?
9. France (01.12.) ? ? ? ? ? 154 ? 481
10. Germany (01.12.) ? ? ? ? ? ? ? ?
11. Greece (02.12.) ? ? ? ? ? ? ? ?
12. Hungary (29.11.) ? ? ? ? ? ? ? ?
13. Iceland (26.11.) ? 5 ? 180 ? 1 ? 20
14. Ireland (02.12.) ? 181 ? 974 ? 12 ? 83
15. Italy (03.12) ? ? - 730 ? ? ? 391
16. Latvia (25.11.) ? ? ? ? ? ? ? ?
17. Liechtenstein (26.11.) ? ? ? ? ? ? ? ?
18. Lithuania (04.11.) ? ? ? ? ? ? ? ?
19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (27.11.) ? 289 ? 1587 ? 29 ? 167
22. Norway (02.12.) ? 37 ? 1206 ? 19 ? 151
23. Poland (30.11.) ? ? ? ? ? ? ? ?
24. Portugal (02.12.) - 149 ? ? - 22 ? ?
25. Romania (23.11) - 10 ? ? - 5 ? ?
26. Slovakia (02.12.) ? 38 ? 81 ? 8 ? 31
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (03.12.) ? ? ? ? ? ? ? ?
29. Sweden (29.11.) ? 119 - 1014 ? ? ? ?
30. Switzerland (26.11.) ? 23 - 127 ? ? ? 30
31. United Kingdom (a) (03.12.) - 747 ? ? - 161 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (1 274 cumulative hospitalisations), Wales (423) and Northern Ireland (563).

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

• EU AND EFTA COUNTRIES
  
  • Austria ? ? 3
  • Belgium 1 ? 14
  • Bulgaria ? ? 5
  • Czech Republic 2 ? 22
  • Denmark ? ? 9
  • Estonia ? ? 1
  • Finland ? ? 17
  • France 10 ? 124 (a)
  • Germany ? ? 66
  • Greece ? ? 21
  • Hungary ? ? 8
  • Iceland ? ? 2
  • Ireland 1 ? 18
  • Italy 4 ? 111
  • Latvia 3 ? 12
  • Lithuania ? ? 6
  • Luxembourg ? ? 2
  • Malta ? ? 3
  • Netherlands ? ? 36
  • Norway ? ? 25
  • Poland ? ? 24
  • Portugal ? ? 23
  • Romania 1 ? 6
  • Slovakia ? ? 1
  • Slovenia ? ? 7
  • Spain 34 ? 169
  • Sweden 1 ? 16
  • Switzerland ? ? 3
  • United Kingdom 20 ? 270
    
    • Total 77 ? 1024
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Belarus ? ? 20
  • Bosnia and Herzegovina ? ? 3
  • Croatia ? ? 19
  • Former Yugoslav Republic of Macedonia ? - 4
  • Kosovo 3 ? 10
  • Moldova ? ? 13
  • Montenegro 1 ? 1
  • Russia ? ? 19
  • Serbia ? ? 22
  • Ukraine ? ? 41
    
    • Total 4 ? 154
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Algeria 3 ? 7
  • Bahrain ? ? 7
  • Egypt 2 ? 23
  • Iran ? ? 140
  • Iraq 11 ? 26
  • Israel 3 ? 66
  • Jordan ? ? 14
  • Kuwait ? ? 27
  • Lebanon ? ? 3
  • Libya ? ? 1
  • Morocco ? ? 4
  • Occupied Palestinian Territory ? ? 9
  • Oman ? ? 27
  • Qatar ? ? 8
  • Saudi Arabia ? ? 81
  • Syria ? ? 50
  • Tunisia ? ? 2
  • Turkey ? ? 195
  • United Arab Emirates ? ? 6
  • Yemen ? ? 22
    
    • Total 19 ? 718
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 2
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 92
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? - 110
• NORTH AMERICA
  
  • Canada ? ? 329
  • Mexico ? ? 656
  • USA 175 ? 1817
    
    • Total 175 ? 2802
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 40
  • Cuba 7 ? 27
  • Dominican Republic ? ? 23
  • El Salvador ? ? 27
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 6
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Saint Lucia ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total 7 ? 196
• SOUTH AMERICA
  
  • Argentina ? ? 613
  • Bolivia ? ? 58
  • Brazil ? ? 1528
  • Chile ? ? 148
  • Colombia ? ? 163
  • Ecuador ? ? 88
  • Paraguay ? ? 52
  • Peru ? ? 200
  • Uruguay ? ? 33
  • Venezuela 1 ? 115
    
    • Total 1 ? 2998
• NORTH-EAST & SOUTH ASIA
  
  • Afghanistan ? ? 16
  • Bangladesh ? ? 6
  • China (Mainland) ? ? 178
  • Hong Kong SAR China 2 - 43
  • India 12 ? 591
  • Japan ? ? 28
  • Macao SAR China ? ? 2
  • Maldives ? ? 1
  • Mongolia ? ? 24
  • Pakistan ? ? 1
  • South Korea 13 ? 117
  • Sri Lanka ? ? 5
  • Taiwan 2 ? 32
    
    • Total 29 ? 1044
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 5
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 19
  • Thailand ? ? 187
  • Vietnam ? ? 44
    
    • Total ? ? 374
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 190
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 20
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 216
• TOTAL 312 ? 9634

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 7 in the Reunion, 1 in Martinique, 2 in Mayotte, 5 in Guadeloupe and 92 in mainland France.
(?)
-
------

[Giuseppe]

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

Pandemic (H1N1) 2009 Update 07 December 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]
ECDC DAILY UPDATE
Pandemic (H1N1) 2009 Update 07 December 2009, 09:00 hours CEST

Main developments in past 72 hours

• 17 EU countries reported widespread activity in week 48 while all EU reporting countries are still experiencing medium to very high influenza intensity
• A total of 1 066 fatal cases in Europe and EFTA countries and 8 731 in the rest of the world have been reported up to date
• EMEA advises of risk of fever among young children following pandemic vaccination

This report is based on official information provided by national public health websites or through other official communication channels. Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 07 December 2009, 09:00 hours (CEST) in EU and EFTA countries are in Table 1. An update on the number of confirmed fatal cases is presented in Table 2 - as of 06 December 2009 - 16:00 hours CEST, for the world, and 07 December 2009 - 09:00 hours CEST, for Europe.

Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 1 066 deaths have been reported since April 2009 (Table 2). Since week 41 the numbers of deaths each has shown a steady increase almost doubling every fortnight over the last six weeks, but with a slight increase in week 48, compared to the previous week. While the most deaths have to date been in Western Europe there are increasing numbers of deaths being reported from Central and Eastern Europe. Latest new and confirmed fatal pandemic (H1N1) cases outside the EU/EFTA area are presented in Table 2 as well. Available updates on hospital admissions, per Member State, can be found in Table 1

The Weekly Influenza Surveillance Report
The Weekly Influenza Surveillance Overview was published on December 4th for week 48/2009. LINK

• Overall, 17 EU countries reported widespread activity in week 48 while all EU reporting countries are still experiencing medium to very high influenza intensity.
• Eleven countries reported increasing activity, many of which are in Eastern and Southern Europe. However, Influenza intensity has been declining for at least two consecutive weeks in nine countries, many of which are located in Northern, Western and Central Europe.
• Ten countries reported 41 new deaths.
• Seven countries reported 207 SARI cases, 41 of whom had symptom onset during week 48/2009.
• Oseltamivir resistance has been reported at very low levels in the EU
• Seasonal influenza strains continue to be very rarely detected and more than 99% of subtyped viruses have been influenza A(H1N1)v.
• The percentage of samples from sentinel patients positive for influenza seen in primary care has declined since week 46. Nevertheless, the percentage is higher in countries reporting increasing trends.

Other updates
EMEA advises of risk of fever among young children following pandemic vaccination
The European Medicines Agency is warning that young children may experience fever after their second dose of the pandemic influenza vaccine Pandemrix. Prescribers and parents should monitor the temperature of the vaccinated child and, if necessary, take measures to lower the fever (e.g. giving an antipyretic such as paracetamol). However, the Agency noted that the second dose increases the immune response against pandemic influenza.
For further information, see:
- EMEA Press Release
- EMEA Questions & answers

Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 07 December 2009, 09:00 hours (CEST) in EU and EFTA countries
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (18.11.) ? ? ? ? ? ? ? ?
2. Belgium (03.12.) ? ? ? ? ? ? ? ?
3. Bulgaria (29.11) ? ? ? ? ? ? ? ?
4. Cyprus(23.11) ? ? ? ? ? ? ? 6
5. Czech Republic (03.12.) ? ? ? ? ? ? ? ?
6. Denmark (02.12.) ? ? ? ? ? ? ? ?
7. Estonia (02.12.) ? ? ? ? ? ? ? ?
8. Finland (03.12.) - 17 ? ? - 10 ? ?
9. France (04.12.) ? ? ? 567 - 155 ? ?
10. Germany (01.12.) ? ? ? ? ? ? ? ?
11. Greece (02.12.) ? ? ? ? ? ? ? ?
12. Hungary (29.11.) ? ? ? ? ? ? ? ?
13. Iceland (26.11.) ? 5 ? 180 ? 1 ? 20
14. Ireland (02.12.) ? 181 ? 974 ? 12 ? 83
15. Italy (03.12) ? ? - 730 ? ? ? 391
16. Latvia (04.12.) ? ? ? ? ? ? ? ?
17. Liechtenstein (26.11.) ? ? ? ? ? ? ? ?
18. Lithuania (30.11.) ? ? ? ? ? ? ? ?
19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (04.12.) ? 227 ? 1969 ? 14 ? 183
22. Norway (02.12.) ? 37 ? 1206 ? 19 ? 151
23. Poland (30.11.) ? ? ? ? ? ? ? ?
24. Portugal (02.12.) - 149 ? ? - 22 ? ?
25. Romania (23.11) - 10 ? ? - 5 ? ?
26. Slovakia (02.12.) ? 38 ? 81 ? 8 ? 31
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (03.12.) ? ? ? ? ? ? ? ?
29. Sweden (29.11.) ? 119 - 1014 ? ? ? ?
30. Switzerland (03.12.) ? 26 - 195 ? ? ? 49
31. United Kingdom (a) (03.12.) - 747 ? ? - 161 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (1 274 cumulative hospitalisations), Wales (423) and Northern Ireland (563).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 07 December 2009, 09:00 hours CEST, and in the rest of the world by country, as of 06 December 2009, 16:00 hours CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Austria ? ? 3
  • Belgium ? ? 14
  • Bulgaria ? ? 5
  • Czech Republic ? ? 22
  • Denmark 1 ? 10
  • Estonia 3 ? 4
  • Finland ? ? 17
  • France 19 ? 143 (a)
  • Germany ? ? 66
  • Greece ? ? 21
  • Hungary ? ? 8
  • Iceland ? ? 2
  • Ireland ? ? 18
  • Italy ? ? 111
  • Latvia ? ? 12
  • Lithuania 1 ? 7
  • Luxembourg ? ? 2
  • Malta ? ? 3
  • Netherlands 6 ? 42
  • Norway ? ? 25
  • Poland ? ? 24
  • Portugal ? ? 23
  • Romania 6 ? 12
  • Slovakia 2 ? 3
  • Slovenia ? ? 7
  • Spain ? ? 169
  • Sweden ? ? 16
  • Switzerland 4 ? 7
  • United Kingdom ? ? 270
    
    • Total 42 ? 1066
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Albania 1 ? 1
  • Belarus ? ? 20
  • Bosnia and Herzegovina ? ? 3
  • Croatia ? - 19
  • Former Yugoslav Republic of Macedonia 2 ? 6
  • Kosovo ? ? 10
  • Moldova ? ? 13
  • Montenegro ? ? 1
  • Russia ? ? 19
  • Serbia ? ? 22
  • Ukraine ? ? 41
    
    • Total 3 ? 155
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Algeria 1 ? 8
  • Bahrain ? ? 7
  • Egypt 1 ? 24
  • Iran 7 ? 147
  • Iraq ? ? 26
  • Israel ? ? 66
  • Jordan ? ? 14
  • Kuwait ? ? 27
  • Lebanon ? ? 3
  • Libya ? ? 1
  • Morocco ? ? 4
  • Occupied Palestinian Territory ? ? 9
  • Oman ? ? 27
  • Qatar ? ? 8
  • Saudi Arabia ? ? 81
  • Syria ? ? 50
  • Tunisia 2 ? 4
  • Turkey 46 ? 241
  • United Arab Emirates ? ? 6
  • Yemen ? ? 22
    
    • Total 57 ? 775
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar 1 ? 3
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 92
  • Sudan ? ? 1
  • Tanzania ? - 1
    
    • Total 1 ? 111
• NORTH AMERICA
  
  • Canada 28 ? 357
  • Mexico 15 ? 671
  • USA ? ? 1817
    
    • Total 43 ? 2845
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 40
  • Cuba ? ? 27
  • Dominican Republic ? ? 23
  • El Salvador ? ? 27
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 6
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Saint Lucia ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total ? ? 196
• SOUTH AMERICA
  
  • Argentina ? ? 613
  • Bolivia ? ? 58
  • Brazil ? ? 1528
  • Chile ? ? 148
  • Colombia ? ? 163
  • Ecuador ? ? 88
  • Paraguay ? ? 52
  • Peru ? ? 200
  • Uruguay ? ? 33
  • Venezuela ? ? 115
    
    • Total ? ? 2998
• NORTH-EAST & SOUTH ASIA
  
  • Afghanistan ? ? 16
  • Bangladesh ? ? 6
  • China (Mainland) ? - 178
  • Hong Kong SAR China ? ? 43
  • India 17 ? 608
  • Japan ? ? 28
  • Macao SAR China ? ? 2
  • Maldives ? ? 1
  • Mongolia ? ? 24
  • Pakistan ? ? 1
  • South Korea ? ? 117
  • Sri Lanka ? ? 5
  • Taiwan ? ? 32
    
    • Total 17 ? 1061
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 5
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 19
  • Thailand ? ? 187
  • Vietnam ? ? 44
    
    • Total ? ? 374
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 190
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 20
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 216
• TOTAL 163 ? 9797

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 7 in the Reunion, 1 in Martinique, 2 in Mayotte, 5 in Guadeloupe and 111 in mainland France.
(?)
-
-------

[Giuseppe]

Pandemic (H1N1) 2009 Update 08 December 2009, 09:00 hours CEST (ECDC, edited)

Pandemic (H1N1) 2009 Update 08 December 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]
ECDC DAILY UPDATE
Pandemic (H1N1) 2009 Update 08 December 2009, 09:00 hours CEST

Main developments in past 24 hours

• Updates from U.S.A. and Canada included
• Updates from Moldova, Ukraine, Belarus and Russia included
• CIDRAP launches promising practices database
• A total of 1 079 fatal cases in Europe and EFTA countries and 8 892 in the rest of the world have been reported up to date

This report is based on official information provided by national public health websites or through other official communication channels. Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 08 December 2009, 09:00 hours (CEST) in EU and EFTA countries are in Table 1. An update on the number of confirmed fatal cases is presented in Table 2 - as of 07 December 2009 - 16:00 hours CEST, for the world, and 08 December 2009 - 09:00 hours CEST, for Europe.

Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 1 079 deaths have been reported since April 2009 (Table 2). Since week 41 the numbers of deaths each has shown a steady increase almost doubling every fortnight over the last six weeks, but with a slight increase in week 48, compared to the previous week. While the most deaths have to date been in Western Europe there are increasing numbers of deaths being reported from Central and Eastern Europe. Latest new and confirmed fatal pandemic (H1N1) cases outside the EU/EFTA area are presented in Table 2 as well. Available updates on hospital admissions, per Member State, can be found in Table 1.

Updates from U.S.A. and Canada
From U.S. Centers for Disease Control and Prevention (CDC) weekly influenza surveillance report: Week 47 (22-28 November 2009)

• Influenza activity continued to decrease in the U.S.
• 15.4% specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division were positive for influenza.
• Over 99% of all sub-typed influenza A viruses being reported to CDC were 2009 influenza A (H1N1) viruses.
• The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold for the ninth consecutive week.
• Seventeen influenza-associated paediatric deaths were reported. Twelve of these deaths were associated with 2009 influenza A (H1N1) virus infection and five were associated with an influenza A virus for which the subtype was undetermined. Since August 30, 2009, CDC has received 189 reports of influenza-associated paediatric deaths that occurred during the current influenza season (34 deaths in children less than 2 years old, 20 deaths in children 2-4 years old, 71 deaths in children 5-11 years old, and 64 deaths in children 12-17 years old).
• The proportion of outpatient visits for influenza-like illness (ILI) was 3.7% which is above the national baseline of 2.3%.
• Twenty-five states reported geographically widespread influenza activity, 17 states reported regional influenza activity, the District of Columbia, Puerto Rico and six states reported local influenza activity, and Guam, the U.S. Virgin Islands and two states reported sporadic influenza activity.
• Other news:
  
  • To assess the safety profile of H1N1 vaccines in the United States, CDC reviewed vaccine safety results for the H1N1 vaccines from reports received through the U.S. Vaccine Adverse Event Reporting System (VAERS) and electronic data from managed-care organizations in the Vaccine Safety Datalink (VSD), a large, population-based database with administrative and diagnostic data, in the first 2 months of reporting (as of November 24). No substantial differences between H1N1 and seasonal influenza vaccines were noted in the proportion or types of serious adverse events reported. No increase in any adverse events under surveillance has been seen in VSD data. (LINK)
• For more information:
  
  1. U.S. Centers for Disease Control and Prevention ?What's New on the H1N1 Flu Site? : LINK
  2. U.S. Centers for Disease Control and Prevention Weekly Influenza Surveillance Report: LINK
  3. Overview of Influenza Surveillance in the United States: LINK

From the Public Health Agency of Canada:

• Nationally, the activity levels reported this week continued to decrease compared to the previous week. All influenza indicators declined.
• The Pandemic (H1N1) 2009 strain accounted for nearly 100% of the positive influenza A sub-typed specimens.
• The intensity of Pandemic (H1N1) 2009 in the population was moderately high with 804 hospitalizations, 139 ICU admissions and 56 deaths reported.
• The proportion of severe cases (ICU admissions and deaths) among all hospitalized cases was lower in the second wave than in the first wave.
• A slight decline has been experienced in all provinces and territories as indicated in the continued decreasing number of reported hospitalized cases, ICU admissions and deaths reported this week.
• For more information:
  
  • Public Health Agency of Canada: LINK
  • Public Health Agency of Canada LINK

Updates from EPINORTH
Situation with influenza-like illnesses and pandemic influenza A(H1N1) in Moldova, Ukraine, Russia and Belarus as of 4 December
Updates on the pandemic situations in the North-East European region are provided by EpiNorth. The EpiNorth project aims to improve communicable disease surveillance, control and communication in the Nordic and Baltic countries and north-west regions of Russia. EpiNorth is funded by the European Centre for Disease Prevention and Control (ECDC), the Barents Health Programme and participating public health institutes.
EpiNorths Secretariat is at the Norwegian Institute of Public Health.
More about EpiNorth at: LINK

• Moldova:
  
  • As of 4 December, out of 4 293 samples, 2 066 cases were reported positive to influenza A(H1N1), among them 13 fatal cases, and 2 227 cases were negative to influenza A(H1N1).
  • National Scientific-Practical Centre for Preventive Medicine of the Republic of Moldova has also published detailed information on the situation with influenza-like diseases and influenza A(H1N1)v:
    
    • for the period January ? November 2009 5 332 cases of influenza (2 510 cases for the first ten months and 2 822 cases in November) were reported in the republic, l 984 cases of laboratory confirmed cases of influenza A (H1N1) (26 cases for the first ten months and 1 958 cases in November), and 284 958 cases of acute upper respiratory infections (224 364 cases for the first ten months and 60 594 cases in November).
    • For the week 48 the following trends were reported: stabilized situation with acute upper respiratory infections, 7% decrease in pneumonias and a 36% increase in influenza-like illnesses.
    • Source: LINK

• Ukraine:
  
  • As of November 3, a total of 1 978 951 cases of ARI/ILI were reported by the Ministry of Health of Ukraine on its website. A total of 119,580 persons were hospitalised in the whole country as of 3 December 2009, of which for the last week ? 2 598. Of those 1 056 were adults, 1 542 were children aged 0-18 years, and 66 pregnant women.
  • As of 3 December, 452 patients had died.
  • Source: LINK

• Russia:
  
  • According to Rospotrebnadzor, as of week 48, in 32 administrative units of the Russian Federation, which got first pandemic influenza (Far East, Siberia, Ural, part of Northwestern and Central Russia), the incidence of ILI/ARI decreased, but still over the threshold.
  • Most affected group was children 7-14 years of age. Based on experience in Moscow and other territories, it was possible to reduce the highest numbers of infected with ILI/ARI by delaying school activities (closing schools for defined period).
  • Rospotrebnadzor continues to control the vaccination process. At the time, 23.6% of whole population of the country (34 478 000 people) is vaccinated against influenza.
  • Source: LINK

• Belarus:
  
  • According to the information published on the website of the Republican Centre for Hygiene, Epidemiology and Public Health, the seasonal increase in incidence of ILI/ARI in Belarus started at week 43, while in previous years it started in January ? February.
  • There was conducted a daily monitoring of the incidence of ILI/ARI in 18 ?control? cities of Belarus, where 53% of countries? population live.
  • For the period of 1 October ? 23 November 2009, a total of 701 635 people sought medical assistance caused by ILI/ARI (13 521.8 per 100,000 population), which is 2 times higher than in the same period last year. The highest incidence was reported in Minsk oblast (16 560.0 per 100 000 population) and Gomel oblast (16 365.2 per 100 000 population). The lowest incidence ? Grodno oblast (10 886.4 per 100 000 population) and Brest oblast (10 942.7 per 100 000 population).
  • The majority of infected people were adults.
  • Proportion of children among infected people has been since the beginning of the season 47.9% (336 022) and since the beginning of epidemic ? 44.7% (260 016).
  • The highest peaks of the incidence of ARI were reported weeks 45 and 46, especially 10 November, when 44 441 cases ARI were reported, and the threshold was exceeded by 9.6 times. At the time, a decrease in the incidence of ARI has been reported. For instance, for the week 16-22 November 104,767 cases of ARI were reported in the 18 cities of Belarus, which is 38.2% lower than previous week.
  • Altogether 1 010 632 people have been vaccinated against influenza in 2009, which is 10.5% of population, which is 36.3% higher than last year (741,434 people were vaccinated in 2008, 7.4% of all population). Of all vaccinated 37.4% (377,594) were children.
  • Source: LINK

Other updates
CIDRAP launches promising practices database
The Centre for Infectious Disease Research and Policy at the University of Minnesota has added public health measures into it its pandemic preparedness web-based database. The database, which accepts submissions, is peer-reviewed and contains now more than 215 tools, promising practices and strategies to enhance public health response to the pandemic. Communications materials and materials in multiple languages, including sign language are available. The project is sponsored by the U.S. Association of State and Territorial Health Officials.
The database can be fount at: LINK

Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 08 December 2009, 09:00 hours (CEST) in EU and EFTA countries
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (18.11.) ? ? ? ? ? ? ? ?
2. Belgium (03.12.) ? ? ? ? ? ? ? ?
3. Bulgaria (29.11) ? ? ? ? ? ? ? ?
4. Cyprus(23.11) ? ? ? ? ? ? ? 6
5. Czech Republic (03.12.) ? ? ? ? ? ? ? ?
6. Denmark (02.12.) ? ? ? ? ? ? ? ?
7. Estonia (02.12.) ? ? ? ? ? ? ? ?
8. Finland (04.12.) - 39 ? ? - 17 ? ?
9. France (07.12.) ? ? ? 599 - 189 ? ?
10. Germany (01.12.) ? ? ? ? ? ? ? ?
11. Greece (02.12.) ? ? ? ? ? ? ? ?
12. Hungary (29.11.) ? ? ? ? ? ? ? ?
13. Iceland (26.11.) ? 5 ? 180 ? 1 ? 20
14. Ireland (02.12.) ? 181 ? 974 ? 12 ? 83
15. Italy (06.12) ? ? - 764 ? ? ? 410
16. Latvia (07.12.) ? ? ? ? ? ? ? ?
17. Liechtenstein (26.11.) ? ? ? ? ? ? ? ?
18. Lithuania (30.11.) ? ? ? ? ? ? ? ?
19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (04.12.) ? 227 ? 1969 ? 14 ? 183
22. Norway (02.12.) ? 37 ? 1206 ? 19 ? 151
23. Poland (30.11.) ? ? ? ? ? ? ? ?
24. Portugal (02.12.) - 149 ? ? - 22 ? ?
25. Romania (23.11) - 10 ? ? - 5 ? ?
26. Slovakia (02.12.) ? 38 ? 81 ? 8 ? 31
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (03.12.) ? ? ? ? ? ? ? ?
29. Sweden (29.11.) ? 119 - 1014 ? ? ? ?
30. Switzerland (03.12.) ? 26 - 195 ? ? ? 49
31. United Kingdom (a) (03.12.) - 747 ? ? - 161 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (1 274 cumulative hospitalisations), Wales (423) and Northern Ireland (563).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 08 December 2009, 09:00 hours CEST, and in the rest of the world by country, as of 07 December 2009, 16:00 hours CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Austria ? ? 3
  • Belgium ? ? 14
  • Bulgaria ? ? 5
  • Czech Republic ? ? 22
  • Denmark 1 ? 11
  • Estonia ? ? 4
  • Finland ? ? 17
  • France 7 ? 150 (a)
  • Germany ? ? 66
  • Greece ? ? 21
  • Hungary ? ? 8
  • Iceland ? ? 2
  • Ireland ? ? 18
  • Italy 3 ? 114
  • Latvia 2 ? 14
  • Lithuania ? ? 7
  • Luxembourg ? ? 2
  • Malta ? ? 3
  • Netherlands ? ? 42
  • Norway ? ? 25
  • Poland ? ? 24
  • Portugal ? ? 23
  • Romania ? ? 12
  • Slovakia ? ? 3
  • Slovenia ? ? 7
  • Spain ? ? 169
  • Sweden ? ? 16
  • Switzerland ? ? 7
  • United Kingdom ? ? 270
    
    • Total 13 ? 1079
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Albania ? ? 1
  • Belarus ? ? 20
  • Bosnia and Herzegovina 2 ? 5
  • Croatia ? - 19
  • Former Yugoslav Republic of Macedonia ? ? 6
  • Kosovo ? ? 10
  • Moldova ? ? 13
  • Montenegro 1 ? 2
  • Russia ? ? 19
  • Serbia 4 ? 26
  • Ukraine ? ? 41
    
    • Total 7 ? 162
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Algeria ? ? 8
  • Bahrain ? ? 7
  • Egypt 5 ? 29
  • Iran ? ? 147
  • Iraq ? ? 26
  • Israel 1 ? 67
  • Jordan ? ? 14
  • Kuwait ? ? 27
  • Lebanon ? ? 3
  • Libya .. ? 1
  • Morocco 1 ? 5
  • Occupied Palestinian Territory ? ? 9
  • Oman ? ? 27
  • Qatar ? ? 8
  • Saudi Arabia ? ? 81
  • Syria ? ? 50
  • Tunisia ? ? 4
  • Turkey ? ? 241
  • United Arab Emirates ? ? 6
  • Yemen ? ? 22
    
    • Total 7 ? 782
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 3
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 92
  • Sudan ? ? 1
  • Tanzania ? - 1
    
    • Total 0 ? 111
• NORTH AMERICA
  
  • Canada ? ? 357
  • Mexico ? ? 671
  • USA ? ? 1817
    
    • Total ? ? 2845
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 40
  • Cuba ? ? 27
  • Dominican Republic ? ? 23
  • El Salvador 2 ? 29
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 6
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Saint Lucia ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total 2 ? 198
• SOUTH AMERICA
  
  • Argentina ? ? 613
  • Bolivia ? ? 58
  • Brazil ? ? 1528
  • Chile 2 ? 150
  • Colombia ? ? 163
  • Ecuador ? ? 88
  • Paraguay ? ? 52
  • Peru ? ? 200
  • Uruguay ? ? 33
  • Venezuela ? ? 115
    
    • Total 2 ? 3000
• NORTH-EAST & SOUTH ASIA
  
  • Afghanistan ? ? 16
  • Bangladesh ? ? 6
  • China (Mainland) 92 - 270
  • Hong Kong SAR China 1 ? 44
  • India 13 ? 621
  • Japan 37 ? 65
  • Macao SAR China ? ? 2
  • Maldives ? ? 1
  • Mongolia ? ? 24
  • Pakistan ? ? 1
  • South Korea ? ? 117
  • Sri Lanka ? ? 5
  • Taiwan ? ? 32
    
    • Total 143 ? 1204
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 5
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 19
  • Thailand ? ? 187
  • Vietnam ? ? 44
    
    • Total ? ? 374
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 190
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 20
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 216
• TOTAL 174 ? 9971

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 7 in the Reunion, 1 in Martinique, 2 in Mayotte, 5 in Guadeloupe and 118 in mainland France.
(?)
-
--------

[Giuseppe]

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

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

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

Main developments in past 24 hours

• Germany considering sales or donations of surplus pandemic vaccine stock
• ECDC describes new clinical management guidance of human pandemic infections produced by WHO and discusses the public health measures that could minimise the impact of pandemic.
• A total of 1 084 fatal cases in Europe and EFTA countries and 8 990 in the rest of the world have been reported up to date

This report is based on official information provided by national public health websites or through other official communication channels. Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 09 December 2009, 09:00 hours (CEST) in EU and EFTA countries are in Table 1. An update on the number of confirmed fatal cases is presented in Table 2 - as of 08 December 2009 - 16:00 hours CEST, for the world, and 09 December 2009 - 09:00 hours CEST, for Europe.

Public Health Development
Clinical management and mitigation strategies during A(H1N1) 2009 influenza pandemic in moderate resource settings
Even at this late stage in the current pandemic and in the face of limited resources clinical services can be prepared for optimally dealing with many people who can be expected to need care. New WHO guidance published in November gives useful indications on what preparations should be made. If limited amounts of antivirals or pandemic vaccines are available they should be given to those in the risk groups. (LINK)

Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 1084 deaths have been reported since April 2009 (Table 2). Since week 41 the numbers of deaths each has shown a steady increase almost doubling every fortnight over the last six weeks, but with a slight increase in week 48, compared to the previous week. While the most deaths have to date been in Western Europe there are increasing numbers of deaths being reported from Central and Eastern Europe. The reported cumulative fatal pandemic (H1N1) cases in the world have now passed 10 000 cases (Table 2). However, because of lack of laboratory confirmation and underreporting among other factors, this is likely to be a gross underestimation of the true number fatalities associated with the pandemic. Available updates on hospital admissions, per Member State, can be found in Table 1.

Other updates
Germany considering sales or donations of surplus pandemic vaccine stock
According to media reports, the minister of health in Germany has indicated that the federal government is open to talks with other countries on selling 2.2 million doses of the pandemic influenza vaccine. Senior state health officials are also discussing the possibility of donating part of this surplus stock.

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

1. Austria (18.11.) ? ? ? ? ? ? ? ?
2. Belgium (03.12.) ? ? ? ? ? ? ? ?
3. Bulgaria (29.11) ? ? ? ? ? ? ? ?
4. Cyprus(23.11) ? ? ? ? ? ? ? 6
5. Czech Republic (03.12.) ? ? ? ? ? ? ? ?
6. Denmark (02.12.) ? ? ? ? ? ? ? ?
7. Estonia (02.12.) ? ? ? ? ? ? ? ?
8. Finland (07.12.) - 39 ? ? - 14 ? ?
9. France (07.12.) ? ? ? 599 - 189 ? ?
10. Germany (01.12.) ? ? ? ? ? ? ? ?
11. Greece (02.12.) ? ? ? ? ? ? ? ?
12. Hungary (29.11.) ? ? ? ? ? ? ? ?
13. Iceland (26.11.) ? 5 ? 180 ? 1 ? 20
14. Ireland (02.12.) ? 181 ? 974 ? 12 ? 83
15. Italy (06.12) ? ? - 764 ? ? ? 410
16. Latvia (07.12.) ? ? ? ? ? ? ? ?
17. Liechtenstein (26.11.) ? ? ? ? ? ? ? ?
18. Lithuania (30.11.) ? ? ? ? ? ? ? ?
19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (04.12.) ? 227 ? 1969 ? 14 ? 183
22. Norway (02.12.) ? 37 ? 1206 ? 19 ? 151
23. Poland (30.11.) ? ? ? ? ? ? ? ?
24. Portugal (02.12.) - 149 ? ? - 22 ? ?
25. Romania (08.12.) ? ? ? ? ? ? ? ?
26. Slovakia (02.12.) ? 38 ? 81 ? 8 ? 31
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (03.12.) ? ? ? ? ? ? ? ?
29. Sweden (29.11.) ? 119 - 1014 ? ? ? ?
30. Switzerland (03.12.) ? 26 - 195 ? ? ? 49
31. United Kingdom (a) (03.12.) - 747 ? ? - 161 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (1 274 cumulative hospitalisations), Wales (423) and Northern Ireland (563).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 09 December 2009, 09:00 hours CEST, and in the rest of the world by country, as of 08 December 2009, 16:00 hours CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Austria ? ? 3
  • Belgium ? ? 14
  • Bulgaria ? ? 5
  • Cyprus 2 ? 2
  • Czech Republic ? ? 22
  • Denmark ? ? 11
  • Estonia ? ? 4
  • Finland ? ? 17
  • France ? ? 150 (a)
  • Germany ? ? 66
  • Greece ? ? 21
  • Hungary ? ? 8
  • Iceland ? ? 2
  • Ireland ? ? 18
  • Italy ? ? 114
  • Latvia ? ? 14
  • Lithuania ? ? 7
  • Luxembourg ? ? 2
  • Malta ? ? 3
  • Netherlands ? ? 42
  • Norway ? ? 25
  • Poland ? ? 24
  • Portugal ? ? 23
  • Romania 2 ? 14
  • Slovakia ? ? 3
  • Slovenia 1 ? 8
  • Spain ? ? 169
  • Sweden ? ? 16
  • Switzerland ? ? 7
  • United Kingdom ? ? 270
    
    • Total 5 - 1 084
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Albania ? ? 1
  • Belarus ? ? 20
  • Bosnia and Herzegovina ? - 5
  • Croatia ? ? 19
  • Former Yugoslav Republic of Macedonia 1 ? 7
  • Kosovo ? ? 10
  • Moldova ? ? 13
  • Montenegro ? ? 2
  • Russia ? ? 19
  • Serbia ? ? 26
  • Ukraine ? ? 41
    
    • Total 1 ? 163
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Algeria 2 ? 10
  • Bahrain ? ? 7
  • Egypt 3 ? 32
  • Iran ? ? 147
  • Iraq 7 ? 33
  • Israel ? ? 67
  • Jordan ? ? 14
  • Kuwait ? ? 27
  • Lebanon ? ? 3
  • Libya ? ? 1
  • Morocco ? ? 5
  • Occupied Palestinian Territory ? ? 9
  • Oman ? ? 27
  • Qatar ? ? 8
  • Saudi Arabia ? ? 81
  • Syria ? ? 50
  • Tunisia ? ? 4
  • Turkey 55 ? 296
  • United Arab Emirates ? ? 6
  • Yemen ? ? 22
    
    • Total 67 ? 849
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 3
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 92
  • Sudan ? ? 1
  • Tanzania ?- 1
    
    • Total ? ? 111
• NORTH AMERICA
  
  • Canada ? ? 357
  • Mexico ? ? 671
  • USA ? ? 1817
    
    • Total ? ? 2845
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica 1 ? 41
  • Cuba ? ? 27
  • Dominican Republic ? ? 23
  • El Salvador 1 ? 30
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 6
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Saint Lucia ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total 2 ? 200
• SOUTH AMERICA
  
  • Argentina ? ? 613
  • Bolivia ? ? 58
  • Brazil ? ? 1528
  • Chile ? ? 150
  • Colombia 20 ? 183
  • Ecuador ? ? 88
  • Paraguay ? ? 52
  • Peru ? ? 200
  • Uruguay ? ? 33
  • Venezuela ? ? 115
    
    • Total 20 ? 3020
• NORTH-EAST & SOUTH ASIA
  
  • Afghanistan ? ? 16
  • Bangladesh ? ? 6
  • China (Mainland) ? ? 270
  • Hong Kong SAR China ? ? 44
  • India 6 ? 627
  • Japan ? ? 65
  • Macao SAR China ? ? 2
  • Maldives ? ? 1
  • Mongolia ? ? 24
  • Pakistan ? ? 1
  • South Korea ? ? 117
  • Sri Lanka ? ? 5
  • Taiwan 1 ? 33
    
    • Total 7 ? 1211
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 5
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 19
  • Thailand ? ? 187
  • Vietnam ? ? 44
    
    • Total ? ? 374
• AUSTRALIA & PACIFIC
  
  • Australia 1 ? 191
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 20
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total 1 ? 217
• TOTAL 103 - 10 074

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 7 in the Reunion, 1 in Martinique, 2 in Mayotte, 5 in Guadeloupe and 118 in mainland France.
(?)
-
------

[Giuseppe]

Pandemic (H1N1) 2009 Update 10 December 2009, 09:00 hours CEST (ECDC, edited)

Pandemic (H1N1) 2009 Update 10 December 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]
ECDC DAILY UPDATE
Pandemic (H1N1) 2009 Update 10 December 2009, 09:00 hours CEST

Main developments in past 24 hours

• Draft WHO influenza global public health research agenda 2009-10 published
• A total of 1 147 fatal cases in Europe and EFTA countries and 9 255 in the rest of the world have been reported up to date

This report is based on official information provided by national public health websites or through other official communication channels. Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 10 December 2009, 09:00 hours (CEST) in EU and EFTA countries are in Table 1. An update on the number of confirmed fatal cases is presented in Table 2 - as of 09 December 2009 - 16:00 hours CEST, for the world, and 10 December 2009 - 09:00 hours CEST, for Europe.

WHO influenza global public health research agenda 2009-10
The Global Influenza Programme (GIP) of WHO is developing a public health research agenda for influenza. Its objective is to identify knowledge gaps and information essential for the development of evidence-based public health guidance and actions for the control of influenza. GIP organized a global consultation meeting in Geneva, 17 - 20 November to collect opinions from influenza experts on building the roadmaps for influenza research based on five streams of public health research needs:

• Stream 1. Reducing the risk of emergence of a pandemic influenza
• Stream 2. Limiting the spread of pandemic, zoonotic and seasonal epidemic influenza
• Stream 3. Minimizing the impact of pandemic, zoonotic and seasonal epidemic influenza
• Stream 4. Optimizing the treatment of patients
• Stream 5. Promoting the development and application of modern public health tools

The technical meetings included public health decision makers, researchers and representatives from more than thirty countries who reviewed the draft version of the research agenda and exchanged their ideas on public health research topics related to influenza that should be prioritized over a medium- to long-term period. The review presentations from the final lessons learnt session have now been posted on the WHO website along with an interim draft document. WHO will now undertake a consultation process continue developing what is a global public health research agenda for influenza including a roadmap with key public health research topics for influenza relating to pandemic (H1N1) 2009, zoonotic infection with pandemic potential and seasonal epidemics along with a framework for monitoring the availability of research results that can fill information gaps essential for public health decision-making.
The Interim Draft Document can be found at: LINK
The presentations can be found at: Lessons Learned Session - 20 November 2009 - Agenda [pdf 202kb]
:: Nancy Cox - Early warning signs of the H1N1 pandemic: importance of laboratory surveillance system [pdf 4.30Mb]
:: Ljubica Latinovic - Risk communication: the Mexico experience [pdf 6.96Mb]
:: Kevin Rooney - Clinical experience on care of severely ill patients with influenza infection [pdf 6.11Mb]
:: Charles Penn - Evidence-based development of guidelines: the WHO antiviral guideline [pdf 1.05Mb]
:: Malik Peiris / Richard Webby - From wild birds to human: the H5N1 experience [pdf 5.58Mb]
:: Marie-Paule Kieny - Vaccine development: experience from H5N1 to pandemic (H1N1) 2009 [pdf 1.26Mb]
:: Neil Ferguson - Application of modeling in public health decision making [pdf 1.83Mb]
:: Marc Guerrier - Ethics in public health policy development for influenza: experiences from developed and developing regions [pdf 783kb]

Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 1 147 deaths have been reported since April 2009 (Table 2). Since week 41 the numbers of deaths each has shown a steady increase almost doubling every fortnight over the last six weeks, but with a slight increase in week 48, compared to the previous week. While the most deaths have to date been in Western Europe there are increasing numbers of deaths being reported from Central and Eastern Europe. The reported cumulative fatal pandemic (H1N1) cases in the world have now passed 10 000 cases (Table 2). However, because of lack of laboratory confirmation and underreporting among other factors, this is likely to be a gross underestimation of the true number fatalities associated with the pandemic. Available updates on hospital admissions, per Member State, can be found in Table 1.

Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 10 December 2009, 09:00 hours (CEST) in EU and EFTA countries
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (02.12.) ? ? ? ? ? ? ? ?
2. Belgium (03.12.) ? ? ? ? ? ? ? ?
3. Bulgaria (29.11) ? ? ? ? ? ? ? ?
4. Cyprus(23.11) ? ? ? ? ? ? ? 6
5. Czech Republic (03.12.) ? ? ? ? ? ? ? ?
6. Denmark (02.12.) ? ? ? ? ? ? ? ?
7. Estonia (09.12.) ? ? ? ? ? ? ? ?
8. Finland (08.12.) - 29 ? ? - 10 ? ?
9. France (07.12.) ? ? ? ? ? 201 ? 630
10. Germany (01.12.) ? ? ? ? ? ? ? ?
11. Greece (02.12.) ? ? ? ? ? ? ? ?
12. Hungary (29.11.) ? ? ? ? ? ? ? ?
13. Iceland (26.11.) ? 5 ? 180 ? 1 ? 20
14. Ireland (02.12.) ? 181 ? 974 ? 12 ? 83
15. Italy (07.12) ? ? - 764 ? ? ? 410
16. Latvia (07.12.) ? ? ? ? ? ? ? ?
17. Liechtenstein (26.11.) ? ? ? ? ? ? ? ?
18. Lithuania (30.11.) ? ? ? ? ? ? ? ?
19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (04.12.) ? 227 ? 1969 ? 14 ? 183
22. Norway (09.12.) ? 27 ? 1283 ? 15 ? 169
23. Poland (30.11.) ? ? ? ? ? ? ? ?
24. Portugal (09.12.) - 127 ? ? - 20 ? ?
25. Romania (08.12.) ? ? ? ? ? ? ? ?
26. Slovakia (02.12.) ? 38 ? 81 ? 8 ? 31
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (03.12.) ? ? ? ? ? ? ? ?
29. Sweden (29.11.) ? 119 - 1014 ? ? ? ?
30. Switzerland (03.12.) ? 26 - 195 ? ? ? 49
31. United Kingdoma (03.12.) - 747 ? ? - 161 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (1 274 cumulative hospitalisations), Wales (423) and Northern Ireland (563).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 10 December 2009, 09:00 hours CEST, and in the rest of the world by country, as of 09 December 2009, 16:00 hours CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU AND EFTA COUNTRIES
  
  • Austria ? ? 3
  • Belgium ? ? 14
  • Bulgaria ? ? 5
  • Cyprus ? ? 2
  • Czech Republic 10 ? 32
  • Denmark 5 ? 16
  • Estonia 1 ? 5
  • Finland ? ? 17
  • France 8 ? 158 (a)
  • Germany 28 ? 94
  • Greece ? ? 21
  • Hungary ? ? 8
  • Iceland ? ? 2
  • Ireland ? ? 18
  • Italy ? ? 114
  • Latvia ? ? 14
  • Lithuania ? ? 7
  • Luxembourg ? ? 2
  • Malta ? ? 3
  • Netherlands ? ? 42
  • Norway 2 ? 27
  • Poland ? ? 24
  • Portugal 9 ? 32
  • Romania ? ? 14
  • Slovakia ? ? 3
  • Slovenia ? ? 8
  • Spain ? ? 169
  • Sweden ? ? 16
  • Switzerland ? ? 7
  • United Kingdom ? ? 270
    
    • Total 63 ? 1147
• OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
  
  • Albania ? ? 1
  • Belarus ? ? 20
  • Bosnia and Herzegovina ? - 5
  • Croatia 3 ? 22
  • Former Yugoslav Republic of Macedonia ? ? 7
  • Kosovo ? ? 10
  • Moldova ? ? 13
  • Montenegro ? ? 2
  • Russia ? ? 19
  • Serbia 5 ? 31
  • Ukraine ? ? 41
    
    • Total 8 ? 171
• MEDITERRANEAN AND MIDDLE-EAST
  
  • Algeria ? ? 10
  • Bahrain ? ? 7
  • Egypt 1 ? 33
  • Iran ? ? 147
  • Iraq 1 ? 34
  • Israel ? ? 67
  • Jordan ? ? 14
  • Kuwait ? ? 27
  • Lebanon ? ? 3
  • Libya ? ? 1
  • Morocco 7 ? 12
  • Occupied Palestinian Territory ? ? 9
  • Oman ? ? 27
  • Qatar ? ? 8
  • Saudi Arabia ? ? 81
  • Syria ? ? 50
  • Tunisia 1 ? 5
  • Turkey ? ? 296
  • United Arab Emirates ? ? 6
  • Yemen ? ? 22
    
    • Total 10 ? 859
• AFRICA
  
  • Ghana ? ? 1
  • Madagascar ? ? 3
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 92
  • Sudan ? ? 1
  • Tanzania ? - 1
    
    • Total ? ? 111
• NORTH AMERICA
  
  • Canada 6 ? 363
  • Mexico 42 ? 713
  • USA 112 ? 1929
    
    • Total 160 ? 3005
• CENTRAL AMERICA & CARIBBEAN
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 41
  • Cuba 5 ? 32
  • Dominican Republic ? ? 23
  • El Salvador ? ? 30
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 6
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Saint Lucia ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total 5 ? 205
• SOUTH AMERICA
  
  • Argentina ? ? 613
  • Bolivia ? ? 58
  • Brazil ? ? 1528
  • Chile ? ? 150
  • Colombia ? ? 183
  • Ecuador 8 ? 96
  • Paraguay ? ? 52
  • Peru ? ? 200
  • Uruguay ? ? 33
  • Venezuela ? ? 115
    
    • Total 8 ? 3028
• NORTH-EAST & SOUTH ASIA
  
  • Afghanistan ? ? 16
  • Bangladesh ? ? 6
  • China (Mainland) 56 - 326
  • Hong Kong SAR China ? ? 44
  • India 16 ? 643
  • Japan ? ? 65
  • Macao SAR China ? ? 2
  • Maldives ? ? 1
  • Mongolia ? ? 24
  • Pakistan ? ? 1
  • South Korea ? ? 117
  • Sri Lanka ? ? 5
  • Taiwan ? ? 33
    
    • Total 72 ? 1283
• SOUTH-EAST ASIA
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 5
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 19
  • Thailand 2 ? 189
  • Vietnam ? ? 44
    
    • Total 2 ? 376
• AUSTRALIA & PACIFIC
  
  • Australia ? ? 191
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 20
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 217
• TOTAL 328 ? 10402

(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 7 in the Reunion, 1 in Martinique, 2 in Mayotte, 5 in Guadeloupe and 126 in mainland France.
(?)
-
------

[Giuseppe]

Pandemic (H1N1) 2009 - 11 December 2009 9.00 CEST (ECDC, edited)

Pandemic (H1N1) 2009 - 11 December 2009 9.00 CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]
ECDC DAILY UPDATE
Pandemic (H1N1) 2009 - 11 December 2009 9.00 CEST

Main developments in the past 24 hours

• Weekly Influenza Surveillance Overview to be published today;
• Eurosurveillance updates published;
• A total of 1 227 fatal cases in Europe and EFTA countries and 9 340 in the rest of the world have been reported up to date.

This report is based on official information provided by national public health websites or through other official communication channels. Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 11 December 2009, 9.00 CEST in EU and EFTA countries are in Table 1. An update on the number of confirmed fatal cases for the world and Europe is presented in Table 2.

Eurosurveillance update
Public perceptions in relation to intention to receive pandemic influenza vaccination in a random population sample: evidence from a cross-sectional telephone survey
A cross-sectional telephone survey on a nationally representative sample of 1,000 Greek households was performed to assess the acceptability of the pandemic influenza A(H1N1)v vaccine, factors associated with intention to decline and stated reasons for declining vaccination. The survey was initiated the last week of August 2009 (week 35) and is still ongoing (analysis up to week 44). The percentage of participants answering they would ?probably not/definitely not? accept the vaccine increased from 47.1% in week 35 to 63.1% in week 44 (test for trend: p<0.001). More than half of the people which chronic illnesses (53.3%) indicated ?probably not/definitely not?. Factors associated with intention to decline vaccination were female sex, age between 30-64 years, perception of low likelihood of getting infected or of low risk associated with influenza, and absence of household members suffering from chronic illnesses. For the majority of the respondents (59.8%), the main reason for intending to decline vaccination was the belief that the vaccine might not be safe. Promotion of vaccination programmes should be designed taking into account the attitudinal barriers to the pandemic vaccine.
Available from: LINK

Behaviours regarding preventive measures against pandemic H1N1 influenza among Italian healthcare workers, October 2009
A survey on attitudes and behaviours towards preventive measures against pandemic H1N1 influenza 2009 was carried out during the month of October 2009 in Italy through an online questionnaire adapted to the Italian situation from a similar survey of the Harvard School of Public Health in the United States (US). Results show that the intention to get vaccinated against pandemic H1N1 influenza 2009 is generally low and that there are differences in attitudes and behaviours towards preventive measures against pandemic H1N1 influenza 2009 between physicians and nurses, especially concerning vaccination. Differences relate also to sex, region of residence and marital status.
Available from: LINK

Behaviour of the pandemic H1N1 influenza virus in Andalusia, Spain, at the onset of the 2009-10 season
In Andalusia, Spain, the pandemic influenza A(H1N1)v virus has spread throughout the community, being the dominant influenza strain in the season so far. The current objective of the Andalusia Health Service is focussed on the mitigation of the health and social impact by appropriate care of the patients at home or in health centres. The 2009-10 seasonal influenza epidemic started early compared with to previous seasons. This article analyses the influenza A(H1N1)v situation in Andalusia until the week 39/2009.
Available from: LINK

Prolonged shedding of influenza A(H1N1)v virus: two case reports from France 2009
We observed a prolonged shedding of virus 14 and 28 days after symptom onset in two patients with pandemic H1N1 influenza, who did not have immunodepression and were treated with neuraminidase inhibitor. This prolonged shedding was not associated with the emergence of resistance mutation H275Y in the viral neuraminidase gene.
Available from: LINK

SELECTED SCIENTIFIC PUBLICATIONS (4TH - 10TH Dec 2009)

• Updated Interim Recommendations for the Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010 Season
  
  • Centers for Disease Control and Prevention (CDC), 7 December, 2009 Available from: LINK
    
    • US CDC has updated its recommendations on the use of antiviral agents for treatment and prophylaxis of influenza during the 2009-2010 influenza season. This focuses especially on a new drug peramivir that is not available in Europe
• The Severity of Pandemic H1N1 Influenza in the United States, from April to July 2009: A Bayesian Analysis
  
  • Presanis AM, De Angelis D, Hagy A et al. PLoS Med 6(12): e1000207; 8 December, 2009 Available from: LINK
    
    • The authors of this study make estimates of the mortality, hospitalization and ICU admissions due to pandemic H1N1 in the United States in autumn and winter 2009/10 by combining data from multiple sources.
• Clinical Features of the Initial Cases of 2009 Pandemic Influenza A (H1N1) Virus Infection in China
  
  • Bin Cao, M.D., Xing-Wang Li, M.D., Yu Mao, M.D. et al. New England Journal of Medicine; 9 December, 2009 Available from: LINK
    
    • This is the first substantial published account to the 2009 H1N1 virus in China. The period covered is May to June 2009 during China?s first wave
• Neuraminidase inhibitors for preventing and treating influenza in healthy adults: systematic review and meta-analysis
  
  • Jefferson T, Jones M, Doshi P et al. British Medical Journal; 339:b5106; 8 December, 2009 Available from: LINK
    
    • This update of a previous review concerns seasonal not pandemic influenza and is confined to randomised controlled trials. It?s reanalysis concludes that these drugs provide no evidence of effectiveness against severe outcomes in healthy adults once a controversial industry sponsored analysis is excluded. A response pointing why these conclusions do not apply in general and specifically not for pandemic H1N1 2009 has been posted by ECDC and the United States CDC at LINK
• Mortality from pandemic A/H1N1 2009 influenza in England: public health surveillance study
  
  • Donaldson L, Rutter P, Ellis B et al. British Medical Journal; 339:b5213; 10 December 2009 Available from: LINK
    
    • This article reports the first results of a large (n = 138) investigation of all reported deaths related to pandemic H1N1 2009 in England. It finds that 36% had no, or only mild, pre-existing illness. Most patients 78% had eventually been prescribed antiviral drugs, but of these 76% did not receive them within the first 48 hours of illness. Two thirds would have been eligible for vaccination in the UK. The authors estimate an overall estimated case fatality rate of 26 (range 11-66) per 100 000. It was lowest for children aged 5-14 (11 (range 3-36) per 100 000) and highest for those aged 65 (980 (range 300-3200) per 100 000).

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

Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 1 227 deaths have been reported since April 2009 (Table 2). Since week 41 the numbers of deaths each has shown a steady increase almost doubling every fortnight over the last six weeks, but with a slight increase in week 48, compared to the previous week. While the most deaths have to date been in Western Europe there are increasing numbers of deaths being reported from Central and Eastern Europe. The reported cumulative fatal pandemic (H1N1) cases in the world have now passed 10 000 cases (Table 2). However, because of lack of laboratory confirmation and underreporting among other factors, this is likely to be a gross underestimation of the true number fatalities associated with the pandemic. Available updates on hospital admissions, per Member State, can be found in Table 1.

Table 1. Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 11 December 2009, 9.00 CEST in EU and EFTA countries.
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (02.12.) ? ? ? ? ? ? ? ?
2. Belgium (10.12.) ? ? ? ? ? ? ? ?
3. Bulgaria (29.11) ? ? ? ? ? ? ? ?
4. Cyprus(23.11) ? ? ? ? ? ? ? 6
5. Czech Republic (09.12.) ? ? ? ? ? ? ? ?
6. Denmark (09.12.) ? ? ? ? ? ? ? ?
7. Estonia (09.12.) ? ? ? ? ? ? ? ?
8. Finland (09.12.) - 9 ? ? - 6 ? ?
9. France (07.12.) ? ? ? ? - 201 ? 630
10. Germany (08.12.) ? ? ? ? ? ? ? ?
11. Greece (09.12.) ? ? ? ? ? ? ? ?
12. Hungary (06.12.) ? ? ? ? ? ? ? ?
13. Iceland (10.12.) ? 3 ? 180 ? 1 ? 20
14. Ireland (10.12.) ? 161 ? 1003 ? 9 ? 84
15. Italy (09.12.) ? ? - 764 ? ? ? 410
16. Latvia (07.12.) ? ? ? ? ? ? ? ?
17. Liechtenstein (26.11.) ? ? ? ? ? ? ? ?
18. Lithuania (30.11.) ? ? ? ? ? ? ? ?
19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (04.12.) ? 227 ? 1969 ? 14 ? 183
22. Norway (09.12.) ? 27 ? 1283 ? 15 ? 169
23. Poland (30.11.) ? ? ? ? ? ? ? ?
24. Portugal (09.12.) - 127 ? ? - 20 ? ?
25. Romania (08.12.) ? ? ? ? ? ? ? ?
26. Slovakia (02.12.) ? 38 ? 81 ? 8 ? 31
27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
28. Spain (03.12.) ? ? ? ? ? ? ? ?
29. Sweden (10.12.) ? 39 - 1092 ? ? ? ?
30. Switzerland (09.12.) ? 19 - 250 ? ? ? 53
31. United Kingdom* (10.12.) - 636 ? ? - 133 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
* Data includes information for England only. Other cumulative hospitalisations are: Scotland (1344), Wales (429) and Northern Ireland (570).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 11 December 2009, 9.00 CEST, and in the rest of the world by country, as of 10 December 2009, 16.00 CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU and EFTA countries
  
  • Austria ? ? 3
  • Belgium ? ? 14
  • Bulgaria ? ? 5
  • Cyprus ? ? 2
  • Czech Republic 2 ? 34
  • Denmark ? ? 16
  • Estonia ? ? 5
  • Finland ? ? 17
  • France ? ? 158*
  • Germany ? ? 94
  • Greece 15 ? 36
  • Hungary 15 ? 23
  • Iceland ? ? 2
  • Ireland 2 ? 20
  • Italy 23 ? 137
  • Latvia ? ? 14
  • Lithuania 2 ? 9
  • Luxembourg ? ? 2
  • Malta ? ? 3
  • Netherlands ? ? 42
  • Norway ? ? 27
  • Poland ? ? 24
  • Portugal 3 ? 35
  • Romania 2 ? 16
  • Slovakia ? ? 3
  • Slovenia ? ? 8
  • Spain ? ? 169
  • Sweden 2 ? 18
  • Switzerland 1 ? 8
  • United Kingdom 13 ? 283
    
    • Total 80 ? 1227
• Other European countries and central Asia
  
  • Albania ? ? 1
  • Belarus ? ? 20
  • Bosnia and Herzegovina ? ? 5
  • Croatia ? ? 22
  • Former Yugoslav Republic of Macedonia ? ? 7
  • Kosovo ? ? 10
  • Moldova ? ? 13
  • Montenegro ? ? 2
  • Russia ? ? 19
  • Serbia 1 ? 32
  • Ukraine ? ? 41
    
    • Total 1 ? 172
• Mediterranean and Middle-East
  
  • Algeria 6 ? 16
  • Bahrain ? ? 7
  • Egypt 2 ? 35
  • Iran ? ? 147
  • Iraq ? ? 34
  • Israel ? ? 67
  • Jordan ? ? 14
  • Kuwait ? ? 27
  • Lebanon ? ? 3
  • Libya ? - 1
  • Morocco ? ? 12
  • Occupied Palestinian Territory ? ? 9
  • Oman ? ? 27
  • Qatar ? ? 8
  • Saudi Arabia ? ? 81
  • Syria ? ? 50
  • Tunisia ? ? 5
  • Turkey 57 ? 353
  • United Arab Emirates ? ? 6
  • Yemen ? ? 22
    
    • Total 65 ? 924
• Africa
  
  • Ghana ? ? 1
  • Madagascar ? ? 3
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 92
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 111
• North America
  
  • Canada ? ? 363
  • Mexico ? ? 713
  • USA ? ? 1929
    
    • Total ? ? 3005
• Central America and Caribbean
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 41
  • Cuba ? ? 32
  • Dominican Republic ? ? 23
  • El Salvador ? ? 30
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 6
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Saint Lucia ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total ? ? 205
• South America
  
  • Argentina ? ? 613
  • Bolivia ? ? 58
  • Brazil ? ? 1528
  • Chile ? ? 150
  • Colombia ? ? 183
  • Ecuador ? ? 96
  • Paraguay ? ? 52
  • Peru ? ? 200
  • Uruguay ? ? 33
  • Venezuela 1 ? 116
    
    • Total 1 ? 3029
• North-East and South Asia
  
  • Afghanistan ? ? 16
  • Bangladesh ? - 6
  • China (Mainland) ? ? 326
  • Hong Kong SAR China 1 ? 45
  • India 12 ? 655
  • Japan ? ? 65
  • Macao SAR China ? ? 2
  • Maldives ? ? 1
  • Mongolia ? ? 24
  • Pakistan ? ? 1
  • South Korea ? ? 117
  • Sri Lanka 5 ? 10
  • Taiwan ? ? 33
    
    • Total 18 ? 1301
• South-East Asia
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 5
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 19
  • Thailand ? ? 189
  • Vietnam ? ? 44
    
    • Total ? ? 376
• Australia and Pacific
  
  • Australia ? ? 191
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 20
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 217
• TOTAL 165 ? 10567

* Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 7 in La R?union, 1 in Martinique, 2 in Mayotte, 5 in Guadeloupe and 126 in mainland France.
(?)
-
------

[Giuseppe]

Pandemic (H1N1) 2009 14 December 2009 9.00 CEST (ECDC, edited)

Pandemic (H1N1) 2009 14 December 2009 9.00 CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]
ECDC DAILY UPDATE
Pandemic (H1N1) 2009 14 December 2009 9.00 CEST

Main developments in the past 72 hours

• Global Health Security Initiative: statement concerning pandemic and vaccination
• EpiSouth update: several countries in the region still showing high or medium level influenza activity
• Weekly influenza surveillance overview: In the majority of countries influenza activity is widespread but thirteen countries have reported decreasing rates of influenza-like illness for at least the last two weeks.
• A total of 1 333 fatal cases in Europe and EFTA countries and 9 530 in the rest of the world have been reported up to date.

This report is based on official information provided by national public health websites or through other official communication channels. Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 14 December 2009, 9.00 CEST in EU and EFTA countries are in Table 1. An update on the number of confirmed fatal cases for the world and Europe is presented in Table 2.

Epidemiologic update
Weekly Influenza Surveillance Overview and Officially Reported Deaths in the EU
The Weekly Influenza Surveillance Overview which presents data from the European Influenza Surveillance Network (EISN) was published on December 11th covering the period November 30th to December 6th. This covers all countries in the European Union and EEA countries. This reported that most countries are still experiencing medium influenza intensity with only nine reporting high to very high levels. The pandemic strain influenza H1N1 2009 still accounts for 99% of all subtyped viruses in sentinel patients. In the majority of countries activity is widespread but thirteen countries have reported decreasing rates of influenza-like illness for at least the last two weeks.
Oseltamivir resistance was found in one percent of influenza pandemic viruses tested in the countries reporting to EISN.
Another important respiratory virus respiratory syncytial virus (RSV) is starting to appear and 11 countries reported to EISN for this. Overall RSV detections are increasing as expected at this time of the year and countries should be on the alert for this virus.
More details of the EISN and Community Network Reference Laboratory are available here: LINK
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 1 333 deaths have been reported since April 2009 (Table 2). Since week 41 the numbers of deaths each has shown a steady increase almost doubling every fortnight over the last six weeks. While the most deaths have to date been in Western Europe there are increasing numbers of deaths being reported from Central and Eastern Europe. The reported cumulative fatal pandemic (H1N1) cases in the world have now passed 10 000 cases (Table 2). However, because of lack of laboratory confirmation and underreporting among other factors, this is likely to be a gross underestimation of the true number fatalities associated with the pandemic. Available updates on hospital admissions, per Member State, can be found in Table 1.

EpiSouth update
As of 07 November 2009, a total of 959 deaths among biologically confirmed A/H1N1/2009 cases have been reported in the EpiSouth region (Mediterranean and the Balkans).
203 new deaths were reported since 01 December 2009: The 1st deaths were reported in Albania and Montenegro, 5 new deaths were recorded in Algeria, 2 in Bosnia and Herzegovina, 8 in Croatia, 10 in Egypt, 3 in FYROM, 3 in Israel, 3 in Kosovo, 2 in Morocco, 1 in Palestine (1st in Gaza), 2 in Tunisia and 46 in Turkey.
In week 48, influenza activity was

• high and increasing in Albania and Turkey,
• medium and stable in Romania,
• medium in Bulgaria,
• decreasing in Croatia, Israel, Serbia.
• Community transmission of A(H1N1)2009 influenza virus has been established in almost all regions of Tunisia.
• Hajj 2009: Iranian health authorities reported limited A(H1N1)2009 infection upon return from Hajj. Tunisian health authorities detected (at Tunis airport) 21 cases of A(H1N1)2009 among Tunisian pilgrims returning from Hajj and 40 cases of A(H1N1)2009 infection among foreign pilgrims in transit. Tunisians pilgrims were quarantined and received treatment.
• Note that Tunisia had banned attending Hajj this year.

For more details please refer to the EpiSouth bulletin: LINK

Other updates
Global Health Security Initiative
Ministers and Commissioner Vassiliou from the countries / unions in the Global Health Security Initiative which includes the European Union, France, Germany, Italy and the UK met recently in London and have issued a statement concerning the pandemic.
This included the following paragraphs on vaccination:

1. Pandemic H1N1 vaccines remain the best protection against the health impact of the virus. We therefore emphasize the importance of timely public communications to encourage broad vaccination uptake. Noting in particular the increased risk which the virus poses for certain segments of our population, we will continue to take steps to target those most at-risk as part of our vaccination strategies;
2. Sustainability and timeliness of vaccine supplies remain critical to the effective implementation of vaccination campaigns, which is especially valid for pandemic vaccines that cannot be stockpiled in advance. Information with respect to production and delivery schedules is critical for the planning and implementation of vaccination campaigns. To this end, our governments will continue to share information with one another and to work with manufacturers;
3. International support is critical to improving access to H1N1 vaccines and other medical supplies that may be needed by all countries to mitigate the health impact of the pandemic. With this recognition, we reaffirm our commitment to work in close partnership with the WHO and other international partners to support developing countries and other countries in need of assistance in responding to the pandemic;
4. We reaffirm our commitment to collaborate on post-market surveillance and to continue monitoring vaccine safety. Effective surveillance and reporting systems are essential for ensuring public confidence in the safety and effectiveness of pandemic vaccines;

For more information see GHSI Ministerial Statement December 2009: LINK

Table 1. Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 14 December 2009, 9.00 CEST in EU and EFTA countries.
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (02.12.) ? ? ? ? ? ? ? ?
2. Belgium (10.12.) ? ? ? ? ? ? ? ?
3. Bulgaria (29.11) ? ? ? ? ? ? ? ?
4. Cyprus(23.11) ? ? ? ? ? ? ? 6
5. Czech Republic (09.12.) ? ? ? ? ? ? ? ?
6. Denmark (09.12.) ? ? ? ? ? ? ? ?
7. Estonia (09.12.) ? ? ? ? ? ? ? ?
8. Finland (10.12.) - 12 ? ? - 5 ? ?
9. France (11.12.) ? ? ? ? ? 184 ? 710
10. Germany (08.12.) ? ? ? ? ? ? ? ?
11. Greece (09.12.) ? ? ? ? ? ? ? ?
12. Hungary (06.12.) ? ? ? ? ? ? ? ?
13. Iceland (10.12.) ? 3 ? 180 ? 1 ? 20
14. Ireland (10.12.) ? 161 ? 1003 ? 9 ? 84
15. Italy (09.12.) ? ? - 764 ? ? ? 410
16. Latvia (07.12.) ? ? ? ? ? ? ? ?
17. Liechtenstein (26.11.) ? ? ? ? ? ? ? ?
18. Lithuania (30.11.) ? ? ? ? ? ? ? ?
19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (11.12.) ? 104 ? 2068 ? 9 ? 196
22. Norway (09.12.) ? 27 ? 1283 ? 15 ? 169
23. Poland (30.11.) ? ? ? ? ? ? ? ?
24. Portugal (09.12.) - 127 ? ? - 20 ? ?
25. Romania (08.12.) ? ? ? ? ? ? ? ?
26. Slovakia (02.12.) ? 38 ? 81 ? 8 ? 31
27. Slovenia (10.08.) - 95 ? ? - 9 ? ?
28. Spain (03.12.) ? ? ? ? ? ? ? ?
29. Sweden (10.12.) ? 39 - 1092 ? ? ? ?
30. Switzerland (09.12.) ? 19 - 250 ? ? ? 53
31. United Kingdom* (10.12.) - 636 ? ? - 133 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
* Data includes information for England only. Other cumulative hospitalisations are: Scotland (1344), Wales (429) and Northern Ireland (570).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as of 14 December 2009, 9.00 CEST, and in the rest of the world by country, as of 13 December 2009, 16.00 CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU and EFTA countries
  
  • Austria ? ? 3
  • Belgium ? ? 14
  • Bulgaria ? ? 5
  • Cyprus ? ? 2
  • Czech Republic ? ? 34
  • Denmark ? ? 16
  • Estonia ? ? 5
  • Finland ? ? 17
  • France 13 - 171*
  • Germany ? ? 94
  • Greece ? ? 36
  • Hungary ? ? 23
  • Iceland ? ? 2
  • Ireland ? ? 20
  • Italy ? ? 137
  • Latvia ? ? 14
  • Lithuania 1 ? 10
  • Luxembourg ? ? 2
  • Malta ? ? 3
  • Netherlands 8 ? 50
  • Norway ? ? 27
  • Poland 43 ? 67
  • Portugal ? ? 35
  • Romania 2 ? 18
  • Slovakia ? ? 3
  • Slovenia ? ? 8
  • Spain 39 ? 208
  • Sweden ? ? 18
  • Switzerland ? ? 8
  • United Kingdom ? ? 283
    
    • Total 106 ? 1333
• Other European countries and central Asia
  
  • Albania ? ? 1
  • Belarus ? ? 20
  • Bosnia and Herzegovina 2 ? 7
  • Croatia ? ? 22
  • Former Yugoslav Republic of Macedonia ? ? 7
  • Georgia 1 ? 1
  • Kosovo ? ? 10
  • Moldova ? ? 13
  • Montenegro ? ? 2
  • Russia ? ? 19
  • Serbia 1 ? 33
  • Ukraine ? ? 41
    
    • Total 4 ? 176
• Mediterranean and Middle-East
  
  • Algeria ? ? 16
  • Bahrain ? ? 7
  • Egypt 11 ? 46
  • Iran ? ? 147
  • Iraq ? ? 34
  • Israel ? ? 67
  • Jordan ? ? 14
  • Kuwait ? ? 27
  • Lebanon ? - 3
  • Libya ? ? 1
  • Morocco 2 ? 14
  • Occupied Palestinian Territory ? ? 9
  • Oman ? ? 27
  • Qatar ? ? 8
  • Saudi Arabia ? ? 81
  • Syria ? ? 50
  • Tunisia ? ? 5
  • Turkey ? ? 353
  • United Arab Emirates ? ? 6
  • Yemen ? ? 22
    
    • Total 13 ? 937
• Africa
  
  • Ghana ? ? 1
  • Madagascar ? ? 3
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 92
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 111
• North America
  
  • Canada 10 ? 373
  • Mexico 19 ? 732
  • USA ? ? 1929
    
    • Total 29 ? 3034
• Central America and Caribbean
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 41
  • Cuba ? ? 32
  • Dominican Republic ? ? 23
  • El Salvador 1 ? 31
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 6
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Saint Lucia ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total 1 ? 206
• South America
  
  • Argentina 3 ? 616
  • Bolivia ? ? 58
  • Brazil 104 ? 1632
  • Chile ? ? 150
  • Colombia ? ? 183
  • Ecuador ? ? 96
  • Paraguay ? ? 52
  • Peru ? ? 200
  • Uruguay ? ? 33
  • Venezuela ? ? 116
    
    • Total 107 ? 3136
• North-East and South Asia
  
  • Afghanistan 1 - 17
  • Bangladesh ? ? 6
  • China (Mainland) ? ? 326
  • Hong Kong SAR China ? ? 45
  • India 19 ? 674
  • Japan ? ? 65
  • Macao SAR China ? ? 2
  • Maldives ? ? 1
  • Mongolia ? ? 24
  • Pakistan ? ? 1
  • South Korea ? ? 117
  • Sri Lanka 13 ? 23
  • Taiwan ? ? 33
    
    • Total 33 ? 1334
• South-East Asia
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 5
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 19
  • Thailand ? ? 189
  • Vietnam 3 ? 47
    
    • Total 3 ? 379
• Australia and Pacific
  
  • Australia ? ? 191
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 20
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 217
• TOTAL 296 ? 10863

* Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 7 in La R?union, 1 in Martinique, 2 in Mayotte, 5 in Guadeloupe and 139 in mainland France.
(?)
-
-------

[Giuseppe]

2009 influenza A (H1N1) pandemic 15 December 2009 9.00 CEST (ECDC, edited)

2009 influenza A (H1N1) pandemic 15 December 2009 9.00 CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]
ECDC DAILY UPDATE
2009 influenza A (H1N1) pandemic 15 December 2009 9.00 CEST

Main developments in the past 24 hours

• Estimates from the US suggest nearly 10,000 deaths due to 2009 pandemic influenza A(H1N1) infection
• US and Canada epidemiological updates included
• A total of 1 371 fatal cases in Europe and EFTA countries and 9 662 in the rest of the world have been reported up to date.

This report is based on official information provided by national public health websites or through other official communication channels. Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 15 December 2009, 9.00 CEST in EU and EFTA countries are in Table 1. An update on the number of confirmed fatal cases for the world and Europe is presented in Table 2.

Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 1 371 deaths have been reported since April 2009 (Table 2). Since week 41 the numbers of deaths each has shown a steady increase almost doubling every fortnight over the last six weeks. While the most deaths have to date been in Western Europe there are increasing numbers of deaths being reported from Central and Eastern Europe. The reported cumulative fatal pandemic (H1N1) cases in the world have now passed 10 000 cases (Table 2). However, because of lack of laboratory confirmation and underreporting among other factors, this is likely to be a gross underestimation of the true number fatalities associated with the pandemic. Available updates on hospital admissions, per Member State, can be found in Table 1.

Updates from US and Canada
Nearly 10,000 pandemic deaths in the US - Updated estimates of numbers of symptomatic cases, hospitalizations and deaths in the United States due to influenza H1N1 2009 April to mid-November.
The United States Centers for Disease Control and Prevention on December 10th published new estimates of the numbers of symptomatic cases, hospitalizations and deaths due to influenza in the USA from April to October 17th this year. The estimates are made using the US CDC Emerging Infections Programme site and from that applying multipliers using a published methodology (1,2). This resulted in estimates that between 34 million and 67 million cases of symptomatic 2009 H1N1 occurred between April and November 14, 2009. The mid-level in this range is about 47 million people. At the same time the estimate is that between about 154,000 and 303,000 2009 H1N1-related hospitalizations occurred between April and November 14, 2009. The mid-level in this range is about 213,000 H1N1-related hospitalizations. Finally CDC estimated that between about 7,070 and 13,930 2009 H1N1-related deaths occurred between April and November 14, 2009. The mid-level in this range was about 9,820 2009 H1N1-related deaths.
More information available at: LINK
References
Reed C, Angulo F, Swerdlow D et al Estimates of the Prevalence of Pandemic (H1N1) 2009, United States, April?July 2009 Emerging Infectious Disease LINK
Centers for Disease Control and Prevention H1N1-Related Deaths, Hospitalizations and Cases: Details of Extrapolations and Ranges: United States, Emerging Infections Program (EIP) Data; November 12th 2009 LINK

From U.S. Centers for Disease Control and Prevention (CDC) weekly influenza surveillance report: Week 48 (29 November-5 December 2009)

• Influenza activity continued to decrease in the U.S.
• 8.9% of specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division were positive for influenza.
• Over 99% of all subtyped influenza A viruses being reported to CDC were 2009 influenza A (H1N1) viruses.
• The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold for the tenth consecutive week.
• 16 influenza-associated pediatric deaths were reported. Thirteen of these deaths were associated with 2009 influenza A (H1N1) virus infection, two were associated with an influenza A virus for which the subtype was undetermined, and one was associated with an influenza B virus infection.
• The proportion of outpatient visits for influenza-like illness (ILI) was 2.7% which is above the national baseline of 2.3%.
• 14 states reported geographically widespread influenza activity, Puerto Rico and 25 states reported regional influenza activity, the District of Columbia and seven states reported local influenza activity, and the U.S. Virgin Islands, Guam and four states reported sporadic influenza activity.
• For more information:
  
  • U.S. Centers for Disease Control and Prevention ?What's New on the H1N1 Flu Site?: LINK
  • U.S. Centers for Disease Control and Prevention Weekly Influenza Surveillance Report: LINK
  • Overview of Influenza Surveillance in the United States: LINK

From the Public Health Agency of Canada:

• Influenza activity continued to decrease in Canada. All influenza indicators declined for at least the third consecutive week.
• The ILI consultation rate was within the expected range for this time of the year.
• The Pandemic (H1N1) 2009 strain accounted for nearly 100% of the positive influenza A subtyped specimens.
• The intensity of Pandemic (H1N1) 2009 in the population was moderate.
• There was a decrease from the previous week in the number of reported hospitalized cases (307 vs. 804), ICU admissions (83 vs. 139) and deaths (33 vs. 56).
• For more information:
  
  • Public Health Agency of Canada: LINK
  • Public Health Agency of Canada FluWatch: LINK

Table 1. Reported number of confirmed 2009 pandemic influenza A(H1N1) cases admitted to hospitals and intensive care, by country, as of 15 December 2009, 9.00 CEST in EU and EFTA countries.
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (02.12.) ? ? ? ? ? ? ? ?
2. Belgium (10.12.) ? ? ? ? ? ? ? ?
3. Bulgaria (06.12) ? ? ? ? ? ? ? ?
4. Cyprus(23.11) ? ? ? ? ? ? ? 6
5. Czech Republic (09.12.) ? ? ? ? ? ? ? ?
6. Denmark (09.12.) ? ? ? ? ? ? ? ?
7. Estonia (09.12.) ? ? ? ? ? ? ? ?
8. Finland (11.12.) - 18 ? ? - 11 ? ?
9. France (14.12.) ? ? ? ? ? 211 ? 743
10. Germany (08.12.) ? ? ? ? ? ? ? ?
11. Greece (09.12.) ? ? ? ? ? ? ? ?
12. Hungary (06.12.) ? ? ? ? ? ? ? ?
13. Iceland (10.12.) ? 3 ? 180 ? 1 ? 20
14. Ireland (10.12.) ? 161 ? 1003 ? 9 ? 84
15. Italy (13.12.) ? ? - 811 ? ? ? 439
16. Latvia (14.12.) ? ? ? ? ? ? ? ?
17. Liechtenstein (09.12.) ? ... ? ? ? ? ? ?
18. Lithuania (30.11.) ? ? ? ? ? ? ? ?
19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (11.12.) ? 104 ? 2068 ? 9 ? 196
22. Norway (09.12.) ? 27 ? 1283 ? 15 ? 169
23. Poland (07.12.) ? ? ? ? ? ? ? ?
24. Portugal (09.12.) - 127 ? ? - 20 ? ?
25. Romania (08.12.) ? ? ? ? ? ? ? ?
26. Slovakia (02.12.) ? 38 ? 81 ? 8 ? 31
27. Slovenia (10.12.) - 95 ? ? - 9 ? ?
28. Spain (03.12.) ? ? ? ? ? ? ? ?
29. Sweden (10.12.) ? 39 - 1092 ? ? ? ?
30. Switzerland (09.12.) ? 19 - 250 ? ? ? 53
31. United Kingdom* (10.12.) - 636 ? ? - 133 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
* Data includes information for England only. Other cumulative hospitalisations are: Scotland (1344), Wales (429) and Northern Ireland (570).

Table 2. Reported number of new and cumulative confirmed fatal 2009 pandemic influenza A(H1N1) cases in EU and EFTA countries, as 15 December 2009, 9.00 CEST, and in the rest of the world by country, as of 14 December 2009, 16.00 CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU and EFTA countries
  
  • Austria ? ? 3
  • Belgium ? ? 14
  • Bulgaria ? ? 5
  • Cyprus ? ? 2
  • Czech Republic ? ? 34
  • Denmark ? ? 16
  • Estonia ? ? 5
  • Finland 19 ? 36
  • France 6 ? 177*
  • Germany ? ? 94
  • Greece ? ? 36
  • Hungary ? ? 23
  • Iceland ? ? 2
  • Ireland ? ? 20
  • Italy 5 ? 142
  • Latvia 3 ? 17
  • Lithuania 1 ? 11
  • Luxembourg ? ? 2
  • Malta ? ? 3
  • Netherlands ? ? 50
  • Norway ? ? 27
  • Poland ? ? 67
  • Portugal 3 ? 38
  • Romania ? ? 18
  • Slovakia ? ? 3
  • Slovenia ? ? 8
  • Spain ? ? 208
  • Sweden 1 ? 19
  • Switzerland ? ? 8
  • United Kingdom ? ? 283
    
    • Total 38 ? 1371
• Other European countries and central Asia
  
  • Albania 2 ? 3
  • Armenia 2 ? 2
  • Belarus ? ? 20
  • Bosnia and Herzegovina ? ? 7
  • Croatia ? ? 22
  • Former Yugoslav Republic of Macedonia 7 ? 14
  • Georgia ? ? 1
  • Kosovo ? ? 10
  • Moldova ? ? 13
  • Montenegro ? ? 2
  • Russia ? ? 19
  • Serbia ? ? 33
  • Ukraine ? ? 41
    
    • Total 11 ? 187
• Mediterranean and Middle-East
  
  • Algeria 3 ? 19
  • Bahrain ? ? 7
  • Egypt 6 ? 52
  • Iran ? ? 147
  • Iraq ? ? 34
  • Israel ? ? 67
  • Jordan ? ? 14
  • Kuwait ? - 27
  • Lebanon ? ? 3
  • Libya ? ? 1
  • Morocco 9 ? 23
  • Occupied Palestinian Territory 8 ? 17
  • Oman 3 ? 30
  • Qatar ? ? 8
  • Saudi Arabia 16 ? 97
  • Syria 53 ? 103
  • Tunisia 1 ? 6
  • Turkey ? ? 353
  • United Arab Emirates ? ? 6
  • Yemen ? ? 22
    
    • Total 99 ? 1036
• Africa
  
  • Ghana ? ? 1
  • Madagascar ? ? 3
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 92
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 111
• North America
  
  • Canada ? ? 373
  • Mexico ? ? 732
  • USA ? ? 1929
    
    • Total ? ? 3034
• Central America and Caribbean
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 41
  • Cuba ? ? 32
  • Dominican Republic ? ? 23
  • El Salvador ? ? 31
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 6
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 1
  • Saint Lucia ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total ? ? 206
• South America
  
  • Argentina ? ? 616
  • Bolivia ? ? 58
  • Brazil ? ? 1632
  • Chile ? ? 150
  • Colombia ? ? 183
  • Ecuador ? ? 96
  • Paraguay ? ? 52
  • Peru ? ? 200
  • Uruguay ? ? 33
  • Venezuela ? ? 116
    
    • Total ? ? 3136
• North-East and South Asia
  
  • Afghanistan ? ? 17
  • Bangladesh ? ? 6
  • China (Mainland) ? ? 326
  • Hong Kong SAR China ? ? 45
  • India 10 ? 684
  • Japan 8 ? 73
  • Macao SAR China ? ? 2
  • Maldives ? ? 1
  • Mongolia 2 ? 26
  • Pakistan ? ? 1
  • South Korea ? ? 117
  • Sri Lanka ? ? 23
  • Taiwan 2 ? 35
    
    • Total 22 ? 1356
• South-East Asia
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 5
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 19
  • Thailand ? ? 189
  • Vietnam ? ? 47
    
    • Total ? ? 379
• Australia and Pacific
  
  • Australia ? ? 191
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 20
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 217
• TOTAL 170 ? 11033

* Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 7 in La R?union, 1 in Martinique, 2 in Mayotte, 5 in Guadeloupe and 145 in mainland France.
(?)
-
------

[Giuseppe]

2009 influenza A (H1N1) pandemic 16 December 2009 9.00 CEST (ECDC, edited)

2009 influenza A (H1N1) pandemic 16 December 2009 9.00 CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]
ECDC DAILY UPDATE
2009 influenza A (H1N1) pandemic 16 December 2009 9.00 CEST

Main developments in the past 24 hours

• A total of 1 393 fatal cases in Europe and EFTA countries and 9 795 in the rest of the world have been reported up to date.

This report is based on official information provided by national public health websites or through other official communication channels. Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 16 December 2009, 9.00 CEST in EU and EFTA countries are in Table 1. An update on the number of confirmed fatal cases for the world and Europe is presented in Table 2.

Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 1 393 deaths have been reported since April 2009 (Table 2). Since week 41 the numbers of deaths each has shown a steady increase almost doubling every fortnight over the last six weeks. While the most deaths have to date been in Western Europe there are increasing numbers of deaths being reported from Central and Eastern Europe. The reported cumulative fatal pandemic (H1N1) cases in the world have now passed 10 000 cases (Table 2). However, because of lack of laboratory confirmation and underreporting among other factors, this is likely to be a gross underestimation of the true number fatalities associated with the pandemic. Available updates on hospital admissions, per Member State, can be found in Table 1.

Table 1. Reported number of confirmed 2009 pandemic influenza A(H1N1) cases admitted to hospitals and intensive care, by country, as of 16 December 2009, 9.00 CEST in EU and EFTA countries.
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (02.12.) ? ? ? ? ? ? ? ?
2. Belgium (10.12.) ? ? ? ? ? ? ? ?
3. Bulgaria (06.12) ? ? ? ? ? ? ? ?
4. Cyprus(23.11) ? ? ? ? ? ? ? 6
5. Czech Republic (09.12.) ? ? ? ? ? ? ? ?
6. Denmark (09.12.) ? ? ? ? ? ? ? ?
7. Estonia (09.12.) ? ? ? ? ? ? ? ?
8. Finland (14.12.) - 19 ? ? - 9 ? ?
9. France (14.12.) ? ? ? ? ? 211 ? 743
10. Germany (08.12.) ? ? ? ? ? ? ? ?
11. Greece (09.12.) ? ? ? ? ? ? ? ?
12. Hungary (06.12.) ? ? ? ? ? ? ? ?
13. Iceland (10.12.) ? 3 ? 180 ? 1 ? 20
14. Ireland (10.12.) ? 161 ? 1003 ? 9 ? 84
15. Italy (15.12.) ? ? - 811 ? ? ? 439
16. Latvia (14.12.) ? ? ? ? ? ? ? ?
17. Liechtenstein (09.12.) ? ? ? ? ? ? ? ?
18. Lithuania (30.11.) ? ? ? ? ? ? ? ?
19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (11.12.) ? 104 ? 2068 ? 9 ? 196
22. Norway (09.12.) ? 27 ? 1283 ? 15 ? 169
23. Poland (07.12.) ? ? ? ? ? ? ? ?
24. Portugal (09.12.) - 127 ? ? - 20 ? ?
25. Romania (08.12.) ? ? ? ? ? ? ? ?
26. Slovakia (02.12.) ? 38 ? 81 ? 8 ? 31
27. Slovenia (10.12.) - 95 ? ? - 9 ? ?
28. Spain (03.12.) ? ? ? ? ? ? ? ?
29. Sweden (10.12.) ? 39 - 1092 ? ? ? ?
30. Switzerland (09.12.) ? 19 - 250 ? ? ? 53
31. United Kingdom* (10.12.) - 636 ? ? - 133 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
* Data includes information for England only. Other cumulative hospitalisations are: Scotland (1344), Wales (429) and Northern Ireland (570).

Table 2. Reported number of new and cumulative confirmed fatal 2009 pandemic influenza A(H1N1) cases in EU and EFTA countries, as 16 December 2009, 9.00 CEST, and in the rest of the world by country, as of 15 December 2009, 16.00 CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU and EFTA countries
  
  • Austria ? ? 3
  • Belgium ? ? 14
  • Bulgaria ? ? 5
  • Cyprus ? ? 2
  • Czech Republic ? ? 34
  • Denmark ? ? 16
  • Estonia ? ? 5
  • Finland ? ? 36
  • France ? ? 177*
  • Germany ? ? 94
  • Greece ? ? 36
  • Hungary ? ? 23
  • Iceland ? ? 2
  • Ireland ? ? 20
  • Italy 7 ? 149
  • Latvia ? ? 17
  • Lithuania 1 ? 12
  • Luxembourg ? ? 2
  • Malta ? ? 3
  • Netherlands ? ? 50
  • Norway ? ? 27
  • Poland ? ? 67
  • Portugal 6 ? 44
  • Romania 7 ? 25
  • Slovakia ? ? 3
  • Slovenia ? ? 8
  • Spain ? ? 208
  • Sweden ? ? 19
  • Switzerland ? ? 8
  • United Kingdom 1 ? 284
    
    • Total 22 ? 1393
• Other European countries and central Asia
  
  • Albania ? ? 3
  • Armenia ? ? 2
  • Belarus ? ? 20
  • Bosnia and Herzegovina ? ? 7
  • Croatia ? ? 22
  • Former Yugoslav Republic of Macedonia ? ? 14
  • Georgia 2 ? 3
  • Kosovo ? ? 10
  • Moldova 2 ? 15
  • Montenegro ? ? 2
  • Russia ? ? 19
  • Serbia 1 ? 34
  • Ukraine ? ? 41
    
    • Total 5 ? 192
• Mediterranean and Middle-East
  
  • Algeria ? ? 19
  • Bahrain ? ? 7
  • Egypt 9 ? 61
  • Iran ? ? 147
  • Iraq ? ? 34
  • Israel ? ? 67
  • Jordan ? ? 14
  • Kuwait ? - 27
  • Lebanon ? ? 3
  • Libya ? ? 1
  • Morocco ? ? 23
  • Occupied Palestinian Territory ? ? 17
  • Oman ? ? 30
  • Qatar ? ? 8
  • Saudi Arabia ? ? 97
  • Syria ? ? 103
  • Tunisia ? ? 6
  • Turkey 62 ? 415
  • United Arab Emirates ? ? 6
  • Yemen ? ? 22
    
    • Total 71 ? 1107
• Africa
  
  • Ghana ? ? 1
  • Madagascar ? ? 3
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 92
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 111
• North America
  
  • Canada ? ? 373
  • Mexico ? ? 732
  • USA ? ? 1929
    
    • Total ? ? 3034
• Central America and Caribbean
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 41
  • Cuba ? ? 32
  • Dominican Republic ? ? 23
  • El Salvador ? ? 31
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 6
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis 1 ? 2
  • Saint Lucia ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total 1 ? 207
• South America
  
  • Argentina ? ? 616
  • Bolivia ? ? 58
  • Brazil ? ? 1632
  • Chile ? ? 150
  • Colombia ? ? 183
  • Ecuador ? ? 96
  • Paraguay ? ? 52
  • Peru ? ? 200
  • Uruguay ? ? 33
  • Venezuela ? ? 116
    
    • Total ? ? 3136
• North-East and South Asia
  
  • Afghanistan ? ? 17
  • Bangladesh ? ? 6
  • China (Mainland) ? ? 326
  • Hong Kong SAR China ? ? 45
  • India 41 ? 725
  • Japan ? ? 73
  • Macao SAR China ? ? 2
  • Maldives ? ? 1
  • Mongolia ? ? 26
  • Pakistan ? ? 1
  • South Korea 15 ? 132
  • Sri Lanka ? ? 23
  • Taiwan ? ? 35
    
    • Total 56 ? 1412
• South-East Asia
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 5
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 19
  • Thailand ? ? 189
  • Vietnam ? ? 47
    
    • Total ? ? 379
• Australia and Pacific
  
  • Australia ? ? 191
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 20
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 217
• TOTAL 155 ? 11188

* Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 7 in La R?union, 1 in Martinique, 2 in Mayotte, 5 in Guadeloupe and 145 in mainland France.
(?)
-
------

[Giuseppe]

2009 influenza A (H1N1) pandemic 17 December 2009 9.00 CEST (ECDC, edited): 561 new fatal cases confirmed worldwide

2009 influenza A (H1N1) pandemic 17 December 2009 9.00 CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]
ECDC DAILY UPDATE
2009 influenza A (H1N1) pandemic 17 December 2009 9.00 CEST

Main developments in the past 24 hours

• ECDC issues the 7th version of its Risk Assessment for the 2009 Pandemic
• A total of 1 470 fatal cases in Europe and EFTA countries and 10 279 in the rest of the world have been reported up to date.

This report is based on official information provided by national public health websites or through other official communication channels. Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 17 December 2009, 9.00 CEST in EU and EFTA countries are in Table 1. An update on the number of confirmed fatal cases for the world and Europe is presented in Table 2.

ECDC Pandemic Risk Assessment updated
This 7th update (dated December 16th) is informed by the experience this autumn in Europe and North America as well as further analyses from the Southern Hemisphere?s temperate countries during their winter season.
It includes as new features:

• The first ?synthesis? from a European country looking at the epidemiological findings from the experience of the UK from April to September 2009.
• An analysis of a number of studies which on balance conclude there is little or no effect of seasonal influenza immunisation on the risk of infection or disease from the 2009 pandemic A(H1N1) virus.
• A table comparing and contrasting the recent experience of seasonal influenza and 2009 pandemic influenza A(H1N1).
• An initial report of the D222G mutation in the haemagglutinin gene though noting that these spontaneous mutations have been observed since the start of pandemic.
• The first reports of transmission of oseltamivir-resistant viruses in Europe in a special setting (a ward with immunocompromised patients).
• The first published report of deaths from the pandemic virus in the EU including an indication of the percentage of these that occurred among people who are and are not in a risk group.
• One report from the United States of increased invasive pneumococcal disease associated with the pandemic infection.
• Discussion of the fact that although infection rates are declining in the countries first affected in the EU (western and northern countries), infection rates are still high and rising in some eastern European countries where access to pharmaceutical countermeasures is likely to be more difficult.
• Note of the risks for the holiday period (Christmas and New Year) when people travelling may be at heightened risk of acquiring infection and also some primary care services may be reduced, thereby putting more pressure on hospital services.

There remains a number of important areas where our information is lacking and questions remain unanswered and again these are highlighted:

• The number and proportions of the population that have been infected and so the Likely timing and pattern of spread of the virus in Europe in the winter and spring of 2010
• The mix of influenza and other viruses that will be circulating this winter in Europe
• Shedding the virus and infectivity
• Relative and attributable risk of more severe disease
• Pathological processes underlying severe disease and individual vulnerability
• Population level mortality attributable to the pandemic virus in Europe
• Protective value of early treatment with antivirals
• Data and analyses concerning patient numbers in hospitals and information on children

The risk assessment will be available later today at: LINK (look for most recently updated)

Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 1 470 deaths have been reported since April 2009 (Table 2). Since week 41 the numbers of deaths each has shown a steady increase almost doubling every fortnight over the last six weeks. While the most deaths have to date been in Western Europe there are increasing numbers of deaths being reported from Central and Eastern Europe. The reported cumulative fatal pandemic (H1N1) cases in the world have now passed 10 000 cases (Table 2). However, because of lack of laboratory confirmation and underreporting among other factors, this is likely to be a gross underestimation of the true number of fatalities associated with the pandemic. Available updates on hospital admissions, per Member State, can be found in Table 1.

Table 1. Reported number of confirmed 2009 pandemic influenza A(H1N1) cases admitted to hospitals and intensive care, by country, as of 17 December 2009, 9.00 CEST in EU and EFTA countries.
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (02.12.) ? ? ? ? ? ? ? ?
2. Belgium (10.12.) ? ? ? ? ? ? ? ?
3. Bulgaria (13.12) ? ? ? ? ? ? ? ?
4. Cyprus(23.11) ? ? ? ? ? ? ? 6
5. Czech Republic (16.12.) ? ? ? ? ? ? ? ?
6. Denmark (16.12.) ? ? ? ? ? ? ? ?
7. Estonia (16.12.) ? ? ? ? ? ? ? ?
8. Finland (15.12.) - 14 ? ? - 9 ? ?
9. France (15.12.) ? ? ? ? ? 237 ? 804
10. Germany (11.12.) ? ? ? ? ? ? ? ?
11. Greece (09.12.) ? ? ? ? ? ? ? ?
12. Hungary (13.12.) ? ? ? ? ? ? ? ?
13. Iceland (10.12.) ? 3 ? 180 ? 1 ? 20
14. Ireland (10.12.) ? 161 ? 1003 ? 9 ? 84
15. Italy (15.12.) ? ? - 811 ? ? ? 439
16. Latvia (14.12.) ? ? ? ? ? ? ? ?
17. Liechtenstein (09.12.) ? ? ? ? ? ? ? ?
18. Lithuania (30.11.) ? ? ? ? ? ? ? ?
19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (11.12.) ? 104 ? 2068 ? 9 ? 196
22. Norway (14.12.) ? 14 ? 1298 ? 5 ? 170
23. Poland (07.12.) ? ? ? ? ? ? ? ?
24. Portugal (13.12.) - 133 ? ? - 25 ? ?
25. Romania (16.12.) ? ? ? ? ? ? ? ?
26. Slovakia (02.12.) ? 38 ? 81 ? 8 ? 31
27. Slovenia (10.12.) - 95 ? ? - 9 ? ?
28. Spain (03.12.) ? ? ? ? ? ? ? ?
29. Sweden (10.12.) ? 39 - 1092 ? ? ? ?
30. Switzerland (09.12.) ? 19 - 250 ? ? ? 53
31. United Kingdom* (10.12.) - 636 ? ? - 133 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
* Data includes information for England only. Other cumulative hospitalisations are: Scotland (1344), Wales (429) and Northern Ireland (570).

Table 2. Reported number of new and cumulative confirmed fatal 2009 pandemic influenza A(H1N1) cases in EU and EFTA countries, as 17 December 2009, 9.00 CEST, and in the rest of the world by country, as of 16 December 2009, 16.00 CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU and EFTA countries
  
  • Austria ? ? 3
  • Belgium ? ? 14
  • Bulgaria ? ? 5
  • Cyprus ? ? 2
  • Czech Republic 4 ? 38
  • Denmark 5 ? 21
  • Estonia 2 ? 7
  • Finland ? ? 36
  • France 4 - 181*
  • Germany 25 ? 119
  • Greece ? ? 36
  • Hungary 13 ? 36
  • Iceland ? ? 2
  • Ireland ? ? 20
  • Italy ? ? 149
  • Latvia ? ? 17
  • Lithuania ? ? 12
  • Luxembourg ? ? 2
  • Malta ? ? 3
  • Netherlands ? ? 50
  • Norway 2 ? 29
  • Poland ? ? 67
  • Portugal 1 ? 45
  • Romania 2 ? 27
  • Slovakia 18 ? 21
  • Slovenia ? ? 8
  • Spain ? ? 208
  • Sweden 1 ? 20
  • Switzerland ? ? 8
  • United Kingdom ? ? 284
    
    • Total 77 ? 1470
• Other European countries and central Asia
  
  • Albania ? ? 3
  • Armenia ? ? 2
  • Belarus ? ? 20
  • Bosnia and Herzegovina ? ? 7
  • Croatia ? ? 22
  • Former Yugoslav Republic of Macedonia ? ? 14
  • Georgia 1 ? 4
  • Kosovo ? ? 10
  • Moldova ? ? 15
  • Montenegro ? ? 2
  • Russia ? ? 19
  • Serbia ? ? 34
  • Ukraine 161 ? 202
    
    • Total 162 ? 354
• Mediterranean and Middle-East
  
  • Algeria 5 ? 24
  • Bahrain ? ? 7
  • Egypt 3 ? 64
  • Iran ? ? 147
  • Iraq ? ? 34
  • Israel ? ? 67
  • Jordan ? ? 14
  • Kuwait ? ? 27
  • Lebanon ? ? 3
  • Libya ? ? 1
  • Morocco ? ? 23
  • Occupied Palestinian Territory ? ? 17
  • Oman ? ? 30
  • Qatar ? ? 8
  • Saudi Arabia ? ? 97
  • Syria ? ? 103
  • Tunisia ? ? 6
  • Turkey ? ? 415
  • United Arab Emirates ? ? 6
  • Yemen ? ? 22
    
    • Total 8 ? 1115
• Africa
  
  • Ghana ? ? 1
  • Madagascar ? ? 3
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 92
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 111
• North America
  
  • Canada 17 ? 390
  • Mexico 38 ? 770
  • USA 109 ? 2038
    
    • Total 164 ? 3198
• Central America and Caribbean
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 41
  • Cuba ? ? 32
  • Dominican Republic ? ? 23
  • El Salvador ? ? 31
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 6
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 2
  • Saint Lucia ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total ? ? 207
• South America
  
  • Argentina ? ? 616
  • Bolivia ? ? 58
  • Brazil ? ? 1632
  • Chile ? ? 150
  • Colombia 7 ? 190
  • Ecuador ? ? 96
  • Paraguay ? ? 52
  • Peru 3 ? 203
  • Uruguay ? ? 33
  • Venezuela ? ? 116
    
    • Total 10 ? 3146
• North-East and South Asia
  
  • Afghanistan ? ? 17
  • Bangladesh ? ? 6
  • China (Mainland) 116 ? 442
  • Hong Kong SAR China ? ? 45
  • India 23 ? 748
  • Japan ? ? 73
  • Macao SAR China ? ? 2
  • Maldives ? ? 1
  • Mongolia ? ? 26
  • Pakistan ? ? 1
  • South Korea ? ? 132
  • Sri Lanka ? ? 23
  • Taiwan ? ? 35
    
    • Total 139 ? 1551
• South-East Asia
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 5
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 19
  • Thailand 1 ? 190
  • Vietnam ? ? 47
    
    • Total 1 ? 380
• Australia and Pacific
  
  • Australia ? ? 191
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 20
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 217
• TOTAL 561 ? 11749

* Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 7 in La R?union, 1 in Martinique, 2 in Mayotte, 5 in Guadeloupe and 150 in mainland France.
(?)
-
-------

[Giuseppe]

2009 influenza A (H1N1) pandemic 18 December 2009 9.00 CEST (ECDC, edited)

2009 influenza A (H1N1) pandemic 18 December 2009 9.00 CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]
ECDC DAILY UPDATE
2009 influenza A (H1N1) pandemic 18 December 2009 9.00 CEST

Main developments in the past 24 hours

• Weekly Influenza Surveillance Overview to be published today;
• Eurosurveillance update: Risk of pandemic influenza in pregnancy and indigenous people
• WHO pandemic modelling group: more serosurveys needed
• ECDC quotes a selection of recent scientific publications
• A total of 1 570 fatal cases in Europe and EFTA countries and 10 307 in the rest of the world have been reported up to date.

This report is based on official information provided by national public health websites or through other official communication channels. Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 18 December 2009, 9.00 CEST in EU and EFTA countries are in Table 1. An update on the number of confirmed fatal cases for the world and Europe is presented in Table 2.

Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 1 570 deaths have been reported since April 2009 (Table 2). Since week 41 the numbers of deaths each has shown a steady increase almost doubling every fortnight over the last six weeks. While the most deaths have to date been in Western Europe there are increasing numbers of deaths being reported from Central and Eastern Europe. The reported cumulative fatal pandemic (H1N1) cases in the world have now passed 10 000 cases (Table 2). However, because of lack of laboratory confirmation and underreporting among other factors, this is likely to be a gross underestimation of the true number of fatalities associated with the pandemic. Available updates on hospital admissions, per Member State, can be found in Table 1.

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

Eurosurveillance update
In this week?s issue Eurosurveillance publishes a Rapid communication by H Kelly, GN Mercer and AC Cheng, entitled Quantifying the risk of pandemic influenza in pregnancy and Indigenous people in Australia in 2009.
Abstract:
An increased relative risk of infection with the 2009 pandemic H1N1 influenza virus associated with pregnancy and Indigenous status has been a common finding in many countries. Using publicly available data from May to October 2009 in Australia, we estimated the relative risk of hospitalisation, admission to intensive care unit and death as 5.2, 6.5 and 1.4 respectively for pregnant women, and as 6.6, 6.2 and 5.2, respectively for Indigenous Australians. Pregnancy and Indigenous status were associated with severe influenza. More complete analyses of risks in these groups are required to understand and prevent influenza morbidity and mortality.
The full paper is available from: LINK

WHO pandemic modelling group calls for more serological studies
A World Health Organization working group of mathematical modellers has presented a list of research needs to help inform policy choices related to the H1N1 pandemic. Key among missing data are serologic surveys to assess what proportion of the population remains susceptible to the virus. French authorities show an example of how presenting information on serosurveys may help to address the question in the ?Bulletin grippe A(H1N1) 2009? which contains a section on regular monitoring of antibodies among pregnant women (SeroGrippeHebdo survey).
More information available at: LINK
and LINK

Selected Scientific Publications (11-17 December 2009)
1) Deaths Related to 2009 Pandemic Influenza A (H1N1) Among American Indian/Alaska Natives - 12 States, 2009 Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report, 11 December 2009 Available from: LINK
A study indicating that American Indians and Alaska Natives had an H1N1-related mortality rate four times higher than persons in all other racial/ethnic populations combined. Reasons for this disparity were unclear however, the authors suggest higher rates of underlying chronic illnesses (e.g. asthma and diabetes) poverty and delayed accessing of health care.

2) Immune response after a single vaccination against 2009 influenza A H1N1 in USA: a preliminary report of two randomised controlled phase 2 trials Plennevaux E, Sheldon E, Blatter M, Reeves-Hoche, Denis M. The Lancet, Published Online December 16, 2009
This USA study of two randomised controlled phase 2 trials found that after vaccination between 45% (7?5 μg dose) and 50% (15 μg) infants aged 6?35 months reached serological protection. In the other age groups adequate levels ranged from 69% (7?5 μg) to 75% (15 μg) of 3?9-year-old children; 95% (7?5 μg) to 100% (30 μg) of 18?64-year-old adults; and 93% (15 μg) to 95% (30 μg) of adults 65 years and older. No vaccine-related serious adverse events occurred among the 1100-1200 subjects. Injection-site and systemic reactions were reported by up to about 50% of every age and vaccine group, with no noticeable differences between vaccine and placebo groups.

3) Safety and immunogenicity of 2009 pandemic influenza A H1N1 vaccines in China: a multicentre, double-blind, randomised, placebo-controlled trial Xiao-Feng Liang, Hua-Qing Wang, Jun-Zhi Wang et. Al. The Lancet, Published Online December 16, 2009
This large double-blind, randomised placebo controlled trial (12-13,000 participants) was conducted in China and found that a 7.5 μg, non-adjuvanted vaccine offered substantial seroprotection?with 87% across all age groups protected (vs 10% for placebo). In the age groups 7.5 μg formulation induced serological protection in 77% of children aged 3?12 years; 97% of adolescents aged 12?18 years; 90% of adults aged 18?60 years; and 80% of adults aged over 60 years. In children aged 3?12 years, a second dose of this same 7.5 μg formulation increased seroprotection rates to 98%. Adverse reactions were mostly mild or moderate, and self-limited. More severe adverse reactions (mostly fever) occurred in 69 (0?6%, 0?5?0?8) recipients of vaccine compared with one recipient (0?1%, 0?0?2) of placebo.

4) Safety and immunogenicity of a 2009 pandemic influenza A H1N1 vaccine when administered alone or simultaneously with the seasonal influenza vaccine for the 2009?10 influenza season: a multicentre, randomised controlled trial Zoltan Vajo, Ferenc Tamas, Laszlo Sinka, Istvan Jankovics. The Lancet, Published Online December 16, 2009
The randomised controlled study undertaken in Hungary examined co-administration of a pandemic H1N1 vaccine and seasonal vaccine; the patients were divided into two groups: group 1 were assigned to 0,5 mL of the pandemic vaccine (Fluval P, a monovalent vaccine with 6 μg haemagglutinin per 0,5 mL and an aluminium phosphate gel adjuvant); group 2 were assigned to 0,5 mL of the same pandemic vaccine and 0,5 mL of the regular trivalent seasonal influenza vaccine. In group 1 seroconversion for adults was 74,3%, and for elderly 61?3%; in group 2: 76?8% and 81?8% respectively. All adverse events were rare, mild, and transient; the most frequent reactions were pain at injection site (eight cases in group 1 vs 18 in group 2) and fatigue for 1?2 days after vaccination (three vs five cases).

5) Effectiveness and cost-effectiveness of vaccination against pandemic influenza (H1N1) 2009 Nayer Khazeni, David W. Hutton, Alan M. Garber Annals of Internal Medicine, December 15, 2009. Available at: LINK
This theoretical study was based on a compartmental epidemic model of residents of a major U.S. metropolitan city as targeted population. The results showed that early vaccination against pandemic (H1N1) 2009 would prevent many deaths and be cost-saving. Complete population coverage was not necessary to reduce the viral reproductive rate sufficiently to help shorten the pandemic.

6) Th1 and Th17 hypercytokinemia as early host response signature in severe pandemic influenza Jesus F Bermejo-Martin, Raul Ortiz de Lejarazu,Tomas Pumarola et al. Critical Care. December 11, 2009 Available at: LINK
One of the unusual features of this pandemic is that a few infected people suffer very severe disease, far more than is seen with seasonal influenza. This study looked at possible mechanism and analyzed different levels of regulating molecules for 20 hospitalized patients, 15 outpatients and 15 control subjects in 10 Spanish hospitals. The authors reported high levels of Th1 and Th17 in the blood of patient with severe H1N1 disease but low levels in patients with the mild form of the disease.

Table 1. Reported number of confirmed 2009 pandemic influenza A(H1N1) cases admitted to hospitals and intensive care, by country, as of 18 December 2009, 9.00 CEST in EU and EFTA countries.
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (17.12.) - 172 ? ? ? ? ? ?
2. Belgium (17.12.) ? ? ? ? ? ? ? ?
3. Bulgaria (13.12) ? ? ? ? ? ? ? ?
4. Cyprus(23.11) ? ? ? ? ? ? ? 6
5. Czech Republic (16.12.) ? ? ? ? ? ? ? ?
6. Denmark (16.12.) ? ? ? ? ? ? ? ?
7. Estonia (16.12.) ? ? ? ? ? ? ? ?
8. Finland (16.12.) - 13 ? ? - 8 ? ?
9. France (15.12.) ? ? ? ? ? 237 ? 804
10. Germany (11.12.) ? ? ? ? ? ? ? ?
11. Greece (16.12.) ? ? ? ? ? ? ? ?
12. Hungary (13.12.) ? ? ? ? ? ? ? ?
13. Iceland (10.12.) ? 3 ? 180 ? 1 ? 20
14. Ireland (16.12.) ? 152 ? 1015 ? 9 ? 84
15. Italy (17.12.) ? ? - 811 ? ? ? 439
16. Latvia (17.12.) ? ? ? ? ? ? ? ?
17. Liechtenstein (17.12.) ? ? ? ? ? ? ? ?
18. Lithuania (30.11.) ? ? ? ? ? ? ? ?
19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (11.12.) ? 104 ? 2068 ? 9 ? 196
22. Norway (14.12.) ? 14 ? 1298 ? 5 ? 170
23. Poland (07.12.) ? ? ? ? ? ? ? ?
24. Portugal (13.12.) - 133 ? ? - 25 ? ?
25. Romania (17.12.) ? ? ? ? ? ? ? ?
26. Slovakia (02.12.) ? 38 ? 81 ? 8 ? 31
27. Slovenia (17.12.) - 76 ? ? ? ? ? ?
28. Spain (17.12.) ? ? ? ? ? ? ? ?
29. Sweden (17.12.) ? 18 - 1169 ? ? ? ?
30. Switzerland (17.12.) ? 23 - 345 ? ? ? 66
31. United Kingdom* (17.12.) - 523 ? ? - 113 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
* Data includes information for England only. Other cumulative hospitalisations are: Scotland (1423), Wales (433) and Northern Ireland (573).

Table 2. Reported number of new and cumulative confirmed fatal 2009 pandemic influenza A(H1N1) cases in EU and EFTA countries, as 18 December 2009, 9.00 CEST, and in the rest of the world by country, as of 17 December 2009, 16.00 CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU and EFTA countries
  
  • Austria ? ? 3
  • Belgium 3 ? 17
  • Bulgaria 30 ? 35
  • Cyprus 1 ? 3
  • Czech Republic ? ? 38
  • Denmark ? ? 21
  • Estonia ? ? 7
  • Finland ? ? 36
  • France 1 ? 182*
  • Germany ? ? 119
  • Greece 15 ? 51
  • Hungary ? ? 36
  • Iceland ? ? 2
  • Ireland 2 ? 22
  • Italy ? ? 149
  • Latvia ? ? 17
  • Lithuania 1 ? 13
  • Luxembourg ? ? 2
  • Malta ? ? 3
  • Netherlands ? ? 50
  • Norway ? ? 29
  • Poland ? ? 67
  • Portugal 1 ? 46
  • Romania 2 ? 29
  • Slovakia ? ? 21
  • Slovenia 5 ? 13
  • Spain 24 ? 232
  • Sweden ? ? 20
  • Switzerland 1 ? 9
  • United Kingdom 14 ? 298
    
    • Total 100 ? 1570
• Other European countries and central Asia
  
  • Albania ? ? 3
  • Armenia ? ? 2
  • Belarus ? ? 20
  • Bosnia and Herzegovina ? ? 7
  • Croatia ? ? 22
  • Former Yugoslav Republic of Macedonia ? ? 14
  • Georgia 1 ? 5
  • Kosovo ? ? 10
  • Moldova 1 ? 16
  • Montenegro ? ? 2
  • Russia ? ? 19
  • Serbia 3 ? 37
  • Ukraine ? ? 202
    
    • Total 5 ? 359
• Mediterranean and Middle-East
  
  • Algeria ? ? 24
  • Bahrain ? ? 7
  • Egypt 4 ? 68
  • Iran ? ? 147
  • Iraq ? ? 34
  • Israel 2 ? 69
  • Jordan 2 ? 16
  • Kuwait ? - 27
  • Lebanon ? ? 3
  • Libya ? ? 1
  • Morocco 1 ? 24
  • Occupied Palestinian Territory ? ? 17
  • Oman ? ? 30
  • Qatar ? ? 8
  • Saudi Arabia ? ? 97
  • Syria ? ? 103
  • Tunisia ? ? 6
  • Turkey ? ? 415
  • United Arab Emirates ? ? 6
  • Yemen 3 ? 25
    
    • Total 12 ? 1127
• Africa
  
  • Ghana ? ? 1
  • Madagascar ? ? 3
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 92
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 111
• North America
  
  • Canada ? ? 390
  • Mexico ? ? 770
  • USA ? ? 2038
    
    • Total ? ? 3198
• Central America and Caribbean
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica ? ? 41
  • Cuba ? ? 32
  • Dominican Republic ? ? 23
  • El Salvador ? ? 31
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 6
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 2
  • Saint Lucia ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total ? ? 207
• South America
  
  • Argentina ? ? 616
  • Bolivia ? ? 58
  • Brazil ? ? 1632
  • Chile ? ? 150
  • Colombia ? ? 190
  • Ecuador ? ? 96
  • Paraguay ? ? 52
  • Peru ? ? 203
  • Uruguay ? ? 33
  • Venezuela ? ? 116
    
    • Total ? ? 3146
• North-East and South Asia
  
  • Afghanistan ? ? 17
  • Bangladesh ? ? 6
  • China (Mainland) ? ? 442
  • Hong Kong SAR China ? ? 45
  • India 11 ? 759
  • Japan ? ? 73
  • Macao SAR China ? ? 2
  • Maldives ? ? 1
  • Mongolia ? ? 26
  • Pakistan ? ? 1
  • South Korea ? ? 132
  • Sri Lanka ? ? 23
  • Taiwan ? ? 35
    
    • Total 11 ? 1562
• South-East Asia
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 5
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 19
  • Thailand ? ? 190
  • Vietnam ? ? 47
    
    • Total ? ? 380
• Australia and Pacific
  
  • Australia ? ? 191
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 20
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 217
• TOTAL 128 ? 11877

* Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 7 in La R?union, 1 in Martinique, 2 in Mayotte, 5 in Guadeloupe and 150 in mainland France.
(?)
-
-------

[Giuseppe]

2009 pandemic influenza A (H1N1) ? December 21, 2009 Update (ECDC, edited)

2009 pandemic influenza A (H1N1) ? December 21, 2009 Update (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]
2009 pandemic influenza A (H1N1) ? December 21, 2009 Update

Main developments in the past
This report is based on official information provided by national public health websites or through other of communication channels. Reported number of confirmed and intensive care, by country, as of 21 December on the number of confirmed fatal cases for the world and Europe is presented in Table 2.

Epidemiologic update
Weekly Influenza Surveillance Overview and Officially Reported Deaths in the EU
The Weekly Influenza Surveillance Overview which presents data from the European Influenza Surveillance Network (EISN) was published on December 18th covering the period December 7th to 13th.
Most countries are witnessing medium influenza intensity with only five reporting high to very high levels. In the majority of countries, activity is however still widespread. Nineteen countries reported decreasing rates of influenza-like illness or acute respiratory infection for at least the last two weeks and the proportion of sentinel respiratory specimens positive for pandemic influenza continued to decline.
The 2009 pandemic influenza A(H1N1) virus strain still accounts for 99% of all subtyped viruses in sentinel patients.
Oseltamivir resistance was found in only one percent of pandemic influenza viruses tested in the countries reporting to EISN. Sentinel and non-sentinel specimens have been tested for respiratory syncytial virus (RSV) in 11 countries reporting to EISN. Overall RSV detections are increasing as expected at this time of the year and countries should be on the alert for this virus.
More details of the EISN and Community Network Reference Laboratory are available here: LINK

All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 1 652 deaths have been reported since April 2009 (Table 2). Since week 41 the numbers of deaths each has shown a steady increase almost doubling every fortnight over the last six weeks. While the most deaths have to date been in Western Europe there are increasing numbers of deaths being reported from Central and Eastern Europe. The reported cumulative fatal pandemic (H1N1) cases in the world have now passed 10 000 cases (Table 2). However, because of lack of laboratory confirmation and underreporting among other factors, this is likely to be a gross underestimation of the true number of fatalities associated with the pandemic. Available updates on hospital admissions, per Member State, can be found in Table 1.

EpiSouth update
Updates on the pandemic situations in the Mediterranean and Balkans region are provided by EpiSouth. The EpiSouth project aims to create a framework of collaboration on epidemiological issues in order to improve communicable diseases surveillance, communication and training across the countries of the Mediterranean and the Balkans.
As per June 2009, the EpiSouth Network counts 26 Countries (9 EU and 17 non-EU). As of 14 December 2009, a total of 1 313 deaths among biologically confirmed 2009 pandemic influenza A(H1N1) cases have been reported in the EpiSouth region (Mediterranean and the Balkans). 354 new 2009 pandemic influenza A(H1N1) related deaths were reported since 07 December 2009 (by more than 2/3 of EpiSouth countries): 16 in Algeria, 4 in Bosnia and Herzegovina, 3 in Croatia, 17 in Egypt, 1 in FYROM, 1 in Israel, 1 in Montenegro, 18 in Morocco, 7 in Palestine, 11 in Serbia, 53 in Syria, 6 in Tunisia and 115 in Turkey.
In week 49, influenza activity was

• increasing in Algeria,
• high and increasing in Serbia and Tunisia,
• high and stable in Albania and Turkey,
• medium and decreasing in Croatia and Israel

For more details please refer to the EpiSouth Bulletin: LINK
EPISOUTH is funded by the European Commission (DG Sanco) and the Italian Ministry of Health, and supported by the EC EuropeAid and DG Enlargement through the TAIEX facility and by the participating public health institutes and ministries of health.
EpiSouth coordination is at the Italian Institute of Public Health.
More about EpiSouth at LINK

Table 1. Reported number of confirmed 2009 pandemic influenza A(H1N1) cases admitted to hospitals and intensive care, by country, as of 21 December 2009, 9.00 CEST in EU and EFTA countries.
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (17.12.) - 172 ? ? ? ? ? ?
2. Belgium (17.12.) ? ? ? ? ? ? ? ?
3. Bulgaria (13.12) ? ? ? ? ? ? ? ?
4. Cyprus(23.11) ? ? ? ? ? ? ? 6
5. Czech Republic (16.12.) ? ? ? ? ? ? ? ?
6. Denmark (16.12.) ? ? ? ? ? ? ? ?
7. Estonia (16.12.) ? ? ? ? ? ? ? ?
8. Finland (17.12.) - 13 ? ? - 9 ? ?
9. France (18.12.) ? ? ? ? ? 211 ? 890
10. Germany (11.12.) ? ? ? ? ? ? ? ?
11. Greece (16.12.) ? ? ? ? ? ? ? ?
12. Hungary (13.12.) ? ? ? ? ? ? ? ?
13. Iceland (10.12.) ? 3 ? 180 ? 1 ? 20
14. Ireland (16.12.) ? 152 ? 1015 ? 9 ? 84
15. Italy (18.12.) ? ? - 832 ? ? ? 448
16. Latvia (17.12.) ? ? ? ? ? ? ? ?
17. Liechtenstein (17.12.) ? ? ? ? ? ? ? ?
18. Lithuania (30.11.) ? ? ? ? ? ? ? ?
19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (18.12.) ? 50 ? 2124 ? 4 ? 203
22. Norway (14.12.) ? 14 ? 1298 ? 5 ? 170
23. Poland (15.12.) ? ? ? ? ? ? ? ?
24. Portugal (13.12.) - 133 ? ? - 25 ? ?
25. Romania (20.12.) ? ? ? ? ? ? ? ?
26. Slovakia (02.12.) ? 38 ? 81 ? 8 ? 31
27. Slovenia (17.12.) - 76 ? ? ? ? ? ?
28. Spain (17.12.) ? ? ? ? ? ? ? ?
29. Sweden (17.12.) ? 18 - 1169 ? ? ? ?
30. Switzerland (17.12.) ? 23 - 345 ? ? ? 66
31. United Kingdom* (17.12.) - 523 ? ? - 113 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
* Data includes information for England only. Other cumulative hospitalisations are: Scotland (1423), Wales (433) and Northern Ireland (573).

Table 2. Reported number of new and cumulative confirmed fatal 2009 pandemic influenza A(H1N1) cases in EU and EFTA countries, as 21 December 2009, 9.00 CEST, and in the rest of the world by country, as of 20 December 2009, 16.00 CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU and EFTA countries
  
  • Austria ? ? 3
  • Belgium ? ? 17
  • Bulgaria ? ? 35
  • Cyprus ? ? 3
  • Czech Republic ? ? 38
  • Denmark ? ? 21
  • Estonia ? ? 7
  • Finland ? ? 36
  • France 14 ? 196*
  • Germany ? ? 119
  • Greece ? ? 51
  • Hungary ? ? 36
  • Iceland ? ? 2
  • Ireland ? ? 22
  • Italy 29 ? 178
  • Latvia ? ? 17
  • Lithuania 1 ? 14
  • Luxembourg ? ? 2
  • Malta ? ? 3
  • Netherlands 1 ? 51
  • Norway ? ? 29
  • Poland 30 ? 97
  • Portugal ? ? 46
  • Romania 3 ? 32
  • Slovakia 4 ? 25
  • Slovenia ? ? 13
  • Spain ? ? 232
  • Sweden ? ? 20
  • Switzerland ? ? 9
  • United Kingdom ? ? 298
    
    • Total 82 ? 1652
• Other European countries and central Asia
  
  • Albania 2 ? 5
  • Armenia ? ? 2
  • Belarus ? ? 20
  • Bosnia and Herzegovina ? ? 7
  • Croatia ? ? 22
  • Former Yugoslav Republic of Macedonia ? ? 14
  • Georgia ? ? 5
  • Kosovo ? ? 10
  • Moldova ? ? 16
  • Montenegro ? ? 2
  • Russia ? ? 19
  • Serbia 1 ? 38
  • Ukraine ? ? 202
    
    • Total 3 ? 362
• Mediterranean and Middle-East
  
  • Algeria 8 ? 32
  • Bahrain ? ? 7
  • Egypt 12 ? 80
  • Iran ? ? 147
  • Iraq 3 ? 37
  • Israel ? ? 69
  • Jordan ? ? 16
  • Kuwait ? - 27
  • Lebanon ? ? 3
  • Libya ? ? 1
  • Morocco 9 ? 33
  • Occupied Palestinian Territory ? ? 17
  • Oman ? ? 30
  • Qatar ? ? 8
  • Saudi Arabia ? ? 97
  • Syria ? ? 103
  • Tunisia 3 ? 9
  • Turkey ? ? 415
  • United Arab Emirates ? ? 6
  • Yemen ? ? 25
    
    • Total 35 ? 1162
• Africa
  
  • Ghana ? ? 1
  • Madagascar ? ? 3
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 92
  • Sudan ? ? 1
  • Tanzania ? ? 1
    
    • Total ? ? 111
• North America
  
  • Canada 7 ? 397
  • Mexico 10 ? 780
  • USA ? ? 2038
    
    • Total 17 ? 3215
• Central America and Caribbean
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Cayman Islands ? ? 1
  • Costa Rica 6 ? 47
  • Cuba ? ? 32
  • Dominican Republic ? ? 23
  • El Salvador ? ? 31
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 6
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 2
  • Saint Lucia ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total 6 ? 213
• South America
  
  • Argentina 1 ? 617
  • Bolivia ? ? 58
  • Brazil ? ? 1632
  • Chile ? ? 150
  • Colombia ? ? 190
  • Ecuador ? ? 96
  • Paraguay ? ? 52
  • Peru ? ? 203
  • Uruguay ? ? 33
  • Venezuela ? ? 116
    
    • Total 1 ? 3147
• North-East and South Asia
  
  • Afghanistan ? ? 17
  • Bangladesh ? ? 6
  • China (Mainland) ? ? 442
  • Hong Kong SAR China ? ? 45
  • India 18 ? 777
  • Japan ? ? 73
  • Macao SAR China ? ? 2
  • Maldives ? ? 1
  • Mongolia ? ? 26
  • Pakistan ? ? 1
  • South Korea ? ? 132
  • Sri Lanka ? ? 23
  • Taiwan ? ? 35
    
    • Total 18 ? 1580
• South-East Asia
  
  • Brunei Darussalam ? ? 1
  • Cambodia 1 ? 6
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 19
  • Thailand ? ? 190
  • Vietnam ? ? 47
    
    • Total 1 ? 381
• Australia and Pacific
  
  • Australia ? ? 191
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 20
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 217
• TOTAL 163 ? 12040

* Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 7 in La R?union, 1 in Martinique, 2 in Mayotte, 5 in Guadeloupe and 164 in mainland France.
(?)
-
------