2009 influenza A (H1N1) pandemic 19 January 2010 09.00 CEST (ECDC, edited) - LAST ISSUE

[Giuseppe]

2009 influenza A (H1N1) pandemic 19 January 2010 09.00 CEST (ECDC, edited)

[Source Full PDF Document: LINK. EDITED.]
ECDC DAILY UPDATE

2009 influenza A (H1N1) pandemic 19 January 2010 09.00 CEST

Main developments in the past 24 hours

• The last ECDC Daily Update;
• Updates from US and Canada included;
• A total of 2 292 fatal cases in Europe and EFTA countries and 12 086 in the rest of the world have been reported up to date.

This report is based on official information provided by national public health websites or through other official communication channels. Reported number of confirmed 2009 pandemic influenza A (H1N1) cases admitted to hospitals and intensive care, by country, as of 19 January 2010, 09.00 CEST in EU and EFTA countries are in Table 1. An update on the number of confirmed fatal cases for the world and Europe is presented in Table 2.

The last Daily Update
The ECDC Public Health Event Strategy Team (PST) decided yesterday to downgrade our crisis management activities to Public Health Event level 0 (PHE 0). ECDC has been operating its pandemic response in under a crisis management plan since April 2009, diverting significant resources from other parts of the organisation to respond in a robust and coherent way. Although the pandemic is far from over and considerable uncertainties on developments in the coming months exist, currently the workload related to pandemic response has clearly decreased. The ECDC activities related to the pandemic will continue under a reinforced influenza programme. We will now stop publishing the Daily Updates. The surveillance work will be reported on Fridays in the Weekly Influenza Surveillance Overviews (WISO) with a technical overview of influenza development in a technical successor to the previous Flu News along with the Weekly Executive Update giving a digest of the technical reports and reporting on ECDC activities. All of these outputs will be published on our website.
ECDC pandemic website is at: (LINK)

Epidemiologic update
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 2 292 deaths have been reported since April 2009 (Table 2). From week 41 to 51 the numbers of deaths each had shown a steady increase almost doubling every fortnight over six weeks. The fall observed in weeks 52 and 53 was to be expected as it represents official reports placed on national web-sites and a number of Member States have not been doing this in what was a holiday week. While the most deaths have to date been in Western Europe there are increasing numbers of deaths being reported from Central and Eastern Europe. The reported cumulative fatal pandemic (H1N1) cases in the world have now passed 10,000 cases (Table 2). However, because of lack of laboratory confirmation and underreporting among other factors, this is likely to be a gross underestimation of the true number of fatalities associated with the pandemic. Available updates on hospital admissions, per Member State, can be found in Table 1.

Updates from the US and Canada
From U.S. Centers for Disease Control and Prevention (CDC) weekly influenza surveillance report: 3 January ? 9 January 2010 (Week 1)

• Influenza activity continued to decrease in the U.S.
• 139 (3.6%) specimens reported to CDC/Influenza Division were positive for influenza.
• All subtyped influenza A viruses reported to CDC were 2009 influenza A (H1N1) viruses.
• One human infection with a novel influenza A virus in September 2009 was reported (see other news).
• The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold.
• Seven influenza-associated pediatric deaths were reported. Six deaths were associated with 2009 influenza A (H1N1) virus infection and one was associated with an influenza A virus for which the subtype was undetermined.
• The proportion of outpatient visits for influenza-like illness (ILI) was 1.9% which is below the national baseline of 2.3%.
• One of the 10 regions (region 9) reported ILI above their region specific baseline. No states reported widespread influenza activity and the U.S. Virgin Islands and two states reported no influenza activity.
• Other news:
  
  • Interim Results: Influenza A (H1N1) 2009 Monovalent Vaccination Coverage --- United States, October--December 2009 Morbidity and Mortality Weekly Report (MMWR) January 15, 2010 / 59(Early Release);1-5 (LINK)
    
    • To estimate 2009 H1N1 vaccination coverage to date for the 2009--10 influenza season, CDC analyzed results from the National 2009 H1N1 Flu Survey (NHFS) and the Behavioral Risk Factor Surveillance System (BRFSS) survey, conducted during 27 December 2009?2 January 2010, and 1--27 December 2009, respectively. The results indicated that, as of 2 January, an estimated 20.3% of the U.S. population (61 million) had been vaccinated, including 27.9% of persons in the initial target groups and 37.5% of those in the limited vaccine subset. An estimated 29.4% of U.S. children aged 6 months--18 years had been vaccinated. Among the 27 December?2 January NHFS participants who had not yet received 2009 H1N1 vaccination, 10.9% said they definitely intended to get vaccinated by June 2010; an additional 22.5% said they would probably get vaccinated. Among parents of unvaccinated children, 21.1% said they definitely intended to have their children vaccinated, and 17.7% said they probably would have their children vaccinated.
  • Novel Influenza A Virus: One case of human infection with a novel influenza A virus was reported by the Iowa Department of Public Health.
    
    • The case patient had onset of symptoms in September 2009, but did not require hospitalization and has fully recovered. The virus was identified as swine influenza A (H3N2) and investigated in November 2009. No clear exposure to swine was identified, but no evidence of sustained human-to-human transmission with this virus was found.
• For more information:
  
  • U.S. Centers for Disease Control and Prevention ―What's New on the H1N1 Flu Site‖: (LINK)
  • U.S. Centers for Disease Control and Prevention Weekly Influenza Surveillance Report: (LINK)
  • Overview of Influenza Surveillance in the United States: (LINK)

From the Public Health Agency of Canada:

• All influenza indicators were at baseline or under the expected level for this time of the year.
• National ILI consultations rate were below the expected range with 17 consultations per 1,000 patient visits.
• 1.3% of the specimens tested were positive for influenza.
• 16.4% were positive for respiratory syncytial virus.
• The Pandemic (H1N1) 2009 strain accounted for 100% of the positive influenza A subtyped specimens and one specimen tested positive for influenza B.
• 28 hospitalized cases, 7 ICU admissions and 2 deaths were reported.
• For more information:
  
  • Public Health Agency of Canada: (LINK)
  • Public Health Agency of Canada FluWatch: (LINK)

Table 1. Reported number of confirmed 2009 pandemic influenza A(H1N1) cases admitted to hospitals and intensive care, by country, as of 19 January 2010, 09.00 CEST in EU and EFTA countries.
[Country - (date of report) - Number of cases currently hospitalised - Cumulative number of cases admitted in hospitals - Number of cases currently in intensive care - Cumulative number of cases admitted to intensive care]

1. Austria (14.01.) - 35 ? ? ? ? ? ?
2. Belgium (14.01.) ? ? ? ? ? ? ? ?
3. Bulgaria (27.12) ? ? ? ? ? ? ? ?
4. Cyprus(13.01) ? ? ? ? ? 3 ? 27
5. Czech Republic (13.01.) ? ? ? ? ? ? ? ?
6. Denmark (13.01.) ? ? ? ? ? 2 ? 84
7. Estonia (10.01.) ? ? ? ? ? ? ? ?
8. Finland (23.12.) - 2 ? ? - 6 ? ?
9. France (15.01.) ? ? ? ? ? 155 ? 1198
10. Germany (12.01.) ? ? ? ? ? ? ? ?
11. Greece (13.01.) ? ? ? ? ? ? ? ?
12. Hungary (30.12.) ? ? ? ? ? ? ? ?
13. Iceland (10.12.) ? 3 ? 180 ? 1 ? 20
14. Ireland (13.01.) ? 150 ? 1052 ? 6 ? 90
15. Italy (14.01.) ? ? - 938 ? ? ? 454
16. Latvia (14.01.) ? ? ? ? ? ? ? ?
17. Liechtenstein (14.01.) ? ? ? ? ? ? ? ?
18. Lithuania (08.01.) ? ? ? ? ? ? ? ?
19. Luxembourg (27.12.) ? ? ? ? ? 0 ? 0
20. Malta (04.09.) ? ? - 46 ? ? ? 1
21. Netherlands (15.01.) ? ? - 2182 ? ? ? ?
22. Norway (13.01.) ? ? ? 1319 ? 2 ? 174
23. Poland (31.12.) ? ? ? ? ? ? ? ?
24. Portugal (13.01.) - 39 ? ? - 7 ? ?
25. Romania (18.01.) ? ? ? ? ? ? ? ?
26. Slovakia (12.01.) ? 38 ? 305 ? 12 ? 110
27. Slovenia (14.01.) - 16 ? ? ? ? ? ?
28. Spain (30.12.) ? ? ? ? ? ? ? ?
29. Sweden (14.01.) ? 1 - 1352 ? ? ? ?
30. Switzerland (14.01.) ? 6 - 528 ? ? ? 94
31. United Kingdom* (14.01.) - 268 ? ? - 79 ? ?

Note: Data for the EU and EFTA countries correspond to the Ministry of Health or surveillance centre websites.
(?) denotes no information readily available in official sources.
* Data includes information for England only. Other cumulative hospitalisations are: Scotland (1517), Wales (444) and Northern Ireland (578).

Table 2. Reported number of new and cumulative confirmed fatal 2009 pandemic influenza A(H1N1) cases in EU and EFTA countries, as 19 January 2010, 09.00 CEST, and in the rest of the world by country, as of 18 January 2010, 16.00 CEST.
[Country - Number of new fatal cases since previous national update - Cumulative number of fatal cases]

• EU and EFTA countries
  
  • Austria ? ? 24
  • Belgium ? ? 17
  • Bulgaria ? ? 35
  • Cyprus ? ? 6
  • Czech Republic ? ? 77
  • Denmark ? ? 30
  • Estonia ? ? 13
  • Finland ? ? 41
  • France ? - 290*
  • Germany ? ? 178
  • Greece ? ? 93
  • Hungary ? ? 57
  • Iceland ? ? 2
  • Ireland ? ? 22
  • Italy ? ? 210
  • Latvia ? ? 31
  • Lithuania 2 ? 21
  • Luxembourg ? ? 3
  • Malta ? ? 4
  • Netherlands ? ? 54
  • Norway ? ? 29
  • Poland ? ? 138
  • Portugal ? ? 83
  • Romania ? ? 107
  • Slovakia ? ? 38
  • Slovenia ? ? 15
  • Spain ? ? 271
  • Sweden ? ? 25
  • Switzerland ? ? 16
  • United Kingdom ? ? 362
    
    • Total 2 ? 2292
• Other European countries and central Asia
  
  • Albania ? ? 6
  • Armenia ? ? 3
  • Belarus ? ? 20
  • Bosnia and Herzegovina ? ? 10
  • Croatia ? ? 26
  • Former Yugoslav Republic of Macedonia ? ? 23
  • Georgia ? ? 21
  • Kosovo ? ? 14
  • Moldova ? ? 35
  • Montenegro ? ? 7
  • Russia ? ? 19
  • Serbia ? ? 71
  • Ukraine ? ? 202
    
    • Total ? ? 457
• Mediterranean and Middle-East
  
  • Algeria ? ? 57
  • Bahrain ? ? 7
  • Egypt 5 ? 219
  • Iran ? ? 147
  • Iraq ? ? 42
  • Israel ? ? 85
  • Jordan ? ? 19
  • Kuwait ? ? 30
  • Lebanon ? ? 5
  • Libya ? - 1
  • Morocco ? ? 53
  • Occupied Palestinian Territory ? ? 28
  • Oman ? ? 31
  • Qatar ? ? 10
  • Saudi Arabia ? ? 124
  • Syria ? ? 127
  • Tunisia ? ? 21
  • Turkey ? ? 415
  • United Arab Emirates ? ? 6
  • Yemen ? ? 28
    
    • Total 5 ? 1455
• Africa
  
  • Ghana ? ? 1
  • Madagascar ? ? 3
  • Mauritius ? ? 8
  • Mozambique ? ? 2
  • Namibia ? ? 1
  • Sao Tome & Principe ? ? 2
  • South Africa ? ? 93
  • Sudan ? ? 5
  • Tanzania ? ? 1
    
    • Total ? ? 116
• North America
  
  • Canada ? ? 418
  • Mexico 13 ? 909
  • USA ? ? 2328
    
    • Total 13 ? 3655
• Central America and Caribbean
  
  • Bahamas ? ? 4
  • Barbados ? ? 3
  • Bermuda ? ? 1
  • Cayman Islands ? ? 1
  • Costa Rica 3 ? 50
  • Cuba ? ? 53
  • Dominican Republic ? ? 23
  • El Salvador ? ? 32
  • Guatemala ? ? 18
  • Honduras ? ? 16
  • Jamaica ? ? 7
  • Nicaragua ? ? 11
  • Panama ? ? 11
  • Saint Kitts and Nevis ? ? 2
  • Saint Lucia ? ? 1
  • Suriname ? ? 2
  • Trinidad-Tobago ? ? 5
    
    • Total 3 ? 240
• South America
  
  • Argentina ? ? 617
  • Bolivia ? ? 59
  • Brazil ? ? 1632
  • Chile ? ? 150
  • Colombia ? ? 198
  • Ecuador ? ? 117
  • Paraguay ? ? 52
  • Peru ? ? 208
  • Uruguay ? ? 33
  • Venezuela 5 ? 129
    
    • Total 5 ? 3195
• North-East and South Asia
  
  • Afghanistan ? ? 17
  • Bangladesh ? - 6
  • China (Mainland) 48 ? 714
  • Hong Kong SAR China ? ? 56
  • India 13 ? 1119
  • Japan ? ? 145
  • Macao SAR China ? ? 2
  • Maldives ? ? 1
  • Mongolia 1 ? 29
  • Nepal ? ? 2
  • Pakistan ? ? 14
  • South Korea ? ? 170
  • Sri Lanka 1 ? 46
  • Taiwan 1 ? 37
    
    • Total 64 ? 2358
• South-East Asia
  
  • Brunei Darussalam ? ? 1
  • Cambodia ? ? 6
  • Indonesia ? ? 10
  • Laos Peoples Democratic Republic ? ? 1
  • Malaysia ? ? 77
  • Philippines ? ? 30
  • Singapore ? ? 19
  • Thailand ? ? 196
  • Vietnam ? ? 53
    
    • Total ? ? 393
• Australia and Pacific
  
  • Australia ? ? 191
  • Cook Islands ? ? 1
  • Marshall Islands ? ? 1
  • New Zealand ? ? 20
  • Samoa ? ? 2
  • Solomon Islands ? ? 1
  • Tonga ? ? 1
    
    • Total ? ? 217
• TOTAL 92 ? 14378

* Deaths reported from France include 1 in Guyana, 9 in New Caledonia, 7 in the French Polynesia, 7 in La R?union, 1 in Martinique, 2 in Mayotte, 5 in Guadeloupe and 258 in mainland France.
(?)
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