European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 10 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 10 June 2009, 17:00 hours CEST

[Original Document: LINK. EDITED.]


Main developments in past 24 hours

• 91 new cases confirmed from EU and EFTA countries;
• 1068 new cases are reported from non EU and EFTA countries;
• No new country reported its first confirmed cases;

This report is based on official information provided by the national public health websites, or through other official communication channels. In addition, outside of the EU and EFTA countries, media reports from credible sources are included when quoting national authorities. An update on the number of confirmed cases as of 9 June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

In the past 24 hours, 91 cases were confirmed in eight EU and EFTA countries (Table 1). The majority of the newly reported cases were from the UK (75). Cases were also reported from Germany (8), Czech Republic (2), The Netherlands (2), Greece (1), Romania (1), Iceland (1), Ireland (1).

Outside of the EU and EFTA countries, a total of 26,465 cases are currently reported, of which 1068 in the last 24 hours (Table 2). The majority of the newly reported cases worldwide have been detected in Chile (804) (http://www.pandemia.cl/pagnew/prensa/REPORTE_09_06_09.pdf )


Assessment and response in the EU and EFTA countries

The number of EU and EFTA countries reporting cases did not change (26 of 31 EU and EFTA countries). No sustained community transmission has yet been declared from EU and EFTA countries and the assessment for the EU and EFTA countries does not change.

ECDC, in collaboration with the Member States, the European Commission and the World Health Organisation, continues to closely monitor this rapidly evolving situation, and provide daily updates on its website.


Possible exportation of cases from EU Member States

In the latest H1N1 epi-bulletin (June 9) Brazil reports that out of the 40 cases confirmed in the country 30 are considered as ?probable? acquired in other countries: two of them are returning travellers reported to have acquired the infection in Europe: 1 from UK and one from another unidentified European country (http://portal.saude.gov.br/portal/arquivos/pdf/influenzaa_h1n1_090620091.pdf ).

In addition Greece had today reported a new case returning from UK on 7th June and developing symptoms on next day. The case was then confirmed by RT-PCR on 9th June.

This is the third case confirmed in Greece with history of travel from UK (http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19226 ).


WHO reports new cases in Egypt

[http://www.emro.who.int/csr/h1n1/]

The Ministry of Health of Egypt reported five new cases of influenza A(H1N1)v on 9 June among foreigners staying in the Zamalek dormitories of the American University in Cairo. Cases were detected by health authorities and throat swabs were taken on 7 and 8 June for laboratory testing, the results of which were confirmed positive for these five cases. Patients have been transferred to Abbassia Fever Hospital and treated with Tamiflu and are in a stable condition. Currently, the dormitory with all its inhabitants has been quarantined.


Table 1: Reported cumulative number of confirmed cases and of in-country transmission of influenza A(H1N1)v as of 10 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Cumulative number of in-country transmission]

1. Austria ... - 6 - 1
2. Belgium ... - 14 - 4
3. Bulgaria ... - 2 - ...
4. Cyprus ... - 1 - ...
5. Czech Republic 2 - 4 - ...
6. Denmark ... - 8 - 2
7. Estonia ... - 4 - 2
8. Finland ... - 4 - ...
9. France ... - 68 - 8
10. Germany 8 - 86 - 19
11. Greece 1 - 6 - ...
12. Hungary ... - 3 - ...
13. Iceland 1 - 3 - ...
14. Ireland 1 - 12 - 1
15. Italy ... - 50 - 3
16. Luxembourg ... - 1 - ...
17. Netherlands 2 - 22 - 2
18. Norway ... - 11 - 1
19. Poland ... - 6 - ...
20. Portugal ... - 2 - ...
21. Romania 1 - 10 - 6
22. Slovakia ... - 3 - 1
23. Spain ... - 331 - 127
24. Sweden ... - 16 - 4
25. Switzerland ... - 16 - ...
26. United Kingdom 75 - 750 - 291

• Total 91 - 1439 - 472

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 10 June 2009, 17:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Russian Federation ... - 3 - ...
2. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Bahrain ... - 1 - ...
2. Egypt 5 - 8 - ...
3. Israel 9 - 63 - ...
4. Kuwait ... - 18 - ...
5. Lebanon 5 - 8 - ...
6. Saudi Arabia ... - 2 - ...
7. Turkey ... - 10 - ...
8. United Arab Emirates ... - 1 - ...

• NORTH AMERICA

1. Canada ... - 2446 - 4
2. Mexico ... - 5717 - 106
3. **USA ... - 13217 - 27

• CENTRAL AMERICA AND CARIBBEAN

1. Bahamas ... - 1 - ...
2. Barbados ... - 2 - ...
3. Bermuda ... - 1 - ...
4. Cayman Islands ... - 1 - ...
5. Costa Rica ... - 93 - 1
6. Cuba ... - 5 - ...
7. Dominica ... - 1 - ...
8. Dominican Republic ... - 72 - 1
9. El Salvador ... - 69 - ...
10. Guatemala 10 - 60 - ...
11. Honduras 55 - 89 - ...
12. Jamaica ... - 7 - ...
13. Martinique ... - 1 - ...
14. Nicaragua 7 - 33 - ...
15. Panama ... - 200 - ...
16. Trinidad-Tobago ... - 2 - ...

• SOUTH AMERICA

1. Argentina 21 - 256 - ...
2. Bolivia ... - 3 - ...
3. Brazil 4 - 40 - ...
4. ****Chile 804 - 1694 - 1
5. *****Colombia 10 - 35 - 1
6. Ecuador ... - 60 - ...
7. Paraguay 18 - 23 - ...
8. Peru 4 - 65 - ...
9. Uruguay 5 - 32 - ...
10. Venezuela ... - 12 - ...

• NORTH-EAST AND SOUTH ASIA

1. China 12 - 101 - ...
2. Hong Kong SAR 4 - 45 - ...
3. India ... - 4 - ...
4. Japan 28 - 485 - ...
5. Korea (South) ... - 48 - ...
6. Taiwan 3 - 24 - ...

• SOUTH-EAST ASIA

1. Malaysia ... - 7 - ...
2. Philippines 23 - 77 - ...
3. Singapore 1 - 18 - ...
4. Thailand ... - 9 - ...
5. Vietnam ... - 11 - ...

• AUSTRALIA AND PACIFIC

1. Australia 36 - 1260 - ...
2. ***French Polynesia ... - 1 - ...
3. New Zealand 4 - 23 - ...

• TOTAL 1068 - 26465 - 141

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. Cases reported from the US include confirmed cases from Puerto Rico.
• (***) The case from French Polynesia was reported by France
• (****) 1161 of the cases reported by Chile correspond to cumulative reports from private health sector
• (*****) The fatal case in Colombia is epidemiologically confirmed

(...)

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[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 11 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 11 June 2009, 17:00 hours CEST

[Original Document: LINK. EDITED.]


Main developments in past 24 hours

• WHO declares Pandemic alert level 6
• 126 new cases confirmed from EU and EFTA countries;
• 1224 new cases are reported from non EU and EFTA countries;

This report is based on official information provided by the national public health websites, or through other official communication channels. In addition, outside of the EU and EFTA countries, media reports from credible sources are included when quoting national authorities. An update on the number of confirmed cases as of 11 June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases did not change with 26 of 31 EU and EFTA countries with confirmed cases.

In the past 24 hours, 126 cases were confirmed in fifteen EU and EFTA countries (Table 1).

The majority of the newly reported cases were from the UK (72) and Spain (26). An additional 13 EU and EFTA countries also reported confirmed cases.

Poland reported the first case of in-country transmission (here) in a 6-year old child who attended the same Kindergarten as 2 previously confirmed cases.

Outside of the EU and EFTA countries, a total of 27,689 cases are currently reported, of which 1224 in the last 24 hours (Table 2). The majority of these are from Mexico (524) and Canada (532).


WHO declares Pandemic Alert Level 6

Today, following the advice from the fourth meeting of the WHO Emergency Committee, the Director General of WHO raised the pandemic alert level from five to six (WHO phases). This upgrade in scale is based on the assessment of the spread of the pandemic virus, A(H1N1)v, with convincing evidence of sustained community transmission in at least two WHO regions.

The change in Phase is not based on the severity of the disease caused by the new virus. Following the advice of the Emergency Committee and a high level consultation at the World Health Assembly (here) WHO has made a statement on the severity of this pandemic at the same time as declaring the phase change. The pandemic has been characterized as ?moderate? by WHO.

It is expected that all EU and EFTA countries will eventually be affected by the new virus.

The announcement of the new alert level does not change the present assessment of risk to EU and EFTA countries of influenza A(H1N1)v (here). As before, the major change for European counties comes when they start being ?affected? ? that is start experiencing community transmission.

The virus has been reported from 26 out of 30 EU and EFTA countries but so far none have reported any degree of community transmission apart from the UK.

This pandemic alert level 6 will facilitate the implementation of proportionate measures foreseen in pandemic plans, both by national, public health and regulatory authorities. It is expected that Phase 6 could last for several months during which time European countries will need to implement their response plans as they become affected.

There are still a number of uncertainties about this pandemic that will need to be addressed in the coming months.

These include how the severity of the disease and the risk groups for most severe manifestations will appear in Europe.

It remains to be seen whether the virus remains sensitive to anti-viral drugs, and especially whether co-circulation of the new virus and existing seasonal influenza strains and A(H5N1) will result in any genetic recombination. Finally it remains to be determined what will be the best strategies for use of a specific vaccine which WHO also announced would now start being produced.

ECDC will continue monitoring the epidemiological and virological developments in European countries and worldwide and provide updated risk assessments when necessary. In line with its mandate, ECDC will also continuously develop and update its scientific guidance in order to support public health decision making as the situation of this pandemic evolves.


Table 1: Reported cumulative number of confirmed cases and of in-country transmission of influenza A(H1N1)v as of 11 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Cumulative number of in-country transmission]

1. Austria 1 - 7 - 1
2. Belgium ... - 14 - 4
3. Bulgaria ... - 2 - ...
4. Cyprus ... - 1 - ...
5. Czech Republic ... - 4 - ...
6. Denmark 2 - 10 - 2
7. Estonia ... - 4 - 2
8. Finland ... - 4 - ...
9. France 3 - 71 - 8
10. Germany 4 - 90 - 21
11. Greece 1 - 7 - ...
12. Hungary 1 - 4 - ...
13. Iceland ... - 3 - ...
14. Ireland ... - 12 - 1
15. Italy 6 - 56 - 4
16. Luxembourg ... - 1 - ...
17. Netherlands 1 - 23 - 4
18. Norway 2 - 13 - 1
19. Poland 1 - 7 - 1
20. Portugal ... - 2 - ...
21. Romania 1 - 11 - 6
22. Slovakia ... - 3 - 1
23. Spain 26 - 357 - 127
24. Sweden 3 - 19 - 4
25. Switzerland 2 - 18 - ...
26. United Kingdom 72 - 822 - 380

• Total 126 - 1565 - 567

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 11 June 2009, 17:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Russian Federation ... - 3 - ...
2. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Bahrain ... - 1 - ...
2. Egypt ... - 8 - ...
3. Israel ... - 63 - ...
4. Kuwait ... - 18 - ...
5. Lebanon ... - 8 - ...
6. Saudi Arabia ... - 2 - ...
7. Turkey ... - 10 - ...
8. United Arab Emirates ... - 1 - ...

• NORTH AMERICA

1. Canada 532 - 2978 - 4
2. Mexico 524 - 6241 - 108
3. **USA ... - 13217 - 27

• CENTRAL AMERICA AND CARIBBEAN

1. Bahamas 1 - 2 - ...
2. Barbados 1 - 3 - ...
3. Bermuda 1 - 2 - ...
4. Cayman Islands 1 - 2 - ...
5. Costa Rica 11 - 104 - 1
6. Cuba 1 - 6 - ...
7. Dominica ... - 1 - ...
8. Dominican Republic ... - 72 - 1
9. El Salvador ... - 69 - ...
10. Guatemala 6 - 66 - ...
11. Honduras ... - 89 - ...
12. Jamaica ... - 7 - ...
13. Martinique ... - 1 - ...
14. Nicaragua ... - 33 - ...
15. Panama ... - 200 - ...
16. Trinidad-Tobago ... - 2 - ...

• SOUTH AMERICA

1. Argentina 25 - 281 - ...
2. Bolivia ... - 3 - ...
3. Brazil 3 - 43 - ...
4. ****Chile ... - 1694 - 2
5. Colombia ... - 35 - 1
6. Ecuador ... - 60 - ...
7. Paraguay 2 - 25 - ...
8. Peru ... - 65 - ...
9. Uruguay 4 - 36 - ...
10. Venezuela 1 - 13 - ...

• NORTH-EAST AND SOUTH ASIA

1. China 10 - 111 - ...
2. Hong Kong SAR 4 - 49 - ...
3. India ... - 4 - ...
4. Japan 33 - 518 - ...
5. Korea (South) 5 - 53 - ...
6. Taiwan 8 - 32 - ...

• SOUTH-EAST ASIA

1. Malaysia ... - 7 - ...
2. Philippines ... - 77 - ...
3. Singapore ... - 18 - ...
4. Thailand ... - 9 - ...
5. Vietnam 4 - 15 - ...

• AUSTRALIA AND PACIFIC

1. Australia 47 - 1307 - ...
2. ***French Polynesia ... - 1 - ...
3. New Zealand ... - 23 - ...

• TOTAL 1224 - 27689 - 144

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. Cases reported from the US include confirmed cases from Puerto Rico.
• (***) The case from French Polynesia was reported by France
• (****) 1161 of the cases reported by Chile correspond to cumulative reports from private health sector

(...)

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[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 12 June 2009, 17:00 hours CEST (ECDC - edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 12 June 2009, 17:00 hours CEST

[Original Document: LINK. EDITED.]


Main developments in past 24 hours

• 294 new cases were reported in EU and EFTA countries;
• 289 new cases were reported from non-EU and EFTA countries;
• The first death was reported from Guatemala today;
• Morocco and the Occupied Palestinian Territory reported their first case.

This report is based on official information provided by the national public health websites, or through other official communication channels. In addition, outside of the EU and EFTA countries, media reports from credible sources are included when quoting national authorities. An update on the number of confirmed cases as of 12 June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases did not change with 26 of 31 EU and EFTA countries with confirmed cases.

In the past 24 hours, 294 cases were confirmed in ten EU and EFTA countries (Table 1).

The majority of the newly reported cases were from Spain (131) and the UK (99).

An additional 8 EU and EFTA countries also reported confirmed cases. Hungary reported the first case of in-country transmission on 11th of June.

The sentinel influenza surveillance systems reported low influenza activity in all of the countries providing data in the European region.

This indicates low circulation of A(H1N1)v and other influenza viruses at the community level.

According to influenza surveillance data from the EU and EFTA Member States, the number of specimens submitted by sentinel physicians for virological testing almost doubled (544) as compared to week 22 (238) and week 21 (188).

Five of these specimens tested positive for influenza A(H1N1)v virus.

The surveillance system also captures virus detections in samples from non-sentinel sources where there is no denominator (total number of samples submitted).

Overall 117 such specimens tested positive for influenza A(H1)v virus without neuraminidase subtyping results being reported. All influenza A(H1N1)v viruses tested for antiviral resistance so far proved to be susceptible to oseltamivir and zanamivir and resistant to adamantanes.

Outside of the EU and EFTA countries, a total of 27,978 cases are currently reported, of which 289 in the last 24 hours (Table 2). The first death was reported from Guatemala. Both Morocco and the Occupied Palestinian Territory confirmed their first case of influenza A(H1N1)v today.


ECDC Risk Assessment on influenza A(H1N1)v

ECDC published an updated risk assessment for Europe concerning the situation of influenza A(H1N1)v (see here). The assessment covers the basic epidemiology of the disease, disease characteristics, features of the virus, disease severity and data from Europe.


EC and Czech presidency respond to Pandemic Alert level 6

The European Commission (EC) and the Czech presidency issued a joint statement following the declaration of Pandemic alert level 6 by WHO on June 11, 2009. As agreed during the Health Council of June 9, the Commission and Member states are committed to using the Health Security Committee in order to coordinate the response and and approach to this threat.

Both the Czech presidency and the Commission stated that they will continue to play an active role in planning, coordinating and facilitating measures to contain and mitigate the effects of influenza A(H1N1)v together with other European and international stakeholders such as WHO and ECDC.


From the scientific literature

1. Confirmed cases analysis from EU and EFTA countries: The preliminary analysis of individual and aggregated data on confirmed cases of influenza A(H1N1)v in EU and EFTA countries reported up to June 8 was published in the latest issue of Eurosurveillance. The results cover the epidemic curve, demographic characteristics and symptoms, underlying disease, rates of hospitalisation and complications, and aspects concerning antiviral prophylaxis, treatment and seasonal influenza vaccination. As the data are still incomplete, the analysis should not be considered as a comprehensive picture of current influenza A(H1N1) cases in EU and EFTA countries.
2. Genetic origins of the influenza A(H1N1)v strain: Researchers from Hong Kong, the UK and the US report in the advanced online version of Nature on 11 June, 2009, about the ?Origins and evolutionary genomics of the 2009 swine-origin H1N1 influenza A epidemic?. The article describes that the new influenza strain is derived from existing influenza viruses which circulate in swine. Additionally, evidence is provided that the likely transmission of this strain of influenza from pigs to humans happened several months before the outbreak was identified.
3. Clinical observations from school outbreak in Japan: the clinical features of confirmed cases of influenza A(H1N1)v associated to a school outbreak of this virus between 11 and 24 May, 2009 in Kobe, Japan, are described in the most recent issue of the Weekly Epidemiological Report (WER). Finding of interest include that upper-respiratory tract symptoms preceded those of fever, which suggesting the replication and possible shedding of the virus during the prodromic period. Additionally, rapid tests failed to correctly identify around 50% of the cases on the day of onset of their symptoms. For this reason, using clinical and epidemiological information of suspected cases might be more reliable for the timely administration of anti-virals in persons at risk of severe disease.

Table 1: Reported cumulative number of confirmed cases and of in-country transmission of influenza A(H1N1)v as of 12 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Cumulative number of in-country transmission]

1. Austria ... - 7 - 1
2. Belgium ... - 14 - 4
3. Bulgaria ... - 2 - ...
4. Cyprus ... - 1 - ...
5. Czech Republic ... - 4 - ...
6. Denmark 1 - 11 - 2
7. Estonia ... - 4 - 2
8. Finland ... - 4 - ...
9. France ... - 71 - 8
10. Germany 26 - 116 - 21
11. Greece 5 - 12 - ...
12. Hungary ... - 4 - 1
13. Iceland 1 - 4 - 1
14. Ireland ... - 12 - 1
15. Italy 3 - 59 - 4
16. Luxembourg ... - 1 - ...
17. Netherlands 12 - 35 - 9
18. Norway ... - 13 - 1
19. Poland ... - 7 - 1
20. Portugal ... - 2 - ...
21. Romania 1 - 12 - 6
22. Slovakia ... - 3 - 1
23. Spain 131 - 488 - 127
24. Sweden 11 - 30 - 4
25. Switzerland 4 - 22 - ...
26. United Kingdom 99 - 921 - 380

• Total 294 - 1859 - 574

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 12 June 2009, 17:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Russian Federation ... - 3 - ...
2. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Bahrain ... - 1 - ...
2. Egypt ... - 8 - ...
3. Israel ... - 63 - ...
4. Kuwait ... - 18 - ...
5. Lebanon ... - 8 - ...
6. Morocco 1 - 1 - ...
7. Occupied Palestinian Territory 1 - 1 - ...
8. Saudi Arabia ... - 2 - ...
9. Turkey ... - 10 - ...
10. United Arab Emirates ... - 1 - ...

• NORTH AMERICA

1. Canada ... - 2978 - 4
2. Mexico ... - 6241 - 108
3. **USA ... - 13217 - 27

• CENTRAL AMERICA AND CARIBBEAN

1. Bahamas ... - 2 - ...
2. Barbados ... - 3 - ...
3. Bermuda ... - 2 - ...
4. Cayman Islands ... - 2 - ...
5. Costa Rica ... - 104 - 1
6. Cuba ... - 6 - ...
7. Dominica ... - 1 - ...
8. Dominican Republic 19 - 91 - 1
9. El Salvador ... - 69 - ...
10. Guatemala 19 - 85 - 1
11. Honduras ... - 89 - ...
12. Jamaica 4 - 11 - ...
13. Martinique ... - 1 - ...
14. Nicaragua 23 - 56 - ...
15. Panama 21 - 221 - ...
16. Trinidad-Tobago 2 - 4 - ...

• SOUTH AMERICA

1. Argentina 62 - 343 - ...
2. Bolivia 2 - 5 - ...
3. Brazil 9 - 52 - ...
4. ****Chile ... - 1694 - 2
5. Colombia ... - 35 - 1
6. Ecuador 7 - 67 - ...
7. Paraguay ... - 25 - ...
8. Peru 15 - 80 - ...
9. Uruguay ... - 36 - ...
10. Venezuela 12 - 25 - ...

• NORTH-EAST AND SOUTH ASIA

1. China 13 - 124 - ...
2. Hong Kong SAR 14 - 63 - ...
3. India ... - 4 - ...
4. Japan 31 - 549 - ...
5. Korea (South) ... - 53 - ...
6. Taiwan 4 - 36 - ...

• SOUTH-EAST ASIA

1. Malaysia ... - 7 - ...
2. Philippines 15 - 92 - ...
3. Singapore 3 - 21 - ...
4. Thailand ... - 9 - ...
5. Vietnam 1 - 16 - ...

• AUSTRALIA AND PACIFIC

1. Australia ... - 1307 - ...
2. ***French Polynesia ... - 1 - ...
3. New Zealand 11 - 34 - ...

• TOTAL 289 - 27978 - 145

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. Cases reported from the US include confirmed cases from Puerto Rico.
• (***) The case from French Polynesia was reported by France
• (****) 1161 of the cases reported by Chile correspond to cumulative reports from private health sector

(...)

-
-----

 

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 13 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 13 June 2009, 17:00 hours CEST

[Original Document: LINK. EDITED.]


Main developments in past 24 hours

• 237 new cases were reported in EU and EFTA countries;
• 6315 new cases were reported from non-EU and EFTA countries;
• UK has reported 200 new cases;
• Netherlands has reported 19 new cases of in-country transmission;
• USA has reported 4638 new cases and 18 deaths during the week ending 6 June.

This report is based on official information provided by the national public health websites, or through other official communication channels. An update on the number of confirmed cases as of 13 June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases did not change, with 26 of 31 EU and EFTA countries reporting confirmed cases.

In the past 24 hours, 237 cases were confirmed in seven EU and EFTA countries (Table 1).

The majority of the newly reported cases were from the UK (200), the Netherlands (16), Italy (8) and France (7). On the 13th June 2009, the Netherlands reported a total of 19 cases of in-country transmission.

Outside of the EU and EFTA countries, a total of 34,293 cases are currently reported, an increase of 6,315 cases (23%) over the previous situation report dated 12 June 2009 (Table 2).

Mexico reported one more death, bringing their total to 109.

USA had 4638 cases and 18 deaths reported for the week ending 6 June.

This represents an increase in their weekly reports of 46.6% over the 3164 cases reported for the previous week (ending 30 May). This brings the current total of influenza A(H1N1)v cases in the USA to 17855, with 45 deaths in all.

Other countries with large increases in their reported cases were Chile (641 new cases), Canada (537 new cases), Australia (134 new cases) and Argentina (127 new cases).


WHO GUIDANCE DOCUMENTS - 3. Healthcare management

WHO has been busy producing and refreshing a large number of documents since the emergence of A(H1N1)v. To assist Member States keep track of these, the ECDC is occasionally listing and explaining the most important of these, by category. The full list of documents are available on the WHO web-site at http://www.who.int/csr/resources/publications/swineflu/en/index.html

Important Note: In EU/EFTA Member States there may be national guidelines for the topics below that should be followed

1. Influenza A(H1N1) patient care checklist (8 June 2009). This checklist is intended for use by hospital staff treating any possible or confirmed case of new influenza A (H1N1). This checklist highlights areas of care critical for the management of new influenza A (H1N1) and it is not intended to replace routine care.
2. Clinical management of human infection with new influenza A (H1N1) virus (21 May 2009). This is an initial guidance developed for clinicians on the management of human disease caused by the new influenza A (H1N1) virus.
3. Advice on the use of masks in the community setting in Influenza A(H1N1) outbreaks (3 May 2009). This document provides interim guidance on the use of masks in communities that have reported community-level outbreaks caused by the new Influenza A(H1N1) virus. It will be revised as more data become available.
4. Pandemic influenza prevention and mitigation in low resource communities (2 May 2009). This summary guidance is derived from the WHO document ?Pandemic influenza preparedness and mitigation in refugee and displaced populations: WHO guidelines for humanitarian agencies?, Second edition, 2008. It provides advice for low resource countries on public health measures to be taken by individuals and communities, care to be provided at home to people with mild illness and measures to be taken in health-care settings.
5. Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patients (29 April 2009). This document provides advice to health care workers on the use of appropriate infection control precautions when caring for patients with influenza-like symptoms in order to minimize the possibility of transmission among themselves, to other health-care workers, patients and visitors.

Table 1: Reported cumulative number of confirmed cases and of in-country transmission of influenza A(H1N1)v as of 13 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Cumulative number of in-country transmission]

1. Austria ... - 7 - 1
2. Belgium ... - 14 - 4
3. Bulgaria ... - 2 - ...
4. Cyprus ... - 1 - ...
5. Czech Republic ... - 4 - ...
6. Denmark 1 - 12 - 4
7. Estonia ... - 4 - 2
8. Finland ... - 4 - ...
9. France 7 - 78 - 8
10. Germany ... - 116 - 21
11. Greece 2 - 14 - ...
12. Hungary ... - 4 - 1
13. Iceland ... - 4 - 1
14. Ireland ... - 12 - 1
15. Italy 8 - 67 - 4
16. Luxembourg ... - 1 - ...
17. Netherlands 16 - 51 - 19
18. Norway ... - 13 - 1
19. Poland ... - 7 - 1
20. Portugal ... - 2 - ...
21. Romania 1 - 13 - 6
22. Slovakia ... - 3 - 1
23. Spain ... - 488 - 127
24. Sweden 2 - 32 - 4
25. Switzerland ... - 22 - ...
26. United Kingdom 200 - 1121 - 380

• Total 237 - 2096 - 586

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 13 June 2009, 17:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Russian Federation ... - 3 - ...
2. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Bahrain ... - 1 - ...
2. Egypt 7 - 15 - ...
3. Israel ... - 63 - ...
4. Kuwait ... - 18 - ...
5. Lebanon ... - 8 - ...
6. Morocco ... - 1 - ...
7. Occupied Palestinian Territory ... - 1 - ...
8. Saudi Arabia ... - 2 - ...
9. Turkey ... - 10 - ...
10. United Arab Emirates ... - 1 - ...

• NORTH AMERICA

1. Canada 537 - 3515 - 4
2. Mexico 162 - 6403 - 109
3. **USA 4638 - 17855 - 45

• CENTRAL AMERICA AND CARIBBEAN

1. Bahamas ... - 2 - ...
2. Barbados ... - 3 - ...
3. Bermuda ... - 2 - ...
4. Cayman Islands ... - 2 - ...
5. Costa Rica ... - 104 - 1
6. Cuba ... - 6 - ...
7. Dominica ... - 1 - ...
8. Dominican Republic 2 - 93 - 1
9. El Salvador ... - 69 - ...
10. Guatemala ... - 85 - 1
11. Honduras ... - 89 - ...
12. Jamaica ... - 11 - ...
13. ***Martinique 1 - 2 - ...
14. Nicaragua ... - 56 - ...
15. Panama ... - 221 - ...
16. Trinidad-Tobago ... - 4 - ...

• SOUTH AMERICA

1. Argentina 127 - 470 - ...
2. Bolivia ... - 5 - ...
3. Brazil 2 - 54 - ...
4. ****Chile 641 - 2335 - 2
5. Colombia 5 - 40 1 ...
6. Ecuador ... - 67 - ...
7. Paraguay ... - 25 - ...
8. Peru 1 - 81 - ...
9. Uruguay ... - 36 - ...
10. Venezuela ... - 25 - ...

• NORTH-EAST AND SOUTH ASIA

1. China ... - 124 - ...
2. Hong Kong SAR ... - 63 - ...
3. India ... - 4 - ...
4. Japan 23 - 572 - ...
5. Korea (South) ... - 53 - ...
6. Taiwan ... - 36 - ...

• SOUTH-EAST ASIA

1. Malaysia ... - 7 - ...
2. Philippines 19 - 111 - ...
3. Singapore 6 - 27 - ...
4. Thailand ... - 9 - ...
5. Vietnam ... - 16 - ...

• AUSTRALIA AND PACIFIC

1. Australia 134 - 1441 - ...
2. ***French Polynesia 1 - 2 - ...
3. New Zealand 9 - 43 - ...

• TOTAL 6315 - 34293 - 164

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO.
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. Cases reported from the US include confirmed cases from Puerto Rico.
• (***) The cases in Martinique and French Polynesia were reported by France
• (****) 1700 of the cases reported by Chile correspond to cumulative reports from private health sector

(...)

-
-----

 

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 14 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 14 June 2009, 17:00 hours CEST

[Original Document: LINK. EDITED.]


Main developments in past 24 hours

• 173 new cases were reported in EU and EFTA countries;
• 302 new cases were reported from non-EU and EFTA countries;
• UK has again reported the largest number of new cases ? 105;
• Germany has reported 54 new cases;

This report is based on official information provided by the national public health websites, or through other official communication channels. An update on the number of confirmed cases as of 14 June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases did not change, with 26 of 31 EU and EFTA countries reporting confirmed cases.

In the past 24 hours, 173 cases were confirmed in six EU and EFTA countries (Table 1).

The majority of the newly reported cases were from the UK (105) and Germany (54), while Belgium, Greece, Netherlands and Romania all reported 5 or less cases.

The cumulative number of cases in the EU and EFTA countries is now 2269.

Outside of the EU and EFTA countries, a total of 34,595 cases have been reported, an increase of 302 cases over the previous situation report dated 14 June 2009 (Table 2).

A small increase in cases is observed in the Mediterranean and Middle East region, as reported by the World Health Organization Regional Office for the Eastern Mediterranean.

Argentina reported 99 new cases bringing their total to 569.

Australia reported 74 new cases bringing their total to 1515.

Japan and New Zealand also reported slight increases in their new cases (below 30).


Update on cases and deaths from A(H1N1)v in Mexico

On 9 June, the Ministry of Health of Mexico, published further epidemiological information on their influenza A(H1N1)v situation (see here), with a further update published on the 11 June (here).

A total of 109 confirmed deaths from the influenza A (H1N1)v virus have been reported in Mexico, which is 1.7% of the cumulative 6403 cases reported from all the 32 Mexican federal units.

The last death was recorded on 31 May.

52% of the deaths were in females and 71.3% of all deaths occurred in persons between 20 and 54 years of age.

The majority of the patients who died had underlying conditions which included metabolic disorders such as obesity and diabetes (37%), cardiovascular disease (18.5%), respiratory diseases (8.3%), while 13% were reported to be smokers.

Currently the general epidemic situation in the country appears to have improved, with the latest new cases of infection with Influenza A(H1N1)v last reported on the 7 June.


SURVEILLANCE AND STUDIES IN A PANDEMIC

Since 2006 ECDC has been working with Member States and WHO on planning what Surveillance activities should be undertaken in a pandemic. Last week ECDC published a Technical Report: Surveillance and Studies in a Pandemic which reflects the latest thinking of specialists from Member States and ECDC on this topic.

This follows on from a series of earlier related publications see here, here and here.

The Report should be seen as complementary advice for Europe to be taken in conjunction with the Interim Guidance issued globally by WHO in April 2009

The document describes a complex topic with four distinct components:

1. Early Detection and Investigation;
2. Comprehensive Early Assessment;
3. Monitoring; and
4. rapid investigation of the Effectiveness and Impact of Countermeasures (including the safety of pharmaceutical countermeasures) in achieving mitigation.

In the light of what happened in 1968, 1957 and probably 1918, a pandemic is unlikely to originate within Europe, and so the early detection and investigation component will probably take place elsewhere. Of course this is what has happened with the 2009 pandemic, even though the virus emerged in the West when most observers had been looking East.

Nevertheless, it will be vital for Europe to undertake the other three components in full, all of which will need to be supported by suitable laboratory-based (microbiological) surveillance and special studies.

Comprehensive Early Assessment (component 2) is vital because of the number of important parameters of pandemics that cannot be anticipated. However, early assessment does not need to be undertaken in every country. Optimally, it will be best done by the earliest affected European countries, with support from the European Centre of Disease Prevention and Control (ECDC) and the World Health Organization (WHO) and then their results shared with all other countries. A good example of this early assessment and sharing partly happened already, because as soon as the pandemic strain was detected, the virus was shared with those who needed it to develop diagnostic tests and start working on the vaccine.

More epidemiological work is now taking place in the most affected countries, not just in Europe, but even more so in North America where the pandemic started earlier. The document points out that all European countries will need to perform Monitoring (component 3) to support the effective management of their own healthcare systems and other services and to better understand what phase of the pandemic their country is in.

ECDC argues that International Monitoring (country reporting to WHO and ECDC) should be kept simple, as many countries will find it difficult to provide detailed routine information to international bodies while maintaining the vital internal processes. ECDC has added Investigations of the Impact of Public Health Measures (and the safety of pharmaceutical countermeasures) as a final Component 4.


Table 1: Reported cumulative number of confirmed cases and of in-country transmission of influenza A(H1N1)v as of 14 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Cumulative number of in-country transmission]

1. Austria ... - 7 - 1
2. Belgium 3 - 17 - 4
3. Bulgaria ... - 2 - ...
4. Cyprus ... - 1 - ...
5. Czech Republic ... - 4 - ...
6. Denmark ... - 12 - 4
7. Estonia ... - 4 - 2
8. Finland ... - 4 - ...
9. France ... - 78 - 8
10. Germany 54 - 170 - 21
11. Greece 5 - 19 - ...
12. Hungary ... - 4 - 1
13. Iceland ... - 4 - 1
14. Ireland ... - 12 - 1
15. Italy ... - 67 - 4
16. Luxembourg ... - 1 - ...
17. Netherlands 3 - 54 - 21
18. Norway ... - 13 - 1
19. Poland ... - 7 - 1
20. Portugal ... - 2 - ...
21. Romania 3 - 16 - 6
22. Slovakia ... - 3 - 1
23. Spain ... - 488 - 127
24. Sweden ... - 32 - 4
25. Switzerland ... - 22 - ...
26. United Kingdom 105 - 1226 - 380

• Total 173 - 2269 - 588

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 14 June 2009, 17:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Russian Federation ... - 3 - ...
2. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Bahrain ... - 1 - ...
2. Egypt 3 - 18 - ...
3. Israel ... - 63 - ...
4. Kuwait ... - 18 - ...
5. Lebanon 1 - 9 - ...
6. Morocco 1 - 2 - ...
7. Occupied Palestinian Territory ... - 1 - ...
8. Saudi Arabia 4 - 6 - ...
9. Turkey ... - 10 - ...
10. United Arab Emirates 1 - 2 - ...

• NORTH AMERICA

1. Canada ... - 3515 - 4
2. Mexico ... - 6403 - 109
3. **USA ... - 17855 - 45

• CENTRAL AMERICA AND CARIBBEAN

1. Bahamas ... - 2 - ...
2. Barbados ... - 3 - ...
3. Bermuda ... - 2 - ...
4. Cayman Islands ... - 2 - ...
5. Costa Rica 14 - 118 - 1
6. Cuba ... - 6 - ...
7. Dominica ... - 1 - ...
8. Dominican Republic ... - 93 - 1
9. El Salvador ... - 69 - ...
10. Guatemala 11 - 96 - 1
11. Honduras ... - 89 - ...
12. Jamaica ... - 11 - ...
13. ***Martinique ... - 2 - ...
14. Nicaragua ... - 56 - ...
15. Panama ... - 221 - ...
16. Trinidad-Tobago ... - 4 - ...

• SOUTH AMERICA

1. Argentina 99 - 569 - ...
2. Bolivia ... - 5 - ...
3. Brazil 4 - 58 - ...
4. ****Chile ... - 2335 - 2
5. Colombia ... - 40 - 1
6. Ecuador ... - 67 - ...
7. Paraguay ... - 25 - ...
8. Peru 10 - 91 - ...
9. Uruguay ... - 36 - ...
10. Venezuela 12 - 37 - ...

• NORTH-EAST AND SOUTH ASIA

1. China ... - 124 - ...
2. Hong Kong SAR ... - 63 - ...
3. India 11 - 15 - ...
4. Japan 22 - 594 - ...
5. Korea (South) ... - 53 - ...
6. Taiwan ... - 36 - ...

• SOUTH-EAST ASIA

1. Malaysia ... - 7 - ...
2. Philippines ... - 111 - ...
3. Singapore 7 - 34 - ...
4. Thailand ... - 9 - ...
5. Vietnam ... - 16 - ...

• AUSTRALIA AND PACIFIC

1. Australia 74 - 1515 - ...
2. ***French Polynesia 2 -...
3. New Zealand 28 - 71 - ...

• TOTAL 302 - 34595 - 164

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO. Therefore, some of these cases may be taken out at a later stage if not validated.
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. Cases reported from the US include confirmed cases from Puerto Rico.
• (***) The cases in Martinique and French Polynesia were reported by France
• (****) The cases reported by Chile correspond to cumulative reports from private health sector

(...)

-
-----

 

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 15 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 15 June 2009, 17:00 hours CEST

[Original Document: LINK. EDITED.]


Main developments in past 24 hours

• 108 new cases were reported in EU and EFTA countries;
• 510 new cases were reported from non-EU and EFTA countries;
• Media report the first death in Europe in UK/Scotland;
• First cluster of community transmission in France.

This report is based on official information provided by the national public health websites, or through other official communication channels. An update on the number of confirmed cases as of 15 June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases did not change, with 26 of 31 EU and EFTA countries reporting confirmed cases.

In the past 24 hours, 108 cases were confirmed in seven EU and EFTA countries (Table 1).

The majority of the newly reported cases were from the UK (94). The Netherlands reported 7 new cases, Belgium and Germany two new cases each, and Luxembourg, Portugal and Sweden one new case each.

The cumulative number of cases in the EU and EFTA countries is now 2,377.

France reports a cluster of 7 cases in a school in south of France. None of the cases have a travel history or a known exposure to a confirmed case.

Outside of the EU and EFTA countries, a total of 35,102 cases have been reported, an increase of 510 cases over the previous situation report dated 14 June 2009 (Table 2).

The highest numbers of new cases have been reported from North-East and South Asia (147) and South-East Asia (238), with Thailand reporting an increase from 9 to 150 confirmed cases.

According to media reports, the first death outside of the Americas has been reported from Glasgow, Scotland. The patient, a 38 year old woman with underlying medical condition, has been hospitalised for treatment, and passed away in the afternoon of June 14. She has been one of ten patients treated for A(H1N1)v in the Glasgow area, the others are reported to be in good clinical condition.


Update on the situation in the United States

Regular data are now published every Friday by the Centers for Disease Control and Prevention in summary at http://www.cdc.gov/h1n1flu/.

A more comprehensive report covering the previous week (FluView) is published at http://www.cdc.gov/flu/weekly/.

Media press conferences with their transcripts are available on Fridays at http://www.cdc.gov/media/transcripts/.

In its latest release (6 June) FluView reports a predominance of the pandemic strain A(H1N1)v.

The pattern continues to be one of great heterogeneity in the country with some areas reporting above baseline levels of influenza-like illness, such as in the North-East.

Because of the heavy work load on the laboratories and the reasonable predictive value of ILI for confirmed influenza, CDC is now recommending not to test all people presenting with ILI.

There remain no reports of antiviral resistance in the new virus.

As with seasonal influenza, children under 2 years old appear to be experiencing a high hospitalization rate. Older people continue to be under-represented among cases.

As indicated in an earlier MMWR, risk factors, for infected people experiencing hospitalization and severe disease continue to be chronic conditions which have been in decreasing frequency: asthma or chronic obstructive airways disease and other conditions causing respiratory insufficiency including morbid obesity, diabetes, immuno-deficiency, chronic cardiovascular disease (not simple hypertension), chronic renal failure, seizure disorders and malignancy.

Currently the pneumonia and influenza mortality through the 122 city mortality surveillance system, is not above normal.


Table 1: Reported cumulative number of confirmed cases and of in-country transmission of influenza A(H1N1)v as of 15 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Cumulative number of in-country transmission]

1. Austria ... - 7 - 1
2. Belgium 2 - 19 - 4
3. Bulgaria ... - 2 - ...
4. Cyprus ... - 1 - ...
5. Czech Republic ... - 4 - ...
6. Denmark ... - 12 - 4
7. Estonia ... - 4 - 2
8. Finland ... - 4 - ...
9. France ... - 78 - 8
10. Germany 2 - 172 - 84
11. Greece ... - 19 - ...
12. Hungary ... - 4 - 1
13. Iceland ... - 4 - 1
14. Ireland ... - 12 - 1
15. Italy ... - 67 - 4
16. Luxembourg 1 - 2 - ...
17. Netherlands 7 - 61 - 19
18. Norway ... - 13 - 1
19. Poland ... - 7 - 1
20. Portugal 1 - 3 - ...
21. Romania ... - 16 - 6
22. Slovakia ... - 3 - 1
23. Spain ... - 488 - 127
24. Sweden 1 - 33 - 10
25. Switzerland ... - 22 - ...
26. United Kingdom 94 - 1320 - 380

• Total 108 - 2377 - 655

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 13 June 2009, 17:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Russian Federation ... - 3 - ...
2. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Bahrain 7 - 8 - ...
2. Egypt 2 - 20 - ...
3. Israel 54 - 117 - ...
4. Kuwait ... - 18 - ...
5. Lebanon ... - 9 - ...
6. Morocco ... - 2 - ...
7. Occupied Palestinian Territory 1 - 2 - ...
8. Saudi Arabia 2 - 8 - ...
9. Turkey ... - 10 - ...
10. United Arab Emirates ... - 1 - ...

• NORTH AMERICA

1. Canada ... - 3515 - 4
2. Mexico ... - 6403 - 109
3. **USA ... - 17855 - 45

• CENTRAL AMERICA AND CARIBBEAN

1. Bahamas ... - 2 - ...
2. Barbados ... - 3 - ...
3. Bermuda ... - 2 - ...
4. Cayman Islands ... - 2 - ...
5. Costa Rica ... - 118 - 1
6. Cuba 1 - 7 - ...
7. Dominica ... - 1 - ...
8. Dominican Republic ... - 93 - 1
9. El Salvador ... - 69 - ...
10. Guatemala ... - 96 - 1
11. Honduras ... - 89 - ...
12. Jamaica ... - 11 - ...
13. ***Martinique ... - 1 - ...
14. Nicaragua ... - 56 - ...
15. Panama ... - 221 - ...
16. Trinidad-Tobago ... - 4 - ...

• SOUTH AMERICA

1. Argentina ... - 569 - ...
2. Bolivia ... - 5 - ...
3. Brazil 11 - 69 - ...
4. ****Chile ... - 2335 - 2
5. Colombia 2 - 42 - 1
6. Ecuador ... - 67 - ...
7. Paraguay ... - 25 - ...
8. Peru 3 - 94 - ...
9. Uruguay ... - 36 - ...
10. Venezuela ... - 37 - ...

• NORTH-EAST AND SOUTH ASIA

1. China 83 - 207 - ...
2. Hong Kong SAR 29 - 92 - ...
3. India 5 - 20 - ...
4. Japan 11 - 605 - ...
5. Korea (South) 6 - 59 - ...
6. Taiwan 13 - 49 - ...

• SOUTH-EAST ASIA

1. Malaysia ... - 7 - ...
2. Philippines 82 - 193 - ...
3. Singapore 6 - 40 - ...
4. Thailand 141 - 150 - ...
5. Vietnam 9 - 25 - ...

• AUSTRALIA AND PACIFIC

1. Australia 27 - 1542 - ...
2. ***French Polynesia ... - 1 - ...
3. New Zealand 15 - 86 - ...

• TOTAL 510 - 35102 - 164

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. Cases reported from the US include confirmed cases from Puerto Rico.
• (***) The cases in Martinique and French Polynesia were reported by France
• (****) 1700 of the cases reported by Chile correspond to cumulative reports from private health sector

(...)

-
-----

 

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 16 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 16 June 2009, 17:00 hours CEST

[Original Document: LINK. EDITED.]


Main developments in past 24 hours

• 197 new cases were reported in EU and EFTA countries;
• 1,533 new cases were reported from non-EU and EFTA countries;
• First death in Europe in UK/Scotland confirmed by health authorities;
• Cluster of community transmission in a school in Germany and in France with increasing number of cases.

This report is based on official information provided by the national public health websites, or through other official communication channels. An update on the number of confirmed cases as of 16 June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases did not change, with 26 of 31 EU and EFTA countries reporting confirmed cases.

In the past 24 hours, 197 cases were confirmed in five EU and EFTA countries: UK reports 141 new cases, 88% of them from West-Midlands, France 28, Germany 23, Sweden four, and Denmark one (Table 1). The cumulative number of cases in the EU and EFTA countries is now 2,574.

Outside of the EU and EFTA countries, a total of 36,686 cases, including 167 deaths, have been reported, representing an increase of 1,533 cases and 4 deaths (three in Canada, one in Argentina) over the previous situation report dated 15 June 2009 (Table 2).

Thailand doubled the number of cases from 150 yesterday to 310 this afternoon.

Canada reports an additional 534 cases (a 15% increase) as of this afternoon, and Argentina has an increase of 29% (164 cases) rising the total to 733 cases.

The first death in Europe has been confirmed in the UK/Scotland. The patient, a 38 year old woman with underlying medical condition, had been hospitalised for treatment, and passed away in the afternoon of June 14. According to the media, she had delivered a boy about 3 months prematurely beginning of June. The baby passed away yesterday, but is reported not to have been infected with H1N1.

The number of affected persons in the school outbreak in the south of France is still rising. As of today, 10 cases are reported to be linked to the cluster, none of them with travel history or known contact to previously confirmed case.

The cluster in a school in North Rhine-Westphalia, Germany, now counts 31 students and 9 family members confirmed positive for A(H1N1)v.

According to the available information, one of the cases in the clusters is hospitalized; the others are in good clinical condition.


Definition of sustained community transmission and affected areas

Following discussions in the EWRS network, ECDC has adopted the following operational definitions for sustained community transmission and affected areas

• Sustained community Transmission
  • Five or more confirmed cases, in a seven day period, without travel history in past 7 days to a country having reported confirmed case(s)
  • AND
  • without traceable links to a confirmed case.

• Affected areas
  • Areas where community transmission is currently occurring. Areas not smaller than the third administrative geographical level shall be considered when declaring an affected area. Removal of an area from affected areas shall be done when the criteria for community transmission are no longer met. Third administrative level is counted from the country being the first administrative level.

Table 1: Reported cumulative number of confirmed cases and of in-country transmission of influenza A(H1N1)v as of 16 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

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

1. Austria ... - 7 - 1 - ...
2. Belgium ... - 19 - 4 - ...
3. Bulgaria ... - 2 - ... - ...
4. Cyprus ... - 1 - ... - ...
5. Czech Republic ... - 4 - ... - ...
6. Denmark 1 - 13 - 5 - ...
7. Estonia ... - 4 - 2 - ...
8. Finland ... - 4 - ... - ...
9. France 28 - 106 - 19 - ...
10. Germany 23 - 195 - 107 - ...
11. Greece ... - 19 - ... - ...
12. Hungary ... - 4 - 1 - ...
13. Iceland ... - 4 - 1 - ...
14. Ireland ... - 12 - 1 - ...
15. Italy ... - 67 - 4 - ...
16. Luxembourg ... - 2 - ... - ...
17. Netherlands ... - 61 - 19 - ...
18. Norway ... - 13 - 1 - ...
19. Poland ... - 7 - 1 - ...
20. Portugal ... - 3 - ... - ...
21. Romania ... - 16 - 6 - ...
22. Slovakia ... - 3 - 1 - ...
23. Spain ... - 488 - 127 - ...
24. Sweden 4 - 37 - 12 - ...
25. Switzerland ... - 22 - ... - ...
26. United Kingdom 141 - 1461 - 380 - 1

• Total 197 - 2574 - 692 - 1

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.
• (*) Deaths are included in the cumulative number of confirmed cases

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 16 June 2009, 17:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Russian Federation ... - 3 - ...
2. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Bahrain ... - 8 - ...
2. Egypt 3 - 23 - ...
3. Israel 14 - 131 - ...
4. Kuwait ... - 18 - ...
5. Lebanon 1 - 10 - ...
6. Morocco ... - 2 - ...
7. Occupied Palestinian Territory ... - 2 - ...
8. Saudi Arabia 3 - 11 - ...
9. Turkey ... - 10 - ...
10. United Arab Emirates ... - 1 - ...

• NORTH AMERICA

1. Canada 534 - 4049 - 7
2. Mexico ... - 6403 - 108
3. **USA ... - 17855 - 45

• CENTRAL AMERICA AND CARIBBEAN

1. Bahamas ... - 2 - ...
2. Barbados ... - 3 - ...
3. Bermuda ... - 2 - ...
4. Cayman Islands ... - 2 - ...
5. Costa Rica 31 - 149 - 1
6. Cuba ... - 7 - ...
7. Dominica ... - 1 - ...
8. Dominican Republic ... - 93 - 1
9. El Salvador 56 - 125 - ...
10. Guatemala 23 - 119 - 1
11. Honduras 11 - 100 - ...
12. Jamaica 1 - 12 - ...
13. ***Martinique ... - 1 - ...
14. Nicaragua 54 - 110 - ...
15. Panama 5 - 277 - ...
16. Trinidad-Tobago 1 - 5 - ...

• SOUTH AMERICA

1. Argentina 164 - 733 - 1
2. Bolivia 2 - 7 - ...
3. Brazil 5 - 74 - ...
4. ****Chile ... - 2335 - 2
5. Colombia 3 - 45 - 1
6. Ecuador 13 - 80 - ...
7. Paraguay ... - 25 - ...
8. Peru 19 - 113 - ...
9. Uruguay ... - 36 - ...
10. Venezuela ... - 37 - ...

• NORTH-EAST AND SOUTH ASIA

1. China 25 - 232 - ...
2. Hong Kong SAR 12 - 104 - ...
3. India 10 - 30 - ...
4. Japan 33 - 638 - ...
5. Korea (South) 6 - 65 - ...
6. Taiwan 2 - 51 - ...

• SOUTH-EAST ASIA

1. Malaysia ... - 7 - ...
2. Philippines 0 - 193 - ...
3. Singapore 7 - 47 - ...
4. Thailand 160 - 310 - ...
5. Vietnam 1 - 26 - ...

• AUSTRALIA AND PACIFIC

1. Australia 311 - 1853 - ...
2. ***French Polynesia ... - 1 - ...
3. New Zealand 23 - 109 - ...

• TOTAL 1533 - 36686 - 167

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. Cases reported from the US include confirmed cases from Puerto Rico.
• (***) The cases in Martinique and French Polynesia were reported by France
• (****) 1,700 of the cases reported by Chile correspond to cumulative reports from private health sector

(...)

-
-----

 

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 17 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 17 June 2009, 17:00 hours CEST

[Original Full Document: LINK. EDITED.]


Main developments in past 24 hours

• 167 new cases were reported in EU and EFTA countries;
• 2,159 new cases were reported from non-EU and EFTA countries;
• The total number of deaths worldwide increased from 168 (16 June 17:00) to 176
• 3 countries in the Mediterranean and Middle Eastern region reported first cases (Jordan, Qatar and Yemen)

This report is based on official information provided by the national public health websites, or through other official communication channels. An update on the number of confirmed cases as of 17 June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases did not change, with 26 of 31 EU and EFTA countries reporting confirmed cases.

In the past 24 hours, 167 cases were confirmed in 11 EU and EFTA countries, the UK reporting 121 cases (Table 1). The cumulative number of cases in the EU and EFTA countries is now 2,741.

Outside of the EU and EFTA countries, a total of 38,845 cases, including 176 deaths, have been reported, representing an increase of 2,159 cases and 8 deaths (five in Mexico, three in Argentina) over the previous situation report dated 16 June 2009 (Table 2).

The largest number of new cases was reported from Chile with 880 newly reported cases representing an increase of 38% compared to yesterday?s figures.


2nd edition of ECDC Guide to public health measures to reduce the impact of influenza pandemics in Europe

The 2nd edition of ?ECDC Guide to public health measures to reduce the impact of influenza pandemics in Europe ? The ECDC Menu? has been posted on the ECDC website as of today. http://www.ecdc.europa.eu/en/files/...c_Health_Measures_for_Influenza_Pandemics.pdf

The revised document presents possible measures as well as public health and scientific information on their likely effectiveness, costs (direct and indirect), acceptability, public expectations and other more practical considerations. It aims at providing scientific advice to European Member States and EU institutions for their decisions on which measures to apply.


Table 1: Reported cumulative number of confirmed cases and of in-country transmission of influenza A(H1N1)v as of 17 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

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

1. Austria ... - 7 - 1 - ...
2. Belgium ... - 19 - 4 - ...
3. Bulgaria ... - 2 - ... - ...
4. Cyprus ... - 1 - ... - ...
5. Czech Republic 1 - 5 - ... - ...
6. Denmark 2 - 15 - 5 - ...
7. Estonia 1 - 5 - 2 - ...
8. Finland 8 - 12 - ... - ...
9. France 14 - 120 - 19 - ...
10. Germany 8 - 203 - 107 - ...
11. Greece ... - 19 - ... - ...
12. Hungary 3 - 7 - 1 - ...
13. Iceland ... - 4 - 1 - ...
14. Ireland ... - 12 - 1 - ...
15. Italy 5 - 72 - 4 - ...
16. Luxembourg ... - 2 - ... - ...
17. Netherlands ... - 61 - 19 - ...
18. Norway ... - 13 - 1 - ...
19. Poland ... - 7 - 1 - ...
20. Portugal 2 - 5 - ... - ...
21. Romania ... - 16 - 6 - ...
22. Slovakia ... - 3 - 1 - ...
23. Spain ... - 488 - 127 - ...
24. Sweden 2 - 39 - 12 - ...
25. Switzerland ... - 22 - ... - ...
26. Kingdom 121 - 1582 - 380 - 1

• Total 167 - 2741 - 692 - 1

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.
• (*) Deaths are included in the cumulative number of confirmed cases

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 17 June 2009, 17:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Russian Federation ... - 3 - ...
2. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Bahrain 5 - 13 - ...
2. Egypt 3 - 26 - ...
3. Israel 21 - 152 - ...
4. Jordan 2 - 2
5. Kuwait ... - 18 - ...
6. Lebanon 1 - 11 - ...
7. Morocco 1 - 3 - ...
8. Occupied Palestinian Territory ... - 2 - ...
9. Qatar 3 - 3
10. Saudi Arabia 3 - 14 - ...
11. Turkey ... - 10 - ...
12. United Arab Emirates ... - 1 - ...
13. Yemen 1 - 1

• NORTH AMERICA

1. Canada ... - 4049 - 7
2. Mexico 680 - 7083 - 113
3. **USA ... - 17855 - 45

• CENTRAL AMERICA AND CARIBBEAN

1. Bahamas ... - 2 - ...
2. Barbados ... - 3 - ...
3. Bermuda ... - 2 - ...
4. Cayman Islands ... - 2 - ...
5. Costa Rica ... - 149 - 1
6. Cuba ... - 7 - ...
7. Dominica ... - 1 - ...
8. Dominican Republic ... - 93 - 1
9. El Salvador ... - 125 - ...
10. Guatemala 9 - 128 - 1
11. Honduras ... - 100 - ...
12. Jamaica ... - 12 - ...
13. ***Martinique ... - 1 - ...
14. Nicaragua 8 - 118 - ...
15. Panama ... - 277 - ...
16. Trinidad-Tobago ... - 5 - ...

• SOUTH AMERICA

1. Argentina 138 - 871 - 4
2. Bolivia ... - 7 - ...
3. Brazil 5 - 79 - ...
4. ****Chile 880 - 3215 - 2
5. Colombia 5 - 50 - 1
6. Ecuador 6 - 86 - ...
7. Paraguay ... - 25 - ...
8. Peru 23 - 136 - ...
9. Uruguay ... - 36 - ...
10. Venezuela 8 - 45 - ...

• NORTH-EAST AND SOUTH ASIA

1. China 20 - 252 - ...
2. Hong Kong SAR 14 - 118 - ...
3. India ... - 30 - ...
4. Japan 27 - 665 - ...
5. Korea (South) ... - 65 - ...
6. Taiwan 4 - 55 - ...

• SOUTH-EAST ASIA

1. Malaysia 11 - 18 - ...
2. Philippines 54 - 247 - ...
3. Singapore 2 - 49 - ...
4. Thailand 95 - 405 - ...
5. Vietnam ... - 26 - ...

• AUSTRALIA AND PACIFIC

1. Australia 112 - 1965 - ...
2. ***French Polynesia ... - 1 - ...
3. New Zealand 18 - 127 - ...

• TOTAL 2159 - 38845 - 175

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. Cases reported from the US include confirmed cases from Puerto Rico.
• (***) The cases in Martinique and French Polynesia were reported by France
• (****) 1700 of the cases reported by Chile correspond to cumulative reports from private health sector

(...)

-
-----

 

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 18 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 18 June 2009, 17:00 hours CEST

[Original Full Document: LINK. EDITED.]


Main developments in past 24 hours

• 260 new cases were reported in EU and EFTA countries;
• 391 new cases were reported from non-EU and EFTA countries;
• The USA decreased death from 45 to 44 totalling 175 worldwide;
• South Africa reports the first case in Africa;
• Cruise ship quarantined off the coast of Venezuela (media).

This report is based on official information provided by the national public health websites, or through other official communication channels. An update on the number of confirmed cases as of 18 June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases did not change, with 26 of 31 EU and EFTA countries reporting confirmed cases.

In the past 24 hours, 260 cases were confirmed in 12 EU and EFTA countries, the UK reporting 170 new cases (Table 1). The cumulative number of cases in the EU and EFTA countries is now 3,000

Outside of the EU and EFTA countries, a total of 39,224 cases, including 174 deaths, have been reported, representing an increase of 391 cases (Table 2).

South Africa reports the first officially confirmed case in Sub-Saharan Africa with a travel history to North America. According to the media, it is a 12-year-old child, who arrived in South Africa from the United States on Sunday. The child presented flu-like symptoms and was admitted to a private hospital.


Other news

Outbreak of A(H1N1)v on a cruise ship in the Caribbean

Media report that a cruise ship with more than 1,200 passengers on board has been quarantined off the Venezuelan island of Margarita following an outbreak of A(H1N1)v on board. The passengers and crew were stopped from disembarking at previous stops in Barbados and Grenada as well after three crew members were confirmed with A(H1N1)v.

According to information received from SHIPSAN, this is the 5th cluster on a cruise ship since the beginning of the pandemic, the first one being reported on may 25.

Public health measures taken to an incident of pandemic influenza on board a ship on international voyage are regulated by the International Health Regulations 2005. A competent authority of a country can refuse departure or entry of a ship according to the national legislation or according to IHR 2005.

The SHIPSAN TRAINET partnership has guidelines to prevent the spread of influenza infections on board cruise ships and ferries. This can be found at http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19219)


Media reports on mutant strain of A(H1N1)v from Brazil

According to media reports, Brazilian scientists have reported to have identified a new mutant strain of A(H1N1)v. However, this has not been confirmed by WHO and GISN, and was rejected by US CDC.


A(H5N1) and A( H1N1)v in Vietnam and Egypt

Both Egypt and Vietnam are countries where A(H5N1) is endemic in poultry, and human cases occur (Egypt 78, Vietnam 111 to date). Both countries are also affected by A(H1N1)v, and have had human cases of A(H5N1) since the beginning of the pandemic.

The first case of A(H1N1)v in Egypt was reported on June 3 while the most recent case of A(H5N1) in Egypt was reported on June 2. In Vietnam, the most recent case of A(H5N1) was reported May 6, and the fist case of A(H1N1)v on June 2.


Cumulative rates of A(H1N1)v

Figure 4 shows the cumulative rates of A(H1N1)v infection in EU and EFTA countries. The source of the denominator population is form the World Bank. A classification of countries by quartile has been applied to depict the distribution of rates. Countries with the highest rates are northern American countries, Chile and Argentina, Australia, New Zealand, United Kingdom, and Iceland. Even though Iceland has only reported 4 cases, one of which in-country acquired, it appears among the countries with highest rates because of a small population. The presentation of cumulative rates does not represent the level of in country transmission, as confirmed cases include both imported and in-country acquired cases.


Safety of neuraminidase inhibitors during pregnancy

Pregnancy was considered as a serious risk during the three previous influenza pandemics. Very limited data from the current A(H1N1)v epidemic suggest a similar risk. A recent review of the literature published in a Canadian Scientific Journal shows the safety and the absence of teratogenic effect of neuraminidase inhibitors in pregnant women. This study confirms the right decision by the FDA of emergency approval for the use of neuraminidase inhibitors. http://www.cmaj.ca/cgi/rapidpdf/cmaj.090866


Table 1: Reported cumulative number of confirmed cases and of in-country transmission of influenza A(H1N1)v as of 18 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

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

1. Austria 1 - 8 - ...
2. Belgium ... - 19 - ...
3. Bulgaria ... - 2 - ...
4. Cyprus ... - 1 - ...
5. Czech Republic ... - 5 - ...
6. Denmark 6 - 21 - ...
7. Estonia** 1 - 5 - ...
8. Finland 1 - 13 - ...
9. France ... - 120 - ...
10. Germany 26 - 229 - ...
11. Greece 11 - 30 - ...
12. Hungary ... - 7 - ...
13. Iceland ... - 4 - ...
14. Ireland ... - 12 - ...
15. Italy 8 - 80 - ...
16. Luxembourg ... - 2 - ...
17. Netherlands 26 - 87 - ...
18. Norway 4 - 17 - ...
19. Poland ... - 7 - ...
20. Portugal ... - 5 - ...
21. Romania 2 - 18 - ...
22. Slovakia ... - 3 - ...
23. Spain ... - 488 - ...
24. Sweden 4 - 43 - ...
25. Switzerland ... - 22 - ...
26. United Kingdom 170 - 1752 - 1

• Total 260 - 3000 - 1

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) One case was erroneously reported fro Estonia yesterday. Therefore, Estonia has reported only 5 confirmed cases to date, including the new one reported today.

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 17 June 2009, 18:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Russian Federation ... - 3 - ...
2. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Bahrain ... - 13 - ...
2. Egypt 3 - 29 - ...
3. Israel ... - 152 - ...
4. Jordan ... - 2
5. Kuwait ... - 18 - ...
6. Lebanon 1 - 12 - ...
7. Morocco 3 - 6 -...
8. Occupied Palestinian Territory 3 - 5 - ...
9. Qatar ... - 3
10. Saudi Arabia 8 - 22 - ...
11. Turkey 6 - 16 - ...
12. United Arab Emirates 1 - 2 - ...
13. Yemen 3 - 4

• AFRICA

1. South Africa 1 - 1 - ...

• NORTH AMERICA

1. Canada ... - 4049 - 7
2. Mexico ... - 7083 - 113
3. **USA ... - 17855 - 44

• CENTRAL AMERICA AND CARIBBEAN

1. Bahamas ... - 2 - ...
2. Barbados 1 - 4 - ...
3. Bermuda ... - 2 - ...
4. Cayman Islands ... - 2 - ...
5. Costa Rica ... - 149 - 1
6. Cuba 7 - 14 - ...
7. Dominica ... - 1 - ...
8. Dominican Republic ... - 93 - 1
9. El Salvador ... - 125 - ...
10. Guatemala ... - 128 - 1
11. Honduras ... - 100 - ...
12. Jamaica 2 - 14 - ...
13. ***Martinique ... - 1 - ...
14. Nicaragua 8 - 118 - ...
15. Panama ... - 277 - ...
16. Trinidad-Tobago 2 - 7 - ...

• SOUTH AMERICA

1. Argentina 47 - 914 - 4
2. Bolivia 4 - 11 - ...
3. Brazil 17 - 96 - ...
4. ****Chile ... - 3215 - 2
5. Colombia 3 - 53 - 1
6. Ecuador ... - 86 - ...
7. Paraguay 2 - 27 - ...
8. Peru 5 - 141 - ...
9. Uruguay ... - 36 - ...
10. Venezuela 7 - 52 - ...

• NORTH-EAST AND SOUTH ASIA

1. China 12 - 264 - ...
2. Hong Kong SAR 53 - 171 - ...
3. India ... - 30 - ...
4. Japan 1 - 666 - ...
5. Korea (South) 8 - 73 - ...
6. Taiwan 3 - 58 - ...

• SOUTH-EAST ASIA

1. Malaysia ... - 18 - ...
2. Philippines ... - 247 - ...
3. Singapore ... - 49 - ...
4. Thailand ... - 405 - ...
5. Vietnam ... - 26 - ...

• AUSTRALIA AND PACIFIC

1. Australia 153 - 2118 - ...
2. ***French Polynesia ... - 1 - ...
3. New Zealand 26 - 153 - ...
4. Samoa 1 - 1 - ...

• TOTAL 391 - 39224 - 174

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. Cases reported from the US include confirmed cases from Puerto Rico.
• (***) The cases in Martinique and French Polynesia were reported by France
• (****) 1700 of the cases reported by Chile correspond to cumulative reports from private health sector

(...)

-
------

 

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 19 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 19 June 2009, 17:00 hours CEST

[Original Full Document: LINK. EDITED.]


Main developments in past 24 hours

• 348 new cases were reported in EU and EFTA countries;
• 2033 new cases were reported from non-EU and EFTA countries;
• 7 new countries and oversees territories reported cases for the first time: Laos Peoples Democratic Republic, Papua New Guinea, Suriname, British Virgin Islands, Macao, Netherlands Antilles and Saint Martin;
• 3 of the cases reported in the Netherlands Antilles detected in a cruise ship (PAHO)
• Australia and New Zealand developed a new response phase to manage the outbreak, reflecting the increased spread of the virus

This report is based on official information provided by the national public health websites, or through other official communication channels. An update on the number of confirmed cases as of 19 June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases did not change, with 26 of 31 EU and EFTA countries reporting confirmed cases.

In the past 24 hours, 348 cases were confirmed in 12 EU and EFTA countries, the UK main reporting country with 232 new cases (Table 1). The cumulative number of cases in the EU and EFTA countries is now 3348.

Outside of the EU and EFTA countries, a total of 41257, including 180 deaths, have been reported, representing an increase of 2033 (Table 2).

Suriname reported 11 cases through IRH for the first time. The Ministry of Health of Suriname confirmed an outbreak of 11 cases with onset on 5 June. Cases have recovered since than. Symptoms were relatively mild.

Other countries and territories reporting cases in the past 24h includes Laos Peoples Democratic Republic (1), Papua New Guinea (1), Suriname (11), British Virgin Islands (1), Netherlands Antilles (4) and Saint Martin (1).


Other news

Media reports on mutant strain of A(H1N1)v from Brazil

Media report of a new form of the Pandemic Strain in Brazil refuted by CDC spokesman.

Earlier this week there were media reports of a laboratory in Brazil stating that they had identified a strain of A(H1N1)v that differed significantly from the main strain. Based on sequencing data the its is reported that CDC did not consider that this differed significantly ( http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/jun1709flustrain.html)

ECDC Comment:
The virus should now be shared with a WHO Collaborating Centre but this initial information is reassuring

There are variants influenza virus variants detected at regular intervals and they go through a procedure of assessment by WHO?s Global Influenza Surveillance Network to determine if they are of significance or not though the process of sequencing and virus sharing.

See for http://ecdc.europa.eu/en/Health_Topics/influenza/Global_Influenza_Surveillance.aspx

Many viruses are assessed but few are of public health concern. News of them are given through WHO in Geneva. What has happened here is that a laboratory has by-passed that process by going public with a virus of high media impact at present. Fortunately the main WHO Collaborating Centre in the United States at the Centers for Disease Control and Prevention has quickly fast tracked a statement and explained that this is not a worrying variant.

However of course the possibility of the emergence of variants of A(H1N1)v is a real risk (See ECDC?s risk Assessment http://www.ecdc.europa.eu/en/Health_topics/Novel_influenza_virus/2009_Outbreak/Risk_assessment.aspx).

Though equally there also needs to be surveillance for new variants of the seasonal viruses: normal A(H1N1) and A(H3N2) and the B viruses.


A(H5N1) and A( H1N1)v in Vietnam and Egypt

Both Egypt and Vietnam are countries where A(H5N1) is endemic in poultry, and human cases occur (Egypt 78, Vietnam 111 to date). Both countries are also affected by A(H1N1)v, and have had human cases of A(H5N1) since the beginning of the pandemic.

The first case of A(H1N1)v in Egypt was reported on June 3 while the most recent case of A(H5N1) in Egypt was reported on June 2. In Vietnam, the most recent case of A(H5N1) was reported May 6, and the fist case of A(H1N1)v on June 2.


Cumulative rates of A(H1N1)v

Figure 2 shows the cumulative rates of A(H1N1)v infection in EU and EFTA countries dated 18 June 2009. The source of the denominator population is form the World Bank. A classification of countries by quartile has been applied to depict the distribution of rates. Countries with the highest rates are northern American countries, Chile and Argentina, Australia, New Zealand, United Kingdom, and Iceland. Even though Iceland has only reported 4 cases, one of which in-country acquired, it appears among the countries with highest rates because of a small population. The presentation of cumulative rates does not represent the level of in country transmission, as confirmed cases include both imported and in-country acquired cases.


Safety of neuraminidase inhibitors during pregnancy

Pregnancy was considered as a serious risk during the three previous influenza pandemics. Very limited data from the current A(H1N1)v epidemic suggest a similar risk. A recent review of the literature published in a Canadian Scientific Journal shows the safety and the absence of teratogenic effect of neuraminidase inhibitors in pregnant women.

This study confirms the right decision by the FDA of emergency approval for the use of neuraminidase inhibitors. http://www.cmaj.ca/cgi/rapidpdf/cmaj.090866


New Pandemic Response Phase implemented in Australia and New Zealand

A new pandemic phase has been implemented in Australia and New Zealand to guide the management of the ongoing response to the disease. The shift in phase reflects the increased spread of the virus, rather than a change in the severity of the illness, recognising that is not as severe as originally envisaged.

More information available at :

• http://www.healthemergency.gov.au/i....nsf/Content/health-swine_influenza-index.htm
• http://www.moh.govt.nz/moh.nsf/indexmh/influenza-a-h1n1-update-eighty-190609
• http://www.moh.govt.nz/moh.nsf/indexmh/influenza-a-h1n1-update-seventynine-180609

ECDC refreshes its downloadable Slide Set

ECDC has refreshed and made more contemporary its downloadable slide set. This replaces the old slide set and is available at http://www.ecdc.europa.eu/en/Health_topics/novel_influenza_virus/2009_Outbreak/


Table 1: Reported cumulative number of confirmed cases and of in-country transmission of influenza A(H1N1)v as of 19 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

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

1. Austria 1 - 9 - ...
2. Belgium ... - 19 - ...
3. Bulgaria ... - 2 - ...
4. Cyprus ... - 1 - ...
5. Czech Republic 1 - 6 - ...
6. Denmark 7 - 28 - ...
7. Estonia ... - 5 - ...
8. Finland ... - 13 - ...
9. France 27 - 147 - ...
10. Germany 27 - 256 - ...
11. Greece 1 - 31 - ...
12. Hungary ... - 7 - ...
13. Iceland ... - 4 - ...
14. Ireland 6 - 18 - ...
15. Italy ... - 80 - ...
16. Luxembourg ... - 2 - ...
17. Netherlands 4 - 91 - ...
18. Norway 3 - 20 - ...
19. Poland ... - 7 - ...
20. Portugal ... - 5 - ...
21. Romania ... - 18 - ...
22. Slovakia ... - 3 - ...
23. Spain 34 - 522 - ...
24. Sweden 5 - 48 - ...
25. Switzerland ... - 22 - ...
26. United Kingdom 232 - 1984 - 1

• Total 348 - 3348 - 1

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.
• (*) Deaths are included in the cumulative number of confirmed cases

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 19 June 2009, 18:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Russian Federation ... - 3 - ...
2. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Bahrain ... - 13 - ...
2. Egypt 1 - 30 - ...
3. Israel ... - 152 - ...
4. Jordan ... - 2
5. Kuwait ... - 18 - ...
6. Lebanon ... - 12 - ...
7. Morocco ... - 6 - ...
8. Occupied Palestinian Territory ... - 5 - ...
9. Qatar ... - 3
10. Saudi Arabia ... - 22 - ...
11. Turkey ... - 16 - ...
12. United Arab Emirates ... - 2 - ...
13. Yemen ... - 4

• AFRICA

1. South Africa ... - 1 - ...

• NORTH AMERICA

1. Canada 856 - 4905 - 12
2. Mexico 541 - 7624 - 113
3. **USA ... - 17855 - 44

• CENTRAL AMERICA AND CARIBBEAN

1. Bahamas ... - 2 - ...
2. Barbados ... - 4 - ...
3. Bermuda ... - 2 - ...
4. British Virgin Islands 1 - 1 - ...
5. Cayman Islands 2 - 4 - ...
6. Costa Rica ... - 149 - 1
7. Cuba 1 - 15 - ...
8. Dominica ... - 1 - ...
9. Dominican Republic ... - 93 - 1
10. El Salvador ... - 125 - ...
11. Guatemala 80 - 208 - 1
12. Honduras 8 - 108 - ...
13. Jamaica ... - 14 - ...
14. ***Martinique ... - 1 - ...
15. *****Netherlands Antilles 4 - 4 - ...
16. Nicaragua 26 - 144 - ...
17. Panama ... - 277 - ...
18. Saint-Martin 1 - 1 - ...
19. Suriname 11 - 11 - ...
20. Trinidad-Tobago 11 - 18 - ...

• SOUTH AMERICA

1. Argentina 32 - 946 - 5
2. Bolivia ... - 11 - ...
3. Brazil ... - 96 - ...
4. ****Chile ... - 3215 - 2
5. Colombia ... - 53 - 1
6. Ecuador ... - 86 - ...
7. Paraguay ... - 27 - ...
8. Peru ... - 141 - ...
9. Uruguay ... - 36 - ...
10. Venezuela 8 - 60 - ...

• NORTH-EAST AND SOUTH ASIA

1. China 38 - 302 - ...
2. Hong Kong SAR 50 - 221 - ...
3. India ... - 30 - ...
4. Japan 74 - 740 - ...
5. Korea (South) 11 - 84 - ...
6. Macao 1 - 1 - ...
7. Taiwan ... - 58 - ...

• SOUTH-EAST ASIA

1. Laos PDR 1 - 1 - ...
2. Malaysia 5 - 23 - ...
3. Philippines 97 - 344 - ...
4. Singapore 28 - 77 - ...
5. Thailand ... - 405 - ...
6. Vietnam ... - 26 - ...

• AUSTRALIA AND PACIFIC

1. Australia 81 - 2199 - ...
2. ***French Polynesia ... - 1 - ...
3. New Zealand 63 - 216 - ...
4. Papua New Guinea 1 - 1 - ...
5. Samoa ... - 1 - ...

• TOTAL 2033 - 41257 - 180

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. Cases reported from the US include confirmed cases from Puerto Rico.
• (***) The cases in Martinique and French Polynesia were reported by France
• (****) 1700 of the cases reported by Chile correspond to cumulative reports from private health sector
• (*****) 3 cases have been reported in a cruise ship.

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

 

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 20 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 20 June 2009, 17:00 hours CEST

[Original Full Document: LINK. EDITED.]


Main developments in past 24 hours

• 303 new cases were reported in EU and EFTA countries;
• 6012 new cases were reported from non-EU and EFTA countries;
• 3 new countries reported cases for the first time: Slovenia, Oman and Sri Lanka
• Australia reported the first fatal case in the country
• The total of fatal cases worldwide reaches now 228 (47 new fatal cases since last report)
• Erratum: on 19 June 2009, Denmark reported a total of 22 cases (not 28 as reported in yesterday's Situation Report)
• Report of DG SANCO Meeting on the animal human interface and reaffirming that new virus cannot be acquired from food
• Media reports on mutant strain of A(H1N1)v from Brazil ? refuted by US CDC

This report is based on official information provided by the national public health websites, or through other official communication channels. An update on the number of confirmed cases as of 20June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases is now 27 out of 31. Slovenia reported the first case in the country.

In the past 24 hours, 43 cases were confirmed in 12 EU and EFTA countries, with Germany as main reporting country with 18 new cases (Table 1). The cumulative number of cases in the EU and EFTA countries is now 3385.

Outside of the EU and EFTA countries, a total of 47269 cases, including 227 deaths, have been reported, representing an increase of 6012 from yesterday (Table 2).

This large increase in the past 24 hours mainly results from Chile reporting 1100 new cases (previous update was 17 June) and USA reporting 3594 new cases (previous update was last week).

The USA cases include 43 new fatal cases.

Slovenia, Oman and Sri Lanka reported new cases for the first time.

Australia reported the first fatal case in the country, in a 26 years old man who had pre-existing health conditions.


Other news

DG SANCO meeting on the animal and human interface for A(H1N1)v

The Directorate of DG SANCO that deals with animal health (SANCO D), recently organised a meeting with scientists, risk assessors and risk managers on the influenza A(H1N1)v about the animal - human interface. This was organised with input from ECDC and the European Food Safety Authority. (see link: http://www.efsa.europa.eu/EFSA/efsa_locale-1178620753812_home.htm).

Scientists from the public health, animal health and food safety field from the EU, USA, Canada and Russia attended the meeting, which was focused on the potential risks posed by the A(H1N1)v virus at the interface between humans and animals, whether humans could infect animals and if these could infect humans.

Reports of the Commission meeting can be found at the following three links Background document, Agenda and presentations and Conclusions of the meeting

The main conclusion of the meeting is the reaffirmation that there is no risk of humans acquiring influenza A(H1N1)v from food.

This scientific view has already been put forward by the INFOSAN network (WHO) and the Food and Agriculture Organization and the World Organization for Animal Health (OIE).
See link: http://www.who.int/mediacentre/news/statements/2009/h1n1_20090430/en/index.html.


Media reports on mutant strain of A(H1N1)v from Brazil ? refuted by CDC

Media report of a new form of the Pandemic Strain in Brazil refuted by CDC spokesman.

Earlier this week there were media reports of a laboratory in Brazil stating that they had identified a strain of A(H1N1)v that differed significantly from the main strain.

Based on sequencing data, CDC did not consider that this differed significantly (http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/jun1709flustrain.html)

ECDC Comment:
The virus should now be shared with a WHO Collaborating Centre but this initial information is reassuring. There are variants of influenza virus variants detected at regular intervals and they go through a procedure of assessment by WHO?s Global Influenza Surveillance Network to determine if they are of significance or not through the process of sequencing and virus sharing. See for http://ecdc.europa.eu/en/Health_Topics/influenza/Global_Influenza_Surveillance.aspx

Many viruses are assessed but few are of public health concern. News of them are given through WHO in Geneva. A laboratory went public with the information about a virus of high media impact at present. The WHO Collaborating Centre in the United States at the Centers for Disease Control and Prevention explained that this is not a worrying variant. However the possibility of the emergence of variants of A(H1N1)v is a real risk. Though equally there is also the need to keep such surveillance for new variants of the seasonal viruses: normal A(H1N1) and A(H3N2) and the B viruses.

(See ECDC?s Risk Assessment at http://www.ecdc.europa.eu/en/Health_topics/Novel_influenza_virus/2009_Outbreak/Risk_assessment.aspx


A(H5N1) and A( H1N1)v in Vietnam and Egypt

Both Egypt and Vietnam are countries where A(H5N1) is endemic in poultry, and human cases occur (Egypt 78, Vietnam 111 to date). Both countries are also affected by A(H1N1)v, and have had human cases of A(H5N1) since the beginning of the pandemic. The first case of A(H1N1)v in Egypt was reported on June 3 while the most recent case of A(H5N1) in Egypt was reported on June 2. In Vietnam, the most recent case of A(H5N1) was reported May 6, and the fist case of A(H1N1)v on June 2.


Cumulative rates of A(H1N1)v

Figure 2 shows the cumulative rates of A(H1N1)v infection in EU and EFTA countries dated 20 June 2009. The source of the denominator population is form the World Bank. A classification of countries by quartile has been applied to depict the distribution of rates. Countries with the highest rates are northern American countries, Chile and Argentina, Australia, New Zealand, United Kingdom, and Iceland. Even though Iceland has only reported 4 cases, one of which in-country acquired, it appears among the countries with highest rates because of a small population. The presentation of cumulative rates does not represent the level of in country transmission, as confirmed cases include both imported and in-country acquired cases.


Safety of neuraminidase inhibitors during pregnancy

Pregnancy was considered as a serious risk during the three previous influenza pandemics. Very limited data from the current A(H1N1)v epidemic suggest a similar risk. A recent review of the literature published in a Canadian Scientific Journal shows the safety and the absence of teratogenic effect of neuraminidase inhibitors in pregnant women.

This study confirms the right decision by the FDA of emergency approval for the use of neuraminidase inhibitors: http://www.cmaj.ca/cgi/rapidpdf/cmaj.090866


New Pandemic Response Phase implemented in Australia and New Zealand

A new pandemic phase has been implemented in Australia and New Zealand to guide the management of the ongoing response to the disease. The shift in phase reflects the increased spread of the virus, rather than a change in the severity of the illness, recognising that is not as severe as originally envisaged.

More information available at:

• http://www.healthemergency.gov.au/i....nsf/Content/health-swine_influenza-index.htm
• http://www.moh.govt.nz/moh.nsf/indexmh/influenza-a-h1n1-update-eighty-190609
• http://www.moh.govt.nz/moh.nsf/indexmh/influenza-a-h1n1-update-seventynine-180609

ECDC refreshes its downloadable Slide Set

ECDC has refreshed and made more contemporary its downloadable slide set. This replaces the old slide set and is available at http://www.ecdc.europa.eu/en/Health_topics/novel_influenza_virus/2009_Outbreak/


Table 1: Reported cumulative number of confirmed cases and of in-country transmission of influenza A(H1N1)v as of 20 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

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

1. Austria ... - 9 - ...
2. Belgium 6 - 25 - ...
3. Bulgaria ... - 2 - ...
4. Cyprus 1 - 2 - ...
5. Czech Republic 1 - 7 - ...
6. **Denmark 1 - 23 - ...
7. Estonia ... - 5 - ...
8. Finland ... - 13 - ...
9. France ... - 147 - ...
10. Germany 18 - 274 - ...
11. Greece ... - 31 - ...
12. Hungary ... - 7 - ...
13. Iceland ... - 4 - ...
14. Ireland ... - 18 - ...
15. Italy 8 - 88 - ...
16. Luxembourg ... - 2 - ...
17. Netherlands ... - 91 - ...
18. Norway ... - 20 - ...
19. Poland ... - 7 - ...
20. Portugal 1 - 6 - ...
21. Romania ... - 18 - ...
22. Slovakia ... - 3 - ...
23. Slovenia 1 - 1 - ...
24. Spain ... - 522 - ...
25. Sweden 1 - 49 - ...
26. Switzerland 5 - 27 - ...
27. United Kingdom 260 - 2244 - 1

• Total 303 - 3645 - 1

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) On 19 June the total number of cases was incorrectly reported for Denmark, due to a misinterpretation of the input in EWRS. The new cases reported were in fact individual detailed reporting of cases number 16- 21. The correct data for 19 June should be 22 in total (including one new case).

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 20 June 2009, 18:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Russian Federation ... - 3 - ...
2. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Bahrain ... - 13 - ...
2. Egypt ... - 30 - ...
3. Israel 67 - 219 - ...
4. Jordan ... - 2 - ...
5. Kuwait ... - 18 - ...
6. Lebanon ... - 12 - ...
7. Morocco 2 - 8 - ...
8. Occupied Palestinian Territory ... - 5 - ...
9. Oman 3 - 3 - ...
10. Qatar ... - 3 - ...
11. Saudi Arabia ... - 22 - ...
12. Turkey 4 - 20 - ...
13. United Arab Emirates ... - 2 - ...
14. Yemen ... - 4 - ...

• AFRICA

1. South Africa ... - 1 - ...

• NORTH AMERICA

1. Canada 805 - 5710 - 13
2. Mexico ... - 7624 - 113
3. **USA 3594 - 21449 - 87

• CENTRAL AMERICA AND CARIBBEAN

1. Bahamas ... - 2 - ...
2. Barbados ... - 4 - ...
3. Bermuda ... - 2 - ...
4. British Virgin Islands ... - 1 - ...
5. Cayman Islands ... - 4 - ...
6. Costa Rica ... - 149 - 1
7. Cuba ... - 15 - ...
8. Dominica ... - 1 - ...
9. Dominican Republic ... - 93 - 1
10. El Salvador 35 - 160 - ...
11. Guatemala ... - 208 - 1
12. Honduras ... - 108 - ...
13. Jamaica ... - 14 - ...
14. ***Martinique ... - 1 - ...
15. ****Netherlands Antilles ... - 4 - ...
16. Nicaragua ... - 144 - ...
17. Panama ... - 277 - ...
18. Saint-Martin ... - 1 - ...
19. Suriname ... - 11 - ...
20. Trinidad-Tobago ... - 18 - ...

• SOUTH AMERICA

1. Argentina 64 - 1010 - 7
2. Bolivia ... - 11 - ...
3. Brazil 35 - 131 - ...
4. *****Chile 1100 - 4315 - 2
5. Colombia 11 - 64 - 1
6. Ecuador ... - 86 - ...
7. Paraguay ... - 27 - ...
8. Peru ... - 141 - ...
9. Uruguay ... - 36 - ...
10. Venezuela ... - 60 - ...

• NORTH-EAST AND SOUTH ASIA

1. China ... - 302 - ...
2. Hong Kong SAR ... - 221 - ...
3. India ... - 30 - ...
4. Japan ... - 740 - ...
5. Korea (South) ... - 84 - ...
6. Macao ... - 1 - ...
7. Sri Lanka 1 - 1 - ...
8. Taiwan ... - 58 - ...

• SOUTH-EAST ASIA

1. Laos PDR ... - 1 - ...
2. Malaysia ... - 23 - ...
3. Philippines ... - 344 - ...
4. Singapore ... - 77 - ...
5. Thailand 113 - 518 - ...
6. Vietnam 1 - 27 - ...

• AUSTRALIA AND PACIFIC

1. Australia 177 - 2376 - 1
2. ***French Polynesia ... - 1 - ...
3. New Zealand ... - 216 - ...
4. Papua New Guinea ... - 1 - ...
5. Samoa ... - 1 - ...

• TOTAL 6012 - 47269 - 227

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. Cases reported from the US include confirmed cases from Puerto Rico.
• (***) The cases in Martinique and French Polynesia were reported by France
• (****) Three of the cases are reported to occur in a cruise ship in Curacao.
• (*****) Chile has changed its reporting to only lab confirmed cases.

(...)

-
-----

 

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 21 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 21 June 2009, 17:00 hours CEST

[Original Full Document: LINK. EDITED.]


Main developments in past 24 hours

• 276 new cases were reported in EU and EFTA countries;
• 512 new cases were reported from non-EU and EFTA countries;
• Two new countries reported cases for the first time: Algeria and Ethiopia.
• The total of fatal cases worldwide is 229
• Developments concerning pandemic influenza in North America

This report is based on official information provided by the national public health websites, or through other official communication channels. An update on the number of confirmed cases as of 21June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases remains 27 out of 31.

In the past 24 hours, 276 cases were confirmed in 6 EU and EFTA countries, with UK as main reporting country with 262 new cases (Table 1). The cumulative number of cases in the EU and EFTA countries is now 3921.

Outside of the EU and EFTA countries, a total of 47781 cases , including 229 deaths, have been reported, representing an increase of 512 from yesterday (Table 2).

Algeria and Ethiopia were the two new countries to report cases for the first time. The Ministry of Health of Algeria confirmed one case in citizen arrival from USA via Frankfurt. The Ministry of Health of Ethiopia reported 2 confirmed cases in young students returning from USA. Although media has reported cases in not affected countries such as Brunei, Cote d?Ivoire and Fiji, no official report is yet available.


Other news

Developments concerning pandemic influenza in North America

Epidemiological Situation:
The epidemiological situation in North America (the United States and Canada) and the way these countries have been responding to it is important for Europe. As the epidemiological picture is similar to the settings in the European Union and EFTA countries, the response in North America provides at least a reference point for how European countries might themselves respond.

Currently the United State Centers for Disease Control and Prevention is making one data report per week on a Friday with the last being on June 19th. This includes the weekly output from the integrated set of mostly sentinel surveillance systems characterised as FluView which presented data on June 19th to the end of Week 23 (week ending June 13th). That showed an epidemiological situation in the United States that remained dynamic but highly heterogenous. There was continuing community transmission in a number of parts of the USA, notably in the North East of the country (New York and New England).

Seven out of the USA?s ten regions have at least one area reporting widespread transmission but at the same time other areas are experiencing little activity.

Laboratory sampling confirms that there are now few influenza viruses circulating apart from A(H1N1)v. The view of the CDC this week as expressed at the weekly teleconference on June 18th was that they expected circulation of the new virus to continue at some level thoughtout the summer before picking up again in the autumn.(1)

The teleconference also recorded that it is still the case that 70% of those needing hospital care because of their infection have a significant underlying condition.

Childrens? Summer Camps
One developing issue is concerns Children?s residential and day camps in the light of there being considerable transmission among children. CDC has rapidly produced detailed guidance on this.(2)

The policies for use of antivirals has been reviewed in both the USA and Canada since the emergence of A(H1N1)v. In view of the mild disease being experienced at present by most people infected with A(H1N1)v in both the United States and Canada the official recommendations are not to offer antivirals when people have simple uncomplicated infection with A(H1N1)v, or a seasonal influenza virus.

Important exceptions to this are if people are in a group where it is expected they are at higher risk of experiencing a severe disease. Because of the lack of certainty as to whether the infection is with seasonal flu or A(H1N1)v the risk groups are a combination of the those becoming recognised for A(H1N1)v as well as those already existing for seasonal influenza.

Antivirals are also recommended for anyone experiencing severe disease where influenza is suspected, even if they are more than 48 hours into the infection.

Post-exposure prophylaxis is only being recommended to be considered when a person in a higher risk group is thought to have been exposed, when health care workers and other ?first responders? have been exposed or where there are outbreaks involving closed institutions.

Pre-exposure prophylaxis is generally not being encouraged.

Neither the US nor the Canadian authorities are recommending the use of case-finding, contact tracing and antivirals for delaying or containing transmission. The approach is one of mitigation, essentially protecting those most at risk of severe disease and health care workers exposed through their work.

1. CDC Telebriefing on Investigation of Human Cases of Novel Influenza A (H1N1) June 18th 2009 http://www.cdc.gov/media/transcripts/2009/t090618.htm
2. CDC Interim CDC Guidance on Day and Residential Camps in Response to Human Infections with the Novel Influenza A (H1N1) Virus. (June 14th) http://www.cdc.gov/h1n1flu/camp.htm
3. CDC Interim Guidance on Antiviral Recommendations for Patients with Novel Influenza A (H1N1) Virus Infection and Their Close Contacts Dated May 6th (accessed June 20th) http://www.cdc.gov/h1n1flu/recommendations.htm
4. Public Health Agency of Canada Use of antivirals to treat H1N1 flu virus (Human Swine Flu) Dated May 1st accessed June 20th http://www.phac-aspc.gc.ca/alert-alerte/swine-porcine/antiviral-antiviraux05-01-eng.php

New Pandemic Response Phase implemented in Australia and New Zealand

A new pandemic phase has been implemented in Australia and New Zealand to guide the management of the ongoing response to the disease. Further explanations were given to the public and information posted on websites of the Ministry of Health of both countries. The Ministry of Health of Australia explained that the closures of schools will no longer be appropriate, giving emphasis on excluding students with respiratory illness from school.

More information available at:

• http://www.healthemergency.gov.au/i....nsf/Content/health-swine_influenza-index.htm
• http://www.moh.govt.nz/moh.nsf/indexmh/influenza-a-h1n1-care-manageit

Cumulative rates of A(H1N1)v

Figure 2 shows the cumulative rates of A(H1N1)v infection in EU and EFTA countries dated 21 June 2009. The source of the denominator population is form the World Bank. A classification of countries by quartile has been applied to depict the distribution of rates. Countries with the highest rates are northern American countries, Chile and Argentina, Australia, New Zealand, United Kingdom, and Iceland. Even though Iceland has only reported 4 cases, one of which in-country acquired, it appears among the countries with highest rates because of a small population. The presentation of cumulative rates does not represent the level of in country transmission, as confirmed cases include both imported and in-country acquired cases.


Table 1: Reported cumulative number of confirmed cases and of in-country transmission of influenza A(H1N1)v as of 21 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

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

1. Austria ... - 9 - ...
2. Belgium 3 - 28 - ...
3. Bulgaria ... - 2 - ...
4. Cyprus 2 - 4 - ...
5. Czech Republic ... - 7 - ...
6. Denmark 5 - 28 - ...
7. Estonia ... - 5 - ...
8. Finland ... - 13 - ...
9. France ... - 147 - ...
10. Germany 1 - 275 - ...
11. Greece ... - 31 - ...
12. Hungary ... - 7 - ...
13. Iceland ... - 4 - ...
14. Ireland ... - 18 - ...
15. Italy ... - 88 - ...
16. Luxembourg ... - 2 - ...
17. Netherlands ... - 91 - ...
18. Norway ... - 20 - ...
19. Poland 3 - 10 - ...
20. Portugal ... - 6 - ...
21. Romania ... - 18 - ...
22. Slovakia ... - 3 - ...
23. Slovenia ... - 1 - ...
24. Spain ... - 522 - ...
25. Sweden ... - 49 - ...
26. Switzerland ... - 27 - ...
27. United Kingdom 262 - 2506 - 1

• Total 276 - 3921 - 1

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.
• (*) Deaths are included in the cumulative number of confirmed cases

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 21 June 2009, 18:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Russian Federation ... - 3 - ...
2. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Algeria 1 - 1 - ...
2. Bahrain 2 - 15 - ...
3. Egypt 4 - 34 - ...
4. Israel ... - 219 - ...
5. Jordan 10 - 12 - ...
6. Kuwait ... - 18 - ...
7. Lebanon ... - 12 - ...
8. Morocco ... - 8 - ...
9. Occupied Palestinian Territory 3 - 8 - ...
10. Oman ... - 3 - ...
11. Qatar ... - 3 - ...
12. Saudi Arabia 12 - 34 - ...
13. Turkey ... - 20 - ...
14. United Arab Emirates ... - 2 - ...
15. Yemen ... - 4 - ...

• AFRICA

1. Ethiopia 2 - 2 - ...
2. South Africa ... - 1 - ...

• NORTH AMERICA

1. Canada ... - 5710 - 13
2. Mexico ... - 7624 - 113
3. **USA ... - 21449 - 87

• CENTRAL AMERICA AND CARIBBEAN

1. Bahamas ... - 2 - ...
2. Barbados ... - 4 - ...
3. Bermuda ... - 2 - ...
4. British Virgin Islands ... - 1 - ...
5. Cayman Islands ... - 4 - ...
6. Costa Rica ... - 149 - 1
7. Cuba ... - 15 - ...
8. Dominica ... - 1 - ...
9. Dominican Republic ... - 93 - 1
10. El Salvador ... - 160 - ...
11. Guatemala ... - 208 - 1
12. Honduras ... - 108 - ...
13. Jamaica 1 - 15 - ...
14. ***Martinique ... - 1 - ...
15. ****Netherlands Antilles ... - 4 - ...
16. Nicaragua ... - 144 - ...
17. Panama 53 - 330 - ...
18. Saint-Martin ... - 1 - ...
19. Suriname ... - 11 - ...
20. Trinidad-Tobago ... - 18 - ...

• SOUTH AMERICA

1. Argentina 70 - 1080 - 7
2. Bolivia 12 - 23 - ...
3. Brazil ... - 131 - ...
4. *****Chile ... - 4315 - 4
5. Colombia ... - 64 - 1
6. Ecuador 9 - 95 - ...
7. Paraguay 21 - 48 - ...
8. Peru ... - 141 - ...
9. Uruguay ... - 36 - ...
10. Venezuela 32 - 92 - ...

• NORTH-EAST AND SOUTH ASIA

1. China 54 - 356 - ...
2. Hong Kong SAR 99 - 320 - ...
3. India 20 - 50 - ...
4. Japan ... - 740 - ...
5. Korea (South) ... - 84 - ...
6. Macao 2 - 3 - ...
7. Sri Lanka ... - 1 - ...
8. Taiwan 3 - 61 - ...

• SOUTH-EAST ASIA

1. Laos PDR ... - 1 - ...
2. Malaysia ... - 23 - ...
3. Philippines ... - 344 - ...
4. Singapore ... - 77 - ...
5. Thailand ... - 518 - ...
6. Vietnam ... - 27 - ...

• AUSTRALIA AND PACIFIC

1. ******Australia 60 - 2436 - 1
2. ***French Polynesia ... - 1 - ...
3. New Zealand 42 - 258 - ...
4. Papua New Guinea ... - 1 - ...
5. Samoa ... - 1 - ...

• TOTAL 512 - 47781 - 229

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. Cases reported from the US include confirmed cases from Puerto Rico.
• (***) The cases in Martinique and French Polynesia were reported by France
• (****) Three of the cases are reported to occur in a cruise ship in Curacao.
• (*****) Chile reports 2 deaths among cases reported 20 June.
• (******) One Australian case reported from a cruise ship.

(...)

-
------

 

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 22 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 22 June 2009, 17:00 hours CEST

[Original Full Document: LINK. EDITED.]


Main developments in past 24 hours

• 326 new cases were reported in EU and EFTA countries;
• 929 new cases were reported from non-EU and EFTA countries;
• The total of fatal cases worldwide is 232;
• Two fatal cases have been reported by Colombia and Philippines since yesterday.

This report is based on official information provided by the national public health websites, or through other official communication channels. An update on the number of confirmed cases as of 22June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases remains 27 out of 31.

In the past 24 hours, 326 cases were confirmed in 11 EU and EFTA countries, with UK as main reporting country with 267 new cases (Table 1). The cumulative number of cases in the EU and EFTA countries is now 4 245.

Outside of the EU and EFTA countries, a total of 48 717 cases, including 231 deaths, have been reported, representing an increase of 929 from yesterday (Table 2).


Other news

Seasonal Influenza activity in Europe

The 2008-2009 influenza season is considered over in Europe by week 22/2009. The European Surveillance Influenza Scheme (EISS) continues collecting information on epidemiological and virological situation. The latest weekly report was published on 19 June for week 24/2009 and can be found in here.


Influenza A(H1N1)v European Case-based report

An updated report on individual cases reported by EU and EEA/EFTA countries is annexed to this report and available as a stand-alone document on the ECDC website by 23 June.


Table 1: Reported cumulative number of confirmed cases and of in-country transmission of influenza A(H1N1)v as of 22 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

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

1. Austria 1 - 10 - ...
2. Belgium 2 - 30 - ...
3. Bulgaria ... - 2 - ...
4. Cyprus 2 - 4 - ...
5. Czech Republic ... - 7 - ...
6. Denmark ... - 28 - ...
7. Estonia ... - 5 - ...
8. Finland ... - 13 - ...
9. France 3 - 150 - ...
10. Germany 3 - 278 - ...
11. Greece 20 - 51 - ...
12. Hungary ... - 7 - ...
13. Iceland ... - 4 - ...
14. Ireland 5 - 23 - ...
15. Italy ... - 88 - ...
16. Luxembourg ... - 2 - ...
17. Netherlands 14 - 105 - ...
18. Norway ... - 20 - ...
19. Poland 3 - 13 - ...
20. Portugal ... - 6 - ...
21. Romania ... - 18 - ...
22. Slovakia 1 - 4 - ...
23. Slovenia ... - 1 - ...
24. Spain ... - 522 - ...
25. Sweden 5 - 54 - ...
26. Switzerland ... - 27 - ...
27. United Kingdom 267 - 2773 - 1

• Total 326 - 4245 - 1

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.
• (*) Deaths are included in the cumulative number of confirmed cases

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 22 June 2009, 17:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Russian Federation ... - 3 - ...
2. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Algeria ... - 1 - ...
2. Bahrain ... - 15 - ...
3. Egypt ... - 34 - ...
4. Israel 50 - 269 - ...
5. Jordan ... - 12 - ...
6. Kuwait ... - 18 - ...
7. Lebanon ... - 12 - ...
8. Morocco ... - 8 - ...
9. Occupied Palestinian Territory ... - 8 - ...
10. Oman ... - 3 - ...
11. Qatar ... - 3 - ...
12. Saudi Arabia ... - 34 - ...
13. Turkey ... - 20 - ...
14. United Arab Emirates ... - 2 - ...
15. Yemen ... - 4 - ...

• AFRICA

1. Ethiopia ... - 2 - ...
2. South Africa ... - 1 - ...

• NORTH AMERICA

1. Canada ... - 5710 - 13
2. Mexico ... - 7624 - 113
3. **USA ... - 21449 - 87

• CENTRAL AMERICA AND CARIBBEAN

1. Bahamas ... - 2 - ...
2. Barbados ... - 4 - ...
3. Bermuda ... - 2 - ...
4. British Virgin Islands ... - 1 - ...
5. Cayman Islands ... - 4 - ...
6. Costa Rica ... - 149 - 1
7. Cuba ... - 15 - ...
8. Dominica ... - 1 - ...
9. Dominican Republic ... - 93 - 1
10. El Salvador ... - 160 - ...
11. Guatemala ... - 208 - 1
12. Honduras ... - 108 - ...
13. Jamaica ... - 15 - ...
14. ***Martinique ... - 1 - ...
15. ****Netherlands Antilles ... - 4 - ...
16. Nicaragua ... - 144 - ...
17. Panama ... - 330 - ...
18. Saint-Martin ... - 1 - ...
19. Suriname ... - 11 - ...
20. Trinidad-Tobago ... - 25 - ...

• SOUTH AMERICA

1. Argentina 38 - 1118 - 7
2. Bolivia ... - 23 - ...
3. Brazil 84 - 215 - ...
4. Chile ... - 4315 - 4
5. Colombia 4 - 68 - 2
6. Ecuador ... - 95 - ...
7. Paraguay ... - 48 - ...
8. Peru 77 - 218 - ...
9. Uruguay ... - 36 - ...
10. Venezuela ... - 92 - ...

• NORTH-EAST AND SOUTH ASIA

1. China 37 - 393 - ...
2. Hong Kong SAR ... - 320 - ...
3. India ... - 50 - ...
4. Japan 109 - 849 - ...
5. Korea (South) ... - 84 - ...
6. Macao ... - 3 - ...
7. Sri Lanka ... - 1 - ...
8. Taiwan ... - 61 - ...

• SOUTH-EAST ASIA

1. Laos PDR ... - 1 - ...
2. Malaysia ... - 23 - ...
3. Philippines 101 - 445 - 1
4. Singapore 65 - 142 - ...
5. Thailand ... - 518 - ...
6. Vietnam 22 - 49 - ...

• AUSTRALIA AND PACIFIC

1. *****Australia 297 - 2733 - 1
2. ***French Polynesia ... - 1 - ...
3. New Zealand 45 - 303 - ...
4. Papua New Guinea ... - 1 - ...
5. Samoa ... - 1 - ...

• TOTAL 929 - 48717 - 231

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. Cases reported from the US include confirmed cases from Puerto Rico.
• (***) The cases in Martinique and French Polynesia were reported by France
• (****) Three of the cases are reported to occur in a cruise ship in Curacao.
• (*****) One Australian case reported from a cruise ship.

(...)

-
------

 

[german-docter]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

6/23/2009 3 :00 :00 PM

ECDC SURVEILLANCE REPORT:
Influenza A(H1N1)v cases reported by 22 EU and EEA/EFTA countries

http://ecdc.europa.eu/en/files/pdf/...)_Analysis_of_individual_data_EU_EEA-EFTA.pdf


Influenza A(H1N1)v cases reported by 22 EU and EEA/EFTA countries
These data were provided by the national contact points for surveillance and the Early Warning and Response System contact points of the EU and EEA/EFTA countries. ECDC wishes to acknowledge the serious commitment and effort of all these individuals and their teams in ensuring the timely reporting of valid case-based data from their respective countries.
Latest developments
? Individual data, allowing for epidemiological analysis, were reported on 879 confirmed cases of influenza A(H1N1)v infection by 22 EU, EEA and EFTA countries from 5 May to 17 June 2009.
? Travel-related cases account for half of the reported cases. The main areas to which cases had travelled were, in chronological order, Mexico, the USA and Europe.
? 70% of the cases are reported in children and young adults under 30 years old.
? The most frequent symptoms are respiratory. At least one gastro-intestinal symptom has been reported by 21% of cases.

Number of cases, travel-association and hospital admission
As published in the ECDC situation report of 17 June, a cumulative number of 2 719 confirmed cases of influenza A(H1N1)v have been reported by 25 EU and EFTA countries.

Out of these, a total of 879 confirmed cases of influenza A(H1N1)v have been reported to ECDC as individual case reports in the Early Warning and Response System. These reports come from 22 out of the 25 EU, EEA/EFTA countries identified through epidemic intelligence to have had cases, from 5 May to 17 June 2009 (Table 1). Country-specific publications and weekly bulletins on A(H1N1)v are available [1-7].

These 879 cases form the basis of the analysis below. However, all variables were not reported for all cases, and the denominator varies for each analysis. Data are most complete for country of infection, and least complete for prophylaxis.

The number of travel-related cases (having been outside the country of notification during the incubation period) is 451 (53%) among 850 A(H1N1)v cases with available information on travel. Among 448 cases who travelled abroad in the week preceding the date of onset (information on country visited missing for three cases), 309 (69%) had returned from the USA, 96 (21%) had travelled from Mexico, five had travelled from both Mexico and the USA, 16 (4%) had returned from Canada (plus one returning from both Canada and the USA). Four cases had travelled from the United Kingdom and 17 (4%) cases had travelled to other countries: Argentina (5), Australia (1), Brazil (1), Dominican Republic (9) and Panama (1).

The information on hospital admission was available for 604 cases reported from 21 countries. Among these 604 cases, 166 (27%) have been admitted to hospital. It is important to note that some hospitalisations were for isolation purposes, and that the proportion of patients admitted to hospital is thus not an indicator for severity of disease.

(? [various graphs and tables])

Treatment and prophylaxis
The information on antiviral treatment was only available for 545 persons (missing and unknown excluded), but in this group the number of persons who have been treated with oseltamivir is 435 (80%). Eleven persons received zanamivir and 25 persons received other treatments. No treatment was administered in 74 (14%) of these 545 patients.

Information on prophylaxis was available for 313 persons (missing and unknown excluded). Only 21 persons (7%) have used an antiviral drug (oseltamivir for 18, zanamivir for two and rimantidine for one) in the 14 days before onset of illness. No prophylaxis was given to 292 of these 313 persons (93%).

Vaccination
The information on the vaccination status for seasonal influenza in the previous season is available for 433 cases. The number of persons that were reported to have been vaccinated during the last season was 42 (10%).

Conclusion, next steps
Results presented in this report provide some general information on demographic characteristics (age, gender, country visited), clinical presentation, treatment and prophylaxis of the population infected by A(H1N1)v in 22 European countries. Although data completeness is decreasing over time when compared with aggregate reporting, individual case reporting remains the only way to produce an epidemic curve by date of onset.

Additional analysis of individual case reports will be presented in the coming weeks, in particular on pre-exiting conditions, complication among hospitalised cases. Although individual case reporting is time-consuming, we would like to encourage EU Member States in their continued efforts to build a comprehensive database in order to better monitor, identify risk groups and contributing factors to the development of the epidemic.

Several different systems are in place in Europe for surveillance of A(H1N1)v pandemic (sentinel system collected via TESSy, aggregate case reporting through EWRS). Sentinel systems can be used throughout the year. Individual case reporting can be replaced by aggregated case reporting when the number of cases becomes too high. Information collected through these different systems should be interpreted in a comprehensive way to monitor and describe the epidemic in European countries.

 

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 23 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 23 June 2009, 17:00 hours CEST

[Original Document: LINK. EDITED.]


Main developments in past 24 hours

• 215 new cases were reported in EU and EFTA countries;
• Latvia has reported its first case;
• 1845 new cases were reported from non-EU and EFTA countries;
• The total of fatal cases worldwide is 239;
• Seven fatal cases have been reported by Canada, Dominican Republic and Argentina and Australia since yesterday.

This report is based on official information provided by the national public health websites, or through other official communication channels. An update on the number of confirmed cases as of 23 June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases is today 28 out of 31.

In the past 24 hours, 215 cases were confirmed in 16 EU and EFTA countries, with UK as main reporting country with 132 new cases (Table 1).

Latvia has today reported its first case in a traveller returning from USA.

The cumulative number of cases in the EU and EFTA countries is now 4 459, including one death.

Outside of the EU and EFTA countries, a total of 50 475 cases, including 238 deaths, have been reported, representing an increase of 1 845 from yesterday (Table 2).


WHO Guidelines on Laboratory and Virology

The following text provides hyperlinks to useful guidelines published by WHO on laboratory and virology issue related to A(H1N1)v virus.

• Characteristics of the emergent influenza A (H1N1) viruses and recommendations for vaccine development 26 May 2009
  • This summary provides an update on the characterization of available influenza A(H1N1)v viruses affecting humans and makes a recommendation on suitable viruses for development of vaccines against this emergent influenza A(H1N1)v virus infection.
• WHO information for Laboratory Diagnosis of New Influenza A (H1N1) Virus in Humans 21 May 2009
  • This document provides information on the diagnostics available as of the above date for the human influenza A (H1N1) A/California/4/2009-like viruses. Further diagnostic information will be updated when available.
• Instructions for storage and transport of suspected or confirmed influenza A (H1N1) human and animal specimens and virus isolates 20 May 2009
  • This is a collection of specifications and technical information that has to be taken into account when specimens of animal or human origin of suspected or confirmed cases of influenza A(H1N1)v virus are handled during storage and transport.
• Protocol for antiviral susceptibility testing by pyrosequencing 13 May 2009
  • The WHO Collaborating Centre for influenza at CDC Atlanta, US, has made available the M2 and the NA-H274 detailed pyrosequencing protocols for antiviral susceptibility testing of influenza A(H1N1)v virus. These documents update and replace the protocols published on 29th April 2009.
• Sequencing primers and protocol 12 May 2009
  • The WHO Collaborating Centre for influenza at CDC, Atlanta (US), has updated the sequencing primers and protocol. This update replaces the previous version published on 29 April 2009.
• Status of candidate vaccine virus development for the current Influenza A(H1N1) virus 9 May 2009
  • For the current influenza A(H1N1)v virus, WHO Collaborating Centres for influenza (WHO CCs), Essential Regulatory Laboratories (ERLs) and other institutions are developing candidate vaccine viruses under the coordination of WHO. Once a vaccine virus is available, WHO will announce the availability on its website.
• Countries able to perform PCR to diagnose influenza A (H1N1) virus infection in humans 7 May 2009
  • Based on performance in the WHO external quality assessment project (EQAP), National Influenza Centres (NICs) of the WHO Global Influenza Surveillance Network (GISN) and national influenza reference laboratories (NIRLs) in countries without NICs, fulfilling certain criteria, have been identified as having PCR capacity, with the necessary laboratory facility and consumables, to detect the influenza A(H1N1)v virus.
• Laboratory bio-risk management for laboratories handling human specimens suspected or confirmed to contain influenza A (H1N1) causing the current international epidemics 6 May 2009
  • This document includes a bio-risk management checklist for laboratory managers and staff, and some recommendations addressing minimal/essential working conditions associated with specific manipulations in laboratory settings.
• Instruction on how to obtain CDC real-time RT-PCR kits for detection of influenza A(H1N1) 2 May 2009
  • The WHO Collaborating Centre for influenza in CDC Atlanta (USA) has developed the primers and probes for the influenza A(H1N1)v virus included in the rRT-PCR kits. These also include detailed procedures as well as positive control materials.
• CDC protocol of real-time RTPCR for influenza A (H1N1) 30 April 2009
  • CDC Atlanta has released the real-time reverse transcription ? polymerase chain reaction (rRT-PCR) protocol for detection and characterization of influenza A(H1N1)v virus (version 2009). CDC emphasises that these protocols are made available under an emergency use authorization (EUA) and are not intended to be used for commercial development or for-profit testing.
• Instructions for shipments of swine influenza A(H1N1) specimens and virus isolates to WHO Collaborating Centres for influenza 28 April 2009
  • WHO, through its Shipment Fund Project (SFP), will continue supporting shipments from any places where outbreaks of influenza A(H1N1)v virus infection occur. ?World Courier?, WHO?s partner in the SFP, is on alert 24 hours / 7 days a week to provide support with those shipments.
• Viral gene sequences to assist update diagnostics for influenza A (H1N1) - GenBank accession numbers 28 April 2009
  • The WHO Collaborating Centre for influenza in CDC Atlanta (US) has posted the full genome sequences of influenza A(H1N1)v virus ? A/California/04/2009 ? on the GenBank sequence database.
• Viral gene sequences to assist update diagnostics for influenza A (H1N1) 25 April 2009
  • The full genome sequence of the newly identified influenza A(H1N1)v virus ? A/California/04/2009 ? has been made available by the WHO Collaborating Centre in CDC, Atlanta, on the GISAID sequence database.

Health care workers and the pandemic virus ? Report from USA

The Centers for Disease Control and Prevention (CDC) in the United States has provided guidance for reducing the risk of transmission of influenza A(H1N1)v in health care settings in that country1 . At the same time as issuing these the CDC asked US State authorities for reports of health care professionals (HCP) with the novel influenza infection. There has now been the first report of that surveillance in the most recent issue of CDC?s Morbidity and Mortality Weekly Report (MMWR) click here .

That publication described the results for 48 cases of A(H1N1)v in HCP. Two of these were hospitalised. Neither required intensive care. For 26 of the 48 there was information on risk factors associated with how the infection was acquired. For 13 of the 26 it was considered most likely that the infection had been acquired in a health care setting, in one case from another HCP and for the other 12 from a patient. There were 11 cases where CDC reported enough information on the use of personal protective equipment to comment on whether this had been adequate compared to what is recommended 1 and in only three of these was there a report of use of a mask or a respirator.

The authors concluded that there needed to be reinforcement of messages about infection control. The results were also mentioned and discussed on the CDC weekly media broadcast on June 18th 2. That mentioned that a difficult and controversial issue in the USA is whether to require or recommend N95 masks or to stick to surgical masks outside of higher risk settings (where aerosols are being generated). Even though there is a preference for respirators from the infection control specialists in the USA there is no consensus 2.

ECDC Comment:

In Europe there are concerns that the use of respirators may not be practical in routine settings3, and it is reported that there are concerns that this may

1. Centers for Disease Control and Prevention Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Novel Influenza A (H1N1) Virus Infection in a Healthcare Setting. http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm
2. CDC Telebriefing on Investigation of Human Cases of Novel Influenza A (H1N1) transcript http://www.cdc.gov/media/transcripts/2009/t090618.htm
3. Phin NF, Rylands AJ, Allan J, Edwards C, Enstone JE, Nguyen-Van-Tam JS.Personal protective equipment in an influenza pandemic: a UK simulation exercise. J Hosp Infect. 2009 Jan;71(1):15-21. Epub 2008 Nov 17

Table 1: Reported new confirmed cases and cumulative number of influenza A(H1N1)v as of 23 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

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

1. Austria ... - 10 - ...
2. Belgium 1 - 31 - ...
3. Bulgaria ... - 2 - ...
4. Cyprus 1 - 5 - ...
5. Czech Republic ... - 7 - ...
6. Denmark 3 - 31 - ...
7. Estonia ... - 5 - ...
8. Finland 13 - 26 - ...
9. France ... - 150 - ...
10. Germany 23 - 301 - ...
11. Greece ... - 51 - ...
12. Hungary ... - 7 - ...
13. Iceland ... - 4 - ...
14. Ireland ... - 23 - ...
15. Italy 8 - 96 - ...
16. Latvia 1 - 1
17. Luxembourg 1 - 3 - ...
18. Netherlands 5 - 110 - ...
19. Norway 2 - 22 - ...
20. Poland ... - 13 - ...
21. Portugal ... - 6 - ...
22. Romania 1 - 19 - ...
23. Slovakia 1 - 4 - ...
24. Slovenia ... - 1 - ...
25. Spain 17 - 539 - ...
26. Sweden 1 - 55 - ...
27. Switzerland 5 - 32 - ...
28. United Kingdom 132 - 2905 - 1

• Total 215 - 4459 - 1

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.
• (*) Deaths are included in the cumulative number of confirmed cases

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 23 June 2009, 17:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Montenegro ... - 1 - ...
2. Russian Federation ... - 3 - ...
3. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Algeria 1 - 2 - ...
2. Bahrain ... - 15 - ...
3. Egypt 6 - 40 - ...
4. Israel 77 - 346 - ...
5. Jordan 1 - 13 - ...
6. Kuwait 8 - 26 - ...
7. Lebanon ... - 12 - ...
8. Morocco 1 - 9 - ...
9. Occupied Palestinian Territory ... - 8 - ...
10. Oman ... - 3 - ...
11. Qatar 7 - 10 - ...
12. Saudi Arabia 5 - 39 - ...
13. Turkey ... - 20 - ...
14. United Arab Emirates ... - 2 - ...
15. Yemen 1 - 5 - ...

• AFRICA

1. Ethiopia ... - 2 - ...
2. South Africa ... - 1 - ...

• NORTH AMERICA

1. Canada 747 - 6457 - 15
2. Mexico ... - 7624 - 113
3. **USA ... - 21449 - 87

• CENTRAL AMERICA AND CARIBBEAN

1. Bahamas ... - 2 - ...
2. Barbados ... - 4 - ...
3. Bermuda ... - 2 - ...
4. British Virgin Islands ... - 1 - ...
5. Cayman Islands ... - 4 - ...
6. Costa Rica 39 - 188 - 1
7. Cuba ... - 15 - ...
8. Dominica ... - 1 - ...
9. Dominican Republic 6 - 99 - 2
10. El Salvador ... - 160 - ...
11. Guatemala 27 - 235 - 1
12. Honduras 10 - 118 - ...
13. Jamaica 4 - 19 - ...
14. ***Martinique ... - 1 - ...
15. ****Netherlands Antilles ... - 4 - ...
16. Nicaragua 45 - 189 - ...
17. Panama ... - 330 - ...
18. Suriname ... - 11 - ...
19. Trinidad-Tobago ... - 25 - ...

• SOUTH AMERICA

1. Argentina 95 - 1203 - 10
2. Bolivia 3 - 26 - ...
3. Brazil 25 - 240 - ...
4. Chile ... - 4315 - 4
5. Colombia 1 - 69 - 2
6. Ecuador ... - 95 - ...
7. Paraguay ... - 48 - ...
8. Peru 77 - 218 - ...
9. Uruguay 159 - 195 - ...
10. Venezuela ... - 92 - ...

• NORTH-EAST AND SOUTH ASIA

1. China 68 - 461 - ...
2. Hong Kong SAR 28 - 348 - ...
3. India ... - 50 - ...
4. Japan 43 - 892 - ...
5. Korea (South) 31 - 115 - ...
6. Macao 2 - 5 - ...
7. Sri Lanka 3 - 4 - ...
8. Taiwan ... - 61 - ...

• SOUTH-EAST ASIA

1. Laos PDR 1 - 2 - ...
2. Malaysia 35 - 58 - ...
3. Philippines ... - 445 - 1
4. Singapore 26 - 168 - ...
5. Thailand 71 - 589 - ...
6. Vietnam 7 - 56 - ...

• AUSTRALIA AND PACIFIC

1. *****Australia 124 - 2857 - 2
2. ***French Polynesia ... - 1 - ...
3. New Zealand 61 - 364 - ...
4. Papua New Guinea ... - 1 - ...
5. Samoa ... - 1 - ...

• TOTAL 1845 - 50475 - 238

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. Cases reported from the US include confirmed cases from Puerto Rico.
• (***) The cases in Martinique and French Polynesia were reported by France
• (****) Three of the cases are reported to occur in a cruise ship in Curacao.
• (*****) One Australian case reported from a cruise ship.

(...)

-
-----

 

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 24 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 24 June 2009, 17:00 hours CEST

[Original Document: LINK. EDITED.]


Main developments in past 24 hours

• 404 new cases were reported in EU and EFTA countries;
• 1845 new cases were reported from non-EU and EFTA countries;
• Eight countries worldwide have today reported their first cases;
• The total of fatal cases worldwide is 239;
• Ten new fatal cases have been reported by Australia (1), Argentina (7) and Mexico (2) since yesterday.

This report is based on official information provided by the national public health websites, or through other official communication channels. An update on the number of confirmed cases as of 24 June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases is today 28 out of 31.

In the past 24 hours, 404 cases were confirmed in 16 EU and EFTA countries, with UK as main reporting country with 349 new cases (Table 1).

The cumulative number of cases in the EU and EFTA countries is now 4 844, including one death.

Outside of the EU and EFTA countries, a total of 51 285 cases, including 248 deaths, have been reported, representing an increase of 1 155 from yesterday (Table 2).

Eight countries have reported their first A)H1N1=v cases today: these are Cape Verde (3), Ivory Coast (2), Antigua and Barbuda (2), Bangladesh (1), Brunei Darussalam (4), Cambodia (1), Indonesia (1) and Fiji (2).


ECDC Press briefings

ECDC is having press briefings (webcast) to provide update on the influenza A(H1N1)v pandemic as well as taking questions from journalists. Senior scientists from ECDC attend the press briefings and answer questions. The latest Press briefing was webcasted today, 24 June, and featured both the epidemiology in the Situation Report of yesterday (June 23rd ) and introduced the documents recently published by ECDC on Mitigation vs Delaying documents published earlier this month. The ECDC webcasts can be watched here .


Table 1: Reported new confirmed cases and cumulative number of influenza A(H1N1)v as of 24 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

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

1. Austria 2 - 12 - ...
2. Belgium 4 - 35 - ...
3. Bulgaria ... - 2 - ...
4. Cyprus 1 - 6 - ...
5. Czech Republic ... - 7 - ...
6. Denmark 3 - 34 - ...
7. Estonia ... - 5 - ...
8. Finland 13 - 26 - ...
9. France ... - 150 - ...
10. Germany 1 - 302 - ...
11. Greece 15 - 66 - ...
12. Hungary 1 - 8 - ...
13. Iceland ... - 4 - ...
14. Ireland ... - 23 - ...
15. Italy ... - 96 - ...
16. Latvia ... - 1
17. Luxembourg ... - 3 - ...
18. Netherlands 2 - 112 - ...
19. Norway 1 - 23 - ...
20. Poland ... - 13 - ...
21. Portugal 1 - 7 - ...
22. Romania 1 - 19 - ...
23. Slovakia 2 - 6 - ...
24. Slovenia ... - 1 - ...
25. Spain ... - 539 - ...
26. Sweden 2 - 57 - ...
27. Switzerland 6 - 33 - ...
28. United Kingdom 349 - 3254 - 1

• Total 404 - 4844 - 1

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.
• (*) Deaths are included in the cumulative number of confirmed cases

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 24 June 2009, 17:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Montenegro ... - 1 - ...
2. Russian Federation ... - 3 - ...
3. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Algeria ... - 2 - ...
2. Bahrain ... - 15 - ...
3. Egypt ... - 40 - ...
4. Israel 29 - 375 - ...
5. Jordan 2 - 15 - ...
6. Kuwait ... - 26 - ...
7. Lebanon 13 - 25 - ...
8. Morocco 9 - ...
9. Occupied Palestinian Territory ... - 8 - ...
10. Oman ... - 3 - ...
11. Qatar 7 - 10 - ...
12. Saudi Arabia 6 - 45 - ...
13. Tunisia 2 - 2
14. Turkey 6 - 26 - ...
15. United Arab Emirates ... - 2 - ...
16. Yemen 1 - 6 - ...

• AFRICA

1. Cape Verde 3 - 3 - ...
2. Ethiopia ... - 2
3. Ivory Coast 2 - 2
4. South Africa ... - 1 - ...

• NORTH AMERICA

1. Canada ... - 6457 - 15
2. Mexico 338 - 7624 - 115
3. **USA ... - 21449 - 87

• CENTRAL AMERICA AND CARIBBEAN

1. Antigua and Barbuda 2 - 2
2. Bahamas 2 - 4
3. Barbados 1 - 5 - ...
4. Bermuda ... - 2 -...
5. British Virgin Islands ... - 1 - ...
6. Cayman Islands 3 - 7 - ...
7. Costa Rica 2 - 190 - 1
8. Cuba ... - 15 - ...
9. Dominica ... - 1 - ...
10. Dominican Republic 9 - 108 - 2
11. El Salvador ... - 160 - ...
12. Guatemala ... - 235 - 1
13. Honduras ... - 118 - ...
14. Jamaica ... - 19 - ...
15. ***Martinique 1 - 2 - ...
16. ****Netherlands Antilles ... - 4 - ...
17. Nicaragua 31 - 220 - ...
18. Panama ... - 330 - ...
19. Suriname ... - 11 - ...
20. Trinidad-Tobago ... - 25 - ...

• SOUTH AMERICA

1. Argentina 91 - 1294 - 17
2. Bolivia 18 - 44 - ...
3. Brazil 94 - 334 - ...
4. Chile ... - 4315 - 4
5. Colombia 4 - 73 - 2
6. Ecuador 20 - 115 - ...
7. Paraguay 10 - 58 - ...
8. Peru ... - 218 - ...
9. Uruguay ... - 195 - ...
10. Venezuela 43 - 135 - ...

• NORTH-EAST AND SOUTH ASIA

1. Bangladesh 1 - 1 - ...
2. China 33 - 494 - ...
3. Hong Kong SAR 60 - 408 - ...
4. India ... - 50 - ...
5. Japan 52 - 944 - ...
6. Korea (South) ... - 115 - ...
7. Macao ... - 5 - ...
8. Sri Lanka 1 - 5 - ...
9. Taiwan ... - 61 - ...

• SOUTH-EAST ASIA

1. Brunei Darussalam 4 - 4 - ...
2. Cambodia 1 - 1
3. Indonesia 1 - 1
4. Laos PDR ... - 2
5. Malaysia 10 - 68 - ...
6. Philippines ... - 445 - 1
7. Singapore 26 - 194 - ...
8. Thailand 185 - 774 - ...
9. Vietnam ... - 56 - ...

• AUSTRALIA AND PACIFIC

1. *****Australia 16 - 2873 - 3
2. Fiji 2 - 2
3. ***French Polynesia ... - 1 - ...
4. New Zealand 22 - 386 - ...
5. Papua New Guinea ... - 1 - ...
6. Samoa ... - 1 - ...
7. Vanuatu 1 - 1

• TOTAL 1155 - 51285 - 248

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. They also include confirmed cases from Puerto Rico.
• (***) The cases in Martinique and French Polynesia were reported by France
• (****) Three of the cases are reported to occur in a cruise ship in Curacao.
• (*****) One Australian case reported from a cruise ship.

(...)

-
------

 

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 25 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 25 June 2009, 17:00 hours CEST

[Original Document: LINK. EDITED.]


Main developments in past 24 hours

• 101 new cases were reported in EU and EFTA countries;
• 2948 new cases were reported from non-EU and EFTA countries;
• Two countries worldwide have today reported their first cases: Iran and Iraq;
• The total of fatal cases worldwide is 258;
• Nine new fatal cases have been reported by Canada (4), Mexico (1) Honduras (1) and Chile (3) since yesterday.

This report is based on official information provided by the national public health websites, or through other official communication channels. An update on the number of confirmed cases as of 25 June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases is today 28 out of 31.

In the past 24 hours, 101 cases were confirmed in 11 EU and EFTA countries, with France as main reporting country with 41 new cases (Table 1).

The cumulative number of cases in the EU and EFTA countries is now 4947, including one death.

Outside of the EU and EFTA countries, a total of 54 232 cases, including 257 deaths, have been reported, representing an increase of 2947 from yesterday (Table 2).

Two countries have reported their first case of Influenza A(H1N1)v cases today: these are Iran (1) and Iraq (7).


Corrigenda

The situation report of yesterday 24 June contained inconsistencies in the count of cases reported in the summary box above which was inadvertently not updated with the daily counts. The figures in the Table 1 and 2 were correct.


Table 1: Reported new confirmed cases and cumulative number of influenza A(H1N1)v as of 25 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

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

1. Austria ... - 12 - ...
2. Belgium ... - 35 - ...
3. Bulgaria 5 - 7 - ...
4. Cyprus ... - 6 - ...
5. Czech Republic 2 - 9 - ...
6. Denmark 3 - 37 - ...
7. Estonia 3 - 8 - ...
8. Finland ... - 26 - ...
9. France 41 - 191 - ...
10. Germany 31 - 333 - ...
11. Greece ... - 66 - ...
12. Hungary ... - 8 - ...
13. Iceland ... - 4 - ...
14. Ireland 3 - 26 - ...
15. Italy 6 - 102 - ...
16. Latvia ... - 1
17. Luxembourg ... - 3 - ...
18. Netherlands ... - 112 - ...
19. Norway ... - 23 - ...
20. Poland ... - 13 - ...
21. Portugal ... - 7 - ...
22. Romania ... - 19 - ...
23. Slovakia 1 - 7 - ...
24. Slovenia ... - 3 - ...
25. Spain 2 - 541 - ...
26. Sweden 4 - 61 - ...
27. Switzerland ... - 33 - ...
28. United Kingdom ... - 3254 - 1

• Total 101 - 4947 - 1

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.
• (*) Cases reported between 23 June 17:00 hours and 24 June 17:00 hours
• (**) Deaths are included in the cumulative number of confirmed cases

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 25 June 2009, 17:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Montenegro ... - 1 - ...
2. Russian Federation ... - 3 - ...
3. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Algeria ... - 2 - ...
2. Bahrain ... - 15 - ...
3. Egypt 3 - 43 - ...
4. Iran 1 - 1 - ...
5. Iraq 7 - 7 - ...
6. Israel ... - 375 - ...
7. Jordan ... - 15 - ...
8. Kuwait ... - 26 - ...
9. Lebanon ... - 25 - ...
10. Morocco ... - 9 - ...
11. Occupied Palestinian Territory 1 - 9 - ...
12. Oman ... - 3 - ...
13. Qatar ... - 10 - ...
14. Saudi Arabia 3 - 48 - ...
15. Tunisia ... - 2
16. Turkey ... - 26 - ...
17. United Arab Emirates ... - 2 - ...
18. Yemen 1 - 6 - ...

• AFRICA

1. Cape Verde ... - 3 - ...
2. Ethiopia ... - 2
3. Ivory Coast ... - 2
4. South Africa ... - 1 - ...

• NORTH AMERICA

1. Canada 275 - 6732 - 19
2. Mexico 993 - 8617 - 116
3. **USA ... - 21449 - 87

• CENTRAL AMERICA AND CARIBBEAN

1. Antigua and Barbuda ... - 2
2. Bahamas ... - 4
3. Barbados ... - 5 - ...
4. Bermuda ... - 2 - ...
5. British Virgin Islands ... - 1 - ...
6. Cayman Islands ... - 7 - ...
7. Costa Rica 32 - 222 - 1
8. Cuba 19 - 34 - ...
9. Dominica ... - 1 - ...
10. Dominican Republic ... - 108 - 2
11. El Salvador ... - 160 - ...
12. Guatemala ... - 235 - 1
13. Honduras 1 - 119 - 1
14. Jamaica ... - 19 - ...
15. ***Martinique ... - 2 - ...
16. ****Netherlands Antilles ... - 4 - ...
17. Nicaragua ... - 220 - ...
18. Panama ... - 330 - ...
19. Suriname ... - 11 - ...
20. Trinidad-Tobago ... - 25 - ...

• SOUTH AMERICA

1. Argentina ... - 1294 - 17
2. Bolivia 3 - 47 - ...
3. Brazil 65 - 399 - ...
4. Chile 871 - 5186 - 7
5. Colombia ... - 73 - 2
6. Ecuador ... - 115 - ...
7. Paraguay 8 - 66 - ...
8. Peru 81 - 299 - ...
9. Uruguay ... - 195 - ...
10. Venezuela ... - 135 - ...

• NORTH-EAST AND SOUTH ASIA

1. Bangladesh ... - 1 - ...
2. China 34 - 528 - ...
3. Hong Kong SAR 36 - 444 - ...
4. India ... - 50 - ...
5. Japan 56 - 1000 - ...
6. Korea (South) ... - 115 - ...
7. Macao 7 - 12 - ...
8. Sri Lanka ... - 5 - ...
9. Taiwan ... - 61 - ...

• SOUTH-EAST ASIA

1. Brunei Darussalam 7 - 11 - ...
2. Cambodia ... - 1
3. Indonesia ... - 1
4. Laos PDR 1 - 3
5. Malaysia ... - 68 - ...
6. Philippines 282 - 727 - 1
7. Singapore ... - 194 - ...
8. Thailand ... - 774 - ...
9. Vietnam 2 - 58 - ...

• AUSTRALIA AND PACIFIC

1. *****Australia 127 - 3000 - 3
2. Fiji ... - 2
3. ***French Polynesia ... - 1 - ...
4. New Zealand 31 - 417 - ...
5. Papua New Guinea ... - 1 - ...
6. Samoa ... - 1 - ...
7. Vanuatu 1 - 2

• TOTAL 2948 - 54232 - 257

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.
• (a) Cases reported between 23 June 17:00 hours and 24 June 17:00 hours
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. They also include confirmed cases from Puerto Rico.
• (***) The cases in Martinique and French Polynesia were reported by France
• (****) Three of the cases are reported to occur in a cruise ship in Curacao.
• (*****) One Australian case reported from a cruise ship.

(...)

-
-----

 

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 26 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 26 June 2009, 17:00 hours CEST

[Original Full Document: LINK. EDITED.]


Main developments in past 24 hours

• 1075 new cases were reported in EU and EFTA countries;
• 62074 new cases were reported from non-EU and EFTA countries;
• The total of fatal cases worldwide is 306;
• Two new countries reported their first cases today: Lithuania (1) and Serbia (2)
• 48 new fatal cases have been reported by the USA (40), Guatemala (1) Argentina (6) and Australia (1) since yesterday.

This report is based on official information provided by the national public health websites, or through other official communication channels. An update on the number of confirmed cases as of 26 June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases is today 29 out of 31.

In the past 24 hours, 1075 cases were confirmed in 16 EU and EFTA countries, with the UK as main reporting country with 996 new cases (Table1).

The cumulative number of cases in the EU and EFTA countries is now 6022, including one death. .

Outside of the EU and EFTA countries, a total of 62 074 cases, including 305 deaths, have been reported, representing an increase of 7816 from yesterday (Table 2).


European Influenza Surveillance Scheme (EISS) weekly report for week 25 published

Low influenza activity was reported in all European countries providing data during week 25. Overall this indicates low circulation of A(H1N1)v and other influenza viruses at community level.

However an increase of the number of A(H1N1)v virus detections from the sentinel networks was observed during week 25 as compared to the previous week.

Of the 399 specimens collected by the sentinel GP networks, 22 were positive for A(H1N1)v of which 15 in England as compared to one out of 194 in week 24.

In addition, 150 specimens from non sentinel sources (i.e. specimens collected for diagnostic purposes in hospitals) were positive for A(H1N1)v virus during week 25.

All new influenza A(H1N1) viruses tested for antiviral resistance so far proved to be susceptible to oseltamivir and zanamivir and resistant to adamantanes.
The EISS report is available here.


WHO Defines Moderate Pandemic and provides guidance on public health measures

When she declared Phase 6 on June 11th the Director of WHO Margaret Chan announced at the same time that she considered the pandemic at present was of moderate severity. There is no consensus definition of what moderate severity, means though there is a discussion of the topic provided by WHO in the Weekly Epidemiological Record of May 29th In a question and answer section on Phase 6 in its web site WHO has not offered a definition by stating that the phrase moderate pandemic reflects the facts that

• Most people recover from infection without the need for hospitalization or medical care.
• Overall, national levels of severe illness from influenza A(H1N1) appear similar to levels seen during local seasonal influenza periods, although high levels of disease have occurred in some local areas and institutions.
• Overall, hospitals and health care systems in most countries have been able to cope with the numbers of people seeking care, although some facilities and systems have been stressed in some localities.

On today?s issue of the Weekly Epidemiological Record WHO provides guidance on surveillance and control measures based on current knowledge, considering the high variability of epidemiological situation among countries.


Table 1: Reported new confirmed cases and cumulative number of influenza A(H1N1)v as of 26 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

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

1. Austria ... - 12 - ...
2. Belgium 2 - 37 - ...
3. Bulgaria ... - 7 - ...
4. Cyprus 8 - 14 - ...
5. Czech Republic ... - 9 - ...
6. Denmark 4 - 41 - ...
7. Estonia 4 - 12 - ...
8. Finland 1 - 27 - ...
9. France ... - 191 - ...
10. Germany 33 - 366 - ...
11. Greece 4 - 70 - ...
12. Hungary ... - 8 - ...
13. Iceland ... - 4 - ...
14. Ireland 3 - 29 - ...
15. Italy ... - 102 - ...
16. Latvia ... - 1
17. Lithuania 1 - 1
18. Luxembourg ... - 3 - ...
19. Netherlands 6 - 118 - ...
20. Norway 1 - 24 - ...
21. Poland ... - 13 - ...
22. Portugal 2 - 9 - ...
23. Romania 4 - 23 - ...
24. Slovakia 2 - 9 - ...
25. Slovenia ... - 3 - ...
26. Spain ... - 541 - ...
27. Sweden 4 - 65 - ...
28. Switzerland ... - 33 - ...
29. United Kingdom 996 - 4250 - 1

• Total 1075 - 6022 - 1

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.
• (*) Cases reported between 23 June 17:00 hours and 24 June 17:00 hours
• (**) Deaths are included in the cumulative number of confirmed cases

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 26 June 2009, 17:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Montenegro ... - 1 - ...
2. Serbia 2 - 2
3. Russian Federation ... - 3 - ...
4. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Algeria ... - 2 - ...
2. Bahrain ... - 15 - ...
3. Egypt ... - 43 - ...
4. Iran ... - 1 - ...
5. Iraq ... - 7 - ...
6. Israel ... - 375 - ...
7. Jordan ... - 15 - ...
8. Kuwait ... - 26 - ...
9. Lebanon ... - 25 - ...
10. Morocco ... - 9 - ...
11. Occupied Palestinian Territory ... - 9 - ...
12. Oman ... - 3 - ...
13. Qatar ... - 10 - ...
14. Saudi Arabia ... - 48 - ...
15. Tunisia ... - 2
16. Turkey ... - 26 - ...
17. United Arab Emirates 5 - 7 - ...
18. Yemen ... - 6 - ...

• AFRICA

1. Cape Verde ... - 3 - ...
2. Ethiopia ... - 2
3. Ivory Coast ... - 2
4. South Africa ... - 1 - ...

• NORTH AMERICA

1. Canada ... - 6732 - 19
2. Mexico ... - 8617 - 116
3. **USA 6268 - 27717 - 127

• CENTRAL AMERICA AND CARIBBEAN

1. Antigua and Barbuda ... - 2
2. Bahamas ... - 4
3. Barbados 5 - 10 - ...
4. Bermuda ... - 2 - ...
5. British Virgin Islands ... - 1 - ...
6. Cayman Islands ... - 7 - ...
7. Costa Rica ... - 222 - 1
8. Cuba ... - 34 - ...
9. Dominica ... - 1 - ...
10. Dominican Republic ... - 108 - 2
11. El Salvador 66 - 226 - ...
12. Guatemala 19 - 254 - 2
13. Honduras ... - 119 - 1
14. Jamaica ... - 19 - ...
15. ***Martinique ... - 2 - ...
16. ****Netherlands Antilles ... - 4 - ...
17. Nicaragua 45 - 265 - ...
18. Panama ... - 358 - ...
19. Suriname ... - 11 - ...
20. Trinidad-Tobago ... - 25 - ...

• SOUTH AMERICA

1. Argentina 194 - 1488 - 23
2. Bolivia ... - 47 - ...
3. Brazil ... - 399 - ...
4. Chile ... - 5186 - 7
5. Colombia ... - 73 - 2
6. Ecuador 10 - 125 - ...
7. Paraguay 13 - 79 - ...
8. Peru 61 - 360 - ...
9. Uruguay ... - 195 - ...
10. Venezuela 19 - 153 - ...

• NORTH-EAST AND SOUTH ASIA

1. Bangladesh 6 - 7 - ...
2. China 42 - 570 - ...
3. Hong Kong SAR 62 - 506 - ...
4. India 23 - 73 - ...
5. Japan 48 - 1048 - ...
6. Korea (South) 27 - 142 - ...
7. Macao 1 - 13 - ...
8. Sri Lanka 2 - 7 - ...
9. Taiwan ... - 61 - ...

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 11 - ...
2. Cambodia 4 - 5
3. Indonesia 1 - 2
4. Laos PDR ... - 3
5. Malaysia ... - 68 - ...
6. Philippines ... - 727 - 1
7. Singapore 121 - 315 - ...
8. Thailand 211 - 985 - ...
9. Vietnam 5 - 63 - ...

• AUSTRALIA AND PACIFIC

1. *****Australia 519 - 3519 - 4
2. Fiji ... - 2
3. ***French Polynesia ... - 1 - ...
4. New Zealand 37 - 453 - ...
5. Papua New Guinea ... - 1 - ...
6. Samoa ... - 1 - ...
7. Vanuatu ... - 2

• TOTAL 7816 - 62074 - 305

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.
• (a) Cases reported between 23 June 17:00 hours and 24 June 17:00 hours
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. They also include confirmed cases from Puerto Rico.
• (***) The cases in Martinique and French Polynesia were reported by France
• (****) Three of the cases are reported to occur in a cruise ship in Curacao.
• (*****) One Australian case reported from a cruise ship.

(...)

-
------

 

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 27 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 27 June 2009, 17:00 hours CEST

[Original Full Document: LINK. EDITED.]


Main developments in past 24 hours

• 70 new cases were reported in EU and EFTA countries;
• 1673 new cases were reported from non-EU and EFTA countries;
• The total of fatal cases worldwide is 312;
• 6 new fatal cases have been reported by the Canada (2), Argentina (3), and Australia (1) since yesterday.

This report is based on official information provided by the national public health websites, or through other official communication channels. An update on the number of confirmed cases as of 27 June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases is 29 out of 31. In the past 24 hours, 70 new cases were confirmed in 9 EU and EFTA countries (Table1).

The cumulative number of cases in the EU and EFTA countries is now 6092, including one death.

Outside of the EU and EFTA countries, a total of 63 747 cases, including 311 deaths, have been reported, representing an increase of 1673 from yesterday (Table 2). There were only 6 new deaths, considerrably less than the 48 new deaths that were reported yesterday worldwide; however, yesterday?s increase was predominantly due to the weekly batch reporting by the USA (40).


Recent developments in the UK

Reports in the Media of Changing Policy on Delaying to Mitigation in the UK

A medical correspondent of the BBC this week reported on a press conference given by the Chief Medical Officer and the UK Health Minister on June 25th. This announced the start of a change of policy at least for the parts of the country that are most affected.

The change is moving from attempting to delay spread of the virus in to one of protecting people at higher risk of experiencing severe disease if they are affected. The statement with a link to a video clip of the Minister and CMO is available on the website of the correspondent scrolling down to the part dated June 25th ECDC has considerable guidance on this topic in two formats a longer evidence based document and a shorter health education version for policy makers. As usual ECDC does not make recommendations but puts the arguments for and against. This was also the topic of an ECDC Web Cast this week.


Package of Clinical Guidance for the Pandemic

ECDC neither produces clinical guidance nor endorses specific national guidance. However it does draw to the attention of Member States evidence-based quidance produced by national and international authorities. The United Kingdom has recently produced a package of guidance which it refers to as the Swine Flu Clinical Package

The swine flu clinical package is a set of tools for use in a pandemic situation by frontline healthcare professionals designed to be used during the phase of a pandemic when there is increased demand for clinical care; i.e. they are not intended to be followed immediately. They are also tailored to the way the health services are structured in the UK and so they will not necessarily suit other European Countries. The tools are designed to support and empower those in primary care, emergency health services and hospitals and are designed to assist these health care professionals to assess patients, authorise treatment, refer those with severe illness or complications, and guide treatment of patients in hospital. There is a companion document about managing surges of patients


Table 1: Reported new confirmed cases and cumulative number of influenza A(H1N1)v as of 27 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

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

1. Austria ... - 12 - ...
2. Belgium 3 - 40 - ...
3. Bulgaria ... - 7 - ...
4. Cyprus 6 - 20 - ...
5. Czech Republic ... - 9 - ...
6. Denmark 2 - 43 - ...
7. Estonia 1 - 13 - ...
8. Finland ... - 27 - ...
9. France 48 - 239 - ...
10. Germany ... - 366 - ...
11. Greece 3 - 73 - ...
12. Hungary ... - 8 - ...
13. Iceland ... - 4 - ...
14. Ireland 4 - 33 - ...
15. Italy ... - 102 - ...
16. Latvia ... - 1
17. Lithuania ... - 1
18. Luxembourg ... - 3 - ...
19. Netherlands ... - 118 - ...
20. Norway ... - 24 - ...
21. Poland ... - 13 - ...
22. Portugal ... - 9 - ...
23. Romania ... - 23 - ...
24. Slovakia ... - 9 - ...
25. Slovenia 1 - 4 - ...
26. Spain ... - 541 - ...
27. Sweden 2 - 67 - ...
28. Switzerland ... - 33 - ...
29. United Kingdom ... - 4250 - 1

• Total 70 - 6092 - 1

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.
• (*) Cases reported between 26 June 17:00 hours and 27 June 17:00 hours
• (**) Deaths are included in the cumulative number of confirmed cases

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 27 June 2009, 17:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Montenegro ... - 1 - ...
2. Serbia ... - 2
3. Russian Federation ... - 3 - ...
4. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Algeria ... - 2 - ...
2. Bahrain ... - 15 - ...
3. Egypt ... - 43 - ...
4. Iran ... - 1 - ...
5. Iraq ... - 7 - ...
6. Israel ... - 375 - ...
7. Jordan ... - 15 - ...
8. Kuwait ... - 26 - ...
9. Lebanon ... - 25 - ...
10. Morocco ... - 9 - ...
11. Occupied Palestinian Territory ... - 9 - ...
12. Oman ... - 3 - ...
13. Qatar ... - 10 - ...
14. Saudi Arabia ... - 48 - ...
15. Tunisia ... - 2
16. Turkey ... - 26 - ...
17. United Arab Emirates ... - 7 - ...
18. Yemen ... - 6 - ...

• AFRICA

1. Cape Verde ... - 3 - ...
2. Ethiopia ... - 2
3. Ivory Coast ... - 2
4. South Africa ... - 1 - ...

• NORTH AMERICA

1. Canada 1043 - 7775 - 21
2. Mexico ... - 8617 - 116
3. **USA ... - 27717 - 127

• CENTRAL AMERICA AND CARIBBEAN

1. Antigua and Barbuda ... - 2
2. Bahamas ... - 4
3. Barbados ... - 10 - ...
4. Bermuda ... - 2 - ...
5. British Virgin Islands ... - 1 - ...
6. Cayman Islands 2 - 9 - ...
7. Costa Rica ... - 222 - 1
8. Cuba 12 - 46 - ...
9. Dominica ... - 1 - ...
10. Dominican Republic ... - 108 - 2
11. El Salvador ... - 226 - ...
12. Guatemala 8 - 262 - 2
13. Honduras ... - 119 - 1
14. Jamaica ... - 19 - ...
15. ***Martinique ... - 2 - ...
16. ****Netherlands Antilles ... - 4 - ...
17. Nicaragua 12 - 277 - ...
18. Panama 45 - 403 - ...
19. Suriname ... - 11 - ...
20. Trinidad-Tobago ... - 25 - ...

• SOUTH AMERICA

1. Argentina 99 - 1587 - 26
2. Bolivia 12 - 59 - ...
3. Brazil 123 - 522 - ...
4. Chile ... - 5186 - 7
5. Colombia ... - 73 - 2
6. Ecuador ... - 125 - ...
7. Paraguay ... - 79 - ...
8. Peru ... - 360 - ...
9. Uruguay ... - 195 - ...
10. Venezuela ... - 153 - ...

• NORTH-EAST AND SOUTH ASIA

1. Bangladesh ... - 7 - ...
2. China ... - 570 - ...
3. Hong Kong SAR ... - 506 - ...
4. India 7 - 80 - ...
5. Japan 1 - 1049 - ...
6. Korea (South) ... - 142 - ...
7. Macao ... - 13 - ...
8. Sri Lanka 1 - 8 - ...
9. Taiwan ... - 61 - ...

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 11 - ...
2. Cambodia ... - 5
3. Indonesia ... - 2
4. Laos PDR ... - 3
5. Malaysia ... - 68 - ...
6. Philippines 134 - 861 - 1
7. Singapore 50 - 365 - ...
8. Thailand 69 - 1054 - ...
9. Vietnam ... - 63 - ...

• AUSTRALIA AND PACIFIC

1. *****Australia ... - 3519 - 5
2. Fiji ... - 2
3. ***French Polynesia 1 - 2 - ...
4. New Zealand 54 - 507 - ...
5. Papua New Guinea ... - 1 - ...
6. Samoa ... - 1 - ...
7. Vanuatu ... - 2

• TOTAL 1673 - 63747 - 311

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.
• (a) Cases reported between 26 June 17:00 hours and 27 June 17:00 hours
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. They also include confirmed cases from Puerto Rico.
• (***) The cases in Martinique and French Polynesia were reported by France
• (****) Three of the cases are reported to occur in a cruise ship in Curacao.
• (*****) One Australian case reported from a cruise ship.

(...)

-
-----

 

[Giuseppe]

Re: European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

Influenza A(H1N1)v infection - Update 28 June 2009, 17:00 hours CEST (ECDC, edited)

ECDC SITUATION REPORT

Influenza A(H1N1)v infection - Update 28 June 2009, 17:00 hours CEST

[Original Document: LINK. EDITED.]


Main developments in past 24 hours

• 26 new cases were reported in EU and EFTA countries;
• 1713 new cases were reported from non-EU and EFTA countries;
• The total of fatal cases worldwide is 320;
• One additional death was reported in the UK since yesterday;
• 7 new fatal cases have been reported from non-EU and EFTA countries by Chile (5) Thailand (2);
• Myanmar reported its first case.

This report is based on official information provided by the national public health websites, or through other official communication channels. An update on the number of confirmed cases as of 28 June, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

The number of EU and EFTA countries reporting cases is 29 out of 31.

In the past 24 hours, 26 new cases were confirmed in 7 EU and EFTA countries (Table1).

73 year old man, who had serious underlying health conditions, had died in Scotland after having been hospitalized in an intensive care unit for 15 days, which brings the total number of deaths in EU and EFTA countries to two.

The cumulative number of cases in the EU and EFTA countries is now 6118, including two deaths.

Outside of the EU and EFTA countries, a total of 65460 cases, including 318 deaths, have been reported, representing an increase of 1713 from yesterday (Table 2). There were 8 new deaths since the last report.


Update on the impact of the pandemic in the United States

The transmission of the pandemic virus in North America is running some weeks ahead of Europe and the American Centers for Disease Prevention and Control (CDC) are analysing data of international importance. Therefore ECDC is looking at their reports especially carefully assuming there will be many similarities between the pandemic in the USA compared to the situation in the European Union and EFTA countries.

CDC are making weekly data-releases as part of their FluView series with accompanying weekly media presentations which are immediately converted into transcripts.(1,2) The most recent update was published on June 26th (http://www.cdc.gov/media/transcripts/2009/t090626.htm )

It noted continued transmission of influenza A(H1N1)v in the USA albeit with marked heterogeneity from area to area.

Overall the USA is experiencing a steady increase in the number of reported cases.

The most recent weekly update documented the largest number of cases (over 6000) reported in a week since the beginning of the outbreak including 27,717 laboratory confirmed cases overall, with over 3000 hospitalizations and 127 fatalities.(1,2)

Higher rates of illness are still being observed in persons less than 50 years of age with the highest rates in people less than 25 years of age and very few people over 60.

Nearly 80% of people who were hospitalized due to the influenza A(H1N1)v infection and reported to CDC were under 50 years of age with the median age of hospitalization being 19 years reflecting high rates of hospitalisation in children under 2 years of age.

The median age of those who died due to influenza A(H1N1)v infection is substantially higher at 37 years.

Individuals with underlying health conditions notably asthma, diabetes, heart disease, chronic lung disease remain at higher risk of hospitalisation along with pregnant women and young children. One risk factor of hospitalisation and death that is being reappraised by CDC is obesity. People with morbid or extreme obesity appear at increased risk of hospitalisation with A(H1N1)v and CDC considers that this is because of diminished respiratory function and that therefore presumably mild obesity is unlikely to be a risk factor for experiencing severe disease when people are infected with A(H1N1)v.

1) CDC Mediabriefing on Investigation of Human Cases of Novel Influenza A (H1N1) June 26th 2009 26th (http://www.cdc.gov/media/transcripts/2009/t090626.htm)
2) CDC FluView 2008-2009 Influenza Season Week 24 ending June 20, 2009 http://www.cdc.gov/flu/weekly/


Table 1: Reported new confirmed cases and cumulative number of influenza A(H1N1)v as of 28 June 2009, 17:00 hours (CEST) in the EU and EFTA countries

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

1. Austria ... - 12 - ...
2. Belgium 1 - 41 - ...
3. Bulgaria ... - 7 - ...
4. Cyprus ... - 20 - ...
5. Czech Republic ... - 9 - ...
6. Denmark 1 - 44 - ...
7. Estonia ... - 13 - ...
8. Finland ... - 27 - ...
9. France ... - 239 - ...
10. Germany ... - 366 - ...
11. Greece ... - 73 - ...
12. Hungary ... - 8 - ...
13. Iceland ... - 4 - ...
14. Ireland 4 - 37 - ...
15. Italy ... - 102 - ...
16. Latvia ... - 1
17. Lithuania ... - 1
18. Luxembourg ... - 3 - ...
19. Netherlands ... - 118 - ...
20. Norway ... - 24 - ...
21. ***Poland 1 - 14 - ...
22. Portugal 2 - 11 - ...
23. Romania 1 - 24 - ...
24. Slovakia ... - 9 - ...
25. Slovenia ... - 4 - ...
26. Spain ... - 541 - ...
27. Sweden ... - 67 - ...
28. Switzerland 16 - 49 - ...
29. United Kingdom ... - 4250 - 2

• Total 26 - 6118 - 2

• Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.
• (*) Cases reported between 27 June 17:00 hours and 28 June 17:00 hours
• (**) Deaths are included in the cumulative number of confirmed cases
• (***) This case patient is an USA citizen who was confirmed and hospitalized while travelling in Poland

Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1)v as of 28 June 2009, 17:00 hours (CEST) outside of the EU and EFTA area

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

• EASTERN EUROPE AND CENTRAL ASIA

1. Montenegro ... - 1 - ...
2. Serbia 3 - 5
3. Russian Federation ... - 3 - ...
4. Ukraine ... - 1 - ...

• MEDITERRANEAN AND MIDDLE-EAST

1. Algeria ... - 2 - ...
2. Bahrain ... - 15 - ...
3. Egypt 7 - 50 - ...
4. Iran ... - 1 - ...
5. Iraq 3 - 10 - ...
6. Israel ... - 375 - ...
7. Jordan ... - 15 - ...
8. Kuwait ... - 26 - ...
9. Lebanon ... - 25 - ...
10. Morocco ... - 9 - ...
11. Occupied Palestinian Territory ... - 9 - ...
12. Oman ... - 3 - ...
13. Qatar ... - 10 - ...
14. Saudi Arabia 14 - 62 - ...
15. Tunisia ... - 2
16. Turkey ... - 26 - ...
17. United Arab Emirates 1 - 8 - ...
18. Yemen ... - 6 - ...

• AFRICA

1. Cape Verde ... - 3 - ...
2. Ethiopia ... - 2
3. Ivory Coast ... - 2
4. South Africa ... - 1 - ...

• NORTH AMERICA

1. Canada ... - 7775 - 21
2. Mexico ... - 8617 - 116
3. **USA ... - 27717 - 127

• CENTRAL AMERICA AND CARIBBEAN

1. Antigua and Barbuda ... - 2
2. Bahamas ... - 4
3. Barbados ... - 10 - ...
4. Bermuda ... - 2 - ...
5. British Virgin Islands ... - 1 - ...
6. Cayman Islands ... - 9 - ...
7. Costa Rica ... - 222 - 1
8. Cuba ... - 46 - ...
9. Dominica ... - 1 - ...
10. Dominican Republic ... - 108 - 2
11. El Salvador ... - 226 - ...
12. Guatemala ... - 262 - 2
13. Honduras ... - 119 - 1
14. Jamaica ... - 19 - ...
15. ***Martinique ... - 2 - ...
16. ****Netherlands Antilles ... - 4 - ...
17. Nicaragua ... - 277 - ...
18. Panama ... - 403 - ...
19. Suriname ... - 11 - ...
20. Trinidad-Tobago ... - 25 - ...

• SOUTH AMERICA

1. Argentina ... - 1587 - 26
2. Bolivia ... - 59 - ...
3. Brazil 69 - 591 - ...
4. Chile 1025 - 6211 - 12
5. Colombia ... - 73 - 2
6. Ecuador ... - 125 - ...
7. Paraguay ... - 79 - ...
8. Peru 146 - 506 - ...
9. Uruguay ... - 195 - ...
10. Venezuela ... - 153 - ...

• NORTH-EAST AND SOUTH ASIA

1. Bangladesh ... - 7 - ...
2. China ... - 570 - ...
3. Hong Kong SAR 90 - 596 - ...
4. India ... - 80 - ...
5. Japan ... - 1049 - ...
6. Korea (South) ... - 142 - ...
7. Macao ... - 13 - ...
8. Sri Lanka ... - 8 - ...
9. Taiwan ... - 61 - ...

• SOUTH-EAST ASIA

1. Brunei Darussalam ... - 11 - ...
2. Cambodia ... - 5
3. Indonesia ... - 2
4. Laos PDR ... - 3
5. Malaysia ... - 68 - ...
6. Myanmar 1 - 1
7. Philippines ... - 861 - 1
8. Singapore ... - 365 - ...
9. Thailand 155 - 1209 - 2
10. Vietnam ... - 63 - ...

• AUSTRALIA AND PACIFIC

1. *****Australia 183 - 3702 - 5
2. Fiji ... - 2
3. ***French Polynesia ... - 2 - ...
4. New Zealand 16 - 523 - ...
5. Papua New Guinea ... - 1 - ...
6. Samoa ... - 1 - ...
7. Vanuatu ... - 2

• TOTAL 1713 - 65460 - 318

• Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.
• (a) Cases reported between 27 June 17:00 hours and 28 June 17:00 hours
• (*) Deaths are included in the cumulative number of confirmed cases
• (**) Cases in the US include both probable and confirmed cases. They also include confirmed cases from Puerto Rico.
• (***) The cases in Martinique and French Polynesia were reported by France
• (****) Three of the cases are reported to occur in a cruise ship in Curacao.
• (*****) One Australian case reported from a cruise ship.

(...)

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