H1N1 (swine flu) weekly highlights: December 2 - December 8, 2009

The World Health Organization (WHO) reports that "Disease activity has peaked and is declining in North America and has either recently peaked or is currently peaking in much of western and northern Europe." In other good news, WHO also reports no signs of widespread resistance to Tamiflu.

Nevertheless, the WHO has clearly stated it is too soon to call the pandemic over. The global death toll from H1N1 rose to 8,768 as Cyprus, Albania, and the Gaza Strip recorded their 1st H1N1 deaths. The Netherlands saw their first Tamiflu-resistant death.

In the United States, only half of all states reported widespread flu activity, down from 43 states only two weeks ago. England reported new cases were half of the previous week's number.


* Please note that this post will conclude our weekly H1N1 blogs. While the pandemic is far from over, reports of first cases and deaths are less common as H1N1 has spread throughout much of the globe. Numerous H1N1 vaccines have been developed in countries all over the world, and the vaccine shortages seen earlier this year have abated.

HealthMap continues to track H1N1 and all other infectious diseases at http://www.healthmap.org. For the latest disease alerts, you can also follow us on twitter. We hope the H1N1 blogs have been informative and helpful.


Photo courtesy of: http://www.washingtonpost.com/wp-dyn/content/article/2009/12/04/AR2009120402611.html?hpid=sec-health

H1N1 (swine flu) weekly highlights: November 25 - December 1, 2009

Montenegro and Libya reported their 1st H1N1 deaths.

South Korea reported a suspect case of H1N1 reinfection in a young girl.

Reports have stated that the United States has likely reached its peak for H1N1, as only 32 of 50 states are now reporting widespread influenza activity.

While H1N1 may have peaked in parts of the Northern hemisphere, the number of deaths worldwide jumped by over 1,000 during the past week, reaching more than 7,800.

Transmission of the virus remains high in East Asia and Canada.

A large outbreak of H1N1 had been feared to occur during this year's Haj season, however only 73 cases and five deaths were reported.

The US Centers for Disease Control (CDC) reported an increase in serious pneumococcal infections associated with H1N1 cases in the United States. The CDC also released new figures stating that as many as 34 million may have already been infected.

Finland confirmed human-to-pig transmission of the H1N1 virus, while a pig herd in Indonesia was also reported to be infected.

Photo: http://www.google.com/hostednews/afp/article/ALeqM5igd_tCu9zIdryTTRkslBF6I39nxw

H1N1 (swine flu) Weekly Highlights: November 18 - 24, 2009

Somalia reported its 1st cases of H1N1, while Lithuania, Switzerland, Macedonia, Maldives, Madagascar, Romania, Estonia, and Denmark reported their 1st deaths.

The World Health Organization (WHO) tallied over 525,000 H1N1 cases and about 6,750 deaths worldwide.

As the US Centers for Disease Control (CDC) reported decreased flu activity in all regions of the US, the WHO noted the eastward spread of H1N1 across Europe and Asia.

Four H1N1 related deaths have been reported among pilgrims for the Hajj which starts on the 26th.

As immunization campaigns continue in over 40 countries, the WHO reiterated the safety of the H1N1 vaccine, adding that investigation into 40 post-vaccine deaths (among the over 65 million doses given in 16 countries alone) has found no association between the vaccine and the documented fatalities.

In a development not unexpected among experts, Tamiflu-resistant H1N1 clusters emerged among hospitalized patients with severe underlying medical conditions in Wales and North Carolina.

Norwegian scientists announced detection of a mutated H1N1 virus that may allow infection deeper into the airways leading to more severe disease. Hong Kong then reported the same mutation, and Finland saw it in July. The WHO subsequently stated that a similar mutation had been observed in six other countries as early as April. Despite the mutations, the H1N1 vaccine is still effective.

A single batch of H1N1 vaccine in Canada has been pulled after a higher than usual rate of severe allergic reactions.

CDC has confirmed a rare second H1N1 infection in the same individual in West Virginia.

In a study of US Army personnel, those who received the 2008 seasonal flu vaccine were 45% less likely to contract H1N1 and 62% less likely to be hospitalized if infected.

Photo source: http://www.examiner.com/x-29691-Boulder-Healthy-Living-Examiner~y2009m11d24-H1N1-Swine-Flu-Symptoms-Is-someone-on-your-flight-showing-flu-signs

H1N1 (swine flu) weekly highlights: November 11 - 17, 2009

Burundi and Greenland have reported their 1st cases of H1N1, while North Cyprus, Bosnia, Poland, Kosovo, Tunisia, and Morocco have reported their 1st H1N1 deaths.

The World Health Organization (WHO) recommended early administration of antiviral medicines to prevent death in pregnant women, very young children, and people with underlying medical problems who fall ill with H1N1. Additionally, the WHO has warned of the dangers of H1N1 spreading rapidly at any big sporting or cultural events, as Saudi Arabia prepares for the arrival of 2.5 million pilgrims for the Hajj (November 25–29). Nine cases have already been diagnosed among the 500,000 early arrivals. Amidst recommendations that those with underlying health conditions delay their pilgrimage by a year, media reports predict a 40% reduction in attendance. Saudi Arabia is mandating vaccination for its citizens who will be participating, and many other countries are mounting widespread vaccination campaigns before the Hajj.

The United States CDC has released revised estimates for H1N1's impact in the U.S.: approximately 22 million infections and 3,900 deaths, including around 540 children.

New research suggests that more people may be able to fight off H1N1 influenza A than previously thought.

Some experts believe that this year's flu season is anything but typical, particularly as more children have already died from H1N1 flu complications than in any regular flu season in recent years.

Disputes have been ongoing over whether or not a new strain of the H1N1 virus has been circulating within the Ukraine. The WHO has stated that preliminary tests reveal no significant change to the H1N1 pandemic virus.

Photo: http://cdc.gov/h1n1flu/qa.htm

H1N1 (swine flu) weekly highlights: November 4 - 10, 2009

Sri Lanka, Pakistan, Slovakia, and St. Lucia reported their first H1N1 deaths, while Nigeria, the Republic of the Congo, Latvia, and Armenia reported their 1st cases of H1N1.

Last week, Ukraine (population 46 million) saw a first wave of H1N1 begin. Since last week's blog, the number infected has increased at least five-fold to 1.3 million sick and 174 dead. Neighboring Slovakia and Russia tightened their borders as Ukraine's outbreak spread.

The World Health Organization (WHO) reported that H1N1 has become the dominant influenza strain around the globe, as the number of deaths due to the virus passed 6,000 worldwide. In addition, the WHO has emphasized the need for doctors and veterinarians to work together to monitor animals as well as farm workers for H1N1 infection.

A pet cat in Iowa tested positive for H1N1. The cat is believed to have caught it from its owners.

Cases of H1N1 virus showing resistance to antiviral drugs are 'isolated and infrequent' according to the WHO.

Recent studies conducted by the California Department of Public Health have shown that H1N1 has disproportionately affected younger individuals, however people who are obese or elderly have a higher risk of death if they become infected.

A new study shows a benefit of combining H1N1 and seasonal influenza vaccines.

HealthMap is now providing Massachusetts state data for the new Google flu clinic finder.

Photo: http://www.google.com/hostednews/afp/article/ALeqM5h00CIlceU0saqI6YM40N2ty4Huxw

H1N1 (swine flu) weekly highlights: October 28 - November 3, 2009

Afghanistan, Ukraine, Moldova, Croatia, Belarus, Slovenia, Austria, and the Canadian provinces of Newfoundland and Yukon reported their first H1N1 deaths.

The World Health Organization (WHO) reported the number of global H1N1 deaths jumped to over 5,700 worldwide.

In other statements, WHO reiterated that the vaccines are safe, that one dose is sufficient for adults and children over 10, and that pregnant women should be vaccinated since they are a high-risk group.

Researchers at the annual meeting of the Infectious Diseases Society of America reported that influenza vaccination of pregnant women was "85 percent effective in preventing hospitalization in their infants under 6 months of age." The study also indicated babies of vaccinated women were bigger, healthier and less likely to be premature.

Following last week's declaration of a national emergency in the US, New York state and the city of Philadelphia made similar declarations. This allows hospitals and local governments freedoms from certain restrictions during the emergency. HHS Secretary Sebilius suspended additional regulations relating to H1N1 treatment.

Long lines and vaccine shortages plagued H1N1 vaccine clinics throughout the United States and Canada.

As the number of US children who have died of H1N1 climbed to 114 and 48 states reported widespread flu, the CDC noted that only half of people who most need immediate treatment for H1N1 swine flu are actually seeking it.

Photo courtesy of: http://www.latimes.com/features/health/la-me-swine-flu-clinics4-2009nov04,0,3665600.story?track=rss

H1N1 (swine flu) weekly highlights: October 21-27, 2009

Serbia, the Czech Republic, Turkey, Finland, Russia, and the U.S. state of North Dakota have all reported their first H1N1 deaths.

The World Health Organization (WHO) has reported that there have been 414,945 confirmed cases of H1N1 worldwide, and nearly 5,000 deaths.

The WHO's Director-General Margaret Chan also stated that the pandemic would reach its natural end when enough people had become immunized.

United States President Barack Obama declared H1N1 (swine flu) a national emergency, as the US death toll surpassed 1,000.

Also in the United States, manufacturing difficulties are delaying the delivery of the H1N1 vaccine. The CDC said that only 16.1 million out of an expected 30 million doses had been shipped. While H1N1 vaccine shipment is delayed, increases in school closures, hospitalization rates, and 11 more pediatric influenza-related deaths point to an intensifying pandemic throughout the US.

Photo courtesy of: http://www.campaignlive.co.uk/News/948015/Government-releases-new-set-swine-flu-ads/

H1N1 (swine flu) weekly highlights: October 14-20, 2009

Trinidad & Tobago and Iceland have reported their first H1N1 deaths.

The World Health Organization (WHO) has stated that the ongoing H1N1 pandemic remains a cause for concern because of its unpredictable nature, and announced that more than 4735 deaths can now be attributed to the virus. In addition, the WHO identified those most at risk and underscored the risk to the young and healthy. Doctors have been urged to treat suspect cases quickly, as the virus may cause viral pneumonia much more commonly than seasonal influenza.

The FDA has warned of online products purported to diagnose, prevent, treat or cure the H1N1 influenza virus.

The USDA's National Veterinary Services Laboratories have confirmed H1N1 in 3 pigs exhibited at the Minnesota State Fair (held Aug. 26-Sept. 1). These are the first pigs in the US diagnosed with pandemic H1N1.

The CDC announced that approximately 6 million doses of H1N1 vaccine have been shipped throughout the United States, however about 25% fewer doses than expected will be available this month because of delays in production.

A recent study from the University of California at Davis may explain why many people over the age of 60 carry antibodies or other types of immunity against the new virus.

The humanitarian agency World Vision, has warned that the spread of H1N1 to developing countries, without adequate means to track the outbreak or to treat those infected, could prove disastrous.


Photo courtesy of: http://www.u.tv/News/Teenager-with-swine-flu-dies/6191b85d-d897-4fae-80c4-28d4b5a0a7c6

H1N1 (swine flu) weekly highlights: October 7-13, 2009

Germany, Cuba, Tanzania, Jordan and Tibet reported their first H1N1 deaths.

WHO reported that over 340,000 people have been infected worldwide and more than 4,525 have died.

Concerns about H1N1 developing resistance to antiviral medications increased as Vietnam reported three Tamiflu-resistant cases and Japan saw a resistant case in a teenager not previously treated with the drug.

The largest U.S. analysis of hospitalized adult swine flu patients to date found 46% did not have underlying conditions.

With 19 new H1N1 deaths in children, the CDC reported 76 US children had died so far.

Two studies published in the Journal of the American Medical Association provide further evidence H1N1 can be unusually aggressive in young healthy adults.

A third study in JAMA reported most patients who underwent extracorporeal membrane oxygenation (ECMO) for H1N1 associated respiratory failure survived.

Researchers at Stanford University created a computer model of the H1N1 pandemic to evaluate the effect of vaccination. In the Annals of Internal Medicine, they report that vaccinating 40 percent of the U.S. population in October would save 2,051 lives and $469 million. Vaccinating 40% in November would still save 1,468 lives and $302 million.

Photo taken from: http://www.voanews.com/english/2009-10-12-voa43.cfm

H1N1 (swine flu) weekly highlights: September 30-October 6, 2009

• Bulgaria, China, and Portugal reported their first H1N1 deaths.

• Twenty-five states, counties and cities in the U.S. started receiving shipments of the H1N1 vaccine this week. Due to the limited quantities available, priority has generally gone to high risk groups such as healthcare workers and children. Australia also launched its mass H1N1 flu vaccination efforts earlier this week, its largest campaign ever.

• A Consumer Reports poll found that only about a third of Americans plan on definitely getting the H1N1 vaccine, while almost half are undecided. The WHO meanwhile reiterated its confidence in the H1N1 vaccine and encouraged mass vaccination.

• A new report warned of a potential hospital bed shortage in 15 states if 35% of Americans were to get H1N1.

• The CDC reported that bacterial co-infections are playing a role in the H1N1 influenza pandemic, finding that almost one third of a sample of patients who died in the past four months from H1N1 had bacterial infections that complicated their illnesses.

• Two studies on the 1918-1919 influenza pandemic were reported this week. One study found that children of women who were infected during the 1918 flu pandemic while in pregnancy were at greater risk of having heart disease later in life. Another found that aspirin misuse might have led to the high death toll during that pandemic.

• A study using data from Mexico found that hospital patients with laboratory-confirmed H1N1 were less likely to have received a flu shot last winter. These findings are the opposite of those from an unpublished Canadian study leaked last week.

Photo taken from: http://www.businessday.co.za/articles/Content.aspx?id=83266

H1N1 (swine flu) weekly highlights: September 23-29, 2009

• Germany, Cambodia, and Barbados reported their first H1N1 deaths as the global death toll approached 4,000.

• Unpublished research using Canadian data has reportedly found that individuals who received the seasonal flu vaccine last year are twice as likely to catch H1N1. The CDC has stated that it has not had similar findings in the US.

• WHO stated that regulatory authorities have licensed H1N1 vaccines in Australia, China, Hungary and the United States. Japan and several European countries will soon license vaccines.

• WHO reported that drug makers can only produce enough H1N1 vaccine each year for half the planet because they lack factory capacity.

• Researchers have reported that the injectable H1N1 vaccine is twice as protective as the inhaled nasal spray version of the vaccine.

Photo taken from: http://www.telegraph.co.uk/health/healthnews/5806751/Swine-flu-vaccine-to-be-given-to-entire-population.html

H1N1 (swine flu) weekly highlights: September 16-22, 2009

Martinique, Mozambique, Russia and the state of Kentucky reported their first deaths from H1N1.

The WHO reported that the global swine flu death toll has reached 3,486, with the Americas region having the highest toll at 2,625. H1N1 cases reached 10,000 on China's mainland.

A large H1N1 outbreak hit the First Nation community on Vancouver Island.

Many schools are reporting outbreaks, as students return to class including Kenya High School and Fowler Middle School. Universities and colleges are also being affected by outbreaks of H1N1 including the State University of New York at Geneseo and the University of Western Ontario.

A pig herd in Northern Ireland has become the first in Europe to test positive the novel human form of swine flu, H1N1.

New research has suggested that people suffering from influenza may be at a higher risk for having a heart attack.

The U.S. Centers for Disease Control and Prevention announced the distribution plan for H1N1 vaccine, to begin in October.

In the face of a predicted shortfall of vaccine production, many nations still volunteered 10% of their vaccine supplies to help WHO efforts at vaccination in poorer countries.

The WHO stated that while the H1N1 virus can mutate at any time, it has not yet done so and is still very similar to its original state.

Image: H1N1 VIRUS: As imaged by an electron microscope. http://www.scientificamerican.com/article.cfm?id=eyes-on-the-swine

H1N1 (swine flu) weekly highlights: September 9-15, 2009

• The Galapagos Islands and Mozambique reported their first H1N1 fatalities.

• Lesotho and Malawi reported their first confirmed H1N1 cases.

• WHO reports 3,200 people have died from H1N1 around the world, and 23 cases of Tamiflu-resistant infection have been documented.

• WHO stated that school closures can be useful in controlling H1N1 outbreaks, but only if closures are instituted quickly, ideally before 1 percent of the population falls ill.

• Studies indicate that the H1N1 vaccines provide immunity to adults after only one dose, effectively doubling the number of individuals that can be vaccinated with the expected production. Still, vaccine manufacturers expect to sell all of their supply easily.

• The FDA in the United States approved H1N1 vaccines by four companies, and Health and Human Services Secretary Sebelius stated vaccinations in the US would likely start in October.

• Research out of Imperial College London indicates that H1N1 may infect cells deeper in the lungs than seasonal flu can.

• Research out of the Institute of Public Health in Quebec, Canada suggests that people infected with H1N1 may be contagious for over a week, much longer than with seasonal flu.

Photo: Glass sculpture of H1N1 viral particle by artist Luke Jerram. Taken from http://www.telegraph.co.uk/technology/picture-galleries/6151478/Artist-Luke-Jerrams-viral-sculptures-trap-bacteria-and-viruses-like-Swine-Flu-HIV-and-E-coli-in-glass.html?image=10

H1N1 (swine flu) weekly highlights: September 2-8, 2009

• Italy, Macau, Namibia, Norway, and the US Virgin Islands reported their first H1N1 fatalities.

• WHO puts the global total of confirmed deaths at 2,837.

• The CDC reported an increase in the number of cases in areas where school has resumed, particularly among children in the US Southeast. Colleges and universities were also reporting large numbers of cases. Washington State University reported over 2,000 students with flu-like symptoms.

• The CDC reported that more H1N1 deaths have been seen in older children than the very young, and that two-thirds of fatal pediatric cases had underlying medical issues.

• The debate over one versus two doses of H1N1 vaccine continues as companies report encouraging results for a single dose protocol.

• Doctors in London successfully treated a gravely ill H1N1 infected cancer patient by treating her intravenously with a batch of Relenza (zanamivir) specially prepared by the drug's manufacturers.

• Authorities have corrected an earlier media report of an Umrah pilgrim infected with both avian and swine (H5N1 and H1N1) influenza. The man had seasonal and swine influenza coinfection.

Photo taken from: http://abcnews.go.com/Health/SwineFlu/

HealthMap has a new iPhone app! - "Outbreaks Near Me"

HealthMap has developed an iPhone application, which can be obtained free of charge from the iTunes store! The app is named “Outbreaks Near Me,” as it uses GPS technology to show health alerts and ongoing outbreak news in the vicinity of the user. The application also allows users to submit disease reports, and to search for outbreaks in specific locations worldwide.

For more information and screenshots see:
http://www.healthmap.org/iphone

To download the app for free on the iTunes store see:
http://itunes.apple.com/WebObjects/MZStore.woa/wa/viewSoftware?id=328358693&mt=8

We look forward to your feedback. And stayed tuned for applications on other devices including the Google and Blackberry phones.

H1N1 (swine flu) weekly highlights: August 25-September 1, 2009

• Bahrain, Bangladesh, Iran, Reunion Island, Sweden, and Syria reported their first H1N1 fatalities.

• Angola reported its first confirmed H1N1 case.

• WHO reports that swine flu is spreading at an "unbelievable" rate and has become the prevalent strain of flu. WHO is also warning of a severe form of flu that "goes straight to the lungs" and can leave healthy young people severely ill.

• A soon to be published study reports that ~10% of New York City's residents (about 800,000 people) were infected with H1N1 in the spring.

• With students returning to school for the fall semester, colleges across the US have already started seeing rises in swine flu cases.

• The first doses of vaccine were delivered to the UK and France, although they cannot be used until the vaccine is licensed. In China, two vaccines passed safety evaluations.

• In response to the H1N1 outbreak in Chilean turkeys last week, the United Nations Food and Agriculture Organization (FAO) stated that turkey meat is still safe for human consumption, but that the disease could spread to other poultry farms in the world, and that the most concerning scenario would be if H1N1 were introduced to poultry populations where Avian Influenza (H5N1) is common.

• An Egyptian man who had been to Saudi Arabia for the Umrah pilgrimage has tested positive for both avian and swine flu (H5N1 and H1N1), although initial reports did not indicate if both were active infections.

Photo taken from http://www.shanghaidaily.com/sp/article/2009/200908/20090827/article_411929.htm

H1N1 (swine flu) weekly highlights: August 21-24, 2009

Schedule change! The weekly updates will now be posted on Wednesdays. This issue includes includes highlights since the previous post on August 21st.

• United Arab Emirates, Oman, Northern Ireland, Malta, and Greece reported their first H1N1 fatalities.

• Chilean authorities announced that they have detected the H1N1 flu virus in turkeys, marking the first time the virus has been found outside of humans and pigs.

• In a new set of guidelines, the WHO stated otherwise healthy people infected with H1N1 do not need antivirals like Tamiflu. This decision should increase availability of the drugs to those who may need them most, as the Northern Hemisphere prepares for a second wave of H1N1 infections.

• As SINOVAC Biotech Company reported a successful preliminary clinical trial for its A/H1N1 influenza vaccine, the WHO urged China to share its vaccine with needy countries.

• While many countries hurried to make mass vaccination plans (particularly in the Northern Hemisphere), New Zealand has taken a "wait and see" approach.

• In the US, the President's Council of Advisors on Science and Technology urged the government to help drug companies expedite the supply of swine flu drugs and vaccines. They also warned that 30,00 to 90,000 Americans could die, almost 2 million be hospitalized, and 30% to 50% of the country could be infected.

• French researchers reported that H1N1 was 100 times more likely to directly cause death than seasonal influenza in a study performed in Mauritius and New Caledonia.

• In an effort to avoid a rapid increase in cases, the Sultanate of Oman is waiting until December to resume classes.

• Fearful of people infecting prized animals, livestock shows around the world have limited human access or canceled pig exhibits.

Image taken from http://www.washingtonpost.com/wp-dyn/content/article/2009/08/22/AR2009082202337.html?hpid=topnews

H1N1 (swine flu) weekly highlights: August 14-20, 2009

• This week, World Health Organization (WHO) reported that 1799 people have died from H1N1 worldwide.

• South Korea, Japan, Ghana, Madagascar, Yemen, Malta, New Caledonia (France), Kuwait, and Cook Islands each reported their first H1N1 fatalities. French Polynesia reported its first death, but diagnostic tests performed in France raised questions about the validity of this report.

• The Democratic Republic of Congo, Mozambique and Belarus each reported their first confirmed H1N1 case.

• In the United States, federal officials urged businesses to prepare for a resurgence in swine flu. Recommendations included flexible sick leave, cross-training individuals with mission critical tasks, limiting face-to-face meetings and travel, and encouraging hand-washing.

• The Health Protection Agency in the UK sent a letter to neurologists requesting they be alert for any increase in diagnoses of Guillain-Barre Syndrome (GBS). GBS, a sometimes fatal nerve disease, has been linked to the swine flu vaccine administed in the United States in 1976.

• WHO reports that over 1 billion doses of vaccine have been ordered. As many companies report lower than expected yields, many countries, including the US, are warning their citizens of delays to planned vaccination timetables.

• A second piggery in Australia has been quarantined due to swine flu.

Image taken from http://www.rte.ie/news/2009/0820/swineflu.html