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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 33 (EW 33), from 16 August to 22 August, 22 countries reported updated information to the Pan American Health Organization (PAHO) regarding the qualitative indicators  to monitor pandemic (H1N1) 2009 (Table 1).

Regarding geographical spread of influenza, 17 of 12 countries (Argentina, Bolivia, Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guatemala, Jamaica, Honduras, Panama, Paraguay, Peru, Saint Lucia, the United States and Venezuela) reported widespread of influenza distribution. Dominica and Saint Kitts and Nevis continue to report no activity of influenza. Bahamas, Brazil and Cuba reported regional spread of influenza (Map 1).

With respect of trends in respiratory diseases Bolivia, Ecuador, and Venezuela are the countries reporting an increasing trend for EW 33. Bolivia has been reporting an increasing trend since EW 30 (Map 2).

Regarding the intensity indicator, Argentina, Costa Rica, El Salvador and Paraguay reported high intensity of acute respiratory diseases. Argentina and Paraguay have been reporting high intensity since EW 30. The other 18 countries reported low or moderate intensity of acute respiratory diseases (Map 3).

On impact on health care services, 10 countries (Bahamas, Belize, Bolivia, Brazil, Costa Rica, Ecuador, El Salvador, Mexico, Paraguay and Peru) reported a moderate impact, while 12 countries reported a low impact on health care services (Map 4).

The impact on health care services is the same as reported in the previous week. No country has reported a high impact on health care services since the EW 29.

In addition to reports received from countries, the following overseas territories have reported regarding the qualitative indicators to monitor pandemic (H1N1) 2009: Guadeloupe, French Overseas Community; Guyane, French Overseas Community; Martinique, French Overseas Community; Saint-Martin, French Overseas Community; and Saint Barthelemy, French Overseas Community. A description of those indicators is available in maps 1, 2, 3 and 4 and table 1. 

Update on the number of cases and deaths


As of August 28, 2009, a total of 116,046 confirmed cases have been notified in all 35 countries in the Americas Region. A total of 2,234 deaths have been reported among the confirmed cases in 22 countries of the Region.

In addition to the figures displayed in Table 2, the following overseas territories have confirmed cases of pandemic (H1N1) 2009: 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 (44); Guadeloupe, French Overseas Community (6); Guyane, French Overseas Community (29); Saint-Martin, French Overseas Community (15); Netherlands Antilles, Aruba (13); Netherlands Antilles, Bonaire (29); Netherlands Antilles, Curaçao* (46); Netherlands Antilles, St. Eustatius (1); and Netherlands Antilles, St. Maarten (22).

* 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

Virological Update

Virological data obtained from Ministry of Health websites, from Ministry of Health reports sent to PAHO and notifications from National Influenza Centers (NICs) (Figure 1).

For the purposes of this analysis, only countries or laboratories that reported Influenza A by subtype were selected. In the calculations of the percentages, laboratory results of influenza cases not subtyped or un-subtypeable were excluded.

These figures have been updated from last week’s report to include Colombia’s data from EW 31. In most of countries, pandemic (H1N1) 2009 virus has almost completely replaced the seasonal influenza subtypes that were circulating initially since de beginning of this year.  However, Colombia has continued to detect seasonal influenza subtypes during this period.

Antiviral susceptibility

To present, a total of 115 pandemic (H1N1) 2009 isolates from 16 countries from Latin America and Caribbean were tested by CDC for anti-viral susceptibility.

These isolates have shown sensitivity to neuraminidase inhibitors (oseltamivir and zanamivir) and resistance to adamantanes.

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.

Download the Full Report
icon Regional Update. Pandemic (H1N1) 2009. (published on August 28, 2009)

Last Updated on Tuesday, 02 March 2010 05:46

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