Monday, August 31, 2009
Saturday, August 29, 2009
Obesity linked to swine flu deaths Study of pandemic reveals that weight problems and pregnancy are significant factors in fatal cases
Mortality patterns were in many cases similar to those associated with normal, seasonal flu. But the team observed: "Nevertheless two risk factors are noticeable: pregnancy and obesity."
But the conclusion that obesity may be a factor in some swine flu deaths opens up a new line of investigation for epidemiologists. Where an underlying disease was found to be present after someone had died of swine flu, in more than one in four cases the deceased had a metabolic condition – diabetes and/or obesity.
There has been a view that fatal cases involving the pandemic have tended to occur among the young, according to the team. And they found the average age of those who have died was 37. More than half of all deaths occurred among the 20- to 49-year-old age group. Overall, 12% of deaths occurred in cases aged 60 years or more.
Thursday, August 27, 2009
- This week there has been a further reduction in the rates of flu-like illness and related activity.
- Weekly GP consultation rates continued to decrease over the last week in England.
- The majority of cases continue to be mild. There is no sign that the virus is changing. It is not becoming more severe or developing resistance to anti-virals.
- Interpretation of data to produce estimates on the number of new cases continues to be subject to a considerable amount of uncertainty. HPA modelling gives an estimate of 5,000 new cases in England last week (range 3,000 to 12,000). There has been a decrease in estimated number of cases in all age groups and in all regions.
This estimate incorporates data from National Pandemic Flu Service and GP consultations.
Disease severity continues to be monitored. The disease is generally mild in most people so far, but is proving severe in a small minority of cases.
Grand total of cases confirmed *
Total deaths reported
In the latest Euroflu bulletin, all countries reported low or moderate intensity indicating a normal or slightly increased proportion of their populations were affected by respiratory illness. Widespread activity was reported for Austria, Israel, England and Swedenhttp://www.euroflu.org/index.php. The majority of new confirmed cases are being reported from Germany (ECDC).
- Maintaining good basic hygiene, for example washing hands frequently with soap and water to reduce the spread of virus from your hands to face or to other people.
- Cleaning hard surfaces (e.g. door handles) frequently using a normal cleaning product.
- Covering your nose and mouth when coughing or sneezing, using a tissue when possible.
- Disposing of dirty tissues promptly and carefully.
- Making sure your children follow this advice.
Swine flu vaccine must sit in storage for over a month while manufacturers wait to see whether it will be given a licence
Wednesday, August 26, 2009
Doctors and nurses are potentially putting patients at risk if they refuse the swine flu vaccine, experts have warned.
Published: 7:30AM BST 26 Aug 2009
Friday, August 21, 2009
Laboratory-confirmed cases of pandemic (H1N1) 2009 as officially reported to WHO by States Parties to the IHR (2005) as of 13 August 2009
The countries and overseas territories/communities that have newly reported their first pandemic (H1N1) 2009 confirmed case(s) since the last web update (No. 61) as of 13 August 2009 are:
Ghana, Zambia, and Tuvalu
as of 13 Aug 2009
WHO Regional Office for
WHO Regional Office for the
WHO Regional Office for the
WHO Regional Office for
WHO Regional Office for
WHO Regional Office for the Western Pacific (WPRO)
*Given that countries are no longer required to test and report individual cases, the number of cases reported actually understates the real number of cases.
Qualitative indicators (Week 31: 27 July - 2 August 2009 and Week 32: 3 August - 9 August 2009)
The qualitative indicators monitor: the global geographic spread of influenza, trends in acute respiratory diseases, the intensity of respiratory disease activity, and the impact of the pandemic on health-care services.Interim WHO guidance for the surveillance of human infection with A(H1N1) virus
A description of WHO pandemic monitoring and surveillance objectives and methods can be found in the updated interim WHO guidance for the surveillance of human infection with pandemic (H1N1) virus.
The attached maps display information on the qualitative indicators reported for weeks 31 and 32. Information is available for approximately 50 to 60 countries each week. Implementation of this monitoring system is ongoing and completeness of reporting is expected to increase over time.List of definitions of qualitative indicators
Geographic spread of influenza activity during week 31 and 32Geographic spread of influenza activity during week 31 [png 157kb]
Geographic spread of influenza activity during week 32 [png 269kb]
Trend of respiratory diseases activity compared to the previous week during week 31 and week 32Trend of respiratory diseases activity compared to the previous week during week 31 [png 155kb]
Trend of respiratory diseases activity compared to the previous week during week 32 [png 266kb]
Intensity of acute respiratory diseases in the population during week 31 and week 32Intensity of acute respiratory diseases in the population during week 31 [png 153kb]
Intensity of acute respiratory diseases in the population during week 32 [png 262kb]
Impact on health care services during week 31 and week 32Impact on health care services during week 31 [png 151kb]
Impact on health care services during week 32 [png 259kb]
As of this week, there have been more than 182,000 laboratory confirmed cases of pandemic influenza H1N1, 1799 deaths, in 177 countries and territories have been reported to WHO. As more and more countries have stopped counting individual cases, particularly of milder illness, the case number is significantly lower than the actually number of cases that have occurred. However, through the WHO monitoring network, it is apparent that rates of influenza illness continue to decline in the temperate regions of the southern hemisphere, except in South Africa where pandemic influenza H1N1 appeared slightly later than the other countries of the region. Active transmission is still seen in some later affected areas of Australia, Chile and Argentina even as national rates decrease.
Areas of tropical Asia are reporting increasing rates of illness as they enter their monsoon season, as represented by India, Thailand, Malaysia, and Hong Kong, four places in the region which have active surveillance programs. Tropical regions of Central America, represented by Costa Rica and El Salvador, are also seeing very active transmission.
In the northern temperate zones, overall rates are declining in both North America and Europe though the virus is still found across a wide area throughout both regions and pockets of high activity are being reported in 3 U.S. states and a few countries of Western Europe.
It has been noted throughout the temperate zones of the southern hemisphere, which are now passing out of their winter season, that when pandemic H1N1 began to circulate, the relative importance of seasonal strains, represented by H3N2 in nearly all countries, rapidly diminished and pandemic H1N1 became the dominant strain. Some seasonal H1N1 strains were reported but were even less common than seasonal H3N2. It is too early to tell if this co-circulation of multiple strains will continue into the coming season of the Northern Hemisphere but it appears very likely that pandemic H1N1 will be the dominant influenza virus in the early part of the winter months.
Many countries including Australia, Canada, New Zealand, and the U.S. have noted that their indigenous peoples appear to be at increased risk of severe disease related to pandemic influenza. While it still has not been clearly determined how much of the increased risk observed in these groups is due to issues related to access to care, high rates of chronic medical conditions that are known to increase risk, or other factors, countries with indigenous and other vulnerable populations should carefully evaluate the situation and consider ways to mitigate the impact of the pandemic in the coming season in these populations.
WHO has also been notified of 12 cases of oseltamivir resistant virus. These isolates have a mutation in the neuraminidase (referred to as H275Y) that confers resistance to oseltamivir, though the viruses remain sensitive to zanamivir. Of these 8 have been associated with oseltamivir post exposure prophylaxis, one with treatment of uncomplicated illness, and two have been from immunocompromised patients receiving oseltamivir treatment. These isolated cases have arisen in different parts of the world (Japan 4, USA 2, China, Hong Kong SAR China 2, and 1 in Denmark, Canada, Singapore and China), and there are no epidemiological links between them. There is also no evidence of onward transmission from these cases.