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EOC Situation Report #8
New influenza A(H1N1)  in the Americas

Summary

  • Sustained human-to-human transmission has been confirmed only in Mexico and USA.  A total of 11 countries have officially reported 331 cases of new influenza A(H1N1) infection.
  • The following countries in other regions have reported laboratory confirmed cases with no deaths: Austria (1), Germany (3), Israel (2), Netherlands (1), New Zealand (3), Spain (13), Switzerland (1) and the United Kingdom (8).
  • The PAHO website  is being constantly updated with new material, including WHO situation reports, recommendations, and frequently-asked questions about the outbreak.
  • WHO has decided to refer to this new virus as “New influenza A(H1N1)”

Status of the Region

  • Mexico: 156 confirmed cases of new influenza A(H1N1), including 9 deaths.
  • The United States: 141 confirmed cases of new influenza A(H1N1), including 1 death.
  • Canada: 34 confirmed cases of new influenza A(H1N1); some with recent travel history to Mexico.
  • A daily epidemiological report is daily posted on the PAHO website ; updated epidemiological reports from Mexico’s Secretary of Health can be found on www.dgepi.salud.gob.mx 

Vaccine Information

  • The seasonal influenza vaccine, despite having an A/H1N1 component, may have little chance of being effective against this current outbreak. 
  • A new vaccine may be available in a relatively short period of time (4-6 months). 
  • Production of this new vaccine will also affect production of the seasonal influenza vaccine.
  • Approximately 1-2 billion doses of the new vaccine should be ready within in 1 year. 
  • The main concern is to guarantee access to the new vaccine to all countries.
  • For more information on vaccines and new influenza A(H1N1), go to the PAHO website.

Overall Recommendations

  • At this time, enhanced surveillance is recommended.  PAHO has published guidelines for the enhancement of surveillance activities (see website).
  • It is recommended that National Influenza Centers (NIC) in LAC countries submit to the WHO Collaborating Center for Influenza (CDC of the United States) all positive specimens of influenza A that cannot be sub-typed.
  • Seasonal influenza vaccination is to be recommended for all countries.
  • No restriction of regular travel or closure of borders is recommended. People who are ill are advised to postpone travel.
  • There is no risk of infection from this virus from consumption of pork and pork products.
  • Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness (ILI).

WHO Pandemic Influenza Preparedness and Response Guidance 2009, Definition of Phases

Phase WHO Pandemic Influenza Preparedness and Response Guidance, 2009
Phase 1 No animal influenza virus circulating among animals has been reported to cause infection in humans.
Phase 2 An animal influenza virus circulating in domesticated or wild animals is known to have caused infection in humans and is therefore considered a specific potential pandemic threat.
Phase 3 An animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks.
Phase 4 Human-to-human transmission (H2H) of an animal or human-animal influenza reassortant virus able to sustain community-level outbreaks has been verified.
Phase 5 The same identified virus has caused sustained community level outbreaks in two or more countries in one WHO region.
Phase 6 In addition to the criteria defined in Phase 5, the same virus has caused sustained community level outbreaks in at least one other country in another WHO region.
Post-peak period Levels of pandemic influenza in most countries with adequate surveillance have dropped below peak levels.
Possible new wave Level of pandemic influenza activity in most countries with adequate surveillance rising again.
Post-pandemic period Levels of influenza activity have returned to the levels seen for seasonal influenza in most countries with adequate surveillance.

Resources

  • The Regional Disaster Information Center (CRID) section of this webpage for useful information for the public and health professionals that has been compiled from different sources (Ministries of Health, Civil Defense and Protection, PAHO and others. See the CRID website . 
  • WHO has published guidelines for the surveillance of human infection for National Focal Points for the International Health Regulations (IHR). It includes a case definition  for surveillance purposes.
  • WHO information on the use of antiviral treatments for influenza including tamiflu is available online.

Conclusions

  • All countries should refer to their National Influenza Pandemic Plans and implement the steps outlined in them for a Phase 5 alert.

For more information

 

Map of at Risk Area

 

Click on the Map to enlarge

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Situation Reports

Last Updated on Tuesday, 12 May 2009 04:47

Regional Office for the Americas of the World Health Organization
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