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Archive - WHO, Pandemic Influenza H1N1 2009 - Weekly virological surveillance (until the end of July 2010)

Giuseppe

Emeritus
WHO - Pandemic (H1N1) 2009, Ukraine - update 1

Pandemic (H1N1) 2009, Ukraine - update 1

3 November 2009


According to the Ministry of Health of the Ukraine, the country has now recorded more than 250,000 cases of influenza-like illness, with 235 patients requiring intensive care.

As of 2 November, 70 deaths from acute respiratory illness have been reported.

Regions in western Ukraine continue to show the highest rates of acute respiratory illness/influenza-like illness.

The level of activity in the Kyiv area is also increasing rapidly.

Laboratory testing in Ukraine has confirmed pandemic H1N1 influenza virus in samples taken from patients in two of the most affected regions.

As the pandemic virus has rapidly become the dominant influenza strain worldwide, it can be assumed that most cases of influenza in Ukraine are caused by the H1N1 virus.

As elsewhere, WHO strongly recommends early treatment with the antiviral drugs, oseltamivir or zanamivir, for patients who meet treatment criteria, even in the absence of a positive laboratory test confirming H1N1 infection.

At the request of the government, a multi-disciplinary team of nine experts has been deployed by WHO and arrived in Kyiv yesterday evening.

Discussions with the Minister of Health were held this morning to brief the team.

Team members will now begin field investigations to characterize the clinical and epidemiological features of the outbreak.

Work will initially begin in Lviv region, where reported numbers of cases showing severe manifestations of acute respiratory illness have been especially high.

Two virologists on the team have started working at the National Influenza Centre and the laboratories of the Central Sanitary and Epidemiological Station in Kyiv to provide diagnostic support.

Samples sent by the Ministry of Health were received today by the WHO Collaborating Centre for Reference and Research on Influenza, Mill Hill in London, UK.

The laboratory will conduct confirmatory tests and further characterize the virus.

Many questions remain to be answered.

The outbreak in Ukraine may be indicative of how the virus can behave in the northern hemisphere during the winter season, particularly in health care settings typically found in Eastern Europe.

Given the potential significance of this outbreak as an early warning signal, WHO commends the government of Ukraine for its transparent reporting and open sharing of samples.

WHO continues to recommend no closing of borders and no restrictions on international travel, including to Ukraine. Experience shows that such measures will not stop further spread of the virus.
-
<cite cite="http://www.who.int/csr/don/2009_11_03/en/index.html">WHO | Pandemic (H1N1) 2009, Ukraine - update 1</cite>
 
Pandemic (H1N1) 2009 - update 73 - Weekly update (Virological surveillance data)

Pandemic (H1N1) 2009 - update 73 - Weekly update (Virological surveillance data)

Pandemic (H1N1) 2009 - update 73 - Weekly update (Virological surveillance data)

Pandemic (H1N1) 2009 - update 73 - Weekly update (Virological surveillance data)

6 November 2009


The Global Influenza Surveillance Network (GISN) continues monitoring the global circulation of influenza viruses, including pandemic, seasonal and other influenza viruses infecting, or with the potential to infect, humans including seasonal influenza.

Globally, since the beginning of the pandemic in 19 April 2009 to October 24th, a total of 80 countries reported to FluNet.

The total number of specimens reportedly positive for influenza viruses by NIC laboratories was 176,815.

Of these, 112,425 (63.6%) were pandemic H1N1, 6963 (3.9%) were seasonal A (H1), 20,392 (11.5%) were A (H3), 32,194 (18.2%) were A (not subtyped) and 4841 (2.7%) were influenza B.

Globally, for this reporting week (18 October to 24 October 2009); a total of 31 countries reported to FluNet.

The total number of specimens reportedly positive for influenza viruses by NIC laboratories was 14,616.

Of these, 10,523 (72%) were pandemic H1N1, 74 (0.5%) were seasonal A (H1), 229 (1.6%) were A (H3), 3643 (24.9%) were A (not subtyped), 147 (1%) were influenza B.

Specifically in Europe, for this reporting week (18 October to 24 October 2009); based on EuroFlu and FluNet, a total of 37 countries reported influenza laboratory results.

The total number of specimens reportedly positive for influenza viruses was 5882.

Of these, 4953 (84.2.%) were pandemic H1N1, 50 (0.85%) were seasonal A (H1), 16 (0.27%) were A (H3), 849 (14.4%) were A (not subtyped), 14 (0.24%) were influenza B.

Systematic surveillance conducted by the Global Influenza Surveillance Network (GISN) including WHO Collaborating Centres (WHOCCs) for reference and research on influenza, continues to detect sporadic incidents of H1N1 pandemic viruses that show resistance to the antiviral oseltamivir.

To date, 42 resistant pandemic H1N1 influenza viruses have been detected and characterized worldwide.

All of these viruses show the same H275Y mutation that confers resistance to the antiviral oseltamivir, but not to the antiviral zanamivir.

Worldwide, more than 10,000 clinical specimens (samples and isolates) of the pandemic H1N1 virus have been tested and found to be sensitive to oseltamivir.

All pandemic H1N1 2009 influenza viruses analysed to date were antigenically and genetically closely related to the vaccine virus A/California/7/2009.
-
<cite cite="http://www.who.int/csr/disease/swineflu/laboratory06_11_2009/en/index.html">WHO | Pandemic (H1N1) 2009 - update 73</cite>
 

Attachments

WHO - Pandemic (H1N1) 2009 - update 74 - Virological Surveillance

WHO - Pandemic (H1N1) 2009 - update 74 - Virological Surveillance

WHO - Pandemic (H1N1) 2009 - update 74

Pandemic (H1N1) 2009 - update 74

Weekly update (Virological surveillance data)

13 November 2009


The Global Influenza Surveillance Network (GISN) continues monitoring the global circulation of influenza viruses, including pandemic, seasonal and other influenza viruses infecting, or with the potential to infect, humans including seasonal influenza.

  • Globally, since the beginning of the pandemic 19 April to October 31st 2009, a total of 81 countries reported to FluNet. The total number of specimens reportedly positive for influenza viruses by NIC laboratories was 195,005. Of these, 126,888 (65.1%) were pandemic H1N1, 7049 (3.6%) were seasonal A (H1), 20,720 (10.6%) were A (H3), 35,381 (18.1%) were A (not sub typed) and 4967 (2.5%) were influenza B.
  • For this reporting week (25 October to 31 October 2009); a total of 32 countries reported to FluNet. The total number of specimens reportedly positive for influenza viruses by NIC laboratories was 15,634. Of these, 12,329 (78.9%) were pandemic H1N1, 85 (0.5%) were seasonal A (H1), 203 (1.3%) were A (H3), 2920 (18.7%) were A (not subtyped), 97 (0.6%) were influenza B.
  • Detailed virological information for the European Region of WHO is included in the EuroFlu Weekly Electronic Bulletin (see link below)
  • The majority of all influenza detections were reported by the United States of America followed by China and Norway. Among the 32 countries reported to FluNet, on average, the pandemic A (H1N1) accounted for 78.8% of all flu detections for the northern hemisphere (30 reporting countries) and (100%; 4/4) for southern hemisphere (2 reporting countries).
  • The above numbers represent only the specimens and results reported to FluNet. Some laboratories (NICs), under pressure of the pandemic surge, do not test for seasonal subtypes and accordingly, this data should be interpreted with caution.
  • Systematic surveillance conducted by the Global Influenza Surveillance Network (GISN) including WHO Collaborating Centres (WHOCCs) for reference and research on influenza, continues to detect sporadic incidents of H1N1 pandemic viruses that show resistance to the antiviral oseltamivir. To date, 52 oseltamivir resistant pandemic H1N1 influenza viruses have been detected and characterized worldwide. All of these viruses show the same H275Y mutation. All these viruses remain sensitive to zanamivir. Worldwide, more than 10,000 clinical specimens (samples and isolates) of the pandemic H1N1 virus have been tested and found to be sensitive to oseltamivir.
  • All pandemic H1N1 2009 influenza viruses analysed to date were antigenically and genetically closely related to the vaccine virus A/California/7/2009.
-
<cite cite="http://www.who.int/csr/disease/swineflu/laboratory13_11_2009/en/index.html">WHO | Pandemic (H1N1) 2009 - update 74</cite>
 

Attachments

Re: WHO - Pandemic (H1N1) 2009 - update 74 - Virological Surveillance

Re: WHO - Pandemic (H1N1) 2009 - update 74 - Virological Surveillance

Just to add a bit of confusion to the mix, consider this.

Not tropical mind you, but guess what looks exactly like a severe
influenza for the first 2 or 3 days and then ends causing death by hemorrhage?

CCHF, Congo-Crimean Hemorrhagic Fever, found in southern Ukraine, Turkey, all the -stans.
 
WHO - Pandemic (H1N1) 2009, Ukraine - update 2

WHO - Pandemic (H1N1) 2009, Ukraine - update 2

WHO - Pandemic (H1N1) 2009, Ukraine - update 2

Pandemic (H1N1) 2009, Ukraine - update 2

17 November 2009


Preliminary tests reveal no significant changes in the pandemic (H1N1) 2009 virus based on investigations of samples taken from patients in Ukraine.

Analyses are being performed by two WHO influenza collaborating centres as part of the global influenza surveillance network.

Preliminary genetic sequencing shows that the virus is similar to the virus used for production of the pandemic influenza vaccine, reconfirming the vaccine's efficacy at this time.

Additional questions about the pandemic virus circulating in Ukraine will be answered as more data is available.

WHO commends the government of Ukraine for its open sharing of samples to inform global monitoring of the virus for signs of change.

A total of 34 samples were analysed independently by the WHO Collaborating Centre for Reference and Research on Influenza, Mill Hill in London, UK, and the WHO Collaborating Centre for the Surveillance, Epidemiology and Control of Influenza in Atlanta, Georgia, USA.
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<cite cite="http://www.who.int/csr/don/2009_11_16/en/index.html">WHO | Pandemic (H1N1) 2009, Ukraine - update 2</cite>
 
Pandemic (H1N1) 2009 - update 75 - Weekly update (Virological surveillance data)

Pandemic (H1N1) 2009 - update 75 - Weekly update (Virological surveillance data)

WHO - Pandemic (H1N1) 2009 - update 75 (Virological Surveillance Data)

Pandemic (H1N1) 2009 - update 75 - Weekly update (Virological surveillance data)

20 November 2009


The Global Influenza Surveillance Network (GISN) continues monitoring the global circulation of influenza viruses, including pandemic, seasonal and other influenza viruses infecting, or with the potential to infect, humans including seasonal influenza.

Since the beginning of the pandemic in 19 April 2009 to 7 November, a total of 81 countries reported to FluNet. The total number of specimens reportedly positive for influenza viruses by NIC laboratories was 272,326. Of these, 187,290 (68.8%) were pandemic H1N1, 7771 (2.9%) were seasonal A (H1), 23,019 (8.5%) were A (H3), 48,653 (17.9%) were A (not subtyped) and 5593 (2.1%) were influenza B.

For this reporting week (1 November to 7 November 2009); a total of 30 countries reported to FluNet. The total number of specimens reportedly positive for influenza viruses was 10,954* (update for last week: 15,634). Of these, 8660 (79.1%) were pandemic H1N1, 28 (0.3%) were seasonal A (H1), 14 (0.1%) were A (H3), 2199 (20.1%) were A (not subtyped), 53 (0.5%) were influenza B.

The above numbers represent only the specimens and results reported to FluNet. Some laboratories (NICs), under pressure of the pandemic surge, do not test for seasonal subtypes and accordingly, this data should be interpreted with caution.

Detailed virological information for the European Region of WHO is included in the EuroFlu Weekly Electronic Bulletin

From the start of H1N1 pandemic (19 April) till 14th November 2009, cumulatively 145 countries shared a total of 17720 specimens (13771 clinical samples and 3949 virus isolates) with WHO CCs. Of these, 13309 specimens (clinical samples and isolates) were tested; 10521 (79.1%) were influenza positive. Of these positives, 6764 (64.3 %) were pandemic H1N1, 2963(28.2%) were seasonal influenza A, 779 (7.4%) were influenza B.

Systematic surveillance conducted by the Global Influenza Surveillance Network (GISN) including WHO Collaborating Centres (WHOCCs) for reference and research on influenza, continues to detect sporadic incidents of H1N1 pandemic viruses that show resistance to the antiviral oseltamivir. To date, 57 oseltamivir resistant pandemic H1N1 influenza viruses have been detected and characterized worldwide. All of these viruses show the same H275Y mutation. All these viruses remain sensitive to zanamivir.

Worldwide, more than 10,000 clinical specimens (samples and isolates) of the pandemic H1N1 virus have been tested and found to be sensitive to oseltamivir.

All pandemic H1N1 2009 influenza viruses analysed to date were antigenically and genetically closely related to the vaccine virus A/California/7/2009.

* Data might be incomplete due to a lag for reporting from some countries. Graphs associated with this update are set up till week 44, since some countries have delayed reporting to FluNet


Virology data update

Download update (.pdf)


For more information

EuroFlu Weekly Electronic Bulletin
FluNet web site
National Influenza Centres
-
<cite cite="http://www.who.int/csr/disease/swineflu/laboratory20_11_2009/en/index.html">WHO | Pandemic (H1N1) 2009 - update 75</cite>
 
Public health significance of virus mutation detected in Norway - Pandemic (H1N1) 2009 briefing note 17

Public health significance of virus mutation detected in Norway - Pandemic (H1N1) 2009 briefing note 17

WHO - Public health significance of virus mutation detected in Norway

Public health significance of virus mutation detected in Norway - Pandemic (H1N1) 2009 briefing note 17

20 NOVEMBER 2009 | GENEVA


The Norwegian Institute of Public Health has informed WHO of a mutation detected in three H1N1 viruses.

The viruses were isolated from the first two fatal cases of pandemic influenza in the country and one patient with severe illness.

Norwegian scientists have analysed samples from more than 70 patients with clinical illness and no further instances of this mutation have been detected. This finding suggests that the mutation is not widespread in the country.

The virus with this mutation remains sensitive to the antiviral drugs, oseltamivir and zanamivir, and studies show that currently available pandemic vaccines confer protection.

Worldwide, laboratory monitoring of influenza viruses has detected a similar mutation in viruses from several other countries, with the earliest detection occurring in April. In addition to Norway, the mutation has been observed in Brazil, China, Japan, Mexico, Ukraine, and the US.

Although information on all these cases is incomplete, several viruses showing the same mutation were detected in fatal cases, and the mutation has also been detected in some mild cases. Worldwide, viruses from numerous fatal cases have not shown the mutation. The public health significance of this finding is thus unclear.

The mutations appear to occur sporadically and spontaneously. To date, no links between the small number of patients infected with the mutated virus have been found and the mutation does not appear to spread.

The significance of the mutation is being assessed by scientists in the WHO network of influenza laboratories. Changes in viruses at the genetic level need to be constantly monitored. However, the significance of these changes is difficult to assess.

Many mutations do not alter any important features of the virus or the illness it causes. For this reason, WHO also uses clinical and epidemiological data when making risk assessments.

Although further investigation is under way, no evidence currently suggests that these mutations are leading to an unusual increase in the number of H1N1 infections or a greater number of severe or fatal cases.

Laboratories in the WHO Global Influenza Surveillance Network closely monitor influenza viruses worldwide and will remain vigilant for any further changes in the virus that may have public health significance.
-
<cite cite="http://www.who.int/csr/disease/swineflu/notes/briefing_20091120/en/index.html">WHO | Public health significance of virus mutation detected in Norway</cite>
 
Re: Public health significance of virus mutation detected in Norway - Pandemic (H1N1) 2009 briefing note 17

Re: Public health significance of virus mutation detected in Norway - Pandemic (H1N1) 2009 briefing note 17



WHO - Public health significance of virus mutation detected in Norway[/URL]


further investigation is under way, no evidence currently suggests that these mutations are leading to an unusual increase in the number of H1N1 infections or a greater number of severe or fatal cases.

Laboratories in the WHO Global Influenza Surveillance Network closely monitor influenza viruses worldwide and will remain vigilant for any further changes in the virus that may have public health significance.
-
<cite


....currently....

:tiphat:
 
Re: Public health significance of virus mutation detected in Norway - Pandemic (H1N1) 2009 briefing note 17

Re: Public health significance of virus mutation detected in Norway - Pandemic (H1N1) 2009 briefing note 17

but...but

tag.png
Didier Raoult - 2 cases of H1N1 deaths in U.S. by a mutated H1N1 - More in India?

...we where told about it

September 15th, 2009

... so, this is not a Precedent.

Seen this, kept an eye on it
 
Pandemic (H1N1) 2009 - update 76 - Weekly update (more data on virological surveillance)

Pandemic (H1N1) 2009 - update 76 - Weekly update (more data on virological surveillance)

WHO - Pandemic (H1N1) 2009 - update 76 - Virological Surveillance (edited)

Pandemic (H1N1) 2009 - update 76 - Weekly update (more data on virological surveillance)

27 November 2009


The Global Influenza Surveillance Network (GISN) continues monitoring the global circulation of influenza viruses, including pandemic, seasonal and other influenza viruses infecting, or with the potential to infect, humans including seasonal influenza.

Since the beginning of the pandemic in 19 April 2009 to 14 November, a total of 82 countries reported to FluNet. The total number of specimens reportedly positive for influenza viruses by NIC laboratories was 297,366. Of these, 209,614 (70.5%) were pandemic H1N1, 8025 (2.7%) were seasonal A (H1), 23,437 (7.9%) were A (H3), 50,533 (17.0%) were A (not subtyped) and 5757 (1.9%) were influenza B.

For this reporting week (8 November to 14 November 2009); a total of 27 countries reported to FluNet. The total number of specimens reportedly positive for influenza viruses by NIC laboratories was 16,817. Of these, 15,040 (89.4%) were pandemic H1N1, 130 (0.8%) were seasonal A (H1), 143 (0.9%) were A (H3), 1446 (8.6%) were A (not subtyped), 58 (0.3%) were influenza B.

The above numbers represent only the specimens and results reported to FluNet. Some laboratories (NICs), under pressure of the pandemic surge, do not test for seasonal subtypes and accordingly, this data should be interpreted with caution.

Detailed virological information for the European Region of WHO is included in the EuroFlu Weekly Electronic Bulletin.

From the start of H1N1 pandemic (19 April) till 21st November 2009, cumulatively 150 countries shared a total of 18501 specimens (14477 clinical samples and 4024 virus isolates) with WHO CCs. Armenia, Dominica, Grenada, Madagascar and Switzerland are new countries sharing samples this week. Of these, 13580 specimens (clinical samples and isolates) were tested; 10768 (79.3%) were influenza positive. Of these positives, 6972 (64.7 %) were pandemic H1N1, 2990 (27.8%) were seasonal influenza A, 791 (7.3%) were influenza B.

A virus mutation at position 222 of the amino acid sequence of the haemagglutinin protein of the pandemic virus was recently reported in a few viruses from Norway.

The mutation is D222G (aspartic acid to glycine), which, according to a public accessible gene sequence database "GenBank", has also been detected sporadically in viruses from several other countries since April 2009.

This change in the virus has been found in mild as well as severe cases. WHO, through its Global Influenza Surveillance Network (GISN) is monitoring virus mutations that are of potential public health importance.

Systematic surveillance conducted by the Global Influenza Surveillance Network (GISN) including WHO Collaborating Centres (WHOCCs) for reference and research on influenza, continues to detect sporadic incidents of H1N1 pandemic viruses that show resistance to the antiviral oseltamivir.

To date, 75 oseltamivir resistant pandemic H1N1 influenza viruses have been detected and characterized worldwide. All of these viruses show the same H275Y mutation. All these viruses remain sensitive to zanamivir. Worldwide, more than 10,000 clinical specimens (samples and isolates) of the pandemic H1N1 virus have been tested and found to be sensitive to oseltamivir.

All pandemic H1N1 2009 influenza viruses analysed to date were antigenically and genetically closely related to the vaccine virus A/California/7/2009.


Virology data update

Download update (.pdf)
-
<cite cite="http://www.who.int/csr/disease/swineflu/laboratory27_11_2009/en/index.html">WHO | Pandemic (H1N1) 2009 - update 76</cite>
 

Attachments

WHO - Pandemic (H1N1) 2009 - update 77 (Virological Surveillance)

WHO - Pandemic (H1N1) 2009 - update 77 (Virological Surveillance)

WHO - Pandemic (H1N1) 2009 - update 77 (Virological Surveillance)

Pandemic (H1N1) 2009 - update 77 - Weekly update (more data on virological surveillance)

4 December 2009


Since the beginning of the pandemic in 19 April 2009 to 21 November, a total of 82 countries reported to FluNet.

The total number of specimens reportedly positive for influenza viruses by NIC laboratories was 309,204.

Of these, 220,641 (71.4%) were pandemic H1N1, 8130 (2.6%) were seasonal A (H1), 23,531 (7.6%) were A (H3), 51,071 (16.5%) were A (Not subtyped) and 5831 (1.9%) were influenza B.

For this reporting week (15 November to 21 November 2009); a total of 22 countries reported to FluNet.

The total number of specimens reportedly positive for influenza viruses by NIC laboratories was 10,364.

Of these, 9643 (93%) were pandemic H1N1, 104 (1%) were seasonal A (H1), 88 (0.8%) were A (H3), 467 (4.5%) were A (Not subtyped), 62 (0.6%) were influenza B.

The above numbers represent only the specimens and results reported to FluNet.

Some laboratories (NICs), under pressure of the pandemic surge, do not test for seasonal subtypes and accordingly, this data should be interpreted with caution.

Detailed virological information for the European Region of WHO is included in the EuroFlu Weekly Electronic Bulletin.

From the start of H1N1 pandemic (19 April) till 28th November 2009, cumulatively 150 countries shared a total of 19284 specimens (14879 clinical samples and 4405 virus isolates) with WHO CCs for confirmatory diagnosis and further characterization.

A mutation of D222G in the amino acid sequence of the haemagglutinin protein of the pandemic virus is being monitored by GISN.

In addition to Norway, the mutation has also been observed in Brazil, China, Chinese Taipei, Finland, France, Italy, Japan, Mexico, Spain, , Ukraine, and USA, in both severe and mild cases.

Systematic surveillance conducted by GISN laboratories continues to detect incidents of H1N1 pandemic viruses that show resistance to the antiviral oseltamivir.

Antiviral susceptibility testing has been carried out on pandemic H1N1 specimens and isolates from at least 31 countries.

96 cases of oseltamivir resistant pandemic H1N1 have been reported from GISN so far.

All of these viruses show the same H275Y mutation, but remain sensitive to zanamivir.
-
<cite cite="http://www.who.int/csr/disease/swineflu/laboratory04_12_2009/en/index.html">WHO | Pandemic (H1N1) 2009 - update 77</cite>
 

Attachments

Pandemic (H1N1) 2009 - update 78 - Weekly update (more data on virological surveillance)

Pandemic (H1N1) 2009 - update 78 - Weekly update (more data on virological surveillance)

WHO - Pandemic (H1N1) 2009 - update 78 (Virological Surveillance)

Pandemic (H1N1) 2009 - update 78 - Weekly update (more data on virological surveillance)

11 December 2009


The Global Influenza Surveillance Network (GISN) continues monitoring the global circulation of influenza viruses, including pandemic, seasonal and other influenza viruses infecting, or with the potential to infect, humans including seasonal influenza.

Since the beginning of the pandemic in 19 April 2009 to 28 November, a total of 82 countries reported to FluNet.

The total number of specimens reportedly positive for influenza viruses by NIC laboratories was 337,902.

Of these, 246,571 (73%) were pandemic H1N1, 8245 (2.4%) were seasonal A (H1), 23,675 (7%) were A (H3), 53,479 (15.8%) were A (not subtyped) and 5932 (1.8%) were influenza B.

For this reporting week (22 November to 28 November 2009); a total of 24 countries reported to FluNet.

The total number of specimens reportedly positive for influenza viruses by NIC laboratories was 14,267. Of these, 12,758 (89.4%) were pandemic H1N1, 118 (0.8%) were seasonal A (H1), 137 (1%) were A (H3), 1182 (8.3%) were A (not subtyped), 72 (0.5%) were influenza B.

The above numbers represent only the specimens and results reported to FluNet. Some laboratories (NICs), under pressure of the pandemic surge, do not test for seasonal subtypes and accordingly, this data should be interpreted with caution.

Detailed virological information for the European Region of WHO is included in the EuroFlu Weekly Electronic Bulletin.

Since the beginning of the pandemic in 19 April 2009 to 5 December, cumulatively 150 countries shared a total of 19523 specimens (15037 clinical samples and 4486 virus isolates) with WHO CCs. Of these, 14097 specimens (clinical samples and isolates) were tested; 11307 (80.2%) were positive for influenza viruses. Of these positives, 7444 (65.8 %) were pandemic H1N1, 3052 (27%) were seasonal influenza A, 796 (7.1%) were influenza B.

A virus mutation at position 222 of the amino acid sequence of the haemagglutinin protein of the pandemic virus was recently reported in a few viruses from Norway. The mutation is D222G (aspartic acid to glycine), which, according to a public accessible gene sequence database "GenBank", has also been detected sporadically in viruses from several other countries like Brazil, China, Japan, Mexico, Italy, Finland, France, Ukraine, US and Hong Kong, since April 2009.

This change in the virus has been found in mild as well as severe cases.

WHO, through its Global Influenza Surveillance Network (GISN) is monitoring virus mutations that are of potential public health importance.

Systematic surveillance conducted by the GISN including WHOCCs for reference and research on influenza, continues to detect sporadic incidents of H1N1 pandemic viruses that show resistance to the antiviral oseltamivir. Antiviral susceptibility testing was carried out by WHO CCs and GISN labs on specimens and isolates of pandemic H1N1 viruses from at least 31 countries. 102 cases of oseltamivir resistant pandemic H1N1 have been reported from GISN so far.

All of these viruses show the same H275Y mutation. All these viruses remain sensitive to zanamivir. Worldwide, more than 10,000 clinical specimens (samples and isolates) of the pandemic H1N1 virus have been tested and found to be sensitive to oseltamivir.

All pandemic H1N1 2009 influenza viruses analysed to date were antigenically and genetically closely related to the vaccine virus A/California/7/2009.

Virology data update - Download update (.pdf)
-
<cite cite="http://www.who.int/csr/disease/swineflu/laboratory11_12_2009/en/index.html">WHO | Pandemic (H1N1) 2009 - update 78</cite>
 

Attachments

WHO - Pandemic (H1N1) 2009 - update 79 (Virological Surveillance)

WHO - Pandemic (H1N1) 2009 - update 79 (Virological Surveillance)

WHO - Pandemic (H1N1) 2009 - update 79 (Virological Surveillance)
Pandemic (H1N1) 2009 - update 79 - Weekly update (more data on virological surveillance)

18 December 2009


The Global Influenza Surveillance Network (GISN) continues monitoring the global circulation of influenza viruses, including pandemic, seasonal and other influenza viruses infecting, or with the potential to infect humans.

Since the beginning of the pandemic in 19 April 2009 to 5 December, a total of 82 countries reported to FluNet. The total number of specimens reportedly positive for influenza viruses by NIC laboratories was 351,047. Of these, 258,698 (73.7%) were pandemic H1N1, 8,358 (2.4%) were seasonal A (H1), 23,777 (6.8%) were A (H3), 54,162 (15.4%) were A (not subtyped) and 6,047 (1.7%) were influenza B.

For this reporting week (15 November to 5 December 2009); a total of 21 countries reported to FluNet. The total number of specimens reportedly positive for influenza viruses by NIC laboratories was 11,159. Of these, 10,286 (92.2%) were pandemic (H1N1) 2009, 111 (1.0%) were seasonal A (H1), 97 (0.9%) were A (H3), 580 (5.2%) were A (not subtyped), 85 (0.8%) were influenza B.

The above numbers represent only the specimens and results reported to FluNet. Some laboratories (NICs), under pressure of the pandemic surge, do not test for seasonal subtypes and accordingly, this data should be interpreted with caution.

Detailed virological information for the European Region of WHO is included in the EuroFlu Weekly Electronic Bulletin.

Since the beginning of the pandemic in 19 April 2009 to 12th December, cumulatively 152 countries (first report from Kazakhstan and Palau was last week) shared a total of 20276 specimens (15464 clinical samples and 4812 virus isolates) with WHO CCs. Of these, 14988 specimens (clinical samples and isolates) were tested; 12019 (80.2%) were positive for influenza viruses. Of these positives, 8017(66.7 %) were pandemic H1N1, 3188 (26.5%) were seasonal influenza A, 799 (7.1%) were influenza B.

A virus mutation at position 222 of the amino acid sequence of the haemagglutinin protein of the pandemic virus has been reported. The mutation is D222G (aspartic acid to glycine), which, according to public accessible gene sequence databases, has also been detected sporadically in viruses from Australia, Brazil , China , China Hong Kong SAR, China (Province of Taiwan), Costa Rica, Finland, France, India, Italy, Japan, Lebanon, Mexico, Norway, Philippines, Russian Federation, Saudi Arabia, Spain, Ukraine, United States of America and Uruguay. This change in the virus has been found in mild as well as severe cases. WHO, through its Global Influenza Surveillance Network (GISN), is monitoring virus mutations that are of potential public health importance.

Systematic surveillance conducted by the GISN including WHOCCs for Reference and Research on Influenza, continues to identify sporadic incidents of H1N1 pandemic viruses that show resistance to the antiviral oseltamivir. Antiviral susceptibility testing was carried out by WHO CCs and GISN labs on specimens and isolates of pandemic H1N1 viruses from at least 31 countries.

136 cases of oseltamivir resistant pandemic H1N1 have been reported by GISN so far.

According to the New England Journal of Medicine and to official media releases, a cluster of oseltamivir-resistant viruses occurred in 7 healthy people sharing one carriage in a train from Ho Chi Minh City to Hanoi in Vietnam. None of the cases knew each other before, none of them were symptomatic and none of them took oseltamivir previously or during the journey. 4 cases developed fever within 12 hours and 2 cases within 48 hours after arrival.

All of these viruses show the same H275Y mutation. All these viruses remain sensitive to zanamivir.

Worldwide, more than 15,000 clinical specimens (samples and isolates) of the pandemic H1N1 virus have been tested and found to be sensitive to oseltamivir.

All pandemic H1N1 2009 influenza viruses analysed to date were antigenically and genetically closely related to the vaccine virus A/California/7/2009.


Virology data update

Download update (.pdf)


For more information

EuroFlu Weekly Electronic Bulletin
FluNet web site
National Influenza Centres
-
<cite cite="http://www.who.int/csr/disease/swineflu/laboratory18_12_2009/en/index.html">WHO | Pandemic (H1N1) 2009 - update 79</cite>
 

Attachments

Pandemic (H1N1) 2009 - update 80 - Weekly virological surveillance update

Pandemic (H1N1) 2009 - update 80 - Weekly virological surveillance update

WHO - Pandemic (H1N1) 2009 - update 80 (Virological Surveillance)

Pandemic (H1N1) 2009 - update 80 - Weekly virological surveillance update

23 December 2009


For this reporting week (6 to 12 December 2009); a total of 28 countries reported to FluNet. The total number of specimens reported positive for influenza viruses was 9507. Of these, 8628 (90.8%) were pandemic A(H1N1) 2009, 94 (1.0%) were seasonal A (H1), 105 (1.1%) were A (H3), 528 (5.6%) were A (not subtyped), and 152 (1.6%) were influenza B.

The above numbers represent only the specimens and results reported to FluNet. Some laboratories (NICs), under pressure of the pandemic surge, do not test for seasonal subtypes and accordingly, this data should be interpreted with caution.

Detailed virological information for the European Region of WHO is included in the EuroFlu Weekly Electronic Bulletin.

Since the beginning of the pandemic in 19 April 2009 to 19th December, cumulatively 153 countries/areas/territories shared a total of 20520 specimens (15648 clinical samples and 4872 virus isolates) with WHO CCs. Of these, 15356 specimens (clinical samples and isolates) were tested; 12312 (80.2%) were positive for influenza viruses. Of these positives, 8179(66.4 %) were pandemic A(H1N1), 3314(26.9%) were seasonal influenza A, and 804 (6.5%) were influenza B.

Systematic surveillance conducted by the Global Influenza Surveillance Network (GISN) including WHOCCs, continues to detect sporadically pandemic A (H1N1) viruses that are resistant to oseltamivir. So far, antiviral susceptibility testing was conducted by WHO CCs and other GISN labs on pandemic A (H1N1) specimens and isolates from at least 86 countries, and 168 cases of oseltamivir resistance have been reported by GISN so far.

All of these viruses showed H275Y mutation but all these viruses remain sensitive to zanamivir.

Worldwide, more than 15,000 clinical specimens (samples and isolates) of the pandemic A (H1N1) virus have been tested and found to be sensitive to oseltamivir.

All pandemic A(H1N1) 2009 influenza viruses analysed to date were antigenically and genetically closely related to the vaccine virus A/California/7/2009.

WHO, through the Global Influenza Surveillance Network (GISN), continues monitoring the evolution and global circulation of influenza viruses, including pandemic, seasonal and other influenza viruses infecting, or with the potential to infect humans.


For more information

EuroFlu Weekly Electronic Bulletin
FluNet web site
National Influenza Centres
-
<cite cite="http://www.who.int/csr/disease/swineflu/laboratory23_12_2009/en/index.html">WHO | Pandemic (H1N1) 2009 - update 80</cite>
 
Pandemic (H1N1) 2009 - update 82 - Weekly virological surveillance update [with detection of 190 H1N1 2009 pdm viruses resistant to oseltamivir]

Pandemic (H1N1) 2009 - update 82 - Weekly virological surveillance update [with detection of 190 H1N1 2009 pdm viruses resistant to oseltamivir]

WHO - Pandemic (H1N1) 2009 - update 82 (Virological Surveillance)

Pandemic (H1N1) 2009 - update 82 - Weekly virological surveillance update

8 January 2010


For this reporting week (20 to 27 December 2009), pandemic A(H1N1) accounted for more than 99% of influenza A viruses detected in many of the countries reporting influenza activity in both northern and southern hemispheres.

One of the exceptions was China where almost 10% of the influenza A viruses were positive for seasonal influenza A(H1N1) and A(H3N2).

Sporadic detections of seasonal A(H1N1), A(H3N2) and influenza B viruses were reported from a few countries including Canada, United States of America and some European countries.

During this week a total of 23 countries reported to FluNet.

The total number of specimens reportedly positive for influenza viruses by NIC laboratories was 4,710.

Of these, 4,048 (85.9%) were pandemic (H1N1) 2009, 17 (0.4 %) were seasonal A (H1), 81 (1.7%) were A (H3), 274 (5.8%) were A (not subtyped), 290 (6.2%) were influenza B.

The majority of all influenza detections reported to FluNet were from China and the Russian Federation followed by Greece.

Of the 23 countries that reported to FluNet, on average, the pandemic A (H1N1) accounted for 85.9% of all influenza detections (85.9%; 4,026/4,688) for the northern hemisphere from 21 reporting countries and (100%; 22/22) for southern hemisphere from 2 reporting countries.

The above numbers represent only the specimens and results reported to FluNet.

As some laboratories (NICs), under pressure of the pandemic surge, are not routinely testing for seasonal subtypes, this data should be interpreted with caution.

Data from countries with NICs which have good virological surveillance nevertheless indicates pandemic (H1N1) 2009 is the predominant circulating virus with low levels of seasonal influenza activity.

Since the beginning of the pandemic in 19 April 2009 to 2nd January 2010 cumulatively 153 countries/areas/territories shared a total of 23,335 specimens (18,171 clinical samples and 5,164 virus isolates) with WHO CCs.

Of these, 15,944 specimens (clinical samples and isolates) were tested; 12,876 (80.8%) were positive for influenza viruses. Of these positives, 8,628 (67 %) were pandemic A(H1N1), 3,385(26.3%) were seasonal influenza A, and 848 (6.6%) were influenza B.

Systematic surveillance conducted by the Global Influenza Surveillance Network (GISN) including WHOCCs, continues to detect sporadically pandemic A (H1N1) viruses that are resistant to oseltamivir.

So far, antiviral susceptibility testing was conducted by WHO CCs and other GISN labs on pandemic A (H1N1) specimens and isolates from at least 86 countries, and 190 cases of oseltamivir resistance have been reported by GISN so far.

All of these viruses showed H275Y mutation but all these viruses remain sensitive to zanamivir.

Worldwide, more than 15,000 clinical specimens (samples and isolates) of the pandemic A (H1N1) virus have been tested and found to be sensitive to oseltamivir.

All pandemic A(H1N1) 2009 influenza viruses analysed to date were antigenically and genetically closely related to the vaccine virus A/California/7/2009.

WHO, through the GISN, continues monitoring the evolution and global circulation of influenza viruses, including pandemic, seasonal and other influenza viruses infecting, or with the potential to infect humans.


For more information

EuroFlu Weekly Electronic Bulletin
FluNet web site
National Influenza Centres
-
<cite cite="http://www.who.int/csr/disease/swineflu/laboratory08_01_2010/en/index.html">WHO | Pandemic (H1N1) 2009 - update 82</cite>
 
Re: Pandemic (H1N1) 2009 - update 82 - Weekly virological surveillance update [with detection of 190 H1N1 2009 pdm viruses resistant to oseltamivir]

Re: Pandemic (H1N1) 2009 - update 82 - Weekly virological surveillance update [with detection of 190 H1N1 2009 pdm viruses resistant to oseltamivir]

Here are the weekly increases beginning with 10/23, Update 70 to Update 80:
35,39,39,42,52,57,75,96,102,136,168,168

It would be helpful if the WHO would publish how many samples have been tested. They've been stuck at that "more than 15,000" number for quite some time.
 
WHO - Pandemic (H1N1) 2009 - update 83 (Virological Surveillance): New PB2 mutation detected K340N

WHO - Pandemic (H1N1) 2009 - update 83 (Virological Surveillance): New PB2 mutation detected K340N

WHO - Pandemic (H1N1) 2009 - update 83 (Virological Surveillance)

Pandemic (H1N1) 2009 - update 83 - Weekly virological surveillance update

15 January 2010


For this reporting week (27th December 2009 to 2nd January 2010), pandemic A (H1N1) accounted for 98.1% of all subtyped influenza A viruses detected in many of the countries reporting influenza activity in both northern and southern hemispheres.

One of the exceptions was China where the pandemic (H1N1) 2009 virus accounted for 90.2% of all specimens tested positive for influenza A viruses. Furthermore, in China, influenza B accounted for 12.6% among the specimens tested positive for influenza viruses.

Sporadic detections of seasonal A(H1N1), A(H3N2) and influenza B viruses were reported from a few countries including some European countries.

During this week a total of 23 countries reported to FluNet.

The total number of specimens reportedly positive for influenza viruses by NIC laboratories was 2,878. Of these, 2,354 (81.8%) were pandemic (H1N1) 2009, 4 (0.1 %) were seasonal A (H1), 41 (1.4%%) were A (H3), 165 (5.7%) were A (not subtyped), 314 (10.9%) were influenza B.

The percentage of pandemic (H1N1) 2009 was 98.1% of all subtyped influenza A viruses.

The majority of all influenza detections were reported by China and France followed by Greece.

Among the 23 countries reported to FluNet, on average, the pandemic A (H1N1) accounted for 81.8% of all influenza detections (81.6%; 2,348/2,878) for the northern hemisphere from 21 reporting countries and (100%; 6/6) for southern hemisphere from 2 reporting countries. The above numbers represent only the specimens and results reported to FluNet*.

Since the beginning of the pandemic in 19 April 2009 to 9th January 2010 cumulatively 153 countries/areas/territories shared a total of 23,376 specimens (18,203 clinical samples and 5,173 virus isolates) with WHO CCs for further analysis. All pandemic A(H1N1) 2009 influenza viruses analysed to date appear to be antigenically and genetically closely related to the vaccine virus A/California/7/2009.

The WHO Global Influenza Surveillance Network (GISN) including WHOCCs conducts systematic surveillance for antiviral susceptibility. So far, antiviral susceptibility testing conducted by WHO CCs and other GISN laboratories on pandemic A (H1N1) specimens and isolates from at least 87 countries indicates that oseltamivir resistant pandemic H1N1 viruses are still detected sporadically and there is no wide community circulation of oseltamivir resistant viruses except for the recently reported transmission of resistant viruses in a few local settings**.

So far, 199 cases of oseltamivir resistance have been reported by GISN and other WHO partners. All of these viruses showed H275Y mutation but all these viruses remain sensitive to zanamivir.

Since the first appearance of pandemic influenza A (H1N1) 2009 viruses, certain mutations including those leading to the D222G substitution in the haemagglutinin (HA) protein and the K340N substitution in the polymerase basic protein 2 (PB2) have been detected sporadically.

These substitutions in HA and/or PB2 have been reported in viruses obtained from mild, severe or fatal illness cases but such viruses have neither formed distinct phylogenetic clustering nor been associated with consistent changes in virus antigenicity. Based on currently available virological, epidemiological, and clinical information, the D222G substitution does not appear to pose a major public health issue.

A preliminary review has been published*** , and the WHO GISN and its partners will continue to closely monitor pandemic viruses for the D222G and other amino acid substitutions and assess associated risks.

WHO, through the GISN, continues monitoring the evolution and global circulation of influenza viruses, including pandemic, seasonal and other influenza viruses infecting, or with the potential to infect humans.

*Some NICs report data to FluNet retrospectively and updates of previous data with new results are frequent.

*
Pandemic (H1N1) 2009: antiviral drug resistance
**Preliminary review of D222G amino acid substitution in the haemagglutinin of pandemic influenza A (H1N1) 2009 viruses

Virology data update
Download update (.pdf)

For more information
National Influenza Centres
EuroFlu Weekly Electronic Bulletin
FluNet web site
-
<cite cite="http://www.who.int/csr/disease/swineflu/laboratory15_01_2010/en/index.html">WHO | Pandemic (H1N1) 2009 - update 83</cite>
 
Re: WHO - Pandemic (H1N1) 2009 - update 83 (Virological Surveillance): New PB2 mutation detected K340N

Re: WHO - Pandemic (H1N1) 2009 - update 83 (Virological Surveillance): New PB2 mutation detected K340N

from NS1 via email -


Are we looking at the WHO report here?

The authors, I am assuming committee authoring due to ambiguity and misdirection, are using confounding language intentionally.

The ?mutations? they are indicating are the single base (ACGT) nucleotide revisions, such as A715G (GaT=>GgT) in India8489, ?leading to? D225G at the amino acid level. The sentence may be more properly written:

Since the first appearance of pandemic influenza A (H1N1) 2009 viruses, certain nucleotide revisions coding for D222G in the haemagglutinin (HA) protein and the K340N in the polymerase basic protein 2 (PB2) have been detected on multiple genetic backgrounds across a wide geographic basis.

As to the PB2 revision, we have noted the polymorphism and will be tracking any growth in count or percentage of the change. At this time, we consider the K340N as a quantifiable marker very loosely correlating to 225G and, as such, may consider including the position as a parameter in our future discussions. As a counter-weight to the perfect world with perfect and complete information, frustration occurs when few PB2 segments are available. Potentially valuable markers like K340N may go undetected or circulate silently due to lack of scientific rigour / inadequate funding among the sequencing labs. Data scarcity is the issue. Sampling bias certainly colors this polymorphism as does selection of sequences for publication.

Ceteris paribus, any change found on fatal and / or RBD variants is clearly noteworthy.
 
WHO - Pandemic (H1N1) 2009 - update 84 - (Virological Surveillance)

WHO - Pandemic (H1N1) 2009 - update 84 - (Virological Surveillance)

WHO - Pandemic (H1N1) 2009 - update 84 - (Virological Surveillance)

Pandemic (H1N1) 2009 - update 84 - Weekly virological surveillance update

22 January 2010


Pandemic influenza A(H1N1) 2009 viruses persist in many countries around the world although most Northern Hemisphere countries have seen decreasing activity in the last few weeks.

The pandemic virus continues to be the predominant circulating influenza virus in all countries where influenza is reported.

Sporadic detections of seasonal A(H1N1), A(H3N2) and influenza B viruses were reported from a few countries.

The majority of seasonal influenza detections were reported by China where increased influenza B detections were observed relative to previous weeks.

For this reporting week (3rd January 2010 to 9th January 2010); a total of 24 countries reported to FluNet.

The total number of specimens reportedly positive for influenza viruses by NIC laboratories was 2,771.

Of these, 2067 (74.6%) were typed as influenza A and 505 (18.2%) as influenza B.

Of all sub-typed influenza A viruses, 97.2% (2,010/2067) were pandemic (H1N1) 2009.

The above numbers represent only the specimens and results reported to FluNet.

Since the beginning of the pandemic in 19 April 2009 to 16th January,2010, cumulatively 153 countries shared a total of 23,527 specimens (18,299 clinical samples and 5,228 virus isolates) with WHO CCs for further analysis.

All pandemic A(H1N1) 2009 influenza viruses analysed to date appear to be antigenically and genetically closely related to the vaccine virus A/California/7/2009.

The pandemic (H1N1) 2009 viruses with D222G substitution have also been seen antigenically indistinguishable to the A/California/7/2009 (H1N1) vaccine virus.

Most of seasonal A(H1N1) viruses tested were antigenically and genetically closely related to the A/Brisbane/59/2007 vaccine virus. Seasonal A(H3N2) viruses were mostly antigenically and genetically closely related to A/Perth/16/2009 -like viruses (WHO recommended virus for 2010 Southern Hemisphere vaccine). Influenza B viruses were predominantly of the B/Victoria-lineage and the majority were antigenically and genetically closely related to the vaccine virus B/Brisbane/60/2008. (WHO recommended virus for 2010 Southern Hemisphere vaccine).

The WHO Global Influenza Surveillance Network (GISN) including WHOCCs conducts systematic surveillance for antiviral susceptibility. So far, antiviral susceptibility testing conducted by WHO CCs and other GISN laboratories on pandemic A (H1N1) specimens and isolates from at least 87 countries indicates that oseltamivir resistant pandemic H1N1 viruses are sporadic detections with rare onward transmission.

So far, 206 cases of oseltamivir resistance have been reported by GISN and other WHO partners.

All of these viruses showed the H275Y mutation and all remain sensitive to zanamivir.

WHO, through the GISN, continues monitoring the evolution and global circulation of influenza viruses, including pandemic, seasonal and other influenza viruses infecting, or with the potential to infect humans.

*Some NICs report data to FluNet retrospectively and updates of previous data with new results are frequent.

Virology data update
Download update (.pdf)

For more information
National Influenza Centres
EuroFlu Weekly Electronic Bulletin
PAHO Weekly Regional Update
FluNet web site
-
<cite cite="http://www.who.int/csr/disease/swineflu/laboratory22_01_2010/en/index.html">WHO | Pandemic (H1N1) 2009 - update 84</cite>
 

Attachments

WHO - Pandemic (H1N1) 2009 - update 85 (Virological Surveillance)

WHO - Pandemic (H1N1) 2009 - update 85 (Virological Surveillance)

WHO - Pandemic (H1N1) 2009 - update 85 (Virological Surveillance)

Pandemic (H1N1) 2009 - update 85 - Weekly virological surveillance update

29 January 2010


Pandemic influenza A(H1N1) 2009 virus activity continued to decline in many countries in the Northern Hemisphere.

The pandemic A(H1N1) continues to be the predominant circulating influenza virus in nearly all countries where influenza is reported.

The most recent available data showed that pandemic A(H1N1) 2009 accounted for 100% of influenza A virus subtype detections in sentinel specimens in WHO EUR (1) and more than 98% in WHO AMR (2) .

China on the other hand reported outbreaks due to influenza B (48.8% of all influenza positive specimens).

Sporadic detections of seasonal A(H1N1), A(H3N2) and influenza B viruses were reported from a few countries such as Iran, Japan, the Russian Federation and Tunisia.

A total of 25 countries reported to FluNet during the period 10th January 2010 to 16th January 2010.

Based on FluNet reporting, the total number of specimens reportedly positive for influenza viruses by NIC laboratories was 3,044. Of these, 1,961 (64.4%) were typed as influenza A and 1,083 (35.6%) as influenza B.

Of all sub-typed influenza A viruses, 95% (1,637/1,724) were pandemic (H1N1) 2009.

Since the beginning of the pandemic in 19 April 2009 to 23th January,2010, cumulatively 153 countries shared a total of 23743 specimens (18368 clinical samples and 5375 virus isolates) with WHO CCs for further analysis.

All pandemic A(H1N1) 2009 influenza viruses analysed to date appear to be antigenically and genetically closely related to the vaccine virus A/California/7/2009.

The pandemic A(H1N1) 2009 viruses with D222G substitution have also been seen antigenically indistinguishable to the A/California/7/2009 (H1N1) vaccine virus.

The WHO Global Influenza Surveillance Network (GISN) including WHOCCs conducts systematic surveillance for antiviral susceptibility. So far, antiviral susceptibility testing conducted by WHO CCs and other GISN laboratories on pandemic A (H1N1) specimens and isolates from at least 88 countries indicates that oseltamivir resistant pandemic H1N1 viruses are sporadic detections with rare onward transmission.

So far, 220 cases of oseltamivir resistance have been reported by GISN and other partners.

All of these viruses showed the H275Y substitution and all remain sensitive to zanamivir.

WHO, through the GISN, continues monitoring the evolution and global circulation of influenza viruses, including pandemic, seasonal and other influenza viruses infecting, or with the potential to infect humans.

*Some NICs report data to FluNet retrospectively and updates of previous data with new results are frequent.


Virology data update
Download update (.pdf)

For more information
National Influenza Centres
(1) EuroFlu Weekly Electronic Bulletin
(2) PAHO Weekly Regional Update
FluNet web site
-
<cite cite="http://www.who.int/csr/disease/swineflu/laboratory29_01_2010/en/index.html">WHO | Pandemic (H1N1) 2009 - update 85</cite>
 
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