Pandemic (H1N1) 2009 - update 73
As of 1 November 2009, worldwide more than 199 countries and overseas territories/communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including over 6000 deaths.
As many countries have stopped counting individual cases, particularly of milder illness, the case count is likely to be significantly lower than the actual number of cases that have occurred. WHO is actively monitoring the progress of the pandemic through frequent consultations with the WHO Regional Offices and member states and through monitoring of multiple sources of data.
Intense and persistent influenza transmission continues to be reported in North America without evidence of a peak in activity. The proportion of sentinel physician visits due to influenza-like-illness (ILI)(8%) has exceeded levels seen over the past 6 influenza seasons; 42% of respiratory samples tested were positive for influenza and 100% of subtyped influenza A viruses were pandemic H1N1 2009. Rates of ILI, proportions of respiratory samples testing positive for influenza, and numbers of outbreaks in educational settings continues to increase sharply in Canada as activity spreads eastward. Significantly more cases of pandemic H1N1 have been recorded in Mexico since September than were observed during the initial springtime epidemic.
In Europe and Central and Western Asia, pandemic influenza activity continues to increase across many countries, signalling an unusually early start to the winter influenza season. Active circulation of virus marked by high proportions of sentinel respiratory samples testing positive for influenza has been reported in Belgium (69%), Ireland (55%), Netherlands (51%), Norway (66%), Spain (46%), Sweden (33%), the United Kingdom (Northern Ireland:81%), and Germany (27%). In addition, there is evidence of increasing and active transmission of pandemic influenza virus across Northern and Eastern Europe (including Ukraine and Belarus), and eastern Russia. For details on the situation in Ukraine please refer to the Disease Outbreak News update below. In Western Asia and the Eastern Mediterranean Region, increasing activity has been reported in Oman and Afghanistan.Pandemic (H1N1) 2009, Ukraine - update 1
In East Asia, intense and increasing influenza activity continues to be reported in Mongolia. In China, after an earlier wave of mixed influenza activity (seasonal H3N2 and pandemic H1N1), pandemic H1N1 influenza activity now predominates and is increasing. Sharp increases in pandemic influenza activity continue to be reported throughout Japan with highest rates of illness being reported on the northern island.
Active influenza transmission and increasing levels of respiratory diseases continues to be reported in parts of the Caribbean, including in Cuba, Haiti, and other Caribbean Epidemiology Centre (CAREC) countries. Most other countries in the tropical region of Central and South America continue to report declining influenza activity. With the exception of Nepal, Sri Lanka, and Cambodia, overall transmission continues to decline in most but not all parts of tropical South and Southeast Asia. Influenza virus isolates from sub-Saharan Africa are predominantly pandemic H1N1 virus but some seasonal H3N2 has been detected even in recent weeks. Unconfirmed media reports from the area indicate that disease activity has increased in recent weeks.
Since the new pandemic H1N1 2009 virus emerged, infections in different species of susceptible animals (pig, turkey, ferret, and cat) have been reported. Limited evidence suggests that these infections occurred following direct transmission of the virus from infected humans. These isolated events have had no impact on the dynamics of the pandemic, which is spreading readily via human-to-human transmission. As human infections become increasingly widespread, transmission of the virus from humans to other animals is likely to occur with greater frequency. Unless the epidemiology of the pandemic changes, these will continue to pose no special risks to human health.Weekly update (Virological surveillance data)
Here is their Special Ukraine Update # 1
This is from the 3rd of November - I will be watching for an update any day from them, regarding the Ukraine.
3 November 2009 -- According to the Ministry of Health of Ukraine, the country has now recorded more than 250 000 cases of influenza-like illness, with 235 patients requiring intensive care. As of 2 November, 70 deaths from acute respiratory illness have been reported.
Regions in western Ukraine continue to show the highest rates of acute respiratory illness/influenza-like illness. The level of activity in the Kyiv area is also increasing rapidly.
Laboratory testing in Ukraine has confirmed pandemic H1N1 influenza virus in samples taken from patients in two of the most affected regions. As the pandemic virus has rapidly become the dominant influenza strain worldwide, it can be assumed that most cases of influenza in Ukraine are caused by the H1N1 virus.
As elsewhere, WHO strongly recommends early treatment with the antiviral drugs, oseltamivir or zanamivir, for patients who meet treatment criteria, even in the absence of a positive laboratory test confirming H1N1 infection.
Recommended use of antivirals
Pandemic (H1N1) 2009
At the request of the government, a multi-disciplinary team of nine experts has been deployed by WHO and arrived in Kyiv yesterday evening. Discussions with the Minister of Health were held this morning to brief the team.
Team members will now begin field investigations to characterize the clinical and epidemiological features of the outbreak. Work will initially begin in Lviv region, where reported numbers of cases showing severe manifestations of acute respiratory illness have been especially high. Two virologists on the team have started working at the National Influenza Centre and the laboratories of the Central Sanitary and Epidemiological Station in Kyiv to provide diagnostic support.
Samples sent by the Ministry of Health were received today by the WHO Collaborating Centre for Reference and Research on Influenza, Mill Hill in London, UK. The laboratory will conduct confirmatory tests and further characterize the virus.
Many questions remain to be answered. The outbreak in Ukraine may be indicative of how the virus can behave in the northern hemisphere during the winter season, particularly in health care settings typically found in Eastern Europe.
Given the potential significance of this outbreak as an early warning signal, WHO commends the government of Ukraine for its transparent reporting and open sharing of samples.
WHO continues to recommend no closing of borders and no restrictions on international travel, including to Ukraine. Experience shows that such measures will not stop further spread of the virus.
Obviously this is old, since one border (Solvakia), so far - is now being closed with Ukraine, except for one road. (information posted below about border closing)