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This report was prepared based on the indicators in the document Human infection with pandemic (H1N1)2009 virus: updated interim WHO guidance on global surveillance available at this link.  

The qualitative indicators for surveillance of the Pandemic (H1N1) 2009 are described in Table 3 of this report. The information presented herein has been obtained through the official sites of the Ministries of Health of the countries in the Region as well as official reports submitted by the International Health Regulation (IHR) National Focal Points.

Update on the Qualitative Indicators

For epidemiological week 31 (EW 31, August 2 to August 8) 17 countries have reported updated information to the Pan American Health Organization (PAHO) regarding the qualitative indicators to monitor the pandemic (H1N1) 2009 (Table 1). Data from the most recent week of notification is considered for the purposes of the analysis below (EW 28 – 31).

Presently, 22 countries in the Region report having widespread geographical distribution of the pandemic (H1N1) 2009 virus. Brazil reported that the geographical distribution is more limited during EW 31, thus its status changed from widespread to regional spread. Barbados reported information on geographical spread of pandemic influenza activity for the first time, reporting widespread distribution for EW 31. While Saint Kitts and Nevis informed having localized activity of pandemic influenza last week, on EW 31 their status has changed to no activity (Map 1).

Four countries reported an increasing trend of respiratory disease, namely Belize, Haiti, Peru, and Saint Lucia. Three countries (Bolivia, Guatemala and Paraguay) that have reported increased trend in previous week, reported unchanged trend in the EW 31 (Map 2).

Regarding the intensity of acute respiratory disease when comparing to the same period in previous years, Mexico reported having a very high intensity for EW 31, an increase from previous week. Argentina, Canada, Cuba, El Salvador, Guatemala, and Paraguay maintained their status of high intensity (Map 3).

Of the 24 countries with information available, 8 countries (Bolivia, Brazil, Cuba, Ecuador, El Salvador, Guatemala, Mexico and Paraguay) reported experiencing moderate impact on health care services. For EW 31, no country reported a severe impact on health care services (Map 4).

Table 1

Update on the number of cases and deaths

As of August 14, 2009, a total of 105,882 confirmed cases have been notified in all 35 countries in the Americas Region. A total of 1,579 deaths have been detected among the confirmed cases in 22 countries of the Region. Nicaragua and Venezuela reported their first deaths during EW 31.

In addition to the figures displayed in Table 2, the following overseas territories have confirmed cases of pandemic (H1N1) 2009: American Samoa, U.S. Territory (8); Guam, U.S. Territory (1); Puerto Rico, U.S. Territory (20); Virgin Islands, U.S. Territory (49); Bermuda, UK Overseas Territory (1); Cayman Islands, UK Overseas Territory (14); British Virgin Islands, UK Overseas Territory (2); Turks and Caicos Islands (3); Martinique, French Overseas Community (15); Guadeloupe, French Overseas Community (11); Saint-Martin, French Overseas Community (4); Netherlands Antilles, Aruba (13); Netherlands Antilles, Bonaire (28); Netherlands Antilles, Curaçao (43)*; Netherlands Antilles, St. Eustatius (1); and Netherlands Antilles, St. Maarten (16).
* Three cases were reported on a cruise-ship.

The distribution of cases and deaths at the first sub-national level can be found in the interactive map available through the following link.

Update on the Virologic Situation

Virological data obtained from Ministry of Health websites, Ministry of Health reports to PAHO and notifications from National Influenza Centers (NICs) is included below.

For the purposes of this analysis, only countries (or laboratories) that reported data on influenza sub type were considered. We excluded from the calculations of the percentages, results from samples of influenza that were not subtyped or were un-subtypeable.

Virological information for countries (or laboratories) that provided that level of detail is display in Table 3.

Among viruses that were subtyped as influenza A (seasonal H1, H3 or pandemic (H1N1) 2009), the predominant virus is the pandemic one (H1N1) 2009 in most countries for which information was available.

Table 4. Qualitative indicators for the monitoring of pandemic (H1N1) 2009

Geographical spread: refers to the number and distribution of sites reporting influenza activity.
No activity: No laboratory confirmed case(s) of influenza, or evidence of increased or unusual respiratory disease activity.
Localized: Limited to one administrative unit of the country (or reporting site) only.
Regional: Appearing in multiple but <50% of the administrative units of the country (or reporting sites).
Widespread: Appearing in ≥50% of the administrative units of the country (or reporting sites).
No information available:

No information available for the previous 1 week period.

Trend of respiratory disease activity compared to the previous week: refers to changes in the level of respiratory disease activity compared with the previous week.

Increasing: Evidence that the level of respiratory disease activity is increasing compared with the previous week.
Unchanged: Evidence that the level of respiratory disease activity is unchanged compared with the previous week.
Decreasing: Evidence that the level of respiratory disease activity is decreasing compared with the previous week.
No information available.  

Intensity of Acute Respiratory Disease in the Population: is an estimate of the proportion of the population with acute respiratory disease, covering the spectrum of disease from influenza‐like illness to pneumonia.

Low or moderate: A normal or slightly increased proportion of the population is currently affected by respiratory illness.
High: A large proportion of the population is currently affected by respiratory illness.
Very high: A very large proportion of the population is currently affected by respiratory illness.
No information available.  

Impact on Health-Care Services: refers to the degree of disruption of health‐care services as a result of acute respiratory disease.

Low: Demands on health-care services are not above usual levels.
Moderate: Demands on health-care services are above the usual demand levels but still below the maximum capacity of those services..
Severe: Demands on health care services exceed the capacity of those services.
No information available.  

Source: Updated interim WHO guidance on global surveillance of human infection with pandemic (H1N1) 2009 virus. 10 July 2009.

The data and information in this report will be updated on a weekly basis and available here.

This report was prepared based on the indicators in the document Human infection with pandemic (H1N1) 2009 virus: updated interim WHO guidance on global surveillance available here.

The information presented herein has been obtained through the official sites of the Ministries of Health of the countries in the Region as well as official reports submitted by the International Health Regulation (2005) National Focal Points.

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icon Regional Update. Pandemic (H1N1) 2009. (published on August 14, 2009)
Last Updated on Tuesday, 02 March 2010 05:39

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