H1H1 Super Spreader in India?

[HenryN]

<TABLE border=0 cellSpacing=0 cellPadding=0 width="85%" align=center><TBODY><TR bgColor=#eff0ef><TD vAlign=top colSpan=2 align=middle>H1N1 update for 25th July, 2009 <HR></TD></TR><TR bgColor=#eff0ef><TD style="TEXT-ALIGN: left" height=30 vAlign=top width=103>[FONT=Arial, Helvetica, sans-serif][/FONT]</TD><TD style="TEXT-ALIGN: right" height=30 vAlign=top width=347>[FONT=Arial, Helvetica, sans-serif]19:56 IST [/FONT]</TD></TR></TBODY></TABLE><TABLE width="90%" align=center><TBODY><TR><TD style="TEXT-ALIGN: justify" class=rel>World Health Organization has reported 94,512 laboratory confirmed cases of influenza A/H1N1 infection from 135 countries as on 6th July 2009. There have been 429 deaths. There is no further update.

Health screening of passengers coming from affected countries is continuing in 22 International airports. 47,014 passengers have been screened on 24.7.2009 of which 37,456 passengers were from affected countries. 224 doctors and 112 paramedics are manning 81 counters at these airports. A cumulative total of 38,32,253 passengers have been screened.

Twenty one new laboratory confirmed cases have been reported today: Delhi (2), Pune (10), Jaipur (4), Vishakhapatnam (2), Hyderabad (1), Cochin (1) and Bangalore (1).

Out of the 2 cases in Delhi, the first is a 14 Year Old Female who travelled from UK by Virgin Airlines flight VS 300 reaching Delhi on 5 July 2009. She became symptomatic on 22 July 2009 and was admitted to identified health facility. The other case in Delhi is a 30 Year old male who arrived from Singapore by Cathay Pacific flight no. CX 751 reaching Delhi 23 July 2009. He was found symptomatic at the Airport and was admitted to the identified health facility.

All 10 cases in Pune were contact cases of previously reported positive cases. Two of the contacts (5/F & 25/F) developed symptoms on 23 July and were admitted. Eight others (38/F; 11/F; 28/M; 10/M; 10/F; 16/M; 10/M & 13/F) developed symptoms and were admitted to the identified health facility on 24 July 2009.

All four cases (50/F; 15/F; 38/F & 13/F) in Jaipur belong to one household/family and are contacts of a previously reported positive case. They developed symptoms on 23 and 24 July and self reported to the identified health facility.

Two cases (5m/F & 48/M) reported on the day from Vishakhapatnam belong to the same family and are contacts of a previously reported case in Vishakhapatnam.

The case is Hyderabad is a 54 year old male who travelled from US to Hyderabad by Emirates Airlines flight no. EK 526 via Dubai reaching 21 July. He self reported with symptoms on 23 July and was admitted to the identified health facility.

The case (74/F) in Cochin is household contact of a previously reported positive case. She developed symptoms on 23 July 2009 and was admitted to the identified health facility.

The case (24/M) in Bangalore travelled from Seoul in South Korea via Hongkong by Cathay Pacific Flight no. CX 152 reaching Bangalore on 20 July 2009. He self reported with symptoms on 22 July 2009 and was admitted to the identified health facility.

1946 persons have been tested so far out of which 413 are positive for Influenza A H1N1 [Swine]. 570 out of the 1946 persons have been identified through entry screening, 333 through contact tracing and the rest were self reported.

Of the 413 positive cases, 294 have been discharged. Rests of them remain admitted.

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http://pib.nic.in/release/release.asp?relid=50971

 

[HenryN]

Re: H1H1 Super Spreader in India?

<TABLE border=0 cellSpacing=0 cellPadding=0 width="85%" align=center><TBODY><TR bgColor=#eff0ef><TD vAlign=top colSpan=2 align=middle>H1N1 update for 25th July, 2009 <HR></TD></TR><TR bgColor=#eff0ef><TD style="TEXT-ALIGN: left" height=30 vAlign=top width=103></TD><TD style="TEXT-ALIGN: right" height=30 vAlign=top width=347>[FONT=Arial, Helvetica, sans-serif]19:56 IST [/FONT]</TD></TR></TBODY></TABLE><TABLE width="90%" align=center><TBODY><TR><TD style="TEXT-ALIGN: justify" class=rel>
All 10 cases in Pune were contact cases of previously reported positive cases. Two of the contacts (5/F & 25/F) developed symptoms on 23 July and were admitted. Eight others (38/F; 11/F; 28/M; 10/M; 10/F; 16/M; 10/M & 13/F) developed symptoms and were admitted to the identified health facility on 24 July 2009.



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http://pib.nic.in/release/release.asp?relid=50971

The above cluster in Pune appears to be rather large and may signal more efficient transmission.

 

[HenryN]

Re: H1H1 Super Spreader in India?

World Health Organization has reported 94,512 laboratory confirmed cases of influenza A/H1N1 infection from 135 countries as on 6th July 2009. There have been 429 deaths. There is no further update.

Health screening of passengers coming from affected countries is continuing in 22 International airports. 47,099 passengers have been screened on 25.7.2009 of which 36, 275 passengers were from affected countries. 224 doctors and 112 paramedics are manning 81 counters at these airports. A cumulative total of 38, 79,352 passengers have been screened.

Sixteen new laboratory confirmed cases have been reported today: Delhi (4), Pune (7), Gurgaon (1), Hyderabad (1), Kozhikode (2) and Bangalore (1).

Out of the 4 cases in Delhi, the first case is a 15 year old male who travelled from Singapore by Cathay Pacific Flight CX 708 transiting Bangkok, reaching Delhi on 22 July 2009. He became symptomatic on 25 July 2009 and was admitted to an identified health facility. The second case in Delhi is a 52 year old male who arrived from Malaysia by Malaysian Airline flight no. MH 190 reaching Delhi 24 July 2009. He was found symptomatic at the Airport and was admitted to the identified health facility. The third case is a 24 year old male who travelled from Sydney, Australia by China Airlines flight no. CI 0181 reaching Delhi on 24 July 2009. He was detected at the airport with fever and was admitted to the identified health facility. The fourth case in Delhi is 20 year old male who is a contact of a previously reported positive case. He was found to be symptomatic on 24 July 2005 and stays admitted at an identified health facility.

Out of the 7 cases in Pune, five cases are contact cases of previously reported positive cases. One case (11/M) developed symptoms on 24 July 2009 and was admitted to the identified health facility. The other four cases (6/F; 15/M; 14/M; 14/F) developed symptoms on 25 July 2009 and were admitted to the identified health facility. The sixth and seventh cases in Pune are a 53 year old male and a 50 year old female who travelled from London,UK by Jet Airways flight 9W 0119 reaching Mumbai on 11 July 2009. They self reported with symptoms and were admitted to an identified health facility.

The case from Gurgaon is a 17 year old male, who is a contact of a previously reported positive case. He was found to be symptomatic on 25 July 2009 and got admitted to the identified health facility.

The case in Hyderabad is a 5 year old male who is contact of a previously reported positive case. He self reported with symptoms on 24 July 2009 and was admitted to the identified health facility.

Out of the two cases in Kozhikode one is a 38 year old male who travelled from Riyadh, Saudi Arabia by Air India Flight no.AI 922 reaching Kozhikode on 19 July 2009. He self reported with symptoms on 24 July 2009 and was admitted to the identified health facility. The second case from Kozhikode is a 48 year old male who travelled from Abu Dhabi, UAE by Air India Express Flight no. IX 348 reaching Kozhikode on 20 July 2009. He developed symptoms on 24 July 2009 and was admitted to the identified health facility.

The lone case in Bangalore (37/F) is a contact of a previously reported positive case. She self reported with symptoms on 24 July 2009 and was admitted to the identified health facility.

1996 persons have been tested so far out of which 429 are positive for Influenza A H1N1 [Swine]. 421 out of the 1946 persons have been identified through entry screening, 353 through contact tracing and the rest were self reported.

Of the 429 positive cases, 298 have been discharged. Rest of them remain admitted.

The situation is being monitored.

http://pib.nic.in/release/release.asp?relid=50977

 

[HenryN]

Re: H1H1 Super Spreader in India?

Out of the 7 cases in Pune, five cases are contact cases of previously reported positive cases. One case (11/M) developed symptoms on 24 July 2009 and was admitted to the identified health facility. The other four cases (6/F; 15/M; 14/M; 14/F) developed symptoms on 25 July 2009 and were admitted to the identified health facility. The sixth and seventh cases in Pune are a 53 year old male and a 50 year old female who travelled from London,UK by Jet Airways flight 9W 0119 reaching Mumbai on 11 July 2009. They self reported with symptoms and were admitted to an identified health facility.


http://pib.nic.in/release/release.asp?relid=50977

Ten on Saturday and five more on Sunday in Pune linked to contacts.

 

[Rwilmer]

Re: H1H1 Super Spreader in India?

Dr. Niman, do I need to remind you of this study that was done:
http://www.medpagetoday.com/InfectiousDisease/SwineFlu/14154

swine flu can transmit very easily, it is flu. Flu spreads like wildfire. Especially to one which people have no immunity, hence the name pandemic. Look at the school in new york city in april.

 

[HenryN]

Re: H1H1 Super Spreader in India?

Dr. Niman, do I need to remind you of this study that was done:
http://www.medpagetoday.com/InfectiousDisease/SwineFlu/14154

swine flu can transmit very easily, it is flu. Flu spreads like wildfire. Especially to one which people have no immunity, hence the name pandemic. Look at the school in new york city in april.

But this may be 15 people infected by one.

 

[HenryN]

Re: H1H1 Super Spreader in India?

Two days earlier

In Pune, all the four cases [10/M, 12/F, 5/M, 11/F] are contact cases of previously reported positive cases.

 

[HenryN]

Re: H1H1 Super Spreader in India?

Three days earlier

Out of the four cases, three [10/F, 72/F, 6/F] of them are contact cases of previously reported positive cases in Pune. The fourth one is a 30 year old male who travelled from Australia via Hongkong by Cathay Pacific Flight CX 134 and CX 709 reaching Mumbai on 19th July 2009. She developed symptoms and was admitted to the identified facility on 21st July 2009.

 

[HenryN]

Re: H1H1 Super Spreader in India?

Four days earlier (may be linked to school outbreak)

The two cases [13 years old females] in Pune are school contacts of previously reported cases in Pune.

 

[HenryN]

Re: H1H1 Super Spreader in India?

Pune school closes for week as H1N1 flu attacks more students

Pune (PTI): A reputed school here was closed down on Tuesday for a week following an alarming rise in the number of its students testing positive for H1N1 virus, which now stands at 13.
Ten students of the English medium school, which had earlier shut down one division of class eight, were already admitted to an isolation ward of Civic Naidu Hospital and the test results of more suspected cases were awaited, hospital officials said.
The total number of confirmed H1N1 flu cases in the city has now risen to 24.
According to medical officer of Pune Municipal Corporation R.R. Pardesi, the school authorities were advised by the State Health Department to close all pre-primary, primary and higher secondary sections after the infection, which had been confined to class eight division till yesterday, when it spread to class five with a boy testing positive for the virus.
"There is a possibility of the infection spreading among many primary school students through close physical contact when they travel in a cluster in rickshaws," he said. The H1N1 flu cases of eight students came to light last week following which preventive measures were initiated by the school and the health authorities.

http://www.hindu.com/thehindu/holnus/004200907211911.htm

 

[HenryN]

Re: H1H1 Super Spreader in India?

With two more children testing positive for swine flu, the total number of schoolchildren infected with the H1N1 virus has reached seven.


The Pune Municipal Corporation health officials and authorities of the city school ? from where the students have been infected ? ensured the parents on Friday that the virus was a mild one. The children are being treated at Naidu Hospital.


The school authorities distributed letters to the parents of Class VIII students, saying academics would not be affected by the temporary closure of one division of the class till July 21. PMC chief medical officer Dr R R Pardeshi said till 6 pm, 34 children from the school were medically examined.


?As many as seven children tested positive for the flu and are undergoing treatment at Naidu Hospital. Further, 14 parents, with their wards ? who did not have swine flu symptoms ? also reported at the hospital for check-ups,? said Pardeshi.

http://www.indianexpress.com/news/swine-flu-civic-body-says-no-cause-for-alarm/490836/

 

[HenryN]

Re: H1H1 Super Spreader in India?

Three schools in Pune have been closed after 26 of their students tested positive for swine flu. City's Abhinav School reported 23 students with swine flu symptoms, Symbiosis two, while Seva Sadan High School reported one case. The number of swine flu victims in the city suddenly shot up after some students returned from a trip to Indiana, US. The schools will remain closed till August 2.


Maharashtra Education Minister, Radhakrishna V.K. Patil who had visited the schools on Saturday, said, "The fear which spread amongst parents that swine flu was spreading has been brought to rest by closing the schools. But shutting down the schools cannot be a solution for countering swine flu."


The school authorities and the city corporation will sit together and sort out the issue, he added.

http://www.indianexpress.com/news/Three-Pune-schools-closed-due-to-swine-flu-threat/494286

 

[HenryN]

Re: H1H1 Super Spreader in India?

Authorities of Abhinav English School, Karve Road, which has eleven positive cases of swine flu so far, are ready to close the school for some period, provided health officials or municipal commissioner gives such order.
A fifth standard girl student of Abhinav School (English Medium) has tested positive for Influenza A HINI virus on Monday. She contracted the virus from her infected brother in eighth standard of the same school. Rising detection of swine flu in the school has caused panic among parents, who are now demanding that school should be closed for some time.
When contacted, managing trustee of the institute Chintamani Latkar said, ?School is ready to close down for some period, if municipal commissioner or health officials give such order. We cannot take this decision as we are not competent to determine the exact spread of virus. Besides, closing down the school without proper health review could cause panic among students and parents. But if the school is needed to be closed, we will ensure that students would not have to bear any academic loss.?
Latkar claimed that the school is in constant touch with parents and health officials to detect and contain swine flu virus.
School closed today
PMC has called a meeting of parents of students from Abhinav English School and various officials to review the situation in the school. The school will remain closed on Tuesday due to the meeting, said Latkar.
PMC tells school to keep affected divisions closed
In its effort to contain the spread of Influenza A H1N1 virus, the health department of the Pune Municipal Corporation (PMC) in a fresh directive has asked the Abhinav English Medium School to keep the affected divisions closed till further orders.
Speaking to Sakal Times here on Monday, PMC chief medical officer Dr R R Pardeshi said that the school administration has been asked to keep the affected sections comprising the Lotus and Rose divisions closed till further orders.
He said that the corporation would organise a meeting at the Yashwantrao Chavan auditorium on Tuesday at 11 am for parents and teachers of the school, which would also be attended by officials of the state government and medical officials.
Meanwhile, Abhinav School authorities said that the affected divisions would remain closed as precautionary measure.
?The school had already shut down the affected divisions as per an earlier advisory issued by the corporation. We are abiding by all the instructions that are coming from government and municipal authorities to contain the virus from further spreading,? school trustee Chintamani Latkar said.
Asked as to how many pupils from the institution tested positive for the virus till date, Latkar said that around 11 students from the Lotus and Rose divisions contracted the virus through fellow pupils.
Two more students test positive
Two more students on Monday tested positive for the Influenza A H1N1 taking the total number of swine flu affected persons in the city to 24.
According to the health ministry communique, two patients (13-year-old and 10-year-old boys) contracted the virus from an earlier reported case in Pune.
The duo reported to the Naidu Hospital with fever, running nose and sore-throat and since has been admitted.
Last week, two 12-year-olds, a boy and a girl, were infected with flu at their school through the relative of a swine flu patient. The patient was part of a group of 40 students that returned from the US on July 8 after a one-year exchange programme.

http://www.sakaaltimes.com/2009/07/21121923/Swine-flu-outbreak-Pune-schoo.html

 

[HenryN]

Re: H1H1 Super Spreader in India?

Eight schools in the city, including six Abhinav schools at Karve road, have been shut down till July 31 as swine flu scare further deepened on Friday.
The education department too has swung into damage control mode and asked schools to send students with symptoms like fever, cold and cough back home as a precaution.
Adarsh Shikshan Mandali (ASM) having Abhinav pre-primary, primary and high schools at Karve road, closed three Marathi medium schools on Friday, in addition to three English medium schools, which were closed on Tuesday following several positive cases of Influenza A H1N1 virus infection.
Sevasadan English Medium School and Symbiosis School, off Prabhat Road too were closed on Friday after they reported one positive case each of swine flu. These schools will reopen on 1st August.
C S Latkar, secretary of ASM clarified that Abhinav Marathi Schools were closed as a precautionary measure though none of them reported any case of swine flu. First unit test of all these schools has been cancelled.
Latkar said, ?Total 19 students of Abhinav English Medium School tested positive for H1N1 virus. Eleven of them have been treated at the Naidu hospital and sent home after they were completely cured. Eight are undergoing treatment. We have disinfected the entire premises of the school.?
Meanwhile, following orders from Deputy Director of Education Sunil Magar, PMC education officers on Friday called urgent meetings of school principals to brief them about the precautionary measures.
Ten divisions of PMC education board conducted meetings in their respective areas. City has 274 PMC schools and more than 350 private aided-unaided schools.
?All schools have been asked to keep close watch on sick students. In case a teacher comes across any student with symptoms like fever, cough and cold, they should request parents not to send their ward until he or she is completely cured.
Students with swine flu like symptoms should be immediately rushed to Naidu hospital for clinical examination,? said PMC education head Ramchandra Jadhav.
In case any sick students misses his or her unit test, schools should compensate by awarding average marks of next three tests, he added.
2 MORE STUDENTS TEST POSITIVE

One more student of Std VI of Symbiosis School and one student of Lotus division of Std VIII of Abhinav English School has been tested positive for swine flu virus on Friday, informed chief of PMC health department Dr R R Pardeshi. Both Symbiosis and Sevasadan School have been asked to shut down for eight days, he said.

http://www.sakaaltimes.com/2009/07/25130734/8-city-schools-in-grip-of-swin.html

 

[hawkeye]

Re: H1H1 Super Spreader in India?

It would be interesting to know where Indiana the students visited.

The number of swine flu victims in the city suddenly shot up after some students returned from a trip to Indiana, US. The schools will remain closed till August 2.

 

[HenryN]

Re: H1H1 Super Spreader in India?

It would be interesting to know where Indiana the students visited.

It's not clear that the cases at the three schools in India are linked, but it seems likely that the students who visited Indiana are from the school with 23 confirmed cases, but I couldn't find a website for that school to see if there was more detail.

 

[hawkeye]

Re: H1H1 Super Spreader in India?

We'll probably never be able to find out.

It's not clear that the cases at the three schools in India are linked, but it seems likely that the students who visited Indiana are from the school with 23 confirmed cases, but I couldn't find a website for that school to see if there was more detail.

 

[Treyfish]

Re: H1H1 Super Spreader in India?

42 cases so far, focus on checking spread

TNN 26 July 2009, 03:26am IST
Pune: School education minister Radhakrishna Vikhe-Patil, who visited three H1N1 flu-affected schools in the city on Saturday, has announced a <TABLE style="MARGIN-TOP: 10px; MARGIN-BOTTOM: 4px; MARGIN-RIGHT: 8px" cellSpacing=0 cellPadding=0 align=left><TBODY><TR><TD id=bellyad></TD></TR></TBODY></TABLE><TABLE style="MARGIN: 0px 10px 0px 0px; CLEAR: both" class=cnt width=200 align=left><TBODY></TBODY></TABLE>coordinated effort in tackling the spread of the influenza A' H1N1 (swine flu) virus. The effort will involve officials from the Pune Municipal Corporation (PMC), state health and education departments.

So far, 42 H1N1 positive cases have been reported including 20 from a single school off Karve road and nine from three other schools near Law college road, Erandwane and in Bhusari colony, Kothrud.

On Saturday, five more H1N1 positive cases, all students from the school near Law college, and another case of a student from the school at Bhusari colony were reported by the medical authorities. The school at Bhusari colony is the latest to be hit by the flu virus.

The situation has led to temporary closure of three schools, which are to reopen on August 3, while the authorities were to take a call on Sunday on the shut down of the school at Bhusari colony.

Of the total affected individuals, 25 have been so far reported as discharged following quarantine and treatment at the PMC's Naidu hospital and the remaining are undergoing treatment.

After reviewing the situation, Vikhe-Patil told reporters that closure of schools was no solution to tackling the problem. "The concern among parents is valid and understandable but, it also begs the question as to how far we should continue with the shutdown approach. Are we to close the schools every time a swine flu case is reported?" he asked.

"The panic level is much higher than the actual intensity of the problem," he said. "There are alternatives to deal with the situation in a coordinated manner to see that there is no further spread of the virus."

To begin with, a joint coordination committee under the PMC additional commissioner Umakant Dangat, will now monitor the situation and will also take a call on all emerging demand for the closure of schools, if required, said Vikhe-Patil.

"The immediate focus will be on carrying out a joint surveillance of the residential areas from where the flu-affected children hail, to see that there is no spread of the virus." Surveillance teams will conduct door-to-door visits in targetted residential areas to check the possibility of people coming in contact with flu-affected individuals and promote preventive measures.

The schools have been directed to ensure that preventive actions like fumigation are carried out on weekends, ie Saturdays and Sundays. These actions have to be on a voluntary basis, he said. :surrender:

The bed capacity at Naidu hospital is being increased to 40 from the existing 20 beds, to ensure efficient treatment services, the minister said. Dangat, who was present on the occasion, said, "The PMC has an adequate stock of medicines required for treatment of H1N1 positive patients."

A 24-hour dedicated helpline (020) 20250050 will go operational at Naidu hospital from Sunday in order to address concerns raised by people regarding swine flu. "The idea is to ease the pressure on school authorities on account of persistent queries made by worried parents," he said.

"Further, the helpline will minimise the panic level by extending valid and scientific information about the virus, the extent of damage it can cause, measures to prevent its spread and the responses in case of any person showing symptoms of the flu," he added.

Authorities manning the helpline have been asked to prepare answers and a data base of frequently asked questions (FAQs). "Anybody with doubts about H1N1 influenza, can call the helpline and get their queries answered," he said.

Referring to the concern aired by parents about the impact of the swine flu situation on the attendance record of their wards, Vikhe-Patil said that all absentees would be condoned. "We are issuing directives to this effect to all schools," he said. The condonation won't be restricted to the three flu-affected schools but to all those students, irrespective of the institution, who may have to undergo the quarantine process. The coordination committee will issue certificates to such students for claiming condonation.

Director of secondary and higher secondary Bhalchandra Desle, director of higher education Rambhau Kirdak, PMC health official R R Pardeshi and other officials were present.

Vikhe-Patil later addressed a meeting of principals and teachers from different city schools as well as parents, at the Balbharati complex.
:tiphat:http://timesofindia.indiatimes.com/...us-on-checking-spread/articleshow/4820832.cms
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[AlaskaDenise]

Re: H1H1 Super Spreader in India?

Dr. Niman, do I need to remind ........
swine flu can transmit very easily, it is flu. Flu spreads like wildfire. Especially to one which people have no immunity, hence the name pandemic. Look at the school in new york city in april.

I believe Dr. Niman (& others) are looking for evidence of the expected replication-control mutation at PB2/627. Increasing cluster sizes and ease of transmission would be such evidence.

.

 

[AlaskaDenise]

Re: H1H1 Super Spreader in India?

I believe Dr. Niman (& others) are looking for evidence of the expected replication-control mutation at PB2/627. Increasing cluster sizes and ease of transmission would be such evidence.

.

From the study RWilmer linked:

Specifically, they cited uncertainties involving incubation and infectious periods, the possibility of cross-immunity from previous exposure to other influenza subtypes, the future evolution of the transmissibility, antigenicity, virulence, and antiviral resistance profile, and whether the new virus will displace existing influenza A subtypes in the human population.

.