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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 36 (EW 36), from 6 September to 12 September, 17 countries reported updated information to the Pan American Health Organization (PAHO) regarding the qualitative indicators to monitor pandemic (H1N1) 2009 (Table 1). Only those 17 countries were included in this analysis.

Presently, 15 countries in the Region report having widespread geographical distribution of influenza virus. Brazil continues to report Regional activity and Dominica continues to report no activity (Map 1).

Honduras, Mexico, Peru, and the United States are the only countries reporting an increasing trend of respiratory disease and this represents change in these countries from last week. Argentina, Bolivia, Brazil, Costa Rica, El Salvador, Panama, and Venezuela, reported a decreasing trend. The other six countries reported an unchanged trend (Map 2).

Regarding the intensity of acute respiratory disease, Bolivia, El Salvador, and Mexico reported high intensity of acute respiratory disease. The remaining 14 countries reported low or moderate intensity (Map 3).

Eight countries (Bolivia, Brazil, Costa Rica, Ecuador, El Salvador, Mexico, United States, and Venezuela) reported moderate impact on health care services, while 8 countries reported low impact (Map 4).

In North America, Mexico and the United States are reporting widespread activity, increasing trend in respiratory disease activity, and moderate impact on healthcare services.

The World Health Organization (WHO) does not recommend any travel restrictions or border closings due to pandemic (H1N1) 2009.

Update on the number of cases and deaths

As of 18th September 2009, a total of 130,448 confirmed cases have been notified in all 35 countries in the Americas Region. A total of 2,948 deaths have been reported among the confirmed cases in 22 countries of the Region (Table 2). One new death has also been reported in Martinique.

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 (44, 1 death); Guadeloupe, French Overseas Community (27); Guyane, French Overseas Community (29); Saint-Martin, French Overseas Community (16); Saint Bartholomew; French Overseas Community (2); Netherlands Antilles, Aruba (13); Netherlands Antilles, Bonaire (29); Netherlands Antilles, Curacao (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: http://www.paho.org/hq/images/atlas/en/atlas.html

Update on the Virological Situation

Influenza virus antiviral susceptibility testing is done routinely as part of the surveillance activities carried out by the WHO collaborating center for Surveillance, Epidemiology & Control of Influenza at the U.S. Centers for Disease Control and Prevention. Susceptibility to neuraminidase inhibitors is carried out for the neuraminidase inhibition assay and resistant viruses are sequenced o determine the presence of established molecular marker of resistance.

The susceptibility to adamantanes is carried out by determining the presence of established molecular markers of resistance.

There are no updates to report this week for antiviral susceptibility testing in Latin America and the Caribbean.

The United States reported, as of August 29, 2009,  nine osteltamivir-resistant pandemic (H1N1) 2009 cases. This is an increase of three cases since the last report.

Update on Antiviral Susceptibility

Influenza virus antiviral susceptibility testing is done routinely as part of the surveillance activities carried out by the WHO collaborating center for Surveillance, Epidemiology & Control of Influenza at the U.S. Centers for Disease Control and Prevention. Susceptibility to neuraminidase is carried out for the neuraminidase inhibition assay and resistant viruses are sequenced to determine the presence of molecular markers of resistance. The susceptibility to adamantanes is carried out by determining the presence of molecular markers of resistance.

There are no updates to report this week for antiviral susceptibility testing in Latin America and the Caribbean.

The United States and Canada reported, as of September 5, 2009, nine and one oseltamivirinhibitors resistant pandemic (H1N1) 2009 cases, respectively.

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 September 18, 2009)

 

Last Updated on Tuesday, 02 March 2010 05:50

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