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

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

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

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

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

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



Main developments in past 24 hours

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

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


Epidemiologic update


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


Daily Update contents


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


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


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


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


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


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

  1. Austria (16.10.) ? ? ? ? ? ? ? ?
  2. Belgium (16.10.) ? ? ? ? ? ? ? ?
  3. Bulgaria ? ? ? ? ? ? ? ?
  4. Cyprus ? ? ? ? ? ? ? ?
  5. Czech Republic (15.10.) ? ? ? ? ? ? ? ?
  6. Denmark (21.10.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (26.10.) ? ? ? ? ? ? ? ?
  9. France (20.10.) ? 37 ? 317 ? 13 ? 43
  10. Germany (21.10.) ? ? ? ? ? ? ? ?
  11. Greece (21.10.) ? ? ? ? ? ? ? ?
  12. Hungary (22.10.) ? ? ? ? ? ? ? ?
  13. Iceland (21.10.) ? 31 ? 80 - 6 ? ?
  14. Ireland (18.10.) ? ? - 325 ? ? ? 26
  15. Italy (18.10) ? ? - 1494 ? ? ? ?
  16. Latvia (13.08.) ? ? - 1 ? ? ? ?
  17. Liechtenstein (21.10.) ? ? ? ? ? ? ? ?
  18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
  19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? - 1
  21. Netherlands (23.10.) ? 54 ? 205 ? 7 ? 31
  22. Norway (22.10.) ? 15 ? 142 ? 4 ? 27
  23. Poland (27.10.) ? ? ? ? ? ? ? ?
  24. Portugal (21.10.) - 15 ? ? - 2 ? ?
  25. Romania (26.10) ? ? ? ? ? ? ? ?
  26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
  28. Spain (22.10.) ? ? - 303 ? ? ? 137
  29. Sweden (22.10.) ? 13 - 145 ? ? ? ?
  30. Switzerland (21.10.) ? ? - 24 ? ? ? 3
  31. United Kingdom (a) (22.10.) - 506 ? ? - 99 ? ?
Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (380 cumulative hospitalisations), Wales (126) and Northern Ireland (346).


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


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

  • EU AND EFTA COUNTRIES
    • Belgium ? ? 5
    • Bulgaria ? ? 1
    • Czech Republic ? ? 1
    • Finland ? ? 1
    • France ? ? 36 (a)
    • Germany ? ? 3
    • Greece ? ? 3
    • Hungary ? ? 4
    • Iceland ? ? 1
    • Ireland ? ? 9
    • Italy ? ? 4
    • Luxembourg ? ? 1
    • Malta ? ? 5
    • Netherlands ? ? 6
    • Norway ? ? 11
    • Portugal ? ? 3
    • Spain ? ? 54
    • Sweden ? ? 2
    • United Kingdom ? ? 130
      • Total ? ? 280
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Serbia ? ? 1
    • Moldova ? ? 1
    • Russia 3 ? 3
      • Total 3 ? 5
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? ? 6
    • Egypt ? ? 3
    • Iran ? ? 16
    • Iraq ? ? 4
    • Israel 1 ? 35
    • Jordan ? ? 3
    • Kuwait 1 ? 13
    • Lebanon ? - 3
    • Occupied Palestinian Territory ? ? 1
    • Oman ? ? 24
    • Qatar ? ? 3
    • Saudi Arabia ? ? 39
    • Syria ? ? 2
    • Turkey ? ? 1
    • United Arab Emirates ? ? 6
    • Yemen ? ? 13
      • Total 2 ? 172
  • AFRICA
    • Ghana ? ? 1
    • Madagascar ? ? 1
    • Mauritius ? ? 8
    • Mozambique ? ? 2
    • Namibia ? ? 1
    • Sao Tome & Principe ? ? 2
    • South Africa ? ? 91
    • Sudan ? ? 1
    • Tanzania ? ? 1
      • Total ? ? 108
  • NORTH AMERICA
    • Canada ? ? 86
    • Mexico ? ? 314
    • USA (b) ? ? 1004
      • Total ? ? 1404
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? ? 1
    • Costa Rica ? ? 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador ? ? 22
    • Guatemala ? ? 13
    • Honduras ? ? 16
    • Jamaica ? ? 5
    • Nicaragua ? ? 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Suriname ? - 2
    • Trinidad-Tobago ? ? 5
      • Total ? ? 161
  • SOUTH AMERICA
    • Argentina ? ? 585
    • Bolivia ? ? 56
    • Brazil ? ? 1368
    • Chile ? ? 136
    • Colombia ? ? 118
    • Ecuador ? ? 70
    • Paraguay ? ? 52
    • Peru ? ? 162
    • Uruguay ? ? 33
    • Venezuela 2 ? 95
      • Total 2 ? 2675
  • NORTH-EAST & SOUTH ASIA
    • Bangladesh ? ? 6
    • China (Mainland) ? ? 3
    • Hong Kong SAR China ? ? 33
    • India 3 - 447
    • Japan ? ? 27
    • Macao SAR China ? ? 1
    • Mongolia 3 ? 4
    • South Korea 3 ? 28
    • Taiwan ? ? 25
      • Total 9 ? 574
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia ? ? 3
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand ? ? 176
    • Vietnam ? ? 32
      • Total ? ? 348
  • AUSTRALIA & PACIFIC
    • Australia ? ? 186
    • Cook Islands ? ? 1
    • Marshall Islands ? - 1
    • New Zealand ? ? 19
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total ? ? 211
  • TOTAL 16 ? 5938
(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 9 in mainland France.
(b) Update today includes reported laboratory-confirmed influenza-associated U.S. fatal cases since August 1.
(?)
-
-------
 
Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

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

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

Main developments in past 24 hours

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

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

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

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

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

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

  1. Austria (16.10.) ? ? ? ? ? ? ? ?
  2. Belgium (16.10.) ? ? ? ? ? ? ? ?
  3. Bulgaria (25.10) ? ? ? ? ? ? ? ?
  4. Cyprus ? ? ? ? ? ? ? ?
  5. Czech Republic (15.10.) ? ? ? ? ? ? ? ?
  6. Denmark (28.10.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (26.10.) ? ? ? ? ? ? ? ?
  9. France (25.10.) ? 99 ? 447 ? 36 ? 73
  10. Germany (21.10.) ? ? ? ? ? ? ? ?
  11. Greece (21.10.) ? ? ? ? ? ? ? ?
  12. Hungary (22.10.) ? ? ? ? ? ? ? ?
  13. Iceland (21.10.) ? 31 ? 80 - 6 ? ?
  14. Ireland (18.10.) ? ? - 325 ? ? ? 26
  15. Italy (18.10) ? ? - 1494 ? ? ? ?
  16. Latvia (13.08.) ? ? - 1 ? ? ? ?
  17. Liechtenstein (21.10.) ? ? ? ? ? ? ? ?
  18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
  19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (23.10.) ? 54 ? 205 ? 7 ? 31
  22. Norway (22.10.) ? 15 ? 142 ? 4 ? 27
  23. Poland (28.10.) ? ? ? ? ? ? ? ?
  24. Portugal (28.10.) - 47 ? ? - 4 ? ?
  25. Romania (26.10) ? ? ? ? ? ? ? ?
  26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
  28. Spain (22.10.) ? ? - 303 ? ? ? 137
  29. Sweden (22.10.) ? 13 - 145 ? ? ? ?
  30. Switzerland (25.10.) ? 3 - 27 ? ? ? ?
  31. United Kingdom (a) (22.10.) - 506 ? ? - 99 ? ?
Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (380 cumulative hospitalisations), Wales (126) and Northern Ireland (346).

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

  • EU AND EFTA COUNTRIES
    • Belgium ? ? 5
    • Bulgaria 1 ? 2
    • Czech Republic ? ? 1
    • Finland ? ? 1
    • France 8 ? 44 (a)
    • Germany ? ? 3
    • Greece ? ? 3
    • Hungary ? ? 4
    • Iceland ? ? 1
    • Ireland 1 ? 10
    • Italy ? ? 4
    • Luxembourg ? ? 1
    • Malta ? ? 5
    • Netherlands ? ? 6
    • Norway 2 ? 13
    • Portugal ? ? 3
    • Spain ? ? 54
    • Sweden ? ? 2
    • United Kingdom ? ? 130
      • Total 12 ? 292
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Serbia ? ? 1
    • Moldova ? ? 1
    • Russia 1 ? 4
      • Total 1 ? 6
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? ? 6
    • Egypt ? ? 3
    • Iran 6 ? 22
    • Iraq ? ? 4
    • Israel ? ? 35
    • Jordan ? ? 3
    • Kuwait ? ? 13
    • Lebanon ? - 3
    • Occupied Palestinian Territory ? ? 1
    • Oman ? ? 24
    • Qatar ? ? 3
    • Saudi Arabia ? ? 39
    • Syria ? ? 2
    • Turkey ? ? 1
    • United Arab Emirates ? ? 6
    • Yemen 3 ? 16
      • Total 9 ? 181
  • AFRICA
    • Ghana ? ? 1
    • Madagascar ? ? 1
    • Mauritius ? ? 8
    • Mozambique ? ? 2
    • Namibia ? ? 1
    • Sao Tome & Principe ? ? 2
    • South Africa ? ? 91
    • Sudan ? ? 1
    • Tanzania ? ? 1
      • Total ? ? 108
  • NORTH AMERICA
    • Canada 3 ? 89
    • Mexico 14 ? 328
    • USA ? ? 1004
      • Total 17 ? 1421
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? ? 1
    • Costa Rica ? ? 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador ? ? 22
    • Guatemala 5 ? 18
    • Honduras ? ? 16
    • Jamaica ? ? 5
    • Nicaragua ? ? 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Suriname ? - 2
    • Trinidad-Tobago ? ? 5
      • Total 5 ? 166
  • SOUTH AMERICA
    • Argentina ? ? 585
    • Bolivia ? ? 56
    • Brazil ? ? 1368
    • Chile ? ? 136
    • Colombia 13 ? 131
    • Ecuador 5 ? 75
    • Paraguay ? ? 52
    • Peru ? ? 162
    • Uruguay ? ? 33
    • Venezuela ? ? 95
      • Total 18 ? 2693
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan 1 ? 1
    • Bangladesh ? ? 6
    • China (Mainland) ? ? 3
    • Hong Kong SAR China ? ? 33
    • India 4 ? 451
    • Japan ? ? 27
    • Macao SAR China ? ? 1
    • Mongolia ? ? 4
    • South Korea 5 ? 33
    • Taiwan 2 ? 27
      • Total 12 ? 586
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia ? ? 3
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand 6 ? 182
    • Vietnam 3 ? 35
      • Total 9 ? 357
  • AUSTRALIA & PACIFIC
    • Australia ? ? 186
    • Cook Islands ? - 1
    • Marshall Islands ? ? 1
    • New Zealand ? ? 19
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total ? ? 211
  • TOTAL 83 ? 6021
(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 17 in mainland France.
(?)
-
-------
 
Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

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

[Source PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

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


Main developments in past 24 hours

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

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


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


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


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


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

  1. Austria (23.10.) ? ? ? ? ? ? ? ?
  2. Belgium (29.10.) ? ? ? ? ? ? ? ?
  3. Bulgaria (25.10) ? ? ? ? ? ? ? ?
  4. Cyprus ? ? ? ? ? ? ? ?
  5. Czech Republic (29.10.) ? ? ? ? ? ? ? ?
  6. Denmark (28.10.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (29.10.) ? ? ? ? ? ? ? ?
  9. France (25.10.) ? 99 ? 447 ? 36 ? 73
  10. Germany (21.10.) ? ? ? ? ? ? ? ?
  11. Greece (21.10.) ? ? ? ? ? ? ? ?
  12. Hungary (25.10.) ? ? - 64 ? ? ? ?
  13. Iceland (29.10.) ? ? ? 100 - 14 ? ?
  14. Ireland (25.10.) ? ? - 438 ? ? ? 38
  15. Italy (18.10) ? ? - 1494 ? ? ? ?
  16. Latvia (13.08.) ? ? - 1 ? ? ? ?
  17. Liechtenstein (25.10.) ? ? ? ? ? ? ? ?
  18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
  19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (23.10.) ? 54 ? 205 ? 7 ? 31
  22. Norway (28.10.) ? 18 ? 144 ? 3 ? 27
  23. Poland (29.10.) ? ? ? ? ? ? ? ?
  24. Portugal (28.10.) - 47 ? ? - 4 ? ?
  25. Romania (26.10) ? ? ? ? ? ? ? ?
  26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
  28. Spain (22.10.) ? ? - 303 ? ? ? 137
  29. Sweden (25.10.) ? 26 - 174 ? ? ? ?
  30. Switzerland (25.10.) ? 3 - 27 ? ? ? ?
  31. United Kingdom (a) (29.10.) - 751 ? ?- 157 ? ?
Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (580 cumulative hospitalisations), Wales (192) and Northern Ireland (437).


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


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

  • EU AND EFTA COUNTRIES
    • Belgium 2 ? 7
    • Bulgaria ? ? 2
    • Czech Republic ? ? 1
    • Finland ? ? 1
    • France ? ? 44 (a)
    • Germany ? ? 3
    • Greece ? ? 3
    • Hungary ? ? 4
    • Iceland ? ? 1
    • Ireland ? ? 10
    • Italy ? ? 4
    • Luxembourg ? ? 1
    • Malta ? ? 5
    • Netherlands ? ? 6
    • Norway ? ? 13
    • Portugal 1 ? 4
    • Spain ? ? 54
    • Sweden ? ? 2
    • United Kingdom 7 ? 137
      • Total 10 ? 302
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Serbia ? ? 1
    • Moldova ? ? 1
    • Russia 1 ? 5
      • Total 1 ? 7
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? ? 6
    • Egypt ? ? 3
    • Iran ? ? 22
    • Iraq ? ? 4
    • Israel ? ? 35
    • Jordan 1 ? 4
    • Kuwait ? ? 13
    • Lebanon ? - 3
    • Occupied Palestinian Territory ? ? 1
    • Oman ? ? 24
    • Qatar ? ? 3
    • Saudi Arabia ? ? 39
    • Syria 4 ? 6
    • Turkey ? ? 1
    • United Arab Emirates ? ? 6
    • Yemen ? ? 16
      • Total 5 ? 186
  • AFRICA
    • Ghana ? ? 1
    • Madagascar ? ? 1
    • Mauritius ? ? 8
    • Mozambique ? ? 2
    • Namibia ? ? 1
    • Sao Tome & Principe ? ? 2
    • South Africa ? ? 91
    • Sudan ? ? 1
    • Tanzania ? ? 1
      • Total ? ? 108
  • NORTH AMERICA
    • Canada ? ? 89
    • Mexico ? ? 328
    • USA ? ? 1004
      • Total ? ? 1421
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? ? 1
    • Costa Rica ? ? 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador ? ? 22
    • Guatemala ? ? 18
    • Honduras ? ? 16
    • Jamaica ? ? 5
    • Nicaragua ? ? 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Suriname ? - 2
    • Trinidad-Tobago ? ? 5
      • Total ? ? 166
  • SOUTH AMERICA
    • Argentina ? ? 585
    • Bolivia ? ? 56
    • Brazil ? ? 1368
    • Chile ? ? 136
    • Colombia ? ? 131
    • Ecuador ? ? 75
    • Paraguay ? ? 52
    • Peru ? ? 162
    • Uruguay ? ? 33
    • Venezuela ? ? 95
      • Total ? ? 2693
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan ? ? 1
    • Bangladesh ? ? 6
    • China (Mainland) 1 ? 4
    • Hong Kong SAR China 4 ? 37
    • India 6 ? 457
    • Japan ? ? 27
    • Macao SAR China 1 ? 2
    • Mongolia ? ? 4
    • South Korea ? ? 33
    • Taiwan ? ? 27
      • Total 12 ? 598
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia 1 ? 4
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand ? ? 182
    • Vietnam 1 ? 36
      • Total 2 ? 359
  • AUSTRALIA & PACIFIC
    • Australia ? ? 186
    • Cook Islands ? ? 1
    • Marshall Islands ? ? 1
    • New Zealand ? ? 19
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total ? ? 211
  • TOTAL 30 ? 6051
(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 17 in mainland France.
(?)
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Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

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

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

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


Main developments in past 72 hours

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



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


New Developments

WHO SAGE Committee advises on pandemic vaccines October 30th 2009


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


Notable conclusions with relevance for European countries were:

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

Severe Acute Respiratory Infection in the Ukraine ? Late October


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


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


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

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


Epidemiologic update


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


Daily Update contents


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


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


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

  1. Austria (23.10.) ? ? ? ? ? ? ? ?
  2. Belgium (29.10.) ? ? ? ? ? ? ? ?
  3. Bulgaria (25.10) ? ? ? ? ? ? ? ?
  4. Cyprus ? ? ? ? ? ? ? ?
  5. Czech Republic (29.10.) ? ? ? ? ? ? ? ?
  6. Denmark (28.10.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (29.10.) ? ? ? ? ? ? ? ?
  9. France (25.10.) ? 99 ? 447 ? 36 ? 73
  10. Germany (21.10.) ? ? ? ? ? ? ? ?
  11. Greece (29.10.) ? ? ? ? ? ? ? ?
  12. Hungary (25.10.) ? ? - 64 ? ? ? ?
  13. Iceland (29.10.) ? ? ? 100 - 14 ? ?
  14. Ireland (25.10.) ? ? - 438 ? ? ? 38
  15. Italy (18.10) ? ? - 1494 ? ? ? ?
  16. Latvia (13.08.) ? ? - 1 ? ? ? ?
  17. Liechtenstein (25.10.) ? ? ? ? ? ? ? ?
  18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
  19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (30.10.) ? 131 ? 335 ? 7 ? 39
  22. Norway (28.10.) ? 18 ? 144 ? 3 ? 27
  23. Poland (29.10.) ? ? ? ? ? ? ? ?
  24. Portugal (28.10.) - 47 ? ? - 4 ? ?
  25. Romania (26.10) ? ? ? ? ? ? ? ?
  26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
  28. Spain (29.10.) ? ? ? ? ? ? ? ?
  29. Sweden (25.10.) ? 26 - 174 ? ? ? ?
  30. Switzerland (25.10.) ? 3 - 27 ? ? ? ?
  31. United Kingdom (a) (29.10.) - 751 ? ? - 157 ? ?
Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (580 cumulative hospitalisations), Wales (192) and Northern Ireland (437).


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


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

  • EU AND EFTA COUNTRIES
    • Belgium ? ? 7
    • Bulgaria ? ? 2
    • Czech Republic ? ? 1
    • Finland ? ? 1
    • France ? ? 44 (a)
    • Germany 2 ? 5
    • Greece ? ? 3
    • Hungary ? ? 4
    • Iceland ? ? 1
    • Ireland ? ? 10
    • Italy ? ? 4
    • Luxembourg ? ? 1
    • Malta ? ? 5
    • Netherlands 4 ? 10
    • Norway ? ? 13
    • Portugal ? ? 4
    • Spain 9 ? 63
    • Sweden ? ? 2
    • United Kingdom ? ? 137
      • Total 15 ? 317
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Serbia ? ? 1
    • Moldova ? ? 1
    • Russia ? ? 5
      • Total ? ? 7
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? ? 6
    • Egypt 1 ? 4
    • Iran ? ? 22
    • Iraq ? ? 4
    • Israel ? ? 35
    • Jordan ? ? 4
    • Kuwait 3 ? 16
    • Lebanon ? - 3
    • Occupied Palestinian Territory ? ? 1
    • Oman ? ? 24
    • Qatar 1 ? 4
    • Saudi Arabia 23 ? 62
    • Syria 1 ? 7
    • Turkey 2 ? 3
    • United Arab Emirates ? ? 6
    • Yemen ? ? 16
      • Total 31 ? 217
  • AFRICA
    • Ghana ? ? 1
    • Madagascar ? ? 1
    • Mauritius ? ? 8
    • Mozambique ? ? 2
    • Namibia ? ? 1
    • Sao Tome & Principe ? ? 2
    • South Africa ? ? 91
    • Sudan ? ? 1
    • Tanzania ? ? 1
      • Total ? ? 108
  • NORTH AMERICA
    • Canada 6 ? 95
    • Mexico 26 ? 354
    • USA ? ? 1004
      • Total 32 ? 1453
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? ? 1
    • Costa Rica ? ? 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador ? ? 22
    • Guatemala ? ? 18
    • Honduras ? ? 16
    • Jamaica ? ? 5
    • Nicaragua ? ? 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Suriname ? - 2
    • Trinidad-Tobago ? ? 5
      • Total ? ? 166
  • SOUTH AMERICA
    • Argentina 8 ? 593
    • Bolivia ? ? 56
    • Brazil ? ? 1368
    • Chile ? ? 136
    • Colombia ? ? 131
    • Ecuador ? ? 75
    • Paraguay ? ? 52
    • Peru ? ? 162
    • Uruguay ? ? 33
    • Venezuela ? ? 95
      • Total 8 ? 2701
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan ? ? 1
    • Bangladesh ? ? 6
    • China (Mainland) ? ? 4
    • Hong Kong SAR China ? ? 37
    • India 15 ? 472
    • Japan ? ? 27
    • Macao SAR China ? ? 2
    • Mongolia ? ? 4
    • South Korea 1 ? 34
    • Taiwan ? ? 27
      • Total 16 ? 614
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia ? ? 4
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand ? ? 182
    • Vietnam ? ? 36
      • Total ? ? 359
  • AUSTRALIA & PACIFIC
    • Australia ? ? 186
    • Cook Islands ? - 1
    • Marshall Islands ? ? 1
    • New Zealand ? ? 19
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total ? ? 211
  • TOTAL 102 ? 6153
(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 17 in mainland France.
(?)
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Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

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

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

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


Main developments in past 24 hours

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

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


Updates from U.S.A. and Canada

United States Update

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

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

Canada Update

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


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

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

Other Updates

WHO Report on the situation in the Ukraine


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


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


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


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


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


Epidemiologic update


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


Daily Update contents


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


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


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


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


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


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

  1. Austria (23.10.) ? ? ? ? ? ? ? ?
  2. Belgium (29.10.) ? ? ? ? ? ? ? ?
  3. Bulgaria (25.10) ? ? ? ? ? ? ? ?
  4. Cyprus ? ? ? ? ? ? ? ?
  5. Czech Republic (29.10.) ? ? ? ? ? ? ? ?
  6. Denmark (28.10.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (29.10.) ? ? ? ? ? ? ? ?
  9. France (25.10.) ? 99 ? 447 ? 36 ? 73
  10. Germany (21.10.) ? ? ? ? ? ? ? ?
  11. Greece (29.10.) ? ? ? ? ? ? ? ?
  12. Hungary (25.10.) ? ? - 64 ? ? ? ?
  13. Iceland (29.10.) ? ? ? 100 - 14 ? ?
  14. Ireland (25.10.) ? ? - 438 ? ? ? 38
  15. Italy (18.10) ? ? - 1494 ? ? ? ?
  16. Latvia (13.08.) ? ? - 1 ? ? ? ?
  17. Liechtenstein (25.10.) ? ? ? ? ? ? ? ?
  18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
  19. Luxembourg (21.10.) ? ? ? ? - 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (30.10.) ? 131 ? 335 ? 7 ? 39
  22. Norway (28.10.) ? 18 ? 144 ? 3 ? 27
  23. Poland (29.10.) ? ? ? ? ? ? ? ?
  24. Portugal (28.10.) - 47 ? ? - 4 ? ?
  25. Romania (26.10) ? ? ? ? ? ? ? ?
  26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
  28. Spain (29.10.) ? ? ? ? ? ? ? ?
  29. Sweden (25.10.) ? 26 - 174 ? ? ? ?
  30. Switzerland (25.10.) ? 3 - 27 ? ? ? ?
  31. United Kingdom (a) (29.10.) - 751 ? ? - 157 ? ?
Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (580 cumulative hospitalisations), Wales (192) and Northern Ireland (437).


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


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

  • EU AND EFTA COUNTRIES
    • Austria 1 ? 1
    • Belgium ? ? 7
    • Bulgaria ? ? 2
    • Czech Republic ? 1
    • Finland ? ? 1
    • France ? ? 44 (a)
    • Germany 1 ? 6
    • Greece ? ? 3
    • Hungary ? ? 4
    • Iceland ? ? 1
    • Ireland ? ? 10
    • Italy ? ? 4
    • Luxembourg ? ? 1
    • Malta ? ? 5
    • Netherlands ? ? 10
    • Norway 2 ? 15
    • Portugal 1 ? 5
    • Spain ? ? 63
    • Sweden ? ? 2
    • United Kingdom 3 ? 140
      • Total 8 ? 325
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Croatia 1 ? 1
    • Moldova ? ? 1
    • Russia ? ? 5
    • Serbia ? ? 1
      • Total 1 ? 8
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? ? 6
    • Egypt ? ? 4
    • Iran ? ? 22
    • Iraq 3 ? 7
    • Israel ? ? 35
    • Jordan 1 ? 5
    • Kuwait 1 ? 17
    • Lebanon ? ? 3
    • Occupied Palestinian Territory ? ? 1
    • Oman 1 ? 25
    • Qatar ? ? 4
    • Saudi Arabia ? ? 62
    • Syria ? ? 7
    • Turkey ? ? 3
    • United Arab Emirates ? ? 6
    • Yemen ? ? 16
      • Total 6 ? 223
  • AFRICA
    • Ghana ? ? 1
    • Madagascar ? ? 1
    • Mauritius ? ? 8
    • Mozambique ? ? 2
    • Namibia ? ? 1
    • Sao Tome & Principe ? ? 2
    • South Africa ? ? 91
    • Sudan ? ? 1
    • Tanzania ? ? 1
      • Total ? ? 108
  • NORTH AMERICA
    • Canada ? ? 95
    • Mexico ? ? 354
    • USA ? ? 1004
      • Total ? ? 1453
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? ? 1
    • Costa Rica ? ? 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador ? ? 22
    • Guatemala ? ? 18
    • Honduras ? ? 16
    • Jamaica ? ? 5
    • Nicaragua ? ? 11
    • Panama ? - 11
    • Saint Kitts and Nevis ? ? 1
    • Suriname ? ? 2
    • Trinidad-Tobago ? ? 5
      • Total ? ? 166
  • SOUTH AMERICA
    • Argentina ? ? 593
    • Bolivia ? ? 56
    • Brazil ? ? 1368
    • Chile ? ? 136
    • Colombia ? ? 131
    • Ecuador ? ? 75
    • Paraguay ? ? 52
    • Peru ? ? 162
    • Uruguay ? ? 33
    • Venezuela ? ? 95
      • Total ? ? 2701
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan ? ? 1
    • Bangladesh ? ? 6
    • China (Mainland) 2 ? 6
    • Hong Kong SAR China ? ? 37
    • India 1 ? 473
    • Japan ? ? 27
    • Macao SAR China ? ? 2
    • Mongolia ? ? 4
    • South Korea ? ? 34
    • Taiwan ? ? 27
      • Total 3 ? 617
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia ? ? 4
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand ? ? 182
    • Vietnam ? ? 36
      • Total ? ? 359
  • AUSTRALIA & PACIFIC
    • Australia ? ? 186
    • Cook Islands ? ? 1
    • Marshall Islands ? ? 1
    • New Zealand ? ? 19
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total ? ? 211
  • TOTAL 18 - 6171
(?)
-
-----
 
Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

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

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

Main developments in past 24 hours

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

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

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

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

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

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

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

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

  1. Austria (23.10.) ? ? ? ? ? ? ? ?
  2. Belgium (29.10.) ? ? ? ? ? ? ? ?
  3. Bulgaria (25.10) ? ? ? ? ? ? ? ?
  4. Cyprus ? ? ? ? ? ? ? ?
  5. Czech Republic (29.10.) ? ? ? ? ? ? ? ?
  6. Denmark (28.10.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (03.11.) ? ? ? ? ? ? ? ?
  9. France (25.10.) ? 99 ? 447 ? 36 ? 73
  10. Germany (29.10.) ? ? ? ? ? ? ? ?
  11. Greece (29.10.) ? ? ? ? ? ? ? ?
  12. Hungary (25.10.) ? ? - 64 ? ? ? ?
  13. Iceland (30.10.) - 43 ? ? - 11 ? ?
  14. Ireland (29.10.) ? 109 ? 492 ? 23 ? 45
  15. Italy (18.10) ? ? - 1494 ? ? ? ?
  16. Latvia (13.08.) ? ? - 1 ? ? ? ?
  17. Liechtenstein (25.10.) ? ? ? ? ? ? ? ?
  18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
  19. Luxembourg (21.10.) ? ? ? ?- 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (30.10.) ? 131 ? 335 ? 7 ? 39
  22. Norway (28.10.) ? 18 ? 144 ? 3 ? 27
  23. Poland (03.11.) ? ? ? ? ? ? ? ?
  24. Portugal (28.10.) - 47 ? ? - 4 ? ?
  25. Romania (02.11) ? ? ? ? ? ? ? ?
  26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
  28. Spain (29.10.) ? ? ? ? ? ? ? ?
  29. Sweden (25.10.) ? 26 - 174 ? ? ? ?
  30. Switzerland (25.10.) ? 3 - 27 ? ? ? ?
  31. United Kingdom (a) (29.10.) - 751 ? ? - 157 ? ?
Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (580 cumulative hospitalisations), Wales (192) and Northern Ireland (437).

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

  • EU AND EFTA COUNTRIES
    • Austria ? ? 1
    • Belgium ? ? 7
    • Bulgaria 2 ? 4
    • Czech Republic ? ? 1
    • Finland ? ? 1
    • France ? ? 44 (a)
    • Germany ? ? 6
    • Greece ? ? 3
    • Hungary ? ? 4
    • Iceland ? ? 1
    • Ireland ? ? 10
    • Italy 13 ? 17
    • Luxembourg ? ? 1
    • Malta ? ? 3
    • Netherlands ? ? 10
    • Norway ? ? 15
    • Portugal ? ? 5
    • Spain ? ? 63
    • Sweden ? ? 2
    • United Kingdom 2 ? 142
      • Total 17 ? 340
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Croatia ? ? 1
    • Moldova ? ? 1
    • Russia 9 ? 14
    • Serbia ? ? 1
      • Total 9 ? 17
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? ? 6
    • Egypt 1 ? 5
    • Iran 6 ? 28
    • Iraq ? ? 7
    • Israel 4 - 39
    • Jordan 2 ? 7
    • Kuwait 4 ? 21
    • Lebanon ? ? 3
    • Occupied Palestinian Territory ? ? 1
    • Oman ? ? 25
    • Qatar ? ? 4
    • Saudi Arabia ? ? 62
    • Syria ? ? 7
    • Turkey 8 ? 11
    • United Arab Emirates ? ? 6
    • Yemen ? ? 16
      • Total 25 ? 248
  • AFRICA
    • Ghana ? ? 1
    • Madagascar ? ? 1
    • Mauritius ? ? 8
    • Mozambique ? ? 2
    • Namibia ? ? 1
    • Sao Tome & Principe ? ? 2
    • South Africa ? ? 91
    • Sudan ? ? 1
    • Tanzania ? ? 1
      • Total ? ? 108
  • NORTH AMERICA
    • Canada ? ? 95
    • Mexico 23 ? 377
    • USA ? ? 1004
      • Total 23 ? 1476
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? ? 1
    • Costa Rica ? ? 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador ? ? 22
    • Guatemala ? ? 18
    • Honduras ? ? 16
    • Jamaica ? ? 5
    • Nicaragua ? - 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Suriname ? ? 2
    • Trinidad-Tobago ? ? 5
      • Total ? ? 166
  • SOUTH AMERICA
    • Argentina ? ? 593
    • Bolivia ? ? 56
    • Brazil ? ? 1368
    • Chile ? ? 136
    • Colombia ? ? 131
    • Ecuador ? ? 75
    • Paraguay ? ? 52
    • Peru ? ? 162
    • Uruguay ? ? 33
    • Venezuela ? ? 95
      • Total ? ? 2701
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan ? ? 1
    • Bangladesh ? ? 6
    • China (Mainland) 1 ? 7
    • Hong Kong SAR China ? ? 37
    • India 2 ? 475
    • Japan ? ? 27
    • Macao SAR China ? ? 2
    • Mongolia ? ? 4
    • South Korea 8 ? 42
    • Taiwan ? ? 27
      • Total 11 ? 628
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia ? ? 4
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand ? ? 182
    • Vietnam 1 ? 37
      • Total 1 - 360
  • AUSTRALIA & PACIFIC
    • Australia ? ? 186
    • Cook Islands ? ? 1
    • Marshall Islands ? ? 1
    • New Zealand ? ? 19
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total ? ? 211
  • TOTAL 86 - 6255
(?)
-
------
 
Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

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

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

Main developments in past 24 hours

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

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

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

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

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

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

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

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

  1. Austria (23.10.) ? ? ? ? ? ? ? ?
  2. Belgium (29.10.) ? ? ? ? ? ? ? ?
  3. Bulgaria (25.10) ? ? ? ? ? ? ? ?
  4. Cyprus ? ? ? ? ? ? ? ?
  5. Czech Republic (29.10.) ? ? ? ? ? ? ? ?
  6. Denmark (04.11.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (03.11.) ? ? ? ? ? ? ? ?
  9. France (04.11.) ? 203 ? 625 ? 36 ? 131
  10. Germany (29.10.) ? ? ? ? ? ? ? ?
  11. Greece (29.10.) ? ? ? ? ? ? ? ?
  12. Hungary (25.10.) ? ? - 64 ? ? ? ?
  13. Iceland (30.10.) - 43 ? ? - 11 ? ?
  14. Ireland (29.10.) ? 109 ? 492 ? 23 ? 45
  15. Italy (04.11) ? ? ? ? ? ? ? ?
  16. Latvia (13.08.) ? ? - 1 ? ? ? ?
  17. Liechtenstein (25.10.) ? ? ? ? ? ? ? ?
  18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
  19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (30.10.) ? 131 ? 335 ? 7 ? 39
  22. Norway (04.11.) ? 69 ? 497 ? 4 ? 69
  23. Poland (04.11.) ? ? ? ? ? ? ? ?
  24. Portugal (04.11.) - 63 ? ? - 9 ? ?
  25. Romania (04.11) ? ? ? ? ? ? ? ?
  26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
  28. Spain (29.10.) ? ? ? ? ? ? ? ?
  29. Sweden (25.10.) ? 26 - 174 ? ? ? ?
  30. Switzerland (25.10.) ? 3 - 27 ? ? ? ?
  31. United Kingdom (a) (29.10.) - 751 ? ? - 157 ? ?
Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (580 cumulative hospitalisations), Wales (192) and Northern Ireland (437).

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

  • EU AND EFTA COUNTRIES
    • Austria ? ? 1
    • Belgium 1 ? 8
    • Bulgaria 1 ? 5
    • Czech Republic ? ? 1
    • Finland ? ? 1
    • France 5 ? 49 (a)
    • Germany ? ? 6
    • Greece ? ? 3
    • Hungary ? ? 4
    • Iceland ? ? 1
    • Ireland ? ? 10
    • Italy 4 ? 21
    • Luxembourg ? ? 1
    • Malta ? ? 3
    • Netherlands ? ? 10
    • Norway ? ? 15
    • Portugal ? ? 5
    • Spain ? ? 63
    • Sweden ? ? 2
    • United Kingdom 1 ? 143
      • Total 12 ? 352
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Belarus 1 ? 1
    • Croatia ? ? 1
    • Moldova 1 ? 2
    • Russia ? ? 14
    • Serbia 1 ? 2
    • Ukraine 1 ? 1
      • Total 4 ? 21
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? ? 6
    • Egypt 1 ? 6
    • Iran ? - 28
    • Iraq ? ? 7
    • Israel ? ? 39
    • Jordan ? ? 7
    • Kuwait ? ? 21
    • Lebanon ? ? 3
    • Occupied Palestinian Territory ? ? 1
    • Oman ? ? 25
    • Qatar ? ? 4
    • Saudi Arabia 4 ? 66
    • Syria ? ? 7
    • Turkey 4 ? 15
    • United Arab Emirates ? ? 6
    • Yemen 1 ? 17
      • Total 10 ? 258
  • AFRICA
    • Ghana ? ? 1
    • Madagascar ? ? 1
    • Mauritius ? ? 8
    • Mozambique ? ? 2
    • Namibia ? ? 1
    • Sao Tome & Principe ? ? 2
    • South Africa ? ? 91
    • Sudan ? ? 1
    • Tanzania ? ? 1
      • Total ? ? 108
  • NORTH AMERICA
    • Canada 6 ? 101
    • Mexico ? ? 377
    • USA ? ? 1004
      • Total 6 ? 1482
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? ? 1
    • Costa Rica ? ? 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador ? ? 22
    • Guatemala ? ? 18
    • Honduras ? - 16
    • Jamaica ? ? 5
    • Nicaragua ? ? 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Suriname ? ? 2
    • Trinidad-Tobago ? ? 5
      • Total ? ? 166
  • SOUTH AMERICA
    • Argentina ? ? 593
    • Bolivia ? ? 56
    • Brazil ? ? 1368
    • Chile ? ? 136
    • Colombia 5 ? 136
    • Ecuador ? ? 75
    • Paraguay ? ? 52
    • Peru ? ? 162
    • Uruguay ? ? 33
    • Venezuela ? ? 95
      • Total 5 ? 2706
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan ? ? 1
    • Bangladesh ? ? 6
    • China (Mainland) 1 ? 8
    • Hong Kong SAR China ? ? 37
    • India 3 ? 478
    • Japan 1 ? 28
    • Macao SAR China ? ? 2
    • Mongolia 2 ? 6
    • South Korea 3 ? 45
    • Taiwan ? ? 27
      • Total 10 ? 638
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia ? ? 4
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand 2 - 184
    • Vietnam ? ? 37
      • Total 2 ? 362
  • AUSTRALIA & PACIFIC
    • Australia ? ? 186
    • Cook Islands ? ? 1
    • Marshall Islands ? ? 1
    • New Zealand ? ? 19
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total ? ? 211
  • TOTAL 49 ? 6304
(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 22 in mainland France.
(?)
-
------
 
Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

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

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

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


Main developments in past 24 hours

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

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


Other updates

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

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

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


Weekly Influenza Surveillance Overview


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


Eurosurveillance update


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

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


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

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


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

Measures against transmission of pandemic H1N1 influenza in Japan

in 2009: Simulation model. LINK


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

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


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

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

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


Epidemiologic update


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


Daily Update contents


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


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


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

  1. Austria (23.10.) ? ? ? ? ? ? ? ?
  2. Belgium (05.11.) ? ? ? ? ? ? ? ?
  3. Bulgaria (04.11) ? ? ? ? ? ? ? ?
  4. Cyprus ? ? ? ? ? ? ? ?
  5. Czech Republic (05.11.) ? ? ? ? ? ? ? ?
  6. Denmark (04.11.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (04.11.) ? ? ? ? ? ? ? ?
  9. France (04.11.) ? 203 ? 625 ? 36 ? 131
  10. Germany (29.10.) ? ? ? ? ? ? ? ?
  11. Greece (04.11.) ? ? ? ? ? ? ? ?
  12. Hungary (01.11.) ? ? - 68 ? ? ? ?
  13. Iceland (30.10.) - 43 ? ? - 11 ? ?
  14. Ireland (05.11.) ? 165 ? 665 ? 19 ? 54
  15. Italy (05.11) ? ? ? ? ? ? ? ?
  16. Latvia (13.08.) ? ? - 1 ? ? ? ?
  17. Liechtenstein (05.11.) ? ? ? ? ? ? ? ?
  18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
  19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (30.10.) ? 131 ? 335 ? 7 ? 39
  22. Norway (04.11.) ? 69 ? 497 ? 4 ? 69
  23. Poland (05.11.) ? ? ? ? ? ? ? ?
  24. Portugal (04.11.) - 63 ? ? - 9 ? ?
  25. Romania (05.11) ? ? ? ? ? ? ? ?
  26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ...
  28. Spain (05.11.) ? ? ? ? ? ? ? ?
  29. Sweden (01.11.) ? 51 - 241 ? ? ? ?
  30. Switzerland (01.11.) ? 6 - 33 ? ? ? ?
  31. United Kingdom (a) (05.11.) - 848 ? ? - 172 ? ?
Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (691 cumulative hospitalisations), Wales (251) and Northern Ireland (495).


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


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

  • EU AND EFTA COUNTRIES
    • Austria ? ? 1
    • Belgium ? ? 8
    • Bulgaria ? ? 5
    • Czech Republic ? ? 1
    • Finland 1 ? 2
    • France ? ? 49 (a)
    • Germany 3 ? 9
    • Greece 2 ? 5
    • Hungary 1 ? 5
    • Iceland ? ? 1
    • Ireland 4 ? 14
    • Italy 4 ? 25
    • Luxembourg ? ? 1
    • Malta ? ? 3
    • Netherlands ? ? 10
    • Norway ? ? 15
    • Portugal ? ? 5
    • Spain 10 ? 73
    • Sweden 1 ? 3
    • United Kingdom 11 ? 154
      • Total 37 ? 389
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Belarus 6 ? 7
    • Croatia ? ? 1
    • Moldova ? ? 2
    • Russia ? ? 14
    • Serbia 1 ? 3
    • Ukraine ? ? 1
      • Total 7 ? 28
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? ? 6
    • Egypt ? ? 6
    • Iran 5 - 33
    • Iraq ? ? 7
    • Israel ? ? 39
    • Jordan ? ? 7
    • Kuwait ? ? 21
    • Lebanon ? ? 3
    • Occupied Palestinian Territory ? ? 1
    • Oman ? ? 25
    • Qatar 1 ? 5
    • Saudi Arabia ? ? 66
    • Syria ? ? 7
    • Turkey 4 ? 19
    • United Arab Emirates ? ? 6
    • Yemen ? ? 17
      • Total 10 ? 268
  • AFRICA
    • Ghana ? ? 1
    • Madagascar ? ? 1
    • Mauritius ? ? 8
    • Mozambique ? ? 2
    • Namibia ? ? 1
    • Sao Tome & Principe ? ? 2
    • South Africa ? ? 91
    • Sudan ? 1
    • Tanzania ? ? 1
      • Total ? ? 108
  • NORTH AMERICA
    • Canada ? ? 101
    • Mexico ? ? 377
    • USA ? ? 1004
      • Total ? ? 1482
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? ? 1
    • Costa Rica ? ? 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador 1 ? 23
    • Guatemala ? ? 18
    • Honduras ? - 16
    • Jamaica ? ? 5
    • Nicaragua ? ? 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Suriname ? ? 2
    • Trinidad-Tobago ? ? 5
      • Total 1 ? 167
  • SOUTH AMERICA
    • Argentina ? ? 593
    • Bolivia ? ? 56
    • Brazil ? ? 1368
    • Chile ? ? 136
    • Colombia ? ? 136
    • Ecuador 5 ? 80
    • Paraguay ? ? 52
    • Peru 18 ? 180
    • Uruguay ? ? 33
    • Venezuela ? ? 95
      • Total 23 ? 2729
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan 8 ? 9
    • Bangladesh ? ? 6
    • China (Mainland) ? ? 8
    • Hong Kong SAR China 2 ? 39
    • India ? ? 478
    • Japan ? ? 28
    • Macao SAR China ? ? 2
    • Mongolia ? ? 6
    • South Korea ? ? 45
    • Taiwan ? ? 27
      • Total 10 ? 648
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia ? ? 4
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand ? - 184
    • Vietnam 2 ? 39
      • Total 2 ? 364
  • AUSTRALIA & PACIFIC
    • Australia ? ? 186
    • Cook Islands ? ? 1
    • Marshall Islands ? ? 1
    • New Zealand ? ? 19
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ?- 1
      • Total ? ? 211
  • TOTAL 90 ? 6394
(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 22 in mainland France.
(?)
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Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

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

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

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


Main developments in past 72 hours

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

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


ECDC Pandemic Risk Assessment updated


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

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


Other updates

A(H1N1) detected in animals


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



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



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



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



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


Full WHO note available at: LINK


Epidemiologic update


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


Surveillance Trends weeks 44 and 45


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



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



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



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


ECDC Weekly Influenza Surveillance Overview: LINK


Update contents


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


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


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


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


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

  1. Austria (02.11.) ? ? ? ? ? ? ? ?
  2. Belgium (05.11.) ? ? ? ? ? ? ? ?
  3. Bulgaria (04.11) ? ? ? ? ? ? ? ?
  4. Cyprus ? ? ? ? ? ? ? ?
  5. Czech Republic (05.11.) ? ? ? ? ? ? ? ?
  6. Denmark (04.11.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (04.11.) ? ? ? ? ? ? ? ?
  9. France (04.11.) ? 203 ? 625 ? 36 ? 131
  10. Germany (29.10.) ? ? ? ? ? ? ? ?
  11. Greece (04.11.) ? ? ? ? ? ? ? ?
  12. Hungary (01.11.) ? ? - 68 ? ? ? ?
  13. Iceland (30.10.) - 43 ? ? - 11 ? ?
  14. Ireland (05.11.) ? 165 ? 665 ? 19 ? 54
  15. Italy (07.11) ? ? ? ? ? ? ? ?
  16. Latvia (13.08.) ? ? - 1 ? ? ? ?
  17. Liechtenstein (05.11.) ? ? ? ? ? ? ? ?
  18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
  19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (06.11.) ? 273 ? 611 ? 28 ? 69
  22. Norway (04.11.) ? 69 ? 497 ? 4 ? 69
  23. Poland (05.11.) ? ? ? ? ? ? ? ?
  24. Portugal (04.11.) - 63 ? ? - 9 ? ?
  25. Romania (08.11) ? ? ? ? ? ? ? ?
  26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
  28. Spain (05.11.) ? ? ? ? ? ? ? ?
  29. Sweden (01.11.) ? 51 - 241 ? ? ? ?
  30. Switzerland (01.11.) ? 6 - 33 ? ? ? ?
  31. United Kingdom (a) (05.11.) - 848 ? ? - 172 ? ?
Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (691 cumulative hospitalisations), Wales (251) and Northern Ireland (495).


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


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

  • EU AND EFTA COUNTRIES
    • Austria ? ? 1
    • Belgium ? ? 8
    • Bulgaria ? ? 5
    • Czech Republic ? ? 1
    • Finland ? ? 2
    • France ? ? 49 (a)
    • Germany ? ? 9
    • Greece ? ? 5
    • Hungary ? ? 5
    • Iceland ? ? 1
    • Ireland ? ? 14
    • Italy 4 ? 29
    • Luxembourg ? ? 1
    • Malta ? ? 3
    • Netherlands 7 ? 17
    • Norway ? ? 15
    • Portugal ? ? 5
    • Spain ? ? 73
    • Sweden ? ? 3
    • United Kingdom 1 ? 155
      • Total 12 ? 401
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Belarus ? ? 7
    • Croatia ? ? 1
    • Moldova 1 ? 3
    • Russia 1 ? 15
    • Serbia 1 ? 4
    • Ukraine ? ? 1
      • Total 3 ? 31
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? ? 6
    • Egypt ? ? 6
    • Iran ? ? 33
    • Iraq ? - 7
    • Israel ? ? 39
    • Jordan ? ? 7
    • Kuwait 1 ? 22
    • Lebanon ? ? 3
    • Occupied Palestinian Territory 1 ? 2
    • Oman ? ? 25
    • Qatar ? ? 5
    • Saudi Arabia ? ? 66
    • Syria ? ? 7
    • Turkey 4 ? 23
    • United Arab Emirates ? ? 6
    • Yemen ? ? 17
      • Total 6 ? 274
  • AFRICA
    • Ghana ? ? 1
    • Madagascar ? ? 1
    • Mauritius ? ? 8
    • Mozambique ? ? 2
    • Namibia ? ? 1
    • Sao Tome & Principe ? ? 2
    • South Africa ? ? 91
    • Sudan ? ? 1
    • Tanzania ? ? 1
      • Total ? ? 108
  • NORTH AMERICA
    • Canada 14 ? 115
    • Mexico 21 ? 398
    • USA ? ? 1004
      • Total 35 ? 1517
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? ? 1
    • Costa Rica ? ? 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador ? ? 23
    • Guatemala ? ? 18
    • Honduras ? ? 16
    • Jamaica ? - 5
    • Nicaragua ? ? 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Suriname ? ? 2
    • Trinidad-Tobago ? ? 5
      • Total ? ? 167
  • SOUTH AMERICA
    • Argentina 7 ? 600
    • Bolivia ? ? 56
    • Brazil ? ? 1368
    • Chile 4 ? 140
    • Colombia ? ? 136
    • Ecuador ? ? 80
    • Paraguay ? ? 52
    • Peru ? ? 180
    • Uruguay ? ? 33
    • Venezuela 2 ? 97
      • Total 13 ? 2742
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan ? ? 9
    • Bangladesh ? ? 6
    • China (Mainland) 8 ? 16
    • Hong Kong SAR China ? ? 39
    • India 6 ? 484
    • Japan ? ? 28
    • Macao SAR China ? ? 2
    • Mongolia 2 ? 8
    • South Korea 3 ? 48
    • Taiwan ? ? 27
      • Total 19 ? 667
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia ? ? 4
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand ? ? 184
    • Vietnam ? - 39
      • Total ? ? 364
  • AUSTRALIA & PACIFIC
    • Australia 1 ? 187
    • Cook Islands ? ? 1
    • Marshall Islands ? ? 1
    • New Zealand ? ? 19
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total 1 ? 212
  • TOTAL 89 ? 6483
(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 22 in mainland France.
(?)
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Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

For those trying to understand what is going on in Europe and, more generally, it is more than a little disturbing that the table which starts all of these European CDC reports is largely empty or more accurately populated with ...'s which the legend defines as
(...) denotes no information readily available in official sources.
Click to expand...
and we are not just talking about Liechtenstein & Lithuania. Of the four categories - 'Hospitalisations' and 'in ICU' plus their cumulative totals - there is no data in any of the boxes from Germany, Italy or Spain. Of the 31 countries listed only the Norwegians, Dutch, French and Irish have ticked every box. This is not esoteric data or tricky to estimate - like total case numbers - if some one gets as far as being hospitalised or given an ICU bed one would expect a G8 country to be able to count them and report same to the body overseeing data collection - we have had this pandemic in europe for over 6 months now let's see if we can get the counting sorted out.

Scores: Europe C- (Should do better)
 
Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

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

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

Main developments in past 24 hours

  • Updates from U.S.A. and Canada included;
  • Updates from EpiWatch included;
  • Total of 414 fatal cases in Europe and EFTA countries and 6 094 in the rest of the world have been reported up to date.

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases is presented in Table 2 - as of 09 November 2009 -16:00 hours CEST, for the world, and 10 November 2009 - 09:00 hours CEST, for Europe.

Updates from U.S.A. and Canada
United States
Update Data as of 06 November 2009 17:00 CEST, for week ending 31 October, 2009 (Week 43)

  • Virology:
    • >99% of all subtyped influenza A viruses reported to CDC were 2009 influenza A (H1N1) viruses.
    • 99.7% of all specimens were type A. Two A(H3), 1 A(H1), and 14 type B were reported. One seasonal influenza A (H1N1) virus was tested and is related to the influenza A (H1N1) component of the 2009-10 Northern Hemisphere influenza vaccine (A/Brisbane/59/2007).
    • Both influenza A (H3N2) viruses tested showed reduced titers with antisera produced against A/Brisbane/10/2007, the 2009-2010 Northern Hemisphere influenza A (H3N2) vaccine component, and were antigenically related to A/Perth/16/2009, the WHO recommended influenza A (H3N2) component of the 2010 Southern Hemisphere vaccine formulation.
    • Since September 1, 2009, four infections with Oseltamivir resistant 2009 influenza A (H1N1) viruses have been identified in the United States (N.B. A previously reported case has been reclassified as susceptible).
  • Mortality Surveillance:
    • Pneumonia and Influenza Hospitalization and Deaths:
      • From August 30 ? October 24, 2009, 17,838 laboratory-confirmed influenza associated hospitalizations, 672 laboratory-confirmed influenza associated deaths were reported to CDC.
    • Pneumonia and Influenza (P&I) Mortality Surveillance:
      • During week 43, 7.4% of all deaths reported through the 122-Cities Mortality Reporting System were due to P&I. This percentage was above the epidemic threshold of 6.7% for week 43 and the percentage has been above the threshold for 5 weeks.
    • Influenza-associated Pediatric Mortality:
      • Eighteen influenza-associated pediatric deaths were reported to CDC during week 43. Fifteen of these deaths were associated with 2009 influenza A (H1N1) virus infection and three were associated with an influenza A virus for which the subtype is undetermined. These deaths occurred between 12 July and 31 October 2009.
      • Since 30 August 2009, CDC has received 85 reports of influenza-associated pediatric deaths that occurred during the current influenza season (73 due to 2009 influenza A(H1N1) and 12 due to undetermined subtype influenza A).
      • Among the 85 deaths in children, 53 children had specimens collected for bacterial culture from normally sterile sites and 17 (32.1%) of the 53 were positive; Staphylococcus aureus was identified in 8 (47.1%) of the 17 children.
      • A total of 129 deaths in children associated with 2009 H1N1 virus have been reported to CDC.
  • Influenza-associated hospitalizations:
    • Laboratory-confirmed influenza-associated hospitalizations are monitored in the U.S. using a population-based surveillance network comprising 10 Emerging Infections Program sites and 6 new sites.
    • Laboratory-confirmed influenza-associated hospitalization rates were reported during 01 September ? 31 October 2009 (rates include influenza A, influenza B, and 2009 influenza A (H1N1)).
      • Rates [EIP (new sites)] for children aged 0-4 years and 5-17 years were 3.1 (7.3) and 1.5 (2.9)per 10,000, respectively.
      • Rates [EIP (new sites)] for adults aged 18-49 years, 50-64 years, and ≥ 65 years were 1.2 (1.2), 1.3 (1.2) and 1.0 (1.1)per 10,000, respectively.
  • Influenza-like Illness (ILI):
    • Nationwide during week 43, 7.7% of patient visits reported through the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) were due to influenza-like illness (ILI). This percentage is above the national baseline of 2.3%. On a regional level, the percentage of outpatient visits for ILI ranged from 5.0% to 10.7% during week 43.
  • Geographic spread:
    • Widespread influenza activity was reported by 48 states. Regional influenza activity was reported by 2 states. Local influenza activity was reported by the District of Columbia. Sporadic influenza activity was reported by Puerto Rico and Guam. The U.S. Virgin Islands did not report.
  • Other information: The 2009-2010 U.S. Influenza Season (for purposes of surveillance and reporting) began 4 October 2009.
    • For more information: U.S. Centers for Disease Control and Prevention ?What's New on the H1N1 Flu Site? LINK
    • U.S. Centers for Disease Control and Prevention Weekly Influenza Surveillance Report LINK
    • Overview of Influenza Surveillance in the United States LINK

Canada Update
Data as of November 2009 19:00 CEST, for week ending 31 October, 2009 (Week 43)
There was an increase in the influenza activity level reported this week with the proportion of positive influenza tests of more than 35%, the national ILI consultation rate higher than 100 per 1,000 visits and over 700 influenza outbreaks reported.
This increased activity occurred in almost all provinces and territories.

  • Virology:
    • 99.7% of all subtyped influenza A viruses being reported to Public Health Agency of Canada (PHAC) were 2009 influenza A (H1N1) viruses; the remainder were A(H1), A(H3) and B.
    • The proportion of tests that were positive for influenza was 36.3% which was a significant increase to the previous weeks.
    • 2009 influenza A (H1N1) viruses continue to be similar to the strain chosen for the vaccine.
    • No viruses resistant to Oseltamivir were detected in week 43.
  • Hospitalizations and Deaths:
    • 661 hospitalizations (a large increase over the previous week) and 8 deaths were reported for week 43.
    • Pediatric Influenza Hospitalizations and Deaths:
      • In week 43, 120 laboratory-confirmed influenza-associated pediatric hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network.
      • Since the beginning of the pandemic, four deaths due to Pandemic (H1N1) 2009 had been reported through the IMPACT network among children under 16 years of age.
  • Influenza-like Illness (ILI):
    • The national ILI consultation rate increased to 111consultations per 1,000 patient visits this week which was a large increase over the previous week and an increase for a seventh consecutive week and was above the expected range for this time of the year.
  • Geographic spread:
    • Nineteen regions reported widespread activity and 16 regions reported localized activity, while 18 regions reported sporadic activity and 7 regions reported no activity.
    • 737 influenza outbreaks were reported; all were in schools except for 11 in hospitals, 9 in an unspecified location and 7 in long-term care facilities.
  • Other information:
    • All the provinces and territories have started their vaccination campaigns.
    • For more information:
      • Public Health Agency of Canada: LINK
      • Public Health Agency of Canada FluWatch LINK

Updates from EpiNorth
Update on situation in Moldova
As of November 9 at 7:30 am, 615 suspected cases of A(H1N1) were reported in the Republic of Moldova, according to the National Scientific-Practical Centre for Preventive Medicine of the Republic of Moldova. Among them 316 cases of influenza A(H1N1) were laboratory confirmed. Also, there were reported 3 deaths caused by influenza A(H1N1) in the Republic of Moldova.
Read more from EpiWatch.

Update on epidemics in Ukraine
As of November 8, a total of 969, 247 cases of SARI/ILI were reported by the Ministry of Health of Ukraine on its website. The worst situation is reported from Lviv Oblast ? 155,895 cases, Ivano-Frankivsk Oblast ? 88,703 cases, Kiev-city ? 60,366 cases, Chernivtsi Oblast ? 47,167 cases, Donetsk Oblast ? 48,263, and Ternopil Oblast ? 30,510 cases. Furthermore, a total of 48,972 persons were hospitalised in the whole country, of them 155 people died as of 8 November 2009.
Read more from EpiWatch.

Outbreak of influenza A(H1N1) at the chess tournament in Vologda oblast, Russia
As of 9 November, 75 cases of influenza A(H1N1), among them 59 children, were reported at the Northwestern Russia chess tournament held in Vologda oblast, according to the Directorate of Rospotrebnadzor in Vologda oblast. Read more from EpiWatch.

Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 414 deaths have been reported; the information is available in Table 2. The latest available updates as of November 09, 2009, at 16:00, on new and on confirmed fatal pandemic A(H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.

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

  1. Austria (02.11.) ? ? ? ? ? ? ? ?
  2. Belgium (05.11.) ? ? ? ? ? ? ? ?
  3. Bulgaria (04.11) ? ? ? ? ? ? ? ?
  4. Cyprus(01.11) ? ? ? ? ? ? ? 4
  5. Czech Republic (05.11.) ? ? ? ? ? ? ? ?
  6. Denmark (04.11.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (04.11.) ? ? ? ? ? ? ? ?
  9. France (04.11.) ? 203 ? 625 ? 36 ? 131
  10. Germany (05.11.) ? ? ? ? ? ? ? ?
  11. Greece (04.11.) ? ? ? ? ? ? ? ?
  12. Hungary (01.11.) ? ? - 68 ? ? ? ?
  13. Iceland (30.10.) - 43 ? ? - 11 ? ?
  14. Ireland (05.11.) ? 165 ? 665 ? 19 ? 54
  15. Italy (09.11) ? ? - 184 ? ? ? 82
  16. Latvia (13.08.) ? ? - 1 ? ? ? ?
  17. Liechtenstein (05.11.) ? ? ? ? ? ? ? ?
  18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
  19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (06.11.) ? 273 ? 611 ? 28 ? 69
  22. Norway (04.11.) ? 69 ? 497 ? 4 ? 69
  23. Poland (09.11.) ? ? ? ? ? ? ? ?
  24. Portugal (04.11.) - 63 ? ? - 9 ? ?
  25. Romania (08.11) ? ? ? ? ? ? ? ?
  26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
  28. Spain (05.11.) ? ? ? ? ? ? ? ?
  29. Sweden (01.11.) ? 51 - 241 ? ? ? ?
  30. Switzerland (01.11.) ? 6 - 33 ? ? ? ?
  31. United Kingdom (a) (05.11.) - 848 ? ? - 172 ? ?
Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (691 cumulative hospitalisations), Wales (251) and Northern Ireland (495).

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

  • EU AND EFTA COUNTRIES
    • Austria ? ? 1
    • Belgium ? ? 8
    • Bulgaria ? ? 5
    • Czech Republic ? ? 1
    • Finland ? ? 2
    • France 8 ? 57 (a)
    • Germany ? ? 9
    • Greece ? ? 5
    • Hungary ? ? 5
    • Iceland ? ? 1
    • Ireland ? ? 14
    • Italy 2 ? 31
    • Latvia 1 ? 1
    • Luxembourg ? ? 1
    • Malta ? ? 3
    • Netherlands ? ? 17
    • Norway 1 ? 16
    • Portugal ? ? 5
    • Slovakia 1 ? 1
    • Spain ? ? 73
    • Sweden ? ? 3
    • United Kingdom ? ? 155
      • Total 13 ? 414
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Belarus ? ? 7
    • Croatia ? ? 1
    • Moldova ? ? 3
    • Russia ? ? 15
    • Serbia 3 ? 7
    • Ukraine ? ? 1
      • Total 3 ? 34
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? - 6
    • Egypt ? ? 6
    • Iran ? ? 33
    • Iraq ? ? 7
    • Israel ? ? 39
    • Jordan ? ? 7
    • Kuwait ? ? 22
    • Lebanon ? ? 3
    • Occupied Palestinian Territory ? ? 2
    • Oman ? ? 25
    • Qatar ? ? 5
    • Saudi Arabia ? ? 66
    • Syria ? ? 7
    • Turkey 4 ? 27
    • United Arab Emirates ? ? 6
    • Yemen ? ? 17
      • Total 4 ? 278
  • 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 ? ? 115
    • Mexico ? ? 398
    • USA ? ? 1004
      • Total ? ? 1517
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? ? 1
    • Costa Rica ? ? 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador ? - 23
    • Guatemala ? ? 18
    • Honduras ? ? 16
    • Jamaica ? ? 5
    • Nicaragua ? ? 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Saint Lucia 1 ? 1
    • Suriname ? ? 2
    • Trinidad-Tobago ? ? 5
      • Total 1 ? 168
  • SOUTH AMERICA
    • Argentina ? ? 600
    • Bolivia ? ? 56
    • Brazil ? ? 1368
    • Chile ? ? 140
    • Colombia ? ? 136
    • Ecuador ? ? 80
    • Paraguay ? ? 52
    • Peru ? ? 180
    • Uruguay ? ? 33
    • Venezuela ? ? 97
      • Total ? ? 2742
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan 2 ? 11
    • Bangladesh ? ? 6
    • China (Mainland) ? ? 16
    • Hong Kong SAR China ? ? 39
    • India 1 ? 485
    • Japan ? ? 28
    • Macao SAR China ? ? 2
    • Mongolia ? ? 8
    • South Korea ? ? 48
    • Sri Lanka 1 ? 1
    • Taiwan ? ? 27
      • Total 4 ? 671
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia ? ? 4
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? - 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand ? ? 184
    • Vietnam ? ? 39
      • Total ? ? 364
  • AUSTRALIA & PACIFIC
    • Australia ? ? 187
    • Cook Islands ? ? 1
    • Marshall Islands ? ? 1
    • New Zealand ? ? 19
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total ? ? 212
  • TOTAL 25 ? 6508
(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 30 in mainland France.
(?)
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Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

Pandemic (H1N1) 2009 Update 11 November 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 11 November 2009, 09:00 hours CEST


Main developments in past 24 hours

  • WHO published revised clinical management guidance;
  • Total of 423 fatal cases in Europe and EFTA countries and 6 169 in the rest of the world have been reported up to date.

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases is presented in Table 2 - as of 10 November 2009 -16:00 hours CEST, for the world, and 11 November 2009 - 09:00 hours CEST, for Europe.


WHO published revised clinical management guidance


Based on a international consultation of experts in October 2009, the World Health Organization (WHO ) has now revised its clinical management guidelines for pandemic influenza. The revisions emphasise the need to begin treatment of suspect cases without laboratory confirmation as there are issues related to the laboratory confirmation. Early treatment of patients with severe or rapidly progressing illness and patients belonging to risk groups is recommended. Antibiotic treatment, oxygen therapy and critical care issues are also discussed in the guidelines. A clinical triage algorithm for ILI and pneumonia is provided for resource-poor settings.


Find the full WHO guidance document at: LINK


Epidemiologic update


All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 423 deaths have been reported (Table 2) and the number of deaths by week has being clearly increasing over the last 4 weeks. The latest available updates as of November 10, 2009, at 16:00, on new and on confirmed fatal pandemic A(H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.


Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 11 November 2009, 09:00 hours (CEST) in the EU and EFTA countries


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

  1. Austria (10.11.) ? ? ? ? ? ? ? ?
  2. Belgium (05.11.) ? ? ? ? ? ? ? ?
  3. Bulgaria (04.11) ? ? ? ? ? ? ? ?
  4. Cyprus(01.11) ? ? ? ? ? ? ? 4
  5. Czech Republic (05.11.) ? ? ? ? ? ? ? ?
  6. Denmark (04.11.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (04.11.) ? ? ? ? ? ? ? ?
  9. France (04.11.) ? 203 ? 625 ? 36 ? 131
  10. Germany (09.11.) ? ? ? ? ? ? ? ?
  11. Greece (04.11.) ? ? ? ? ? ? ? ?
  12. Hungary (01.11.) ? ? - 68 ? ? ? ?
  13. Iceland (30.10.) - 43 ? ? - 11 ? ?
  14. Ireland (05.11.) ? 165 ? 665 ? 19 ? 54
  15. Italy (10.11) ? ? - 184 ? ? ? 82
  16. Latvia (13.08.) ? ? - 1 ? ? ? ?
  17. Liechtenstein (05.11.) ? ? ? ? ? ? ? ?
  18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
  19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (06.11.) ? 273 ? 611 ? 28 ? 69
  22. Norway (04.11.) ? 69 ? 497 ? 4 ? 69
  23. Poland (10.11.) ? ? ? ? ? ? ? ?
  24. Portugal (04.11.) - 63 ? ? - 9 ? ?
  25. Romania (08.11) ? ? ? ? ? ? ? ?
  26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
  28. Spain (05.11.) ? ? ? ? ? ? ? ?
  29. Sweden (01.11.) ? 51 - 241 ? ? ? ?
  30. Switzerland (01.11.) ? 6 - 33 ? ? ? ?
  31. United Kingdom (a) (05.11.) - 848 ? ? - 172 ? ?
Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (691 cumulative hospitalisations), Wales (251) and Northern Ireland (495).


Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 11 November 2009, 09:00 hours CEST, and in the rest of the world by country, as of 10 November 2009, 16:00 hours CEST.


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

  • EU AND EFTA COUNTRIES
    • Austria ? ? 1
    • Belgium ? ? 8
    • Bulgaria ? ? 5
    • Czech Republic ? ? 1
    • Finland 3 ? 5
    • France ? ? 57 (a)
    • Germany 3 ? 12
    • Greece ? ? 5
    • Hungary ? ? 5
    • Iceland ? ? 1
    • Ireland ? ? 14
    • Italy 3 ? 34
    • Latvia ? ? 1
    • Luxembourg ? ? 1
    • Malta ? ? 3
    • Netherlands ? ? 17
    • Norway ? ? 16
    • Portugal ? ? 5
    • Slovakia ? ? 1
    • Spain ? ? 73
    • Sweden ? ? 3
    • United Kingdom ? ? 155
      • Total 9 ? 423
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Belarus ? ? 7
    • Croatia 1 ? 2
    • Moldova 1 ? 4
    • Russia ? ? 15
    • Serbia ? ? 7
    • Ukraine ? ? 1
      • Total 2 ? 36
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? ? 6
    • Egypt ? - 6
    • Iran ? ? 33
    • Iraq ? ? 7
    • Israel ? ? 39
    • Jordan ? ? 7
    • Kuwait ? ? 22
    • Lebanon ? ? 3
    • Occupied Palestinian Territory ? ? 2
    • Oman ? ? 25
    • Qatar ? ? 5
    • Saudi Arabia ? ? 66
    • Syria ? ? 7
    • Turkey 3 ? 30
    • United Arab Emirates ? ? 6
    • Yemen ? ? 17
      • Total 3 ? 281
  • 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 ? ? 115
    • Mexico 35 ? 433
    • USA ? ? 1004
      • Total 35 ? 1552
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? ? 1
    • Costa Rica ? ? 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador ? ? 23
    • Guatemala ? - 18
    • Honduras ? ? 16
    • Jamaica ? ? 5
    • Nicaragua ? ? 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Saint Lucia ? ? 1
    • Suriname ? ? 2
    • Trinidad-Tobago ? ? 5
      • Total ? ? 168
  • SOUTH AMERICA
    • Argentina ? ? 600
    • Bolivia ? ? 56
    • Brazil ? ? 1368
    • Chile ? ? 140
    • Colombia ? ? 136
    • Ecuador ? ? 80
    • Paraguay ? ? 52
    • Peru ? ? 180
    • Uruguay ? ? 33
    • Venezuela ? ? 97
      • Total ? ? 2742
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan ? ? 11
    • Bangladesh ? ? 6
    • China (Mainland) 14 ? 30
    • Hong Kong SAR China ? ? 39
    • India 17 - 502
    • Japan ? ? 28
    • Macao SAR China ? ? 2
    • Mongolia ? ? 8
    • South Korea 4 ? 52
    • Sri Lanka ? ? 1
    • Taiwan ? ? 27
      • Total 35 ? 706
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia ? ? 4
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? - 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand ? ? 184
    • Vietnam ? ? 39
      • Total ? ? 364
  • AUSTRALIA & PACIFIC
    • Australia ? ? 187
    • Cook Islands ? ? 1
    • Marshall Islands ? ? 1
    • New Zealand ? ? 19
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total ? ? 212
  • TOTAL 84 ? 6592
(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 30 in mainland France.
(?)
-
------
 
Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

Pandemic (H1N1) 2009 Update 12 November 2009, 09:00 hours CEST (ECDC, edited)

[Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 12 November 2009, 09:00 hours CEST


Main developments in past 24 hours

  • Public Health Development on critical care services published;
  • European Planning Assumptions for Pandemic 2009 published;
  • Updates from EpiSouth included;
  • GSK vaccine approved by US FDA;
  • Total of 429 fatal cases in Europe and EFTA countries and 6 277 in the rest of the world have been reported up to date.

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases is presented in Table 2 - as of 11 November 2009 -16:00 hours CEST, for the world, and 12 November 2009 - 09:00 hours CEST, for Europe.


The approaching pandemic pressures on critical care services in European hospitals - preparation is crucial


Countries in the southern hemisphere and the Americas have already experienced the first marked peaks of the 2009 pandemic. The greatest pressures were in hospitals and especially critical or intensive care. Already this autumn the first affected European countries are seeing the same and a few European countries are known to have made plans to significantly increase their capacity, for example for ventilating patients.


Reports on epidemiological and clinical presentation of influenza pandemic in other countries provide reliable estimates of the burden of disease, the effectiveness of treatment and best use of public health resources and likely outcomes for patients.


Recently ECDC attended a WHO global consultation to gather such information.


This Public Health development summarises some of the findings from that meeting and seven recent publications.


The main points include the need to keep primary and secondary care integrated (so that hospitals are not over burdened), to develop protocols for triaging sick patients, to increase critical care and especially ventilatory capacity and to ensure early use of antivirals as there is convincing observational evidence that this is effective in averting or mitigating severe disease.


Full Public health development will be published today on the ECDC website: LINK


Epidemiologic update


All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 429 deaths have been reported (Table 2) and the number of deaths by week has being clearly increasing over the last 3 weeks. The latest available updates as of November 11, 2009, at 16:00, on new and on confirmed fatal pandemic A(H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.


Other Updates

European Planning Assumptions for Pandemic 2009


Following a number of requests ECDC working with representatives of its Advisory Forum and WHO yesterday published recommended planning assumptions for this pandemic for clinical attack rate, hospitalisations (including use of intensive care) and deaths that apply to countries that did not experience a significant wave of infection over the summer.


The assumptions may also be applicable to other countries. To aid planning as far as is possible, data are expressed per 100 000 population but no allowance is made for the effect of countermeasures, which include vaccines and antivirals.


It is important to emphasise that the figures are not predictions. Rather like other planning assumptions they represent a reasonable worse case that European health services are advised to prepare for.


Closely related to this and contributing is a scientific review produced by WHO on the transmission dynamics and impact of pandemic influenza 2009 which will appear in the Weekly Epidemiological Record 2009: 84: 477-484.


EPISOUTH update


As of 09 November 2009, a total of 244 deaths among biologically confirmed A/H1N1/2009 cases have been reported in the EpiSouth region (Mediterranean and the Balkans).

  • 86 new deaths were notified since 03 November 2009:
    • 4 in Bulgaria,
    • 2 in Egypt,
    • 5 in France,
    • 2 in Greece,
    • 4 in Israel,
    • 18 in Italy,
    • 2 in Jordan,
    • 2 in Palestine,
    • 4 in Serbia,
    • 19 in Spain,
    • 5 in Syria and
    • 20 in Turkey.
For weeks 44-45, influenza activity was high in Bulgaria and Italy, increasing in France, and Spain, moderate in Albania, Israel, Palestine, Romania and Serbia, Low in Croatia and Slovenia,


For more details please refer to the EpiSouth bulletin LINK


GSK vaccine approved by US FDA


The U.S. Food and Drug Administration approved a supplemental biologics license for GlaxoSmithKline?s (GSK) unadjuvanted influenza A(H1N1) pandemic vaccine.


Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 12 November 2009, 09:00 hours (CEST) in the EU and EFTA countries


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

  1. Austria (11.11.) ? ? ? ? ? ? ? ?
  2. Belgium (05.11.) ? ? ? ? ? ? ? ?
  3. Bulgaria (04.11) ? ? ? ? ? ? ? ?
  4. Cyprus(01.11) ? ? ? ? ? ? ? 4
  5. Czech Republic (05.11.) ? ? ? ? ? ? ? ?
  6. Denmark (11.11.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (04.11.) ? ? ? ? ? ? ? ?
  9. France (04.11.) ? 203 ? 625 ? 36 ? 131
  10. Germany (09.11.) ? ? ? ? ? ? ? ?
  11. Greece (04.11.) ? ? ? ? ? ? ? ?
  12. Hungary (01.11.) ? ? - 68 ? ? ? ?
  13. Iceland (11.11.) ? ? - 170 ? ? ? 19
  14. Ireland (05.11.) ? 165 ? 665 ? 19 ? 54
  15. Italy (11.11) ? ? - 264 ? ? ? 116
  16. Latvia (13.08.) ? ? - 1 ? ? ? ?
  17. Liechtenstein (05.11.) ? ? ? ? ? ? ? ?
  18. Lithuania (13.08.) ? ? ? ? ? ? ? ?
  19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (06.11.) ? 273 ? 611 ? 28 ? 69
  22. Norway (11.11.) ? 86 ? 623 ? 13 ? 75
  23. Poland (10.11.) ? ? ? ? ? ? ? ?
  24. Portugal (11.11.) - 121 ? ? - 17 ? ?
  25. Romania (11.11) ? ? ? ? ? ? ? ?
  26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
  28. Spain (05.11.) ? ? ? ? ? ? ? ?
  29. Sweden (01.11.) ? 51 - 241 ? ? ? ?
  30. Switzerland (01.11.) ? 6 - 33 ? ? ? ?
  31. United Kingdom (a) (05.11.) - 848 ? ? - 172 ? ?
Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
(a) Data includes all probable cases for England only. Does not include Scotland (691 cumulative hospitalisations), Wales (251) and Northern Ireland (495).


Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 12 November 2009, 09:00 hours CEST, and in the rest of the world by country, as of 11 November 2009, 16:00 hours CEST.


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

  • EU AND EFTA COUNTRIES
    • Austria ? ? 1
    • Belgium ? ? 8
    • Bulgaria ? ? 5
    • Czech Republic ? ? 1
    • Finland 1 ? 6
    • France ? ? 57 (a)
    • Germany ? ? 12
    • Greece ? ? 5
    • Hungary ? ? 5
    • Iceland ? ? 1
    • Ireland ? ? 14
    • Italy 4 ? 38
    • Latvia ? ? 1
    • Luxembourg ? ? 1
    • Malta ? ? 3
    • Netherlands ? ? 17
    • Norway ? ? 16
    • Portugal ? ? 5
    • Slovakia ? ? 1
    • Spain ? ? 73
    • Sweden ? ? 3
    • United Kingdom 1 ? 156
      • Total 6 ? 429
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Azerbaijan 2 ? 2
    • Belarus ? ? 7
    • Croatia ? ? 2
    • Moldova ? ? 4
    • Russia 1 ? 16
    • Serbia ? ? 7
    • Ukraine 13 ? 14
      • Total 16 ? 52
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? - 6
    • Egypt ? ? 6
    • Iran 25 ? 58
    • Iraq ? ? 7
    • Israel ? ? 39
    • Jordan ? ? 7
    • Kuwait 4 ? 26
    • Lebanon ? ? 3
    • Occupied Palestinian Territory ? ? 2
    • Oman ? ? 25
    • Qatar ? ? 5
    • Saudi Arabia ? ? 66
    • Syria ? ? 7
    • Turkey 6 ? 36
    • United Arab Emirates ? ? 6
    • Yemen ? ? 17
      • Total 35 ? 316
  • 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 20 ? 135
    • Mexico 19 ? 452
    • USA ? ? 1004
      • Total 39 ? 1591
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? ? 1
    • Costa Rica ? ? 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador ? - 23
    • Guatemala ? ? 18
    • Honduras ? ? 16
    • Jamaica ? ? 5
    • Nicaragua ? ? 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Saint Lucia ? ? 1
    • Suriname ? ? 2
    • Trinidad-Tobago ? ? 5
      • Total ? ? 168
  • SOUTH AMERICA
    • Argentina ? ? 600
    • Bolivia ? ? 56
    • Brazil ? ? 1368
    • Chile ? ? 140
    • Colombia 5 ? 141
    • Ecuador 2 ? 82
    • Paraguay ? ? 52
    • Peru 3 ? 183
    • Uruguay ? ? 33
    • Venezuela 4 ? 101
      • Total 14 ? 2756
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan ? ? 11
    • Bangladesh ? ? 6
    • China (Mainland) ? ? 30
    • Hong Kong SAR China ? ? 39
    • India 3 ? 505
    • Japan ? ? 28
    • Macao SAR China ? ? 2
    • Mongolia ? ? 8
    • South Korea ? ? 52
    • Sri Lanka ? ? 1
    • Taiwan ? ? 27
      • Total 3 ? 709
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia ? ? 4
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand ? ? 184
    • Vietnam 1 ? 40
      • Total 1 ? 365
  • AUSTRALIA & PACIFIC
    • Australia ? ? 187
    • Cook Islands ? ? 1
    • Marshall Islands ? ? 1
    • New Zealand ? ? 19
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total ? ? 212
  • TOTAL 114 ? 6706
(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 30 in mainland France.
(?)
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Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

Pandemic (H1N1) 2009 Update 13 November 2009, 09:00 hours CEST (ECDC, edited)

[Full PDF Document: LINK. EDITED.]
ECDC DAILY UPDATE
Pandemic (H1N1) 2009 Update 13 November 2009, 09:00 hours CEST

Main developments in past 24 hours

  • Weekly Influenza Surveillance Overview to be published today;
  • Eurosurveillance updates published;
  • Situation update ? Ukraine;
  • CDC estimates number of cases infected with H1N1;
  • Two studies on effectiveness of seasonal influenza vaccine againt pandemic influenza published;
  • Total of 474 fatal cases in Europe and EFTA countries and 6 294 in the rest of the world have been reported up to date.

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases is presented in Table 2 - as of 12 November 2009 -16:00 hours CEST, for the world, and 13 November 2009 - 09:00 hours CEST, for Europe.

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. Since April 2009, a total 474 deaths have been reported (Table 2) and the number of deaths by week has being clearly increasing over the last 3 weeks. The latest available updates as of November 12, 2009, at 16:00, on new and on confirmed fatal pandemic A(H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.

Other Updates
Situation in Ukraine
From 18 October to 12 November, the Ministry of Health has reported a total of 1,253,558 cases of acute respiratory illness and 239 deaths. The majority of cases is concentrated in the Western oblasts in Ukraine, but spreads to Kyiv and other parts of the country. Influenza A(H1N1) has been identified in a number of samples in national laboratories and confirmed by the WHO?s reference laboratory in London. The last official number of laboratory confirmed A(H1N1) cases in Ukraine was 32 (data from 06/11/09).

CDC estimates number of cases infected with H1N1
CDC estimated that between 14 million and 34 million cases of influenza A(H1N1)v occurred between April and October 2009. The methods are described in detail in the attached documents and are based on laboratory surveillance, published hospitalization estimates and multipliers derived from previously published prevalence estimates.
The full CDC document is available at: LINK

Mexican study shows protective effect of seasonal influenza vaccine
A study published in the Lancet describes the first 63 479 notified pandemic influenza cases in Mexico up to 31st July, 2009 and analyzes risk and protective factors for infection, hospitalisation and fatal outcome. According to this study the risk of infection with influenza A(H1N1), verified mainly by rapid tests, was lower among people vaccinated for seasonal influenza.
The full article can be found at: LINK

A CDC study finds no protective effect of seasonal influenza vaccine
The CDC Mortality and Morbidity Weekly Report (MMWR) published an analysis on the effectiveness of the 2008-09 trivalent seasonal influenza vaccine against pandemic influenza H1N1. This case-cohort analysis was based on notifications data and did not show any vaccine effectiveness.
The full CDC report can be found at: LINK

Eurosurveillance update
In their paper H Nishiura et al. present a study comparing the risk of clinical attack rates between one- and two-dose vaccination schemes. They demonstrate that if the efficacies do not greatly vary between one- and two -dose schemes, a one-dose vaccination scheme may well be supported. Nevertheless, two-dose vaccination is shown to result in less morbidity if the vaccine efficacies are greatly diminished by reducing the dose. From the results the authors conclude that as long as the detailed efficacy estimates rest on theoretical assumptions, single-dose vaccination may only be sufficiently justified in a specific setting where the number of vaccines is extremely limited. (LINK)
A second paper in yesterday?s Eurosurveillance issue reports about an ongoing outbreak in pigs of infections with pandemic influenza A(H1N1)v virus in Norway. According to M Hofshagen et al. the first herd was confirmed positive on 10 October 2009 and as of 26 October, a total of 23 herds have been diagnosed as positive. The majority of the herds seem to have been infected by humans. Sequence analysis of pig viruses from the index farm shows that they are identical or virtually identical to human viruses from the same geographical region. Currently further investigations are being carried out to clarify the extent of the outbreaks in the rest of Norway and studies are underway to evaluate risk factors for the infection at farm level. (LINK)
A third paper by Columbier et al. reports on a notable surge in messages communicated through the Early Warning and Response System (EWRS) for the prevention and control of communicable diseases in the European Union recorded since the start of 2009 H1N1 influenza pandemic. In order to measure the impact of this increase on the reporting of other events, the authors compared the messages posted in the EWRS since April 2009 with those posted in the previous years (2004-2008). The analysis revealed that a ten-fold increase in messages was recorded during the pandemic period, from April to September 2009, and that the reporting of other threats dropped to a significantly low rate. They authors conclude that their results suggest an important impact on the notification process of events in case of a situation requiring extensive mobilisation of public health resources and emphasise the importance of keeping an appropriate balancing of resources during sustained emergencies, in particular in view of a possible second wave of pandemic influenza cases, to ensure prompt detection and reporting of potential concomitant emerging threats. (LINK)

Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 13 November 2009, 09:00 hours (CEST) in the EU and EFTA countries
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

  1. Austria (11.11.) ? ? ? ? ? ? ? ?
  2. Belgium (12.11.) ? ? ? ? ? ? ? ?
  3. Bulgaria (04.11) ? ? ? ? ? ? ? ?
  4. Cyprus(01.11) ? ? ? ? ? ? ? 4
  5. Czech Republic (12.11.) ? ? ? ? ? ? ? ?
  6. Denmark (11.11.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (11.11.) ? ? ? ? ? ? ? ?
  9. France (12.11.) ? ? ? ? ? 71 ? 188
  10. Germany (10.11.) ? ? ? ? ? ? ? ?
  11. Greece (11.11.) ? ? ? ? ? ? ? ?
  12. Hungary (01.11.) ? ? - 68 ? ? ? ?
  13. Iceland (11.11.) ? ? - 170 ? ? ? 19
  14. Ireland (12.11.) ? 191 ? 785 ? 22 ? 65
  15. Italy (11.11) ? ? - 264 ? ? ? 116
  16. Latvia (12.11.) ? ? - 1 ? ? ? ?
  17. Liechtenstein (11.11.) ? ? ? ? ? ? ? ?
  18. Lithuania (04.11.) ? ? ? ? ? ? ? ?
  19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (06.11.) ? 273 ? 611 ? 28 ? 69
  22. Norway (11.11.) ? 86 ? 623 ? 13 ? 75
  23. Poland (10.11.) ? ? ? ? ? ? ? ?
  24. Portugal (11.11.) - 121 ? ? - 17 ? ?
  25. Romania (11.11) ? ? ? ? ? ? ? ?
  26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ... ? ?
  28. Spain (05.11.) ? ? ? ? ? ? ? ?
  29. Sweden (01.11.) ? 51 - 241 ? ? ? ?
  30. Switzerland (11.11.) ? 15 - 48 ? ? ? 11
  31. United Kingdom (a) (12.11.) - 785 ? ? - 173 ? ?
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 (841 cumulative hospitalisations), Wales (327) and Northern Ireland (527).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 13 November 2009, 09:00 hours CEST, and in the rest of the world by country, as of 12 November 2009, 16:00 hours CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

  • EU AND EFTA COUNTRIES
    • Austria ? ? 1
    • Belgium ? ? 8
    • Bulgaria ? ? 5
    • Czech Republic ? ? 1
    • Finland ? ? 6
    • France 2 ? 59 (a)
    • Germany 1 ? 13
    • Greece ? ? 5
    • Hungary ? ? 5
    • Iceland ? ? 1
    • Ireland 1 ? 15
    • Italy ? ? 38
    • Latvia ? ? 1
    • Luxembourg ? ? 1
    • Malta ? ? 3
    • Netherlands ? ? 17
    • Norway ? ? 16
    • Portugal ? ? 5
    • Slovakia ? ? 1
    • Spain 15 ? 88
    • Sweden 2 ? 5
    • United Kingdom 23 ? 180
      • Total 44 ? 474
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Azerbaijan ? ? 2
    • Belarus ? ? 7
    • Croatia 1 ? 3
    • Moldova ? ? 4
    • Russia ? ? 16
    • Serbia 1 ? 8
    • Ukraine ? ? 14
      • Total 2 ? 54
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? - 6
    • Egypt ? ? 6
    • Iran ? ? 58
    • Iraq ? ? 7
    • Israel ? ? 39
    • Jordan ? ? 7
    • Kuwait ? ? 26
    • Lebanon ? ? 3
    • Occupied Palestinian Territory ? ? 2
    • Oman ? ? 25
    • Qatar ? ? 5
    • Saudi Arabia ? ? 66
    • Syria ? ? 7
    • Turkey 4 ? 40
    • United Arab Emirates ? ? 6
    • Yemen ? ? 17
      • Total 4 ? 320
  • 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 ? ? 135
    • Mexico ? ? 452
    • USA ? ? 1004
      • Total ? ? 1591
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? ? 1
    • Costa Rica ? ? 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador ? - 23
    • Guatemala ? ? 18
    • Honduras ? ? 16
    • Jamaica ? ? 5
    • Nicaragua ? ? 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Saint Lucia ? ? 1
    • Suriname ? ? 2
    • Trinidad-Tobago ? ? 5
      • Total ? ? 168
  • SOUTH AMERICA
    • Argentina ? ? 600
    • Bolivia ? ? 56
    • Brazil ? ? 1368
    • Chile ? ? 140
    • Colombia ? ? 141
    • Ecuador ? ? 82
    • Paraguay ? ? 52
    • Peru ? ? 183
    • Uruguay ? ? 33
    • Venezuela 2 ? 103
      • Total 2 ? 2758
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan ? ? 11
    • Bangladesh ? ? 6
    • China (Mainland) 6 ? 36
    • Hong Kong SAR China ? ? 39
    • India 3 ? 508
    • Japan ? ? 28
    • Macao SAR China ? ? 2
    • Mongolia ? ? 8
    • South Korea ? ? 52
    • Sri Lanka ? ? 1
    • Taiwan ? ? 27
      • Total 9 ? 718
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia ? ? 4
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand ? ? 184
    • Vietnam ? ? 40
      • Total ? ? 365
  • AUSTRALIA & PACIFIC
    • Australia ? ? 187
    • Cook Islands ? ? 1
    • Marshall Islands ? ? 1
    • New Zealand ? ? 19
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total ? ? 212
  • TOTAL 61 ? 6768
(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 32 in mainland France.
(?)
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Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

Pandemic (H1N1) 2009 Update 16 November 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 16 November 2009, 09:00 hours CEST

  • The number of deaths directly attributed by EU/EEA countries to pandemic influenza increased again in week 46;
  • Total of 501 fatal cases in Europe and EFTA countries and 6 550 in the rest of the world have been reported up to date;
  • WHO: Interim planning considerations for mass gatherings;
  • WHO: Transmission dynamics and impact of pandemic influenza A (H1N1) 2009 Virus;
  • WHO: Health conditions for travellers to Saudi Arabia for the pilgrimage to Mecca (Hajj).

Main developments in past 72 hours
This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases is presented in Table 2 - as of 15 November 2009 -16:00 hours CEST, for the world, and 16 November 2009 - 09:00 hours CEST, for Europe.

Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 501 deaths have been reported (Table 2) and the number of deaths by week has been increasing over the last 4 weeks. In week The latest available updates as of November 15, 2009, at 16:00, on new and on confirmed fatal pandemic A(H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.

Weekly Influenza Surveillance Overview for Week 45
In the ECDC Weekly Influenza Surveillance Overview for Week 45 the data for twenty countries across the EU/EEA countries indicated an increasing trend in pandemic influenza seen in primary care. Seven countries (Bulgaria, Iceland, Ireland, Norway and Sweden) reported very high levels of intensity while Poland and part of the UK (Northern Ireland) reported high levels of intensity and 14 countries reported medium intensity. Fourteen other countries are reporting high or very high pandemic intensity.
Almost all influenza that are typed are of the pandemic virus A(H1N1). There remain very few influenza A(H3N2) viruses in circulation and no seasonal A(H1N1). In sentinel data between 40 and 50% of specimens show the influenza virus.
The full overview report is available at: LINK

Other Updates
WHO interim planning considerations for mass gatherings published
The World Health Organization (WHO) published interim planning considerations for mass gatherings in the context of pandemic (H1N1) 2009 influenza. The purpose of the documents is to outline key planning considerations for planners of mass gatherings and it should be used in conjunction with WHO?s ?Communicable disease alert and response for mass gatherings) document.
The WHO guidance document can be found at: LINK

Health conditions for travellers to Saudi Arabia for the pilgrimage to Mecca (Hajj)
In the latest Weekly epidemiological report of the WHO, Health-related requirements and recommendations issued by the Ministry of Health of Saudi Arabia for entry visas for the Hajj and Umra seasons in 2009 were published. Among other issues these recommend that persons with underlying conditions increasing the risk of severe forms of pandemic influenza A(H1N1) disease and persons under the age of 12 and over the age of 65 to defer from defer from performing the Hajj this year (2009). For seasonal influenza vaccine and pandemic (H1N1) 2009 vaccine, Saudi Arabian embassies will address health authorities in all countries about the availability of vaccines for this year?s pilgrimage to Hajj. Where the vaccines are available in countries, proof of both vaccinations will be required by competent authorities before issuing visas. Where vaccines are not available, visas will be issued to pilgrims by the responsible health authority of each country.

Transmission dynamics and impact of pandemic influenza A (H1N1) 2009 Virus
In the same issue, the WHO also summarizes some of the key observations from selected countries on hospitalization rates, mortality rates and risk groups that may inform preparations being made for the winter influenza season in countries of the northern hemisphere. In addition, members of the WHO informal mathematical modelling network for the 2009 influenza pandemic are working with their respective governments to estimate the reproductive rate (R0), attack rates, incubation period and generation time using data on pandemic influenza (H1N1) 2009 cases by date of onset, cases of influenzalike illness (ILI), rates of physician visits over time, and outbreak investigations in schools and other settings.
The full WHO report is available at: LINK

Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 16 November 2009, 09:00 hours (CEST) in the EU and EFTA countries
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

  1. Austria (11.11.) ? ? ? ? ? ? ? ?
  2. Belgium (12.11.) ? ? ? ? ? ? ? ?
  3. Bulgaria (08.11) ? ? ? ? ? ? ? ?
  4. Cyprus(01.11) ? ? ? ? ? ? ? 4
  5. Czech Republic (12.11.) ? ? ? ? ? ? ? ?
  6. Denmark (11.11.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (13.11.) ? ? ? ? ? ? ? ?
  9. France (12.11.) ? ? ? ? ? 71 ? 188
  10. Germany (10.11.) ? ? ? ? ? ? ? ?
  11. Greece (11.11.) ? ? ? ? ? ? ? ?
  12. Hungary (08.11.) ? ? - 78 ? ? ? ?
  13. Iceland (11.11.) ? 31 ? 170 ? 7 ? 19
  14. Ireland (12.11.) ? 191 ? 785 ? 22 ? 65
  15. Italy (13.11) ? ? - 329 ? ? ? 167
  16. Latvia (12.11.) ? ? - 1 ? ? ? ?
  17. Liechtenstein (11.11.) ? ? ? ? ? ? ? ?
  18. Lithuania (04.11.) ? ? ? ? ? ? ? ?
  19. Luxembourg (21.10.) ? ? ? ? ? 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (13.11.) ? 291 ? 909 ? 19 ? 91
  22. Norway (11.11.) ? 86 ? 623 ? 13 ? 75
  23. Poland (12.11.) ? ? ? ? ? ? ? ?
  24. Portugal (11.11.) - 121 ? ? - 17 ? ?
  25. Romania (11.11) ? ? ? ? ? ? ? ?
  26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
  28. Spain (12.11.) ? ? ? ? ? ? ? ?
  29. Sweden (08.11.) ? 74 - 336 ? ? ? ?
  30. Switzerland (11.11.) ? 15 - 48 ? ? ? 11
  31. United Kingdom (a) (12.11.) - 785 ? ? - 173 ? ?
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 (841 cumulative hospitalisations), Wales (327) and Northern Ireland (527).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 16 November 2009, 09:00 hours CEST, and in the rest of the world by country, as of 15 November 2009, 16:00 hours CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

  • EU AND EFTA COUNTRIES
    • Austria ? ? 1
    • Belgium 3 ? 11
    • Bulgaria ? ? 5
    • Czech Republic ? ? 1
    • Finland 1 ? 7
    • France ? ? 59 (a)
    • Germany 3 ? 16
    • Greece ? ? 5
    • Hungary ? ? 5
    • Iceland ? ? 1
    • Ireland ? ? 15
    • Italy 6 ? 44
    • Latvia ? ? 1
    • Luxembourg ? ? 1
    • Malta ? ? 3
    • Netherlands 5 ? 22
    • Norway 2 ? 18
    • Poland 1 ? 1
    • Portugal 1 ? 6
    • Slovakia ? ? 1
    • Spain ? ? 88
    • Sweden ? ? 5
    • United Kingdom 5 ? 185
      • Total 27 ? 501
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Azerbaijan ? ? 2
    • Belarus ? ? 7
    • Croatia 1 ? 4
    • Kosovo 1 ? 1
    • Moldova 2 ? 6
    • Russia 3 ? 19
    • Serbia 1 ? 9
    • Ukraine .. ? 14
      • Total 8 - 62
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? ? 6
    • Egypt 1 ? 7
    • Iran ? ? 58
    • Iraq .. ? 7
    • Israel 2 ? 41
    • Jordan 3 ? 10
    • Kuwait ? ? 26
    • Lebanon ? ? 3
    • Occupied Palestinian Territory ? ? 2
    • Oman 2 ? 27
    • Qatar ? ? 5
    • Saudi Arabia ? ? 66
    • Syria 6 ? 13
    • Turkey 20 ? 60
    • United Arab Emirates ? ? 6
    • Yemen ? ? 17
      • Total 34 ? 354
  • 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 26 ? 161
    • Mexico 30 ? 482
    • USA 119 ? 1123
      • Total 175 ? 1766
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? ? 1
    • Costa Rica ? ? 38
    • Cuba ? - 7
    • Dominican Republic ? ? 22
    • El Salvador 2 ? 25
    • Guatemala ? ? 18
    • Honduras ? ? 16
    • Jamaica ? ? 5
    • Nicaragua ? ? 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Saint Lucia ? ? 1
    • Suriname ? ? 2
    • Trinidad-Tobago ? ? 5
      • Total 2 ? 170
  • SOUTH AMERICA
    • Argentina ? ? 600
    • Bolivia 1 ? 57
    • Brazil ? ? 1368
    • Chile ? ? 140
    • Colombia ? ? 141
    • Ecuador ? ? 82
    • Paraguay ? ? 52
    • Peru ? ? 183
    • Uruguay ? ? 33
    • Venezuela ? ? 103
      • Total 1 ? 2759
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan ? ? 11
    • Bangladesh ? ? 6
    • China (Mainland) 7 ? 43
    • Hong Kong SAR China 1 ? 40
    • India 6 ? 514
    • Japan ? ? 28
    • Macao SAR China ? ? 2
    • Mongolia 7 ? 15
    • South Korea 12 ? 64
    • Sri Lanka ? ? 1
    • Taiwan ? ? 27
      • Total 33 ? 751
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia ? - 4
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand ? ? 184
    • Vietnam ? ? 41
      • Total ? ? 366
  • AUSTRALIA & PACIFIC
    • Australia 2 ? 189
    • Cook Islands ? ? 1
    • Marshall Islands ? ? 1
    • New Zealand ? ? 19
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total 2 ? 214
  • TOTAL 282 ? 7051
(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 32 in mainland France.
(?)
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Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

Pandemic (H1N1) 2009 Update 17 November 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 17 November 2009, 09:00 hours CEST


Main developments in past 24 hours

  • Updates from U.S.A. and Canada included;
  • Study on hospitalized pandemic influenza patients in Melbourne published;
  • Total of 515 fatal cases in Europe and EFTA countries and 6 577 in the rest of the world have been reported up to date;

This report is based on official information provided by the national public health websites or through other official communication channels. An update on the number of confirmed fatal cases is presented in Table 2 - as of 16 November 2009 -16:00 hours CEST, for the world, and 17 November 2009 - 09:00 hours CEST, for Europe.


Updates from U.S.A. and Canada

From U.S. Centers for Disease Control and Prevention weekly influenza surveillance report: Week 44 (1-7 November 2009)

  • Influenza activity decreased slightly in the U.S.
  • 30.1% of specimens tested by collaborating laboratories and reported to CDC/Influenza Division were positive for influenza.
  • 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 sixth consecutive week.
  • Thirty-five influenza-associated paediatric deaths were reported.
  • Twenty-six of these deaths were associated with 2009 influenza A (H1N1) virus infection, eight 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 6.7% which is above the national baseline of 2.3%.
  • All regions reported ILI above region-specific baseline levels. Forty-six states reported geographically widespread influenza activity.
  • Other news:
    • CDC released new estimates of 2009 influenza A (H1N1) cases, hospitalizations and deaths in the U.S. that occurred April- 17 October 2009.
      • Cases: Approximately 22 million;
      • Hospitalizations: Approximately 98,000;
      • Deaths: Approximately 3,900.
    • For details see LINK
  • 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: Week 44 (1-7 November 2009)

  • There was a considerable increase in the influenza activity level.
  • More than 38% of influenza tests were positive.
  • The Pandemic (H1N1) 2009 strain accounted for 99.8% of the positive influenza A subtyped specimens.
  • The ILI consultation rate was almost 100 per 1,000 patient visits. 25 regions reported widespread activity and over 750 influenza outbreaks were reported. This increased activity occurred in almost all provinces and territories.
  • There were 1,324 hospitalizations and 35 deaths reported from Pandemic (H1N1) 2009.
  • The number of deaths was four times higher than the previous week.
  • The activity levels reported during the previous weeks were even higher than the peak period of the first wave (the three first weeks of June, 2009).
  • Other news:
    • Health Canada approved an unadjuvanted H1N1 flu vaccine for protection against the H1N1 flu virus.
      • The vaccine, Influenza A (H1N1) 2009 Pandemic Monovalent Vaccine (Without Adjuvant), is manufactured by Canada's pandemic vaccine supplier, GlaxoSmithKline.
  • For more information:
    • Public Health Agency of Canada LINK
    • Public Health Agency of Canada FluWatch LINK

Other updates

Study on hospitalized pandemic influenza patients in Melbourne published
The Medical Journal of Australia published a study describing prospectively a case series of 112 patients hospitalized with pandemic influenza infections. The study highlights risk-factors for severe disease and the authors suggest there is a need to concentrate healthcare resources effectively in high-risk patient groups.
See full study at: LINK


Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. Since April 2009, a total 515 deaths have been reported (Table 2) and the number of deaths by week has been increasing over the last 4 weeks. In week The latest available updates as of November 16, 2009, at 16:00, on new and on confirmed fatal pandemic A(H1N1) cases outside the EU/EFTA area by country, are also presented in Table 2. The latest available updates on hospital admissions per Member State are presented in Table 1.

Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care by country as of 17 November 2009, 09:00 hours (CEST) in the EU and EFTA countries
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

  1. Austria (11.11.) ? ? ? ? ? ? ? ?
  2. Belgium (12.11.) ? ? ? ? ? ? ? ?
  3. Bulgaria (08.11) ? ? ? ? ? ? ? ?
  4. Cyprus(01.11) ? ? ? ? ? ? ? 4
  5. Czech Republic (12.11.) ? ? ? ? ? ? ? ?
  6. Denmark (11.11.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (13.11.) ? ? ? ? ? ? ? ?
  9. France (12.11.) ? ? ? ? ? 71 ? 188
  10. Germany (10.11.) ? ? ? ? ? ? ? ?
  11. Greece (11.11.) ? ? ? ? ? ? ? ?
  12. Hungary (08.11.) ? ? - 78 ? ? ? ?
  13. Iceland (11.11.) ? 31 ? 170 ? 7 ? 19
  14. Ireland (12.11.) ? 191 ? 785 ? 22 ? 65
  15. Italy (15.11) ? ? - 329 ? ... ? 167
  16. Latvia (12.11.) ? ? - 1 ? ? ? ?
  17. Liechtenstein (11.11.) ? ? ? ? ? ? ? ?
  18. Lithuania (04.11.) ? ? ? ? ? ? ? ?
  19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (13.11.) ? 291 ? 909 ? 19 ? 91
  22. Norway (11.11.) ? 86 ? 623 ? 13 ? 75
  23. Poland (12.11.) ? ? ? ? ? ? ? ?
  24. Portugal (11.11.) - 121 ? ? - 17 ? ?
  25. Romania (16.11) ? ? ? ? ? ? ? ?
  26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
  28. Spain (12.11.) ? ? ? ? ? ? ? ?
  29. Sweden (08.11.) ? 74 - 336 ? ? ? ?
  30. Switzerland (11.11.) ? 15 - 48 ? ? ? 11
  31. United Kingdom (a) (12.11.) - 785 ? ? - 173 ? ?
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 (841 cumulative hospitalisations), Wales (327) and Northern Ireland (527).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 17 November 2009, 09:00 hours CEST, and in the rest of the world by country, as of 16 November 2009, 16:00 hours CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

  • EU AND EFTA COUNTRIES
    • Austria ? ? 1
    • Belgium ? ? 11
    • Bulgaria ? ? 5
    • Czech Republic ? ? 1
    • Finland ? ? 7
    • France ? ? 59 (a)
    • Germany ? ? 16
    • Greece ? ? 5
    • Hungary ? ? 5
    • Iceland ? ? 1
    • Ireland ? ? 15
    • Italy 9 ? 53
    • Latvia ? ? 1
    • Luxembourg 1 ? 2
    • Malta ? ? 3
    • Netherlands ? ? 22
    • Norway 1 ? 19
    • Poland 1 ? 2
    • Portugal 1 - 7
    • Slovakia ? ? 1
    • Spain ? ? 88
    • Sweden ? ? 5
    • United Kingdom 1 ? 186
      • Total 14 ? 515
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Azerbaijan ? ? 2
    • Belarus ? ? 7
    • Croatia ? ? 4
    • Kosovo ? ? 1
    • Moldova 1 ? 7
    • Russia ? ? 19
    • Serbia ? ? 9
    • Ukraine ? ? 14
      • Total 1 ? 63
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain 1 - 7
    • Egypt ? ? 7
    • Iran ? ? 58
    • Iraq 2 ? 9
    • Israel 5 ? 46
    • Jordan 1 ? 11
    • Kuwait ? ? 26
    • Lebanon ? ? 3
    • Occupied Palestinian Territory 3 ? 5
    • Oman ? ? 27
    • Qatar ? ? 5
    • Saudi Arabia ? ? 66
    • Syria ? ? 13
    • Tunisia 2 ? 2
    • Turkey ? ? 60
    • United Arab Emirates ? ? 6
    • Yemen ? ? 17
      • Total 14 ? 368
  • 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 ? ? 161
    • Mexico ? ? 482
    • USA ? ? 1123
      • Total ? ? 1766
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? ? 1
    • Costa Rica ? - 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador ? ? 25
    • Guatemala ? ? 18
    • Honduras ? ? 16
    • Jamaica ? ? 5
    • Nicaragua ? ? 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Saint Lucia ? ? 1
    • Suriname ? ? 2
    • Trinidad-Tobago ? ? 5
      • Total ? ? 170
  • SOUTH AMERICA
    • Argentina ? ? 600
    • Bolivia ? ? 57
    • Brazil ? ? 1368
    • Chile ? ? 140
    • Colombia ? ? 141
    • Ecuador ? ? 82
    • Paraguay ? ? 52
    • Peru ? ? 183
    • Uruguay ? ? 33
    • Venezuela 1 ? 104
      • Total 1 ? 2760
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan ? ? 11
    • Bangladesh ? ? 6
    • China (Mainland) ? ? 43
    • Hong Kong SAR China ? ? 40
    • India 9 ? 523
    • Japan ? ? 28
    • Macao SAR China ? ? 2
    • Mongolia ? ? 15
    • South Korea ? ? 64
    • Sri Lanka ? ? 1
    • Taiwan 2 ? 29
      • Total 11 ? 762
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? - 1
    • Cambodia ? ? 4
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand ? ? 184
    • Vietnam ? ? 41
      • Total ? ? 366
  • AUSTRALIA & PACIFIC
    • Australia ? ? 189
    • Cook Islands ? ? 1
    • Marshall Islands ? ? 1
    • New Zealand ? ? 19
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total ? ? 214
  • TOTAL 41 ? 7092
(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 32 in mainland France.
(?)
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Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

Pandemic (H1N1) 2009 Update 18 November 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 18 November 2009, 09:00 hours CEST


Main developments in past 24 hours

  • Total of 543 fatal cases in Europe and EFTA countries and 6 624 in the rest of the world have been reported up to date;
  • WHO report describes the first cases of 2009 A(H1N1) influenza viruses resistant to oseltamivir worldwide. Cases are few and hardly any are transmitting from human to human
  • Pandemic A(H1N1) Influenza virus in Ukraine no different than elsewhere in Europe
  • New Vaccines receive authorization First short term vaccine safety data provide no new safety concerns

This report is based on official information provided by national public health websites or through other official communication channels. An update on the number of confirmed fatal cases is presented in Table 2 - as of 17 November 2009 - 16:00 hours CEST, for the world, and 18 November 2009 - 09:00 hours CEST, for Europe.


Epidemiologic update


All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 543 deaths have been reported since April 2009 (Table 2). The number of weekly deaths has shown an increase over the last 4 weeks. 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.


Public Health Development

Oseltamivir-resistant pandemic (H1N1) 2009 influenza virus, October 2009
An article recently published by the WHO summarises the characteristics of 39 cases of 2009 A(H1N1) pandemic influenza viruses resistant to the neuraminidase inhibitor oseltamivir reported so far worldwide.
Almost all cases (29 out of 32 for whom this information was available) developed oseltamivir resistance after receiving oseltamivir treatment or prophylaxis.
A substantial number (n=7) of cases had immunosuppression, a known risk factor for developing oseltamivir resistance.
The authors of the WHO article recommends antiviral resistance testing to be considered for patients with persistent and complicated illness after 5 or more days of antiviral treatment and for patients presenting with an influenza-like illness despite having received antiviral prophylaxis.
In the context of the 2009 A(H1N1) influenza pandemic resistance to oseltamivir remains a very rare event.
No evidence of zanamivir resistance has been detected.
Resistance to the adamantenes (amantidine and rimantadine) is common for the pandemic virus.
WHO points out that the risk of emerging antiviral resistance is no reason for denying treatment with the neuraminidase inhibitors (oseltamivir and zanamivir) to those to for whom they are recommended while at the same time their use in prophylaxis should be very sparing."
More details can later today be found at: LINK


Other updates

Pandemic A(H1N1) Influenza virus in Ukraine no different than elsewhere in Europe
WHO yesterday released the first information on the genetic characterization of Influenza A virus strains collected from Ukraine.
The preliminary analysis by two different specialist laboratories shows that the virus is very similar to the other strains causing the current Influenza A(H1N1) pandemic elsewhere in Europe.
More details can be found at: LINK


New Vaccines receive marketing authorization
Two new pandemic vaccines, Panenza?, produced by Sanofi Pasteur, and Celtura?, produced by Novartis, have recently received marketing authorization in France and Germany, respectively. Sanofi Pasteur has filed a decentralized marketing authorization application for Panenza? in six European Union countries; Belgium, France (acting as ?Reference Member State?), Germany, Italy, Luxembourg and Spain. Authorizations in the other five countries will follow the authorization in France. Novartis continues to pursue registration in other countries including Japan and Switzerland.
Panenza? is a non-adjuvanted, egg-derived, inactivated monovalent influenza A(H1N1) 2009 vaccine containing 15 μg of hemagglutinin of influenza A/California/07/2009 (H1N1)v-like virus per dose. Clinical trials have been performed in France and Finland in adults and children aged 6 months of age and older. First immunogenicity and safety data have been presented to the French drug agency Afssaps (Agence fran?aise de s?curit? sanitaire des produits de sant?) before authorization.
Celtura? is an MF59? adjuvanted, cell-derived, inactivated monovalent influenza A(H1N1) 2009 vaccine containing 3.75 μg of hemagglutinin of influenza A/California/07/2009 (H1N1)v-like virus per dose. Clinical studies in more than 1,850 subjects evaluating safety and immunogenicity have been presented to the German drug agency Paul Ehrlich Institut before authorization. Previously, in the European Union, the European Commission has granted authorisation for three specific A(H1N1) vaccines following a positive scientific opinion issued by the Committee for Medicinal Products for Human Use (CHMP) at the European Medicines Agency (EMEA).
The products centrally authorised are Focetria? (Novartis), Pandemrix? (GlaxoSmithKline) and Celvapan? (Baxter). The vaccines are authorised for use in all Member States of the EU and the EEA (Iceland, Liechtenstein and Norway).
For further information including indications and doses in different age groups, see LINK
In addition, the National Regulatory Agency in Hungary previously has provided a national licence to a pandemic vaccine, Fluval P, produced by the Hungarian manufacturer Omninvest. For further information, see LINK


First short term vaccine safety data provide no new safety concerns
The first short-term safety data after initiation of the national vaccination campaigns are publicly available either in English or the local language on the list of web-pages below.
There are no safety concerns of clinical significance reported so far in addition to those described in the initial trials with either of the vaccines used in these countries; Celvapan and Pandemrix.
With both vaccines allergic reactions requiring medical attention have been reported and its important that healthcare professionals remember that, as with all injectable vaccines, appropriate medical treatment and supervision should always be readily available in case of a serious allergic reaction and possibly a rare anaphylactic event following the administration of the vaccine

  • L?gemiddelstyrelsen, Denmark (also in English) LINK
  • Paul Ehrlich Institute, Germany (also in English) LINK
  • IMB, Ireland LINK
  • Statens Legemiddelverk, Norway LINK
  • L?kemedelsverket, Sweden (also in English) LINK
  • MHRA, United Kingdom LINK
These web-pages will be updated on a weekly basis

Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 18 November 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 (11.11.) ? ? ? ? ? ? ? ?
  2. Belgium (12.11.) ? ? ? ? ? ? ? ?
  3. Bulgaria (08.11) ? ? ? ? ? ? ? ?
  4. Cyprus(01.11) ? ? ? ? ? ? ? 4
  5. Czech Republic (12.11.) ? ? ? ? ? ? ? ?
  6. Denmark (11.11.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (17.11.) ? ? ? ? ? ? ? ?
  9. France (12.11.) ? ? ? ? ? 71 ? 188
  10. Germany (16.11.) ? ? ? ? ? ? ? ?
  11. Greece (11.11.) ? ? ? ? ? ? ? ?
  12. Hungary (08.11.) ? ? - 78 ? ? ? ?
  13. Iceland (11.11.) ? 31 ? 170 ? 7 ? 19
  14. Ireland (12.11.) ? 191 ? 785 ? 22 ? 65
  15. Italy (17.11) ? ? - 405 ? ? ? 205
  16. Latvia (17.11.) ? ? - 1 ? ? ? ?
  17. Liechtenstein (11.11.) ? ? ? ? ? ? ? ?
  18. Lithuania (04.11.) ? ? ? ? ? ? ? ?
  19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (13.11.) ? 291 ? 909 ? 19 ? 91
  22. Norway (11.11.) ? 86 ? 623 ? 13 ? 75
  23. Poland (12.11.) ? ? ? ? ? ? ? ?
  24. Portugal (11.11.) - 121 ? ? - 17 ? ?
  25. Romania (16.11) ? ? ? ? ? ? ? ?
  26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
  28. Spain (12.11.) ? ? ? ? ? ? ? ?
  29. Sweden (08.11.) ? 74 - 336 ? ? ? ?
  30. Switzerland (11.11.) ? 15 - 48 ? ? ? 11
  31. United Kingdom (a) (12.11.) - 785 ? ? - 173 ? ?
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 (841 cumulative hospitalisations), Wales (327) and Northern Ireland (527).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 18 November 2009, 09:00 hours CEST, and in the rest of the world by country, as of 17 November 2009, 16:00 hours CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

  • EU AND EFTA COUNTRIES
    • Austria ? ? 1
    • Belgium ? ? 11
    • Bulgaria ? ? 5
    • Czech Republic ? ? 1
    • Finland 2 ? 9
    • France 11 ? 70 (a)
    • Germany 5 ? 21
    • Greece ? ? 5
    • Hungary ? ? 5
    • Iceland ? ? 1
    • Ireland ? ? 15
    • Italy 5 ? 58
    • Latvia ? ? 1
    • Luxembourg ? ? 2
    • Malta ? ? 3
    • Netherlands ? ? 22
    • Norway 2 ? 21
    • Poland 2 ? 4
    • Portugal ? ? 7
    • Slovakia ? ? 1
    • Spain ? ? 88
    • Sweden ? ? 5
    • United Kingdom 1 ? 187
      • Total 28 ? 543
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Azerbaijan ? ? 2
    • Belarus ? ? 7
    • Croatia 1 ? 5
    • Kosovo ? ? 1
    • Moldova ? ? 7
    • Russia ? ? 19
    • Serbia 2 ? 11
    • Ukraine 1 ? 15
      • Total 4 - 67
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? ? 7
    • Egypt ? ? 7
    • Iran ? ? 58
    • Iraq ? ? 9
    • Israel 2 ? 48
    • Jordan ? ? 11
    • Kuwait ? ? 26
    • Lebanon ? ? 3
    • Morocco 1 ? 1
    • Occupied Palestinian Territory ? ? 5
    • Oman ? ? 27
    • Qatar ? ? 5
    • Saudi Arabia ? ? 66
    • Syria 9 ? 22
    • Tunisia ? ? 2
    • Turkey 13 ? 73
    • United Arab Emirates ? ? 6
    • Yemen 1 ? 18
      • Total 26 ? 394
  • 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 ? ? 161
    • Mexico ? ? 482
    • USA ? ? 1123
      • Total ? ? 1766
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? - 1
    • Costa Rica ? ? 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador ? ? 25
    • Guatemala ? ? 18
    • Honduras ? ? 16
    • Jamaica ? ? 5
    • Nicaragua ? ? 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Saint Lucia ? ? 1
    • Suriname ? ? 2
    • Trinidad-Tobago ? ? 5
      • Total ? ? 170
  • SOUTH AMERICA
    • Argentina ? ? 600
    • Bolivia ? ? 57
    • Brazil ? ? 1368
    • Chile ? ? 140
    • Colombia ? ? 141
    • Ecuador ? ? 82
    • Paraguay ? ? 52
    • Peru ? ? 183
    • Uruguay ? ? 33
    • Venezuela ? ? 104
      • Total ? ? 2760
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan 3 ? 14
    • Bangladesh ? ? 6
    • China (Mainland) 10 ? 53
    • Hong Kong SAR China ? ? 40
    • India 3 ? 526
    • Japan ? ? 28
    • Macao SAR China ? ? 2
    • Mongolia ? ? 15
    • Pakistan 1 ? 1
    • South Korea ? ? 64
    • Sri Lanka ? ? 1
    • Taiwan ? ? 29
      • Total 17 - 779
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia ? ? 4
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand ? ? 184
    • Vietnam ? ? 41
      • Total ? ? 366
  • AUSTRALIA & PACIFIC
    • Australia ? ? 189
    • Cook Islands ? ? 1
    • Marshall Islands ? ? 1
    • New Zealand ? ? 19
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total ? ? 214
  • TOTAL 75 ? 7167
(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 43 in mainland France.
(?)
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------
 
Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

Pandemic (H1N1) 2009 Update 19 November 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 19 November 2009, 09:00 hours CEST


Main developments in past 24 hours

  • Total of 549 fatal cases in Europe and EFTA countries and 6 747 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. An update on the number of confirmed fatal cases is presented in Table 2 - as of 18 November 2009 - 16:00 hours CEST, for the world, and 19 November 2009 - 09:00 hours CEST, for Europe.


Epidemiologic update


All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 549 deaths have been reported since April 2009 (Table 2). The number of weekly deaths has shown an increase over the last 4 weeks. 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 19 November 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 (11.11.) ? ? ? ? ? ? ? ?
  2. Belgium (12.11.) ? ? ? ? ? ? ? ?
  3. Bulgaria (08.11) ? ? ? ? ? ? ? ?
  4. Cyprus (01.11) ? ? ? ? ? ? ? 4
  5. Czech Republic (12.11.) ? ? ? ? ? ? ? ?
  6. Denmark (18.11.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (18.11.) ? ? ? ? ? ? ? ?
  9. France (12.11.) ? ? ? ? ? 71 ? 188
  10. Germany (18.11.) ? ? ? ? ? ? ? ?
  11. Greece (18.11.) ? ? ? ? ? ? ? ?
  12. Hungary (08.11.) ? ? - 78 ? ? ? ?
  13. Iceland (11.11.) ? 31 ? 170 ? 7 ? 19
  14. Ireland (12.11.) ? 191 ? 785 ? 22 ? 65
  15. Italy (17.11) ? ? - 405 ? ? ? 205
  16. Latvia (17.11.) ? ? - 1 ? ? ? ?
  17. Liechtenstein (11.11.) ? ? ? ? ? ? ? ?
  18. Lithuania (04.11.) ? ? ? ? ? ? ? ?
  19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (13.11.) ? 291 ? 909 ? 19 ? 91
  22. Norway (18.11.) ? 89 ? 916 ? 24 ? 108
  23. Poland (12.11.) ? ? ? ? ? ? ? ?
  24. Portugal (18.11.) - 164 ? ? - 18 ? ?
  25. Romania (18.11) ? ? ? ? ? ? ? ?
  26. Slovakia (12.08.) ? 2 ? 33 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
  28. Spain (12.11.) ? ? ? ? ? ? ? ?
  29. Sweden (08.11.) ? 74 - 336 ? ? ? ?
  30. Switzerland (11.11.) ? 15 - 48 ? ? ? 11
  31. United Kingdom (a) (12.11.) - 785 ? ? - 173 ? ?
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 (841 cumulative hospitalisations), Wales (327) and Northern Ireland (527).


Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 19 November 2009, 09:00 hours CEST, and in the rest of the world by country, as of 18 November 2009, 16:00 hours CEST.


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

  • EU AND EFTA COUNTRIES
    • Austria ? ? 1
    • Belgium ? ? 11
    • Bulgaria ? ? 5
    • Czech Republic ? ? 1
    • Finland ? ? 9
    • France ? ? 70 (a)
    • Germany 1 ? 22
    • Greece 3 ? 8
    • Hungary ? ? 5
    • Iceland ? ? 1
    • Ireland ? ? 15
    • Italy ? ? 58
    • Latvia ? ? 1
    • Lithuania 1 ? 1
    • Luxembourg ? ? 2
    • Malta ? ? 3
    • Netherlands ? ? 22
    • Norway 1 ? 22
    • Poland ? ? 4
    • Portugal ? ? 7
    • Slovakia ? ? 1
    • Spain ? ? 88
    • Sweden ? ? 5
    • United Kingdom ? ? 187
      • Total 6 ? 549
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Azerbaijan ? ? 2
    • Belarus ? ? 7
    • Bosnia and Herzegovina 1 - 1
    • Croatia ? ? 5
    • Kosovo ? ? 1
    • Moldova ? ? 7
    • Russia ? ? 19
    • Serbia 2 ? 13
    • Ukraine ? - 15
      • Total 3 ? 70
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? ? 7
    • Egypt ? ? 7
    • Iran 42 ? 100
    • Iraq ? ? 9
    • Israel ? ? 48
    • Jordan ? ? 11
    • Kuwait ? ? 26
    • Lebanon ? ? 3
    • Morocco ? ? 1
    • Occupied Palestinian Territory ? ? 5
    • Oman ? ? 27
    • Qatar ? ? 5
    • Saudi Arabia ? ? 66
    • Syria ? ? 22
    • Tunisia ? ? 2
    • Turkey ? ? 73
    • United Arab Emirates ? ? 6
    • Yemen ? ? 18
      • Total 42 ? 436
  • 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 37 ? 198
    • Mexico ? ? 482
    • USA ? ? 1123
      • Total 37 ? 1803
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? - 3
    • Cayman Islands ? ? 1
    • Costa Rica ? ? 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador 1 ? 26
    • Guatemala ? ? 18
    • Honduras ? ? 16
    • Jamaica ? ? 5
    • Nicaragua ? ? 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Saint Lucia ? ? 1
    • Suriname ? ? 2
    • Trinidad-Tobago ? ? 5
      • Total 1 ? 171
  • SOUTH AMERICA
    • Argentina ? ? 600
    • Bolivia ? ? 57
    • Brazil ? ? 1368
    • Chile ? ? 140
    • Colombia 10 ? 151
    • Ecuador ? ? 82
    • Paraguay ? ? 52
    • Peru 7 ? 190
    • Uruguay ? ? 33
    • Venezuela ? ? 104
      • Total 17 ? 2777
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan ? ? 14
    • Bangladesh ? ? 6
    • China (Mainland) ? ? 53
    • Hong Kong SAR China ? ? 40
    • India 4 ? 530
    • Japan ? ? 28
    • Macao SAR China ? ? 2
    • Mongolia ? ? 15
    • Pakistan ? ? 1
    • South Korea 18 ? 82
    • Sri Lanka ? ? 1
    • Taiwan ? - 29
      • Total 22 ? 801
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia ? ? 4
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand 1 ? 185
    • Vietnam ? ? 41
      • Total 1 ? 367
  • AUSTRALIA & PACIFIC
    • Australia ? ? 189
    • Cook Islands ? ? 1
    • Marshall Islands ? ? 1
    • New Zealand ? ? 19
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total ? ? 214
  • TOTAL 129 ? 7296
(a) Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 6 in the Reunion, 1 in Martinique, 2 in Mayotte, 1 in Guadeloupe and 43 in mainland France.
(?)
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Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

Pandemic (H1N1) 2009 Update 20 November 2009, 09:00 hours CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

Pandemic (H1N1) 2009 Update 20 November 2009, 09:00 hours CEST


Main developments in past 24 hours

  • Weekly Influenza Surveillance Overview to be published today;
  • Eurosurveillance updates published;
  • Total of 636 fatal cases in Europe and EFTA countries and 6 795 in the rest of the world have been reported up to date;
  • Other updates: Safety of pandemic vaccines - WHO says results to date are encouraging

This report is based on official information provided by national public health websites or through other official communication channels. An update on the number of confirmed fatal cases is presented in Table 2 - as of 19 November 2009 - 16:00 hours CEST, for the world, and 20 November 2009 - 09:00 hours CEST, for Europe.


Weekly Influenza Surveillance Overview


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


Eurosurveillance update

Differentiation of two distinct clusters among currently circulating Influenza A(H1N1)v viruses, march-september 2009


Analysis of all complete genome sequences of the pandemic influenza A(H1N1)v virus available as of 10 September 2009 revealed that two closely related but distinct clusters were circulating in most of the affected countries at the same time. The characteristic differences are located in genes encoding the two surface proteins - haemagglutinin and neuraminidase - and four internal proteins ? the polymerase PB2 subunit, nucleoprotein, matrix protein M1 and the non-structural protein NS1. Phylogenetic inference was demonstrated by neighbour joining, maximum likelihood and Bayesian trees analyses of the involved genes and by tree construction of concatenated sequences


Fereidouni SR, Beer M, Vahlenkamp T, Starick E. Differentiation of two distinct clusters among currently circulating influenza A(H1N1)v viruses, March-September 2009. Euro Surveill. 2009;14(46):pii=19409. Available online: LINK


Epidemiologic update


All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 636 deaths have been reported since April 2009 (Table 2). The number of weekly deaths has shown an increase over the last 4 weeks. 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

Safety of pandemic vaccines - WHO says results to date are encouraging


The World Health Organisation yesterday released their "Pandemic (H1N1) 2009 briefing note 16" discussing the safety of pandemic vaccines. The briefing discusses common side effects, GBS and deaths. To date, WHO has received vaccination information from 16 of around 40 countries conducting national H1N1 pandemic vaccine campaigns.
Detailed information can be found at: LINK


Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 20 November 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 (19.11.) ? ? ? ? ? ? ? ?
  3. Bulgaria (08.11) ? ? ? ? ? ? ? ?
  4. Cyprus(01.11) ? ? ? ? ? ? - 4
  5. Czech Republic (19.11.) ? ? ? ? ? ? ? ?
  6. Denmark (18.11.) ? ? ? ? ? ? ? ?
  7. Estonia (23.10.) ? ? - 11 ? ? ? ?
  8. Finland (18.11.) ? ? ? ? ? ? ? ?
  9. France (19.11.) ? ? ? ? ? 81 ? 245
  10. Germany (18.11.) ? ? ? ? ? ? ? ?
  11. Greece (18.11.) ? ? ? ? ? ? ? ?
  12. Hungary (18.11.) - 2 ? ? ? ? ? ?
  13. Iceland (11.11.) ? 31 ? 170 ? 7 ? 19
  14. Ireland (18.11.) ? 182 ? 857 ? 20 ? 72
  15. Italy (18.11) ? ? - 432 ? ? ? 216
  16. Latvia (18.11.) ? ? ? ? ? ? ? ?
  17. Liechtenstein (18.11.) ? ? ? ? ? ? ? ?
  18. Lithuania (04.11.) ? ? ? ? ? ? ? ?
  19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (13.11.) ? 291 ? 909 ? 19 ? 91
  22. Norway (18.11.) ? 89 ? 916 ? 24 ? 108
  23. Poland (17.11.) ? ? ? ? ? ? ? ?
  24. Portugal (18.11.) - 164 ? ? - 18 ? ?
  25. Romania (19.11) ? ? ? ? ? ? ? ?
  26. Slovakia (19.11.) ? 6 ? 39 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
  28. Spain (19.11.) ? ? ? ? ? ? ? ?
  29. Sweden (19.11.) ? 167 - 570 ? ? ? ?
  30. Switzerland (18.11.) ? 13 - 84 ? ? ? 16
  31. United Kingdom (a) (19.11.) - 783 ? ? - 180 ? ?
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 (969 cumulative hospitalisations), Wales (377) and Northern Ireland (545).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 20 November 2009, 09:00 hours CEST, and in the rest of the world by country, as of 19 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 2 ? 3
    • Belgium 1 ? 12
    • Bulgaria ? ? 5
    • Czech Republic 1 - 2
    • Finland ? ? 9
    • France 6 ? 76 (a)
    • Germany 5 ? 27
    • Greece ? ? 8
    • Hungary 2 ? 7
    • Iceland ? ? 1
    • Ireland 1 ? 16
    • Italy 4 ? 62
    • Latvia ? ? 1
    • Lithuania ? ? 1
    • Luxembourg ? ? 2
    • Malta ? ? 3
    • Netherlands ? ? 22
    • Norway 1 ? 23
    • Poland 1 ? 5
    • Portugal 1 ? 8
    • Slovakia ? ? 1
    • Spain 27 ? 115
    • Sweden 6 ? 11
    • Switzerland 1 ? 1
    • United Kingdom 28 ? 215
      • Total 87 ? 636
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Azerbaijan ? ? 2
    • Belarus ? ? 7
    • Bosnia and Herzegovina ? ? 1
    • Croatia ? ? 5
    • Former Yugoslav Republic of Macedonia 1 ? 1
    • Kosovo ? ? 1
    • Moldova ? ? 7
    • Russia ? - 19
    • Serbia 3 ? 16
    • Ukraine ? ? 15
      • Total 4 ? 74
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? ? 7
    • Egypt ? ? 7
    • Iran ? ? 100
    • Iraq ? ? 9
    • Israel ? ? 48
    • Jordan ? ? 11
    • Kuwait ? ? 26
    • Lebanon ? ? 3
    • Morocco ? ? 1
    • Occupied Palestinian Territory ? ? 5
    • Oman ? ? 27
    • Qatar ? ? 5
    • Saudi Arabia ? ? 66
    • Syria ? ? 22
    • Tunisia ? ? 2
    • Turkey ? ? 73
    • United Arab Emirates ? ? 6
    • Yemen ? ? 18
      • Total ? ? 436
  • 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 ? ? 198
    • Mexico 38 ? 520
    • USA ? ? 1123
      • Total 38 ? 1841
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? ? 1
    • Costa Rica ? ? 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador ? ? 26
    • Guatemala ? ? 18
    • Honduras ? ? 16
    • Jamaica 1 ? 6
    • Nicaragua ? ? 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Saint Lucia ? ? 1
    • Suriname ? ? 2
    • Trinidad-Tobago ? ? 5
      • Total 1 ? 172
  • SOUTH AMERICA
    • Argentina ? ? 600
    • Bolivia ? ? 57
    • Brazil ? ? 1368
    • Chile ? ? 140
    • Colombia ? ? 151
    • Ecuador ? ? 82
    • Paraguay ? ? 52
    • Peru ? ? 190
    • Uruguay ? ? 33
    • Venezuela ? ? 104
      • Total ? ? 2777
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan ? ? 14
    • Bangladesh ? ? 6
    • China (Mainland) ? ? 53
    • Hong Kong SAR China ? ? 40
    • India 4 ? 534
    • Japan ? ? 28
    • Macao SAR China ? ? 2
    • Mongolia ? ? 15
    • Pakistan ? ? 1
    • South Korea ? - 82
    • Sri Lanka ? ? 1
    • Taiwan ? ? 29
      • Total 4 ? 805
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia ? ? 4
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand ? ? 185
    • Vietnam ? ? 41
      • Total ? ? 367
  • AUSTRALIA & PACIFIC
    • Australia ? ? 189
    • Cook Islands ? ? 1
    • Marshall Islands ? ? 1
    • New Zealand 1 ? 20
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total 1 ? 215
  • TOTAL 135 ? 7431
(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 48 in mainland France.
(?)
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Re: Pandemic Influenza H1N1 2009, European Centre of Diseases Prevention and Control (ECDC) Situation Updates (since Sep. 26, 2009)

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

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

[Source Full PDF Document: LINK. EDITED.]

ECDC DAILY UPDATE

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


Main developments in past 72 hours

  • The number of confirmed deaths reported by EU & EFTA countries as due to the pandemic rose by two thirds in one week to 169;
  • Routine surveillance reports from primary care indicate that almost all European countries reported intensity above baseline levels. Seventeen countries showed increasing trends mostly counties in Eastern Europe. But some countries are now reported decreasing trends;
  • EMEA?s Committee on Human Medical Products has strengthened its previous statement that a single injection of the vaccines Focetria and Pandemrix may be sufficient to protect children over age 10 and adults to age sixty;
  • EMEA also sees no evidence to date that any of the licensed vaccines have side effects more than those expected from the clinical trials;
  • A mutation in the Haemagglutinin gene of the pandemic virus has been reported from Norway;
  • Two clusters of possible transmission of oseltamivir resistant Pandemic Influenza A(H1N1)v among hospitalized patients in the United Kingdom and United States;
  • Episouth update from countries of the Mediterranean and the Balkans included.

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


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 670 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. 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 Overview was published in November 20th for week 46/2009, Twenty seven countries reported epidemiological data, the highest total to date this pandemic.


For the activity intensity indicator?national network levels for ILI and/or ARI? Italy, Norway and Sweden reported very high intensity; Bulgaria, Denmark, Germany, Iceland, Ireland, Lithuania, Luxembourg, Poland and Portugal reported high intensity; medium intensity was reported by 14 countries and one country reported low intensity.


For the geographic spread indicator, increases were noted compared to the previous week with 15 countries reporting widespread activity. Nine countries reported regional activity.


The other countries reported sporadic or no activity.


Seventeen countries reported an increasing trend of influenza activity compared to twenty in the previous week. Countries in Central and Eastern Europe were especially experiencing rising trends. Seven countries, Belgium, Bulgaria, Iceland, Ireland, Luxembourg, Norway and parts of the UK (Northern Ireland), reported decreasing trends.
Belgium, Iceland and the UK (Northern Ireland), reported decreasing trends in week 45 as well. In most countries where influenza activity has risen above baseline levels, the most affected group includes those younger than 15 years.


Virological data indicate that there remains very viruses apart from the pandemic strain. The proportion of sentinel specimens that are confirmed influenza is 45%, a high level normally only seen during the peaks of previous winter influenza epidemics.


Pandemic Vaccine Information from EMEA


EMEA?s Committee on Human Medical Products (CHMP) met through last week and considered the latest data from the experience with the pandemic vaccines. Its conclusion are summarised in a Press Release issued on November 20th. The Committee concluded that the data on Focetria (Novartis) and Pandemrix (GSK) indicate that a single dose of these vaccines is able to trigger an immune response likely to be sufficient to give protection against the H1N1 pandemic influenza in older children, adolescents and younger adults. For both vaccines, a single dose may be used in persons aged between 10 and 60 years. Pandemrix may also be used as a single dose in the elderly. For certain groups, such as younger children and immunocompromised patients, the recommendation remains that two doses should be given, to ensure that their immune system responds adequately to the vaccination. Further data will become available in the coming months.


Data on Celvapan (Baxter) are still being assessed.


The CHMP also concluded that Focetria and Pandemrix can be co-administered with non-adjuvanted seasonal flu vaccines. EMEA also noted that the safety profile of H1N1 pandemic influenza vaccines is being continuously monitored by itself and in Member States. This post marketing surveillance is based on about 5 million people who have been vaccinated so far in Europe. To date, the side effects reported have mainly been mild symptoms such as fever, nausea, headache, allergic reactions and injection site reactions, confirming the safety profile of the three vaccines.


A very small number of cases of Guillain-Barr? syndrome and foetal death have been reported in patients previously vaccinated with a pandemic vaccine. EMEA is still in the process of gathering all relevant information and evaluating the data. However, on the basis of the available information it concludes there is no evidence to link these to the vaccines.


Other updates

Mutation in the Haemagglutinin gene of pandemic Influenza A(H1N1)v reported from Norway


The Norwegian Institute of Public Health reported on 20 November 2009 the detection of a mutation in the viruses affecting three cases of severe pandemic Influenza A(H1N1)v infection . Overall approximately 70 influenza viruses from ill patients have been sequenced in Norway, including six from patients who died.


The three viruses with this mutation were isolated from the first two fatal cases of pandemic influenza in Norway and one patient with severe respiratory disease. The two fatal cases , who were not epidemiologically linked, died in July and August, 2009.


Based on the currently available information it appears that the mutated virus is not circulating in the Norwegian population, but may the result of a spontaneous change occurring in severely ill patients [1].


In a note responding to the report from Norway WHO reported that worldwide, a similar mutation has been was detected in viruses from several other countries, with the earliest detection reported in April.


In addition to Norway, the mutation has been observed in Brazil, China, Japan, Mexico, Ukraine and the USA.[2]


1. LINK
2. LINK

ECDC comment:


The amino acid change in the haemagglutinin HA1 gene at position 222 (225 in influenza H3 numbering) from aspartic acid (D) to glycine (G) observed, may influence receptor binding specificity and therefore has the potential to affect the pathogenicity of the virus. This might allow the mutated virus to infect tissues deeper in the respiratory tract, although the receptor binding preferences have not been determined yet.


Currently, there is no evidence about the consequences of this mutation on the biological properties of the virus. In addition, if the receptor preference of the mutated virus corresponds to the deeper airways, this most likely will tend to reduce the likelihood for easy human-to-human spread.


A likely explanation of this finding is that it is an adaptive mutation of the virus. At this moment there is no indication of change in the virulence of the circulating pandemic Influenza A(H1N1)v virus.


The virus with this mutation remains sensitive to oseltamivir and zanamivir.



Studies show that the currently available vaccines confer protection.



Continued close virological monitoring in particular of severe cases, is needed to elucidate any potential relationship between the mutation and the clinical outcome of infection.


Two clusters of possible transmission of oseltamivir resistant Pandemic Influenza A(H1N1)v among hospitalized patients, United Kingdom and United States

UK: Nine Pandemic Influenza A(H1N1)v confirmed cases have been reported amongst patients on a hospital ward in Wales.[3] Five of these cases are determined to be resistant to oseltamivir, one is sensitive and for three resistance status is currently unknown. The cluster is in a group of patients with haematological problems which result in immuno-suppression either because of the disorder or the chemotherapy given to treat the disorder. Although further epidemiological investigation is underway, it would seem likely that transmission of oseltamivir-resistant H1N1 virus has taken place.


Further follow-up of cases and their close contacts both on the ward and in the community is underway to ascertain if there is evidence of transmission.


The virus remains sensitive to the other licensed neuraminidase inhibitor zanamivir which is being used as an alternative antiviral and to which patients are responding.[3]

USA: Four patients at a hospital in North Carolina who developed influenza in October were found to have oseltamivir resistant pandemic influenza A(H1N1) [4]. The cluster was detected when the patients did not respond to oseltamivir treatment. Three of the four patients have died. All of the patients were located in a ward for people with cancer or severe blood disorders. All were severely ill and were highly susceptible to infections.


Preliminary genetic evidence suggests that the virus spread among patients at the hospital.


The U.S. Centers for Disease Control and Prevention (CDC) is testing virus samples from the patients at Duke to see whether they're indistinguishable from one another.


In addition to investigating the hospital cluster, state and federal epidemiologists are trying to determine whether oseltamivir resistant influenza is circulating elsewhere in North Carolina.


3. LINK
4. LINK

ECDC comment:


Oseltamivir resistance to influenza viruses is well documented in immunosuppressed individuals and can develop quickly if oseltamivir is being given. It is likely to be associated with the high viral load which may occur during infection in these patients. In addition, immunosuppressed people may be more susceptible to infection (i.e., a smaller exposure may result in infection in these patients). It is thus not surprising that spread of resistant virus may occur from patients in whom resistance is more likely to develop during treatment to patients who are very susceptible, especially in a confined setting such as a hospital ward.


The range of manifestations (e.g., asymptomatic, mild, severe) of influenza infection, such as observed with the 2009 A(H1N1) pandemic, makes it difficult, if not impossible, to determine if any given patient or healthcare worker is carrying virus. Thus, people in contact with an index patient can innocently spread influenza to other patients.


Unvaccinated healthcare workers and visitors in contact with these patients may be at risk for being infected with this resistant strain. At this time it is difficult to predict the likelihood of spread of this resistant strain into the community through these people or another means. The conditions under which these clusters occurred are likely to be present at other medical centres throughout the EU. That is, transmission of influenza in the community with immunocompromised patients in healthcare settings receiving either prophylactic or therapeutic oseltamivir.


Thus, member states should remain vigilant for similar clusters now and in the future. Unless oseltamivir resistance becomes more common, it remains appropriate to use oseltamivir for the treatment and prophylaxis of influenza in the UK, the US and elsewhere. Treatment failure is a reason to consider alternative treatment and to test a viral isolate for resistance.



The continuous surveillance for resistance from a sample of isolates taken from community infections should be maintained in countries where resources for testing are available.


Countries without resistance testing capacity should send samples elsewhere for testing on a periodic basis. The best ways to prevent the spread of antiviral susceptible and antiviral resistant influenza in the healthcare setting and between healthcare settings and the community is to ensure healthcare workers are immunized and that there is strict adherence to infection control procedures.


EPISOUTH update


EPISOUTH is a European Commission funded project, whose aim is 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).


Excerpts from the bulletin 87 (11th Nov-17th Nov) is published here:


As of 17 November 2009, a total of 382 deaths among biologically confirmed A/H1N1/2009 cases have been reported in the EpiSouth region. 138 new deaths were reported since 10 November 2009: 1 in Bosnia and Herzegovina (1st), 4 in Croatia, 3 in Egypt, 9 in Israel, 15 in France, 25 in Italy, 4 in Jordan, 1 in Kosovo (1st),1 in Morocco (1st), 4 in Palestine, 4 in Serbia,15 in Syria 2, in Tunisia (1st) and 50 in Turkey.


Influenza activity is globally on the rise across Southern Europe and the Balkans. For week 45, influenza activity was high in Croatia, Serbia and Turkey. Bosnia and Herzegovina reported its first death from influenza A/H1N1/2009. Kosovo reported its first A/H1N1/2009 confirmed death.


As of 17 November 2009, Palestine had 7 fatalities.


Israel reported widespread, medium influenza activity for week 45.
Morocco reported its first death on 13 November 2009 from influenza A/H1N1 in Oujda (North-east).


Community transmission of A/H1N1/2009 influenza virus has been established in Tunisia. The country experiences an increasing epidemic trend since the beginning of November. Tunisia reported its first 2 deaths from influenza A/H1N1/2009 during week 46.


The full EPISOUTH bulletin can be accessed at: LINK


Table 1: Reported number of confirmed Pandemic (H1N1) 2009 influenza cases admitted to hospitals and intensive care, by country, as of 23 November 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 (19.11.) ? ? ? ? ? ? ? ?
  3. Bulgaria (08.11) ? ? ? ?- ? ? ?
  4. Cyprus(01.11) ? ? ? ? ? ? ? 4
  5. Czech Republic (19.11.) ? ? ? ? ? ? ? ?
  6. Denmark (18.11.) ? ? ? ? ? ? ? ?
  7. Estonia (20.11.) ? ? ? ? ? ? ? ?
  8. Finland (20.11.) ? ? ? ? ? ? ? ?
  9. France (19.11.) ? ? ? ? ? 81 ? 245
  10. Germany (18.11.) ? ? ? ? ? ? ? ?
  11. Greece (18.11.) ? ? ? ? ? ? ? ?
  12. Hungary (18.11.) - 2 ? ? ? ? ? ?
  13. Iceland (11.11.) ? 31 ? 170 ? 7 ? 19
  14. Ireland (18.11.) ? 182 ? 857 ? 20 ? 72
  15. Italy (21.11.) ? ? - 489 ? ? ? 241
  16. Latvia (18.11.) ? ? ? ? ? ? ? ?
  17. Liechtenstein (18.11.) ? ? ? ? ? ? ? ?
  18. Lithuania (04.11.) ? ? ? ? ? ? ? ?
  19. Luxembourg (16.11.) ? ? ? ? ? 0 ? 0
  20. Malta (04.09.) ? ? - 46 ? ? ? 1
  21. Netherlands (20.11.) ? 359 ? 1270 ? 38 ? 134
  22. Norway (18.11.) ? 89 ? 916 ? 24 ? 108
  23. Poland (17.11.) ? ? ? ? ? ? ? ?
  24. Portugal (18.11.) - 164 ? ? - 18 ? ?
  25. Romania (19.11) ? ? ? ? ? ? ? ?
  26. Slovakia (19.11.) ? 6 ? 39 ? 0 ? 0
  27. Slovenia (10.08.) ? ? ? ? ? ? ? ?
  28. Spain (19.11.) ? ? ? ? ? ? ? ?
  29. Sweden (19.11.) ? 167 - 570 ? ? ? ?
  30. Switzerland (18.11.) ? 13 - 84 ? ? ? 16
  31. United Kingdom (a) (19.11.) - 783 ? ? - 180 ? ?
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 (969 cumulative hospitalisations), Wales (377) and Northern Ireland (545).

Table 2. Reported number of new and cumulative confirmed fatal Pandemic (H1N1) 2009 influenza cases in EU and EFTA countries, as 23 November 2009, 09:00 hours CEST, and in the rest of the world by country, as of 22 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 ? ? 12
    • Bulgaria ? ? 5
    • Czech Republic ? ? 2
    • Denmark 2 ? 2
    • Finland 3 ? 12
    • France 8 ? 84 (a)
    • Germany 3 ? 30
    • Greece ? ? 8
    • Hungary ? ? 7
    • Iceland ? ? 1
    • Ireland ? ? 16
    • Italy 8 ? 70
    • Latvia ? ? 1
    • Lithuania ? ? 1
    • Luxembourg ? ? 2
    • Malta ? ? 3
    • Netherlands 6 ? 28
    • Norway ? ? 23
    • Poland ? ? 5
    • Portugal 3 ? 11
    • Slovakia ? ? 1
    • Spain ? ? 115
    • Sweden ? ? 11
    • Switzerland ? ? 1
    • United Kingdom 1 ? 216
      • Total 34 ? 670
  • OTHER EUROPEAN COUNTRIES & CENTRAL ASIA
    • Azerbaijan ? ? 2
    • Belarus ? ? 7
    • Bosnia and Herzegovina ? ? 1
    • Croatia ? ? 5
    • Former Yugoslav Republic of Macedonia ? ? 1
    • Kosovo 1 ? 2
    • Moldova 1 - 8
    • Russia ? ? 19
    • Serbia ? ? 16
    • Ukraine ? ? 15
      • Total 2 ? 76
  • MEDITERRANEAN AND MIDDLE-EAST
    • Bahrain ? ? 7
    • Egypt 3 ? 10
    • Iran ? ? 100
    • Iraq ? ? 9
    • Israel ? ? 48
    • Jordan ? ? 11
    • Kuwait ? ? 26
    • Lebanon ? ? 3
    • Morocco ? ? 1
    • Occupied Palestinian Territory 2 ? 7
    • Oman ? ? 27
    • Qatar 2 ? 7
    • Saudi Arabia 4 ? 70
    • Syria ? ? 22
    • Tunisia ? ? 2
    • Turkey 20 ? 93
    • United Arab Emirates ? ? 6
    • Yemen ? ? 18
      • Total 31 ? 467
  • 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 52 ? 250
    • Mexico 53 ? 573
    • USA ? ? 1123
      • Total 105 ? 1946
  • CENTRAL AMERICA & CARIBBEAN
    • Bahamas ? ? 4
    • Barbados ? ? 3
    • Cayman Islands ? ? 1
    • Costa Rica ? ? 38
    • Cuba ? ? 7
    • Dominican Republic ? ? 22
    • El Salvador ? ? 26
    • Guatemala ? ? 18
    • Honduras ? ? 16
    • Jamaica ? ? 6
    • Nicaragua ? ? 11
    • Panama ? ? 11
    • Saint Kitts and Nevis ? ? 1
    • Saint Lucia ? ? 1
    • Suriname ? ? 2
    • Trinidad-Tobago ? ? 5
      • Total ? ? 172
  • SOUTH AMERICA
    • Argentina ? ? 600
    • Bolivia ? ? 57
    • Brazil ? ? 1368
    • Chile ? ? 140
    • Colombia ? ? 151
    • Ecuador ? ? 82
    • Paraguay ? ? 52
    • Peru ? ? 190
    • Uruguay ? ? 33
    • Venezuela 3 ? 107
      • Total 3 ? 2780
  • NORTH-EAST & SOUTH ASIA
    • Afghanistan ? ? 14
    • Bangladesh ? ? 6
    • China (Mainland) ? ? 53
    • Hong Kong SAR China ? ? 40
    • India 19 ? 553
    • Japan ? ? 28
    • Macao SAR China ? ? 2
    • Maldives 1 ? 1
    • Mongolia 2 - 17
    • Pakistan ? ? 1
    • South Korea ? ? 82
    • Sri Lanka 4 ? 5
    • Taiwan ? ? 29
      • Total 26 ? 831
  • SOUTH-EAST ASIA
    • Brunei Darussalam ? ? 1
    • Cambodia ? ? 4
    • Indonesia ? ? 10
    • Laos Peoples Democratic Republic ? ? 1
    • Malaysia ? ? 77
    • Philippines ? ? 30
    • Singapore ? ? 18
    • Thailand ? ? 185
    • Vietnam ? ? 41
      • Total ? ? 367
  • AUSTRALIA & PACIFIC
    • Australia ? ? 189
    • Cook Islands ? ? 1
    • Marshall Islands ? ? 1
    • New Zealand ? ? 20
    • Samoa ? ? 2
    • Solomon Islands ? ? 1
    • Tonga ? ? 1
      • Total ? ? 215
  • TOTAL 201 ? 7632
(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 56 in mainland France.
(?)
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