Swine Flu Update

CDC can keep calling it H1N1 (as requested by the "pork growers) but I am sticking to calling it what it is as indicated above

INFLUENZA PANDEMIC (H1N1) (36): WHO UPDATE & SEASONAL
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A ProMED-mail post

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Date: Fri 28 May 2010
Source: WHO Global Alert and Response (GAR) Disease Outbreak News
[summ. & edited]



Pandemic (H1N1) 2009 - update 102
---------------------------------
As of 23 May, worldwide more than 214 countries and overseas
territories or communities have reported laboratory confirmed cases of
pandemic influenza (H1N1) 2009, including over 18 114 deaths. 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 information.

Situation update
----------------
The most active areas of pandemic influenza virus transmission
currently are in parts of the Caribbean and Southeast Asia, where low
level circulation is occurring. Except for localized areas of pandemic
influenza activity in parts of Chile, there is little evidence of
pandemic influenza activity in the temperate zone of the southern
hemisphere.

RSV
---
Of note, respiratory syncytial virus (RSV) is widely circulating in
South America resulting in an increase in respiratory disease
activity, complicating somewhat the interpretation of syndromic
surveillance data from the area. RSV primarily affects children under
the age of 5 years.

Seasonal influenza
------------------
Seasonal influenza A viruses continue to be detected at low to
sporadic levels in all regions. Influenza B has been reported in
increasing but low numbers in South America, where it only recently
appeared, while it is decreasing in Asia.

In the Caribbean and Central America, Cuba, and to a much lesser
extent Costa Rica, continue to experience active circulation of
pandemic influenza virus. In Cuba, current pandemic influenza
activity, which began during late February 2010, remains unchanged
since reaching a plateau during mid-April 2010; in addition, over the
past month, there have been sporadic detections of seasonal influenza
B viruses and also evidence of co-circulation of other respiratory
viruses. In Costa Rica, sustained low levels of pandemic influenza
virus have been co-circulating with other respiratory viruses since
the beginning of 2010. Several other countries in the region continue
to report sporadic detections of seasonal influenza B viruses and low
level co-circulation of other respiratory viruses.

In the tropical zone of South America, pandemic and seasonal influenza
viruses continued to circulate at low to sporadic levels. In Peru,
recent regional increases in respiratory diseases activity (in
children under age 5) has been largely associated with circulating
respiratory syncytial virus (RSV). In Colombia and Brazil, low levels
of pandemic and seasonal influenza H3N2 viruses have been detected
over the past month. In Bolivia, a recent period of circulation of
predominantly seasonal influenza type B viruses appears to have
concluded.

In Asia, overall pandemic influenza activity remains low to sporadic,
except in limited areas of south and southeast Asia, particularly
Singapore, Malaysia, and Bangladesh. In Singapore, levels of ARI
[acute respiratory infection] have been elevated since April 2010 and
in recent weeks have remained near epidemic threshold; approximately
39 percent of respiratory specimens from ILI [influenza-like illness]
patients tested positive for pandemic influenza virus during mid May
2010. In neighboring Malaysia, limited data suggest that active
pandemic influenza virus circulation persist after recent activity
peaked during mid April 2010; small numbers of fatal cases have been
reported since that time. In Bangladesh, co-dominant circulation of
pandemic and seasonal influenza B viruses has been observed since mid
April 2010, however, the overall intensity of respiratory diseases was
reported to low during this period. Low levels of pandemic influenza
virus continued to circulate in western India, while low and declining
levels of seasonal influenza B viruses continued to be reported across
East Asia.

In Sub-Saharan Africa, limited data from several countries continues
to suggest that active transmission of pandemic influenza virus in
West Africa has now largely subsided. In addition to the persistence
of low level circulation of pandemic influenza virus in Ghana,
sporadic detections of pandemic influenza virus have been reported
during the past month in Cameroon, Angola, and Rwanda. In Cameroon,
there has been persistent active circulation of seasonal influenza B
viruses since mid-March 2010.

In the temperate regions of the northern and southern hemisphere,
overall pandemic influenza activity remains low to sporadic. In the
southern hemisphere, Chile continues to report increased ILI in
several regions of the country (notably Los Lagos), however, the
increase in respiratory disease activity has been predominantly
associated with circulating RSV and only to a much lesser extent
pandemic influenza virus.

Viruses other than influenza
----------------------------
In neighboring Argentina, Paraguay, and Uruguay, all recent
respiratory diseases activity during the past month has been
associated with viruses other than influenza. Similarly, there have
been no recent detections of influenza virus in South Africa. In New
Zealand and Australia, overall levels of ILI remain low; only sporadic
detections of seasonal influenza H3N2 and pandemic influenza viruses
have been recently reported in Australia.

The Global Influenza Surveillance Network (GISN) continues monitoring
the global circulation of influenza viruses, including pandemic,
seasonal, and other influenza viruses infecting, or with the potential
to infect, humans including seasonal influenza. For more information
on virological surveillance and antiviral resistance, see the full
text of the weekly virology update at the URL above.

Oseltamivir resistance
----------------------
As of 12 May 2010, 4 additional cases of oseltamivir resistant
pandemic influenza A (H1N1) 2009 viruses have been reported. It brings
the cumulative total to 289 so far. All but one of these have the
H275Y substitution and are assumed to remain sensitive to zanamivir.

No countries and overseas territories/communities have newly reported
their 1st pandemic (H1N1) 2009 confirmed cases since the last web
update (no. 101).

Region / Deaths*
WHO Regional Office for Africa (AFRO) / 168
WHO Regional Office for the Americas (AMRO) / At least 8401
WHO Regional Office for the Eastern Mediterranean (EMRO)** / 1019
WHO Regional Office for Europe (EURO) / At least 4878
WHO Regional Office for South-East Asia (SEARO) / 1814
WHO Regional Office for the Western Pacific (WPRO) / 1834
Total* / At least 18114

*The reported number of fatal cases is an under representation of the
actual numbers as many deaths are never tested or recognized as
influenza related.
** No update since 7 March 2010

Since the last update on 16 May the number of fatalities has increased
by at least 17.

--
Communicated by:
ProMED-mail Rapporteur Marianne Hopp

[The most active areas of pandemic influenza virus transmission
currently are in parts of the Caribbean and Southeast Asia
(particularly Singapore, Malaysia, and Bangladesh), where low level
circulation is occurring. Elsewhere influenza activity remains low to
sporadic, and respiratory syncytial virus and other co-circulating
respiratory viruses predominate in the tropical zone of South America.

A map of influenza activity and virus subtypes is accessible at
.
The displayed data reflect the most recent data reported to Flunet
(), WHO regional
offices, or on ministry of health websites in the preceding 2 weeks.
The full text of the WHO update should be consulted for other relevant
links. - Mod.CP]

[see also:
Influenza pandemic (H1N1) (35): Singapore 20100530.1795
Influenza pandemic (H1N1) (34): Indian variants 20100525.1741
Influenza pandemic (H1N1) (33): WHO update, corr. 20100527.1765
Influenza pandemic (H1N1) (33): WHO update 20100522.1700
Influenza pandemic (H1N1) (32): WHO update 20100501.1418
Influenza pandemic (H1N1) (31): UK (Scotland) D222G mut 20100422.1310
Influenza pandemic (H1N1) (30): WHO update 20100417.1250
Influenza pandemic (H1N1) (29): seasonal vaccine 20100415.1224
Influenza pandemic (H1N1) (28): Hong Kong SAR, Norway, D222G mutation
20100409.1147
Influenza pandemic (H1N1) (27): USA (GA) 20100330.1004
Influenza pandemic (H1N1) (26): WHO update 20100327.0965
Influenza pandemic (H1N1) (25): oseltamivir resistance 20100326.0961
Influenza pandemic (H1N1) (24): mutation analysis 20100313.0820
Influenza pandemic (H1N1) (23): WHO Update 20100313.0805
Influenza pandemic (H1N1) (22): Canada (SK), reassortment 20100305.0734
Influenza pandemic (H1N1) (21): Norway, D222G mutation 20100305.0729
Influenza pandemic (H1N1) (20): China, update 20100303.0702
Influenza pandemic (H1N1) (19): reassortment 20100302.0689 2009
Influenza pandemic (H1N1) (18): WHO update 20100221.0587
Influenza pandemic (H1N1) (17): WHO Update 20100216.0546
Influenza pandemic (H1N1) (16): myocarditis in children 20100215.0526
Influenza pandemic (H1N1) (15): update 20100214.0522
Influenza pandemic (H1N1) (14): Finland, cross-reacting antibody 20100205.0392
Influenza pandemic (H1N1) (13): vaccine recall 20100204.0379
Influenza pandemic (H1N1) (12): vaccine distribution, WHO update 20100202.0359
Influenza pandemic (H1N1) (11): WHO statement to CE, corr. 20100129.0312
Influenza pandemic (H1N1) (11): WHO statement to CE 20100126.0289
Influenza pandemic (H1N1) (10): PAHO update 20100121.0240
Influenza pandemic (H1N1) (09): WHO update 20100119.0221
Influenza pandemic (H1N1) (08): USA (vaccine safety), Mongolia 20100117.0194
Influenza pandemic (H1N1) (07): China, travel alert 20100115.0180
Influenza pandemic (H1N1) (06): USA (SD) Native Americans 20100114.0160
Influenza pandemic (H1N1) (05): vaccine update 20100112.0143
Influenza pandemic (H1N1) (04): Australia (WA), i/v zanamivir 20100111.0127
Influenza pandemic (H1N1) (03): USA (WI) minorities 20100109.0103
Influenza pandemic (H1N1) (02): PAHO update 20100108.0093
Influenza pandemic (H1N1) (01): China, 2009 20100105.0040]
........................................cp/mj/jw
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