Pandemic (H1N1) 2009 briefing note 4

[Chuck]

http://www.who.int/csr/disease/swineflu/notes/h1n1_situation_20090724/en/

Pandemic (H1N1) 2009 briefing note 4
Preliminary information important for understanding the evolving situation

24 JULY 2009 | GENEVA -- The number of human cases of pandemic (H1N1) 2009 is still increasing substantially in many countries, even in countries that have already been affected for some time.

Our understanding of the disease continues to evolve as new countries become affected, as community-level spread extends in already affected countries, and as information is shared globally. Many countries with widespread community transmission have moved to testing only samples of ill persons and have shifted surveillance efforts to monitoring and reporting of trends. This shift has been recommended by WHO, because as the pandemic progresses, monitoring trends in disease activity can be done better by following trends in illness cases rather than trying to test all ill persons, which can severely stress national resources. It remains a top priority to determine which groups of people are at highest risk of serious disease so steps to best to protect them can be taken.

In addition to surveillance information, WHO is relying on the results of special research and clinical studies and other data provided by countries directly through frequent expert teleconferences on clinical, virological and epidemiological aspects of the pandemic, to gain a global overview of the evolving situation.
Average age of cases increasing

In most countries the majority of pandemic (H1N1) 2009 cases are still occurring in younger people, with the median age reported to be 12 to 17 years (based on data from Canada, Chile, Japan, UK and the United States of America). Some reports suggest that persons requiring hospitalization and patients with fatal illness may be slightly older.

As the disease expands broadly into communities, the average age of the cases is appearing to increase slightly. This may reflect the situation in many countries where the earliest cases often occurred as school outbreaks but later cases were occurring in the community. Some of the pandemic disease patterns differ from seasonal influenza, where fatal disease occurs most often in the elderly (>65 years old). However, the full picture of the pandemic's epidemiology is not yet fully clear because in many countries, seasonal influenza viruses and pandemic (H1N1) 2009 viruses are both circulating and the pandemic remains relatively early in its development.

Although the risk factors for serious pandemic disease are not know definitively, risk factors such as existing cardiovascular disease, respiratory disease, diabetes and cancer currently are considered risk factors for serious pandemic (H1N1) 2009 disease. Asthma and other forms of respiratory disease have been consistently reported as underlying conditions associated with an augmented risk of severe pandemic disease in several countries.

A recent report suggests obesity may be another risk factor for severe disease. Similarly, there is accumulating evidence suggesting pregnant women are at higher risk for more severe disease. A few preliminary reports also suggest increased risk of severe disease may be elevated in some minority populations, but the potential contributions of cultural, economic and social risk factors are not clear.
Vaccine situation

The development of new candidate vaccine viruses by the WHO network is continuing to improve yields (currently 25% to 50 % of the normal yields for seasonal influenza for some manufacturers). WHO will be able to revise its estimate of pandemic vaccine supply once it has the new yield information. Other important information will also be provided by results of ongoing and soon-to be-initiated vaccine clinical trials. These trials will give a better idea of the number of doses required for a person to be immunized, as well as of the quantity on active principle (antigen) needed in each vaccine dose.

Manufacturers are expected to have vaccines for use around September. A number of companies are working on the pandemic vaccine production and have different timelines.

[theforeigner]

Re: Pandemic (H1N1) 2009 briefing note 4

Interesting that they, in this WHO report, don?t use the term "mild", or anything like it, about the H1N1.

[FrenchieGirl]

Re: Pandemic (H1N1) 2009 briefing note 4

[I'm posting this for information only, there's nothing new that we don't already know. It's all been either in WHO's briefing note 4 above or in the general news. Also, I don't know if the link will work from the "outside world" ]

United Nations Regular Press Briefing Service
Dated 28 July 2009

H1N1 Update

Aphaluck Bhatiasevi of the World Health Organization (WHO), giving a brief overview of the current situation of the H1N1 pandemic, said that as of 22 July more than 124,000 laboratory-confirmed cases had been reported, with more than 800 deaths, mostly in the Americas. The majority of the cases were amongst youngsters of an average age of 12 to 17 years old but with the pandemic spreading further other age groups were also starting to be more affected. The top priority was now to determine which age groups were at highest risk so that measures could be taken to best protect them.

Answering to a journalist on the recommendations that had been issued for the upcoming pilgrimage, Ms. Bhatiasevi said that last week there had been a special regional meeting of health ministers from 22 countries of the WHO Eastern-Mediterranean region. One of the recommendations of the meeting had been that people that were considered high-risk population groups, i.e. pregnant women or people with underlying health conditions, should reconsider going for the pilgrimage this year.

Another journalist asked whether the recommendations for the pilgrimage were only valid for it or also for any other mass gatherings. Ms. Bhatiasevi said that WHO was also consulting with other governments and experts on other kinds of mass gatherings, such as concerts or the FIFA World Cup 2010 in South Africa.

Turning to a journalist?s question on what measures individuals should take in case they had symptoms, Ms. Bhatiasevi said that the pandemic was still considered to be a moderate pandemic and the majority of the cases had had mild symptoms. Individuals that had flu like symptoms should rest at home but if they felt that they had more severe symptoms they should seek hospitalisation for further treatment and care. Amongst measures to prevent the spread of the virus, WHO recommended basic hygiene, regular hand washing and mask wearing for people who had to take care of ill people and for ill people so that they did not expose people around them.

[FrenchieGirl]

Re: Pandemic (H1N1) 2009 briefing note 4

[In the same vein as the above, here is a slightly older UN Press Briefing dated 24 July 2009. Again, I don't know if the link will work from the "outside world"]

United Nations Regular Press Briefing Service
Dated 24 July 2009

H1N1 Update

Gregory Hartl of the World Health Organization, answering to several questions by journalists, said that there were currently five reported cases of anti-viral resistance. These cases were isolated and not connected. The spread of the virus continued and the number of deaths was around 800 now, with 160 countries and territories that had reported laboratory-confirmed cases.

Still unknown was how the virus would change over the next weeks. No changes had been seen in the behaviour of the virus for the moment. There was still a geographical expansion of the virus across and within countries. The more cases there would be, the more deaths one would see, but this would not mean that the virus had changed. Mr. Hartl said that the activity of the virus was expected to increase with the coming winter, as influenza viruses circulated better in colder weather. It was however impossible to give an exact percentage of expected deaths.

The highest percentage of deaths was still being reported in adolescents and young adults. This was probably linked to the fact that it was easier for a virus to spread in schools and institutions. Concerning vaccines, Mr. Hartl said that each vaccine manufacturers was working to its own timetable and WHO could not predict when each individual manufacturer would have its vaccine ready. WHO expected the first doses to be available for human use in early autumn of the northern hemisphere.

In terms of checks at airports and restriction of travelling, Mr. Hartl said that it was not the most efficient way to use public health resources because many people could spread the virus even though they were not symptomatic, while on the other hand people who were coughing or had fever could have theses symptoms for a number of different reasons not linked to H1N1. It was better to concentrate public health resources in identifying and treating severe cases that needed medical attention.

On the distribution of vaccines, Mr. Hartl said that they had been given promises of 150 million doses from two manufacturers and that WHO was working with different partners to secure more vaccines for developing countries. The vaccines WHO would get would be mainly sent to Least Developed Countries, with the main priority being healthcare workers in these countries, as they were the most exposed and because if they fell sick the whole health system would break down. It was still unknown for the moment whether an individual would need one or two shots of vaccine. Clinical trials had only recently started and they had to wait one or two weeks after the first injections to see the reaction of people?s antibodies.