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**tropical** · March 25, 2009, 03:23 AM

Re: Seasonal Flu 2008 - 2009

Originally posted by AlaskaDenise View Post

Given the incidences of seasonal vaccine mismatches, how can we be confident that any pandemic influenza vaccine selection would not be a mismatch?
Under pressure for fast results, would the mismatch possibility increase?
...
.

There would be not "any pandemic influenza vaccine" for the majority of population in time realy.

For the esigue quantities created "in time" during the "few months" rising schedule of the first pand. phase, the match could be enaugh good because of the real pand. virus taken onto the vaccines, instead of an "6 months - 1 year old" guessing strain used for the seasonal flu vaccination.

AD.: "How often are mismatches theoretically avoidable vs. unavoidable?"

That's an probability question of input bio-variables for the math. comp. branch, the actual data probably exists somewhere ...

**Commonground** · March 25, 2009, 07:51 AM

Re: Seasonal Flu 2008 - 2009

Japan:
● flu has been reported.

Arakawa Ward, a point of 11 per week reported at 10.25 and 10.25 last week and did the same. Tokyo has a number of reported 11.46 per point (11 weeks), similar to the previous week was 11.63.
Some schools in the district, school delay action by the flu, some are closed and classes. When you go out to the crowds will ensure prevention of infection.
The flu, the first symptoms is 2-7 days to excrete the virus and infect others. The heat goes, where many people congregate is a good idea to avoid. If you go to work or school is a mask, so please consider UTSUSANAI to people around him.

http://64.233.161.132/translate_c?hl=en&ie=UTF-8&sl=ja&tl=en&u=http://www.city.arakawa.tokyo.jp/a001/b010/d06100184.html&prev=_t&usg=ALkJrhifmtksmbkkIJvIyuM-Mcthm6ZUCQ

**Giuseppe** · March 26, 2009, 01:00 PM

Re: Seasonal Flu 2008 - 2009

Recent Italian Influenza Type B viruses: phylogenetic tree.

From Italian Ministry of Health: see original PDF document (in Italian) at http://www.ministerosalute.it/influe...r_25-03-09.pdf

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From TABLES</td></tr></tbody></table>

**Shiloh** · March 26, 2009, 02:35 PM

Re: Seasonal Flu 2008 - 2009

Source: http://www.bclocalnews.com/vancouver.../41919757.html

(B.C. Canada) Flu season makes a nasty return
Flu sufferers in the Capital Region have been battling a rather virulent strain of the virus lately.

By Vivian Moreau - Victoria News
Updated: March 26, 2009 10:25 AM

Chief medical health officer says doctors need to
re-think treatment

Odd spikes in flu outbreaks, more resistant viruses, and more sick Canadians than Americans ? just some of the strange trends that played out this winter.

?It?s been a curious year,? said Dr. Richard Stanwick, chief medical health officer for the Vancouver Island Health Authority. This season?s unusual flu patterns have scientists scratching their heads.

Influenza traditionally hits the population hardest in January. This year, according to data from the B.C. Centre for Disease Control, the flu has staged a late season comeback through March.

Surrey has particularly suffered with doctors there reporting 40 per cent more patients with the flu than usual for the first week of March. Greater Victoria has not been as hard hit as Surrey but still has seen higher than usual numbers for March. Capital region physicians saw about one flu patient a day in past weeks, while B.C. numbers overall were slightly higher.

?While cold weather and snow have somewhat ruined the flower count it?s also kept people indoors and in closer contact. As a consquence it?s given viruses (greater) opportunity to pass from person to person,? Stanwick said.

Canadians in general have been sicker with the flu than U.S. citizens in the past few weeks. Rates of American flu patients visiting their doctors has remained at 3.5 per cent. Across Canada the rate increased from 28 cases per 1,000 patient visits in the last week of February to 48 per 1,000 cases in the first week of March.

?I can?t say that Canadians are inherently different from Americans or there?s an Obama factor (people feeling more optimistic therefore feeling healthier),? Stanwick said. ?We have not seen anything to explain this phenomenon.?

To complicate matters, medications that ease flu symptoms are not working as well as they have in recent years.

Oseltamivir, also known as Tamiflu, has proven to not work as well, putting it in almost the same category as Amantadine, a drug that doctors have decreased prescribing because viruses are proving resistant.

That certain strains appear to be more resistant to Tamiflu is worrisome, Stanwick said.

?We?re really seeing a curious pattern of sensitivity. Of course, our fear is that viruses swap intelligence,? he said, ?and that, at some point, we?re going to (have to use) Relenza, which is the only drug that can hold out to address this.?

The medical and pharmaceutical communities need to re-examine resistance patterns, he added.

?Perhaps people are using it (anti-flu medication) more liberally than they should. We don?t have a lot of weapons and we certainly don?t want to squander them in terms of managing outbreaks.?

Lastly, what has the medical community most puzzled is that an Influenza B strain of flu was the more virulent virus this winter. Although most vaccines had been prepared to deal with Influenza A/Brisbane and Influenza B/Florida, it was Influenza B/Malaysia that struck 62 per cent of Canadians who came down with the flu this winter. (Viruses are named for the flu?s point of origin.)

?This (B/Malaysia) is supposed to be an annoying little virus that plays a minor role and it certainly played a bigger role,? Stanwick said. ?People who are clearly the experts are looking at the fact that we might have to put not one, but two Influenza B into the vaccine.?

This anomaly demands examination, he said.

?We have to go back and think about what does all this mean and are there trends or facts or some subtleties we have not realized? It will give scientists lots of fodder for the hypotheses mill.?

vmoreau@saanichnews.com

**AlaskaDenise** · March 26, 2009, 05:01 PM

Re: Seasonal Flu 2008 - 2009

...our fear is that viruses swap intelligence....

Good terms.

.

**tropical** · March 27, 2009, 03:41 AM

Re: Seasonal Flu 2008 - 2009

Quote:
Quote:
<TABLE cellSpacing=0 cellPadding=6 width="100%" border=0><TBODY><TR><TD class=alt2 style="BORDER-RIGHT: 1px inset; BORDER-TOP: 1px inset; BORDER-LEFT: 1px inset; BORDER-BOTTOM: 1px inset">...our fear is that viruses swap intelligence.... </TD></TR></TBODY></TABLE>
Good terms.
___

Yes, the "microscopic level bug intelligence" (uhm maybe, but where is it sited ...)

Comparing the above with some folks unwillingness of admiting that animals also have intelligence it is a big step forward ...

**Giuseppe** · March 27, 2009, 11:58 AM

Re: Seasonal Flu 2008 - 2009

EISS - Weekly Electronic Bulletin Week 12 - 27 March 2009: Influenza activity high in the Russian Federation while continuing to decline or remain low in most western, central and northern European countries.

EISS - Weekly Electronic Bulletin Week 12 : 16/03/2009-22/03/2009 - 27 March 2009, Issue N? 298 Influenza activity high in the Russian Federation while continuing to decline or remain low in most western, central and northern European countries

-- Summary:

In week 12/2009, the Russian Federation continued to report high influenza activity in four of seven regions. Several other countries in eastern, central, northern and southern Europe reported medium intensity activity, while in all countries in western Europe the seasonal epidemic is over. While influenza A(H3) continues to be the predominant circulating virus overall this season, influenza B virus detections are currently dominant in over 50% of the countries. However, total weekly virus detections have declined to 22% of peak level detections in week 05/2009.

-- Epidemiological situation - week 12/2009:

For the intensity indicator, the national network levels of influenza-like illness (ILI) and/or acute respiratory infection (ARI) were high in Croatia and in four of seven regions of the Russian Federation, medium in 13 countries, and low in the other 25 countries that reported this indicator. In the Russian Federation, the Northwest, Urals and Siberian regions, but not Volga, all reported an increasing trend; all other countries reporting high or medium intensity reported a stable or decreasing trend.

For the geographical spread indicator, widespread influenza activity was reported in four countries, regional activity in five countries, local activity in six countries and sporadic or no activity in the remaining 23 countries.

-- Cumulative epidemiological situation - 2008-2009 season (weeks 40/2008-12/2009):

Since week 49/2008 consultation rates for ILI and/or ARI have risen above baseline levels in most western and central European countries following a general west to east progression. High influenza intensity, again with peak activity following a general west to east progression, has been reported in 15 countries since week 51/2008. Generally, the highest consultation rates have been in the 0-4 and 5-14 age groups, but Ireland, UK, Norway and Romania have reported their highest ILI consultation rates in the 15-64 age group. In most countries in western, central, northern and southern Europe the seasonal epidemic appears to be over, with consultation rates for ILI and/or ARI having returned to baseline levels.

-- Virological situation - week 12/2009:

The total number of respiratory specimens collected by sentinel physicians in week 12/2009 was 1261, of which 274 (22%) were positive for influenza virus: 89 type A (48 subtype H3, one subtype H1 and 40 not subtyped) and 185 type B. In addition, 533 non-sentinel source specimens (e.g. specimens collected for diagnostic purposes in hospitals) were reported positive for influenza virus: 396 type A (171 subtype H3, 67 subtype H1 and 158 not subtyped) and 137 type B. Compared to week 11, the number of type B detections has increased slightly, accounting for 322 (40%) of 807 influenza-positive sentinel and non-sentinel specimens overall and exceeded type A detections for the week in 20 countries. Influenza B was the only virus type detected in 16 out of 27 (59.2%) countries reporting influenza virus detections. Overall, total weekly virus detections have now declined to 22% of the peak level detections in week 05/2009.

-- Cumulative virological situation - 2008-2009 season (weeks 40/2008-12/2009):

Of 26457 virus detections (sentinel and non-sentinel) since week 40/2008, 23289 (88%) were type A (10294 subtype H3, 1142 subtype H1 and 11853 not subtyped) and 3168 (12%) were type B. Based on the antigenic and/or genetic characterisation of 3110 influenza viruses, 2337 (75.1%) were reported as A/Brisbane/10/2007 (H3N2)-like, 161 (5.2%) as A/Brisbane/59/2007 (H1N1)-like, 24 (0.8%) as B/Florida/4/2006-like (B/Yamagata/16/88 lineage) and 588 (18.9%) as B/Malaysia/2506/2004-like (B/Victoria/2/87 lineage). More detailed antigenic and genetic analyses have shown that B/Victoria/2/87 lineage viruses were either B/Malaysia/2506/2004-like or B/Brisbane/60/2008-like, the prototype vaccine strain recommended by WHO for inclusion in the 2009-10 vaccine (WER 2009; 84(9): 65-76).

Influenza isolates from 18 countries were assessed for antiviral drug susceptibility.

All influenza A(H3N2) viruses tested were sensitive to oseltamivir and zanamivir, but resistant to M2 inhibitors.

Ninety-eight percent of influenza A(H1N1) viruses analysed were resistant to oseltamivir while all those tested against zanamivir were sensitive. One A(H1N1) virus was M2 inhibitor resistant, but sensitive to the neuraminidase inhibitors. The small number of influenza B viruses analysed were sensitive to oseltamivir and zanamivir.

-- Comment:

High intensity influenza activity has been maintained in four of the seven regions of the Russian Federation, with an increasing trend reported in three of these regions. Medium intensity influenza activity, with a decreasing trend is reported in the central region while the far eastern and southern regions both report low intensity activity.

While A(H3N2) is still the dominant influenza virus circulating in the European region, including the Russian Federation, the proportion of type B influenza virus detections per week remains substantial in a few countries (Estonia, Finland, France, Germany and Spain). Of the influenza B viruses that were antigenically and/or genetically characterised, 96% (588/612) were B/Victoria lineage. With the exception of these B/Victoria lineage viruses, the viruses circulating are similar to the three components - A(H1N1), A(H3N2) and B/Yamagata lineage - included in the 2008/2009 Northern Hemisphere influenza vaccine. The mismatch of these B/Victoria/2/87 lineage viruses with the current vaccine is unlikely to be of public health significance and overall this season?s vaccine is expected to be effective.

-- Background:

The Weekly Electronic Bulletin presents and comments on influenza activity in the 53 countries that report to EISS. Of these countries, 35 reported both clinical and virological data, one reported virological data only and four reported clinical data only to EISS in week 12/2009. The spread of influenza viruses and their epidemiological impact in Europe are being monitored by the network under the aegis of the European Centre for Disease Prevention and Control in Stockholm (Sweden) and the WHO Regional Office for Europe in Copenhagen (Denmark), in collaboration with the WHO Collaborating Centre for Reference and Research on Influenza in London (UK).

-- Other bulletins:

The EISS bulletin is prepared using reports from GP consultations and other sources, depending on individual country arrangements. It is important to recognise that different health care systems and types of measurement should also be considered when assessing the impact of influenza.

-- Map

The map presents the intensity of influenza activity and the geographical spread as assessed by each of the networks in EISS.

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From MAPS</td></tr></tbody></table>

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From MAPS</td></tr></tbody></table>

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From MAPS</td></tr></tbody></table>

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From MAPS</td></tr></tbody></table>

Europe Year 2009 / Week 12

A = Dominant virus A
H1N1 = Dominant virus A(H1N1)
H3N2 = Dominant virus A(H3N2)
H1N2 = Dominant virus A(H1N2)
B = Dominant virus B
A & B = Dominant virus A & B
= : stable clinical activity
+ : increasing clinical activity
- : decreasing clinical activity
Low = no influenza activity or influenza at baseline levels
Medium = usual levels of influenza activity
High = higher than usual levels of influenza activity
Very high = particularly severe levels of influenza activity
No activity = no evidence of influenza virus activity (clinical activity remains at baseline levels)
Sporadic = isolated cases of laboratory confirmed influenza infection
Local outbreak = increased influenza activity in local areas (e.g. a city) within a region,or outbreaks in two or more institutions (e.g. schools) within a region. Laboratory confirmed.
Regional activity = influenza activity above baseline levels in one or more regions witha population comprising less than 50% of the country's total population. Laboratory confirmed.
Widespread = influenza activity above baseline levels in one or more regions with a populationcomprising 50% or more of the country's population. Laboratory confirmed.
Finland : Where available, the epidemiological data are provided by a health-care district in South-Western Finland (the health-care district serves 54,000 inhabitants i.e. approximately onepercent of the Finnish population).

-- Network comments (where available)

- Denmark. Note: Week 12, shift from influenza A to influenza B Victoria-like as dominant influenza in Denmark.
- Italy. Low influenza activity is reported. One influenza B virus has been detected during this week.
- The former Yugoslav Republic of Macedonia. Mandatory data.
- Switzerland. Influenza activity is below threshold now.
-

<cite cite="http://www.eiss.org/cgi-files/bulletin_v2.cgi">EISS - Bulletin Review</cite>

**HenryN** · March 29, 2009, 06:52 AM

Re: Seasonal Flu 2008 - 2009

<table border="1"> <caption> INFLUENZA VIRUSES ISOLATED BY
WHO/NREVSS Collaborating Laboratories
2008 - 2009 Season </caption> <tbody><tr> <th id="header1" width="70">Week</th> <th id="header2" width="90">A(H1)</th> <th id="header3" width="70">A(H3)</th> <th id="header4" width="70">A(Unk)</th> <th id="header5" width="70"> B </th> <th id="header6" align="right">Total # Tested</th> <th id="header7" align="right">% Positive</th> </tr> <tr><td headers="header1" align="right"> 40 </td> <td headers="header2" align="right"> 3 </td> <td headers="header3" align="right"> 0 </td> <td headers="header4" align="right"> 8 </td> <td headers="header5" align="right"> 6 </td> <td headers="header6" align="right"> 2598 </td> <td headers="header7" align="right"> 0.65 </td></tr> <tr><td headers="header1" align="right"> 41 </td> <td headers="header2" align="right"> 4 </td> <td headers="header3" align="right"> 4 </td> <td headers="header4" align="right"> 8 </td> <td headers="header5" align="right"> 6 </td> <td headers="header6" align="right"> 2632 </td> <td headers="header7" align="right"> 0.84 </td></tr> <tr><td headers="header1" align="right"> 42 </td> <td headers="header2" align="right"> 13 </td> <td headers="header3" align="right"> 3 </td> <td headers="header4" align="right"> 15 </td> <td headers="header5" align="right"> 6 </td> <td headers="header6" align="right"> 2746 </td> <td headers="header7" align="right"> 1.35 </td></tr> <tr><td headers="header1" align="right"> 43 </td> <td headers="header2" align="right"> 22 </td> <td headers="header3" align="right"> 0 </td> <td headers="header4" align="right"> 24 </td> <td headers="header5" align="right"> 14 </td> <td headers="header6" align="right"> 3198 </td> <td headers="header7" align="right"> 1.88 </td></tr> <tr><td headers="header1" align="right"> 44 </td> <td headers="header2" align="right"> 12 </td> <td headers="header3" align="right"> 3 </td> <td headers="header4" align="right"> 21 </td> <td headers="header5" align="right"> 5 </td> <td headers="header6" align="right"> 3320 </td> <td headers="header7" align="right"> 1.23 </td></tr> <tr><td headers="header1" align="right"> 45 </td> <td headers="header2" align="right"> 32 </td> <td headers="header3" align="right"> 2 </td> <td headers="header4" align="right"> 23 </td> <td headers="header5" align="right"> 11 </td> <td headers="header6" align="right"> 3920 </td> <td headers="header7" align="right"> 1.73 </td></tr> <tr><td headers="header1" align="right"> 46 </td> <td headers="header2" align="right"> 25 </td> <td headers="header3" align="right"> 2 </td> <td headers="header4" align="right"> 23 </td> <td headers="header5" align="right"> 12 </td> <td headers="header6" align="right"> 4145 </td> <td headers="header7" align="right"> 1.5 </td></tr> <tr><td headers="header1" align="right"> 47 </td> <td headers="header2" align="right"> 27 </td> <td headers="header3" align="right"> 1 </td> <td headers="header4" align="right"> 31 </td> <td headers="header5" align="right"> 23 </td> <td headers="header6" align="right"> 4540 </td> <td headers="header7" align="right"> 1.81 </td></tr> <tr><td headers="header1" align="right"> 48 </td> <td headers="header2" align="right"> 40 </td> <td headers="header3" align="right"> 1 </td> <td headers="header4" align="right"> 46 </td> <td headers="header5" align="right"> 24 </td> <td headers="header6" align="right"> 4636 </td> <td headers="header7" align="right"> 2.39 </td></tr> <tr><td headers="header1" align="right"> 49 </td> <td headers="header2" align="right"> 43 </td> <td headers="header3" align="right"> 5 </td> <td headers="header4" align="right"> 57 </td> <td headers="header5" align="right"> 14 </td> <td headers="header6" align="right"> 5355 </td> <td headers="header7" align="right"> 2.22 </td></tr> <tr><td headers="header1" align="right"> 50 </td> <td headers="header2" align="right"> 71 </td> <td headers="header3" align="right"> 9 </td> <td headers="header4" align="right"> 66 </td> <td headers="header5" align="right"> 37 </td> <td headers="header6" align="right"> 5788 </td> <td headers="header7" align="right"> 3.16 </td></tr> <tr><td headers="header1" align="right"> 51 </td> <td headers="header2" align="right"> 73 </td> <td headers="header3" align="right"> 19 </td> <td headers="header4" align="right"> 108 </td> <td headers="header5" align="right"> 56 </td> <td headers="header6" align="right"> 6057 </td> <td headers="header7" align="right"> 4.23 </td></tr> <tr><td headers="header1" align="right"> 52 </td> <td headers="header2" align="right"> 71 </td> <td headers="header3" align="right"> 12 </td> <td headers="header4" align="right"> 152 </td> <td headers="header5" align="right"> 51 </td> <td headers="header6" align="right"> 5829 </td> <td headers="header7" align="right"> 4.91 </td></tr> <tr><td headers="header1" align="right"> 53 </td> <td headers="header2" align="right"> 113 </td> <td headers="header3" align="right"> 19 </td> <td headers="header4" align="right"> 170 </td> <td headers="header5" align="right"> 48 </td> <td headers="header6" align="right"> 6237 </td> <td headers="header7" align="right"> 5.61 </td></tr> <tr><td headers="header1" align="right"> 01 </td> <td headers="header2" align="right"> 165 </td> <td headers="header3" align="right"> 26 </td> <td headers="header4" align="right"> 281 </td> <td headers="header5" align="right"> 82 </td> <td headers="header6" align="right"> 6678 </td> <td headers="header7" align="right"> 8.3 </td></tr> <tr><td headers="header1" align="right"> 02 </td> <td headers="header2" align="right"> 196 </td> <td headers="header3" align="right"> 22 </td> <td headers="header4" align="right"> 419 </td> <td headers="header5" align="right"> 96 </td> <td headers="header6" align="right"> 6775 </td> <td headers="header7" align="right"> 10.82 </td></tr> <tr><td headers="header1" align="right"> 03 </td> <td headers="header2" align="right"> 340 </td> <td headers="header3" align="right"> 44 </td> <td headers="header4" align="right"> 618 </td> <td headers="header5" align="right"> 186 </td> <td headers="header6" align="right"> 7517 </td> <td headers="header7" align="right"> 15.8 </td></tr> <tr><td headers="header1" align="right"> 04 </td> <td headers="header2" align="right"> 556 </td> <td headers="header3" align="right"> 76 </td> <td headers="header4" align="right"> 894 </td> <td headers="header5" align="right"> 359 </td> <td headers="header6" align="right"> 8954 </td> <td headers="header7" align="right"> 21.05 </td></tr> <tr><td headers="header1" align="right"> 05 </td> <td headers="header2" align="right"> 674 </td> <td headers="header3" align="right"> 52 </td> <td headers="header4" align="right"> 1357 </td> <td headers="header5" align="right"> 670 </td> <td headers="header6" align="right"> 11402 </td> <td headers="header7" align="right"> 24.14 </td></tr> <tr><td headers="header1" align="right"> 06 </td> <td headers="header2" align="right"> 811 </td> <td headers="header3" align="right"> 63 </td> <td headers="header4" align="right"> 1335 </td> <td headers="header5" align="right"> 909 </td> <td headers="header6" align="right"> 12334 </td> <td headers="header7" align="right"> 25.28 </td></tr> <tr><td headers="header1" align="right"> 07 </td> <td headers="header2" align="right"> 806 </td> <td headers="header3" align="right"> 64 </td> <td headers="header4" align="right"> 1037 </td> <td headers="header5" align="right"> 884 </td> <td headers="header6" align="right"> 11159 </td> <td headers="header7" align="right"> 25.01 </td></tr> <tr><td headers="header1" align="right"> 08 </td> <td headers="header2" align="right"> 647 </td> <td headers="header3" align="right"> 57 </td> <td headers="header4" align="right"> 913 </td> <td headers="header5" align="right"> 1031 </td> <td headers="header6" align="right"> 10983 </td> <td headers="header7" align="right"> 24.11 </td></tr> <tr><td headers="header1" align="right"> 09 </td> <td headers="header2" align="right"> 408 </td> <td headers="header3" align="right"> 43 </td> <td headers="header4" align="right"> 811 </td> <td headers="header5" align="right"> 995 </td> <td headers="header6" align="right"> 9501 </td> <td headers="header7" align="right"> 23.76 </td></tr> <tr><td headers="header1" align="right"> 10 </td> <td headers="header2" align="right"> 223 </td> <td headers="header3" align="right"> 32 </td> <td headers="header4" align="right"> 577 </td> <td headers="header5" align="right"> 827 </td> <td headers="header6" align="right"> 7941 </td> <td headers="header7" align="right"> 20.89 </td></tr> <tr><td headers="header1" align="right"> 11 </td> <td headers="header2" align="right"> 158 </td> <td headers="header3" align="right"> 27 </td> <td headers="header4" align="right"> 339 </td> <td headers="header5" align="right"> 580 </td> <td headers="header6" align="right"> 5161 </td> <td headers="header7" align="right"> 21.39 </td></tr> </tbody></table>

Return to Current Report

**Giuseppe** · March 30, 2009, 10:58 AM

Re: Seasonal Flu 2008 - 2009

From Italy (Centro Interuniversitario per lo Studio dell'Influenza, CIRI, link: http://www.influciri.it ).

**SuperNova1987A** · April 1, 2009, 03:25 AM

Re: Seasonal Flu 2008 - 2009

Increase in reports of Influenza B, Peak in mid March
Source: http://www.cabrain.net/news/article/newsId/21311.html

According to the surveillance of the National Institute of Infectious Diseases
(NIID), reports of influenza B virus isolation was in increase and presumably
peaked in the 11th week (March 9-15).

As of February 15, reports of influenza A-H1N1 (A Soviet) virus isolation is on
the top with 1576 cases or 56.1%, followed by A-H3N2(A Hongkong) with 898
cases or 32.0% and B type with 335 cases or 11.9%.
As of March 15, B type increased to 761 cases or 16.3% of 4671 reports in
total. (See graph below)

In this flu season, the number of patients per survey point peaked at 37.45
(total number of reports at 178,991) in the 4th week (Jan. 19-25). Then it
decreased to reach 12.05 in the 8th week (Feb. 16-22) but increased again
in 9th week (Feb. 23- Mar. 1) to reach 16.50 in the 11th week, and
decreased again to 15.63 in the 12th week (Mar. 16-22).

It seems that in the first wave (peak in the 4th week ), A-H1N1 was
predominant while B type was predominant in the 2nd wave (peak in the
11th week).

Percentage by type

ML Flu DB supports the above article.

______________________________
SN1987A

**Giuseppe** · April 3, 2009, 10:21 AM

Re: Seasonal Flu 2008 - 2009

EISS - Bulletin Review. Two regions of the Russian Federation report high influenza activity, while activity has returned to out of season levels or further declined in the rest of Europe

EISS - Weekly Electronic Bulletin Week 13 : 23/03/2009-29/03/2009 - 03 April 2009, Issue N? 299 Two regions of the Russian Federation report high influenza activity, while activity has returned to out of season levels or further declined in the rest of Europe

-- Summary:

In week 13/2009, only two (North Western and Urals) of the seven regions of the Russian Federation reported high influenza activity and four countries (Belarus, Croatia, Hungary and Lithuania) reported decreased intensity compared to the previous week.

While most countries have indicated decreasing trends, associated with the seasonal epidemic being effectively over in western European countries, several countries in eastern, central, northern and southern Europe reported medium influenza activity.

Influenza A(H3) continues to be the predominant circulating virus in week 13/2009 as for the season as a whole, while the observed increase in proportion of influenza B virus detections since week 4/2009 has decreased in week 13/2009.

-- Epidemiological situation - week 13/2009:

For the intensity indicator, the national network levels of influenza-like illness (ILI) and/or acute respiratory infection (ARI) were medium in 11 countries and low in the other 27 countries that reported this indicator.

While the Russian Federation reported medium intensity as a whole two regions, North Western and Urals, continued to report high intensity, but with decreasing trends for consultation rates. All other countries (and regions) reported decreasing or stable trends.

For the geographical spread indicator, widespread influenza activity was reported in three countries, regional activity in three countries, local activity in six countries and sporadic or no activity in the remaining 27 countries.

-- Cumulative epidemiological situation - 2008-2009 season (weeks 40/2008-13/2009):

Since week 49/2008 consultation rates for ILI and/or ARI rose above baseline levels in most European countries following a general west to east progression. High influenza intensity has been reported in 15 countries, also following a general west to east progression, since week 51/2008. Generally, the highest consultation rates have been in the 0-4 and 5-14 age groups, but Ireland, UK, Norway and Romania have reported their highest ILI consultation rates in the 15-64 age group.

In most countries in western, central, northern and southern Europe the seasonal epidemic appears to be over, with consultation rates for ILI and/or ARI having returned to baseline levels.

-- Virological situation - week 13/2009:

The total number of respiratory specimens collected by sentinel physicians in week 13/2009 was 1126, of which 238 (21%) were positive for influenza virus: 111 type A (71 subtype H3, four subtype H1 and 36 not subtyped) and 127 type B. In addition, 377 non-sentinel source specimens (e.g. specimens collected for diagnostic purposes in hospitals) were reported positive for influenza virus: 281 type A (119 subtype H3, 48 subtype H1 and 114 not subtyped) and 96 type B.

The number of influenza detections dropped by 24% (807 to 615) compared to week 12 and was approximately 20% of the peak level in week 05/2009.

The proportion of type B detections has decreased from 40% (week 12) to 36% (223 of 615 influenza-positive sentinel and non-sentinel specimens) but exceeded type A detections in 20 countries and was the only virus type detected in eight out of 32 (25%) countries.

-- Cumulative virological situation - 2008-2009 season (weeks 40/2008-13/2009):

Of 27247 virus detections (sentinel and non-sentinel) since week 40/2008, 23748 (87%) were type A (10544 subtype H3, 1202 subtype H1 and 12002 not subtyped) and 3499 (13%) were type B.

Based on the antigenic and/or genetic characterisation of 4999 influenza viruses, 3974 (79%) were reported as A/Brisbane/10/2007 (H3N2)-like, 196 (4%) as A/Brisbane/59/2007 (H1N1)-like, 43 (1%) as B/Florida/4/2006-like (B/Yamagata/16/88 lineage) and 786 (16%) as B/Malaysia/2506/2004-like (B/Victoria/2/87 lineage).

More detailed antigenic and genetic analyses have shown that B/Victoria/2/87 lineage viruses were either B/Malaysia/2506/2004-like or B/Brisbane/60/2008-like, the prototype vaccine strain recommended by WHO for inclusion in the 2009-10 vaccine (WER 2009; 84(9): 65-76).

Influenza isolates from 19 countries were assessed for antiviral drug susceptibility.

All influenza A(H3N2) viruses tested were sensitive to oseltamivir and zanamivir, and all but one of 415 tested were resistant to M2 inhibitors.

Ninety-eight percent of influenza A(H1N1) viruses analysed were resistant to oseltamivir while all those tested against zanamivir were sensitive. One A(H1N1) virus was M2 inhibitor-resistant, but sensitive to the neuraminidase inhibitors.

The small number of influenza B viruses analysed were sensitive to oseltamivir and zanamivir.

-- Comment:

While weekly detections of influenza virus in all countries have continued to fall, A(H3N2) remains the dominant influenza virus circulating in the European region, including the Russian Federation. The proportion of type B influenza virus detections, which showed a rising trend since week 4/2009 (4%) to week 12/2009 (40%), has now dropped to 36% in week 13/2009. Of influenza B viruses that have been antigenically and/or genetically characterised, 95% (786/829) were B/Victoria lineage. With the exception of these B/Victoria lineage viruses, most of the viruses characterised are similar to the three components - A(H1N1), A(H3N2) and B/Yamagata lineage - included in the 2008/2009 Northern Hemisphere influenza vaccine. The mismatch of these B/Victoria/2/87 lineage viruses with the current vaccine is unlikely to be of public health significance and overall vaccine used this season is expected to have been effective.

-- Background:

The Weekly Electronic Bulletin presents and comments on influenza activity in the 53 countries that report to EISS. Of these countries, 36 reported both clinical and virological data, two reported virological data only and two reported clinical data only to EISS in week 13/2009. The spread of influenza viruses and their epidemiological impact in Europe are being monitored by the network under the aegis of the European Centre for Disease Prevention and Control in Stockholm (Sweden) and the WHO Regional Office for Europe in Copenhagen (Denmark), in collaboration with the WHO Collaborating Centre for Reference and Research on Influenza in London (UK).

-- Other bulletins:

The EISS bulletin is prepared using reports from GP consultations and other sources, depending on individual country arrangements. It is important to recognise that different health care systems and types of measurement should also be considered when assessing the impact of influenza.

-- Map

The map presents the intensity of influenza activity and the geographical spread as assessed by each of the networks in EISS.

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From Drop Box</td></tr></tbody></table>

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From Drop Box</td></tr></tbody></table>

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From Drop Box</td></tr></tbody></table>

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From Drop Box</td></tr></tbody></table>

Europe Year 2009 / Week 13

A = Dominant virus A
H1N1 = Dominant virus A(H1N1)
H3N2 = Dominant virus A(H3N2)
H1N2 = Dominant virus A(H1N2)
B = Dominant virus B
A & B = Dominant virus A & B
= : stable clinical activity
+ : increasing clinical activity
- : decreasing clinical activity
Low = no influenza activity or influenza at baseline levels
Medium = usual levels of influenza activity
High = higher than usual levels of influenza activity
Very high = particularly severe levels of influenza activity
No activity = no evidence of influenza virus activity (clinical activity remains at baseline levels)
Sporadic = isolated cases of laboratory confirmed influenza infection
Local outbreak = increased influenza activity in local areas (e.g. a city) within a region,or outbreaks in two or more institutions (e.g. schools) within a region. Laboratory confirmed.
Regional activity = influenza activity above baseline levels in one or more regions with a population comprising less than 50% of the country's total population. Laboratory confirmed.
Widespread = influenza activity above baseline levels in one or more regions with a population comprising 50% or more of the country's population. Laboratory confirmed.
Finland : Where available, the epidemiological data are provided by a health-care district in South-Western Finland (the health-care district serves 54,000 inhabitants i.e. approximately one percent of the Finnish population).

-- Network comments (where available)

- Bulgaria. During last week the number of positive for influenza viruses samples is increasing. From total of 25 samples obtained from hospitalized children up to age of five, three A/H3 and two B positive for influenza were detected. The detection of RSV continues.

- Italy. Low influenza activity is reported. Only 1 A/H3 influenza virus has been detected during this week.

- Switzerland. Influenza B viruses continued to be detected. However, medical consultations are below threshold now.
-

<cite cite="http://www.eiss.org/cgi-files/bulletin_v2.cgi">EISS - Bulletin Review</cite>

**Shiloh** · April 5, 2009, 03:12 PM

Re: Seasonal Flu 2008 - 2009

Source: http://www.stuff.co.nz/dominion-post...strains-of-flu

Kiwis catch drug-resistant strains of flu
By REBECCA PALMER - The Dominion Post
Last updated 05:00 06/04/2009

Four people have been found to have flu viruses resistant to the drug Tamiflu and health experts say growing anti-viral resistance underlines the importance of immunisation.

Environmental Science and Research virologist Sue Huang, head of the WHO national influenza centre in Upper Hutt, said none of the four Kiwis had taken Tamiflu, which is used to treat the disease within the first two days after symptoms appear.

That suggested they had contracted the drug-resistant virus from someone who had travelled overseas.

"It's most likely the virus travelled down to New Zealand."

The first New Zealand cases of resistance were picked up last August, the most recent in January.

Dr Huang said resistance had so far been limited to the H1N1 strain, which is one of the most common flu viruses in humans. In Hong Kong and the United States, the proportion of Tamiflu-resistant H1N1 had grown from 10 per cent to nearly 100 per cent in a year, she said.

The rapid increase in resistance overseas suggested New Zealand would experience a similar pattern.

That reinforced the message that vaccinations were the primary method of protection.

"It doesn't really matter about the Tamiflu-resistant strains if you have the vaccination."

This year's vaccine contains:

* Influenza A/Brisbane (H1N1)-like strain

* Influenza A/Brisbane (H3N2)-like strain

* Influenza B/Florida

It is available from doctors and is free until the end of June for people over 65 and those under 65 with long-term conditions such as heart disease, diabetes, cancers and asthma.

In recent years, fears of an H5N1 "bird flu" epidemic have prompted thousands of Kiwis to stock up on Tamiflu, which is available over the counter at pharmacies.

But Dr Huang said that this year it would be important for people to check which strains of the flu were dominant in a community before taking Tamiflu.

People should ask their doctors which strain they had. Those who had H3N2 or B strains would still find the drug effective, but there was no point using it against a drug-resistant H1N1 strain.

The National Influenza Strategy Group, which promotes immunisation, has warned this flu season could be deadlier than usual, after several mild seasons. The Brisbane strains killed six Australian children last year.

Dr Huang said there was no evidence yet of a "super nasty" strain. "But the virus changes are very fast and very unpredictable."

The Government has a stockpile of more than 1.2 million doses of Tamiflu, as one of the country's main defences in a pandemic. Health Ministry national emergency planning co-ordinator Steve Brazier said the ministry was aware of `resistance issues" but did not believe any action was warranted yet.

**tropical** · April 6, 2009, 05:01 AM

Re: Seasonal Flu 2008 - 2009

Originally posted by Shiloh View Post

Kiwis catch drug-resistant strains of flu
By REBECCA PALMER - The Dominion Post
Last updated 05:00 06/04/2009
...
"It doesn't really matter about the Tamiflu-resistant strains if you have the vaccination."
...
But Dr Huang said that this year it would be important for people to check which strains of the flu were dominant in a community before taking Tamiflu.

People should ask their doctors which strain they had. Those who had H3N2 or B strains would still find the drug effective, but there was no point using it against a drug-resistant H1N1 strain.
...
"But the virus changes are very fast and very unpredictable."
...

"if you have the MATCHED vaccination"

"People should ask their doctors which strain they had."

Maybe at NZ are better fast-ready to lab it, but to got the information of the exact flu (sub)strain name of the infected in the Tamiflu 24-48h schedule (after the first signs) from your GP (or else but some chip fast test) would be imaginary or fogging only ...

**Giuseppe** · April 10, 2009, 10:31 AM

Re: Seasonal Flu 2008 - 2009

EISS - 10 April 2009, Issue N? 300 Influenza activity in Europe is coming to an end for the 2008-2009 season.

EISS - Weekly Electronic Bulletin Week 14 : 30/03/2009-05/04/2009 - 10 April 2009, Issue N? 300 Influenza activity in Europe is coming to an end for the 2008-2009 season: only two regions of the Russian Federation report high influenza activity while activity has returned to out of season levels

-- Summary:

In week 14/2009, only two (Northwestern and Urals) of the seven regions of the Russian Federation reported high influenza activity. All other countries (and regions) in Europe, including all of the EU/EEA, reported decreasing influenza activity or baseline activity. Total weekly influenza virus detections have been declining since week 04/2009, indicating that influenza activity is coming to an end in Europe for the 2008-2009 season.

-- Epidemiological situation - week 14/2009:

For the intensity indicator, the national network levels of influenza-like illness (ILI) and/or acute respiratory infection (ARI) were medium in eight countries and low in the other 27 countries that reported this indicator. While the Russian Federation reported medium intensity as a whole two regions, Northwestern and Urals, continued to report high intensity, but with decreasing trends for consultation rates. All other countries (and regions) reported decreasing or stable trends at baseline levels of clinical activity, with the exception of Luxembourg which reported an increase in consultation rates but still had baseline levels of influenza actvity.

For the geographical spread indicator, widespread influenza activity was only reported in Croatia, regional activity in three countries, local activity in six countries and sporadic or no activity in the remaining 25 countries.

-- Cumulative epidemiological situation - 2008-2009 season (weeks 40/2008-14/2009):

Since week 49/2008 consultation rates for ILI and/or ARI rose above baseline levels in most European countries following a general west to east progression. High influenza intensity has been reported in 16 countries, also following a general west to east progression, since week 51/2008.

Generally, the highest consultation rates have been in the 0-4 and 5-14 age groups, but Ireland, UK, Norway and Romania have reported their highest ILI consultation rates in the 15-64 age group.

In most countries in western, central, northern and southern Europe the seasonal epidemic appears to be over, with consultation rates for ILI and/or ARI having returned to baseline levels.

-- Virological situation - week 14/2009:

The total number of respiratory specimens collected by sentinel physicians in week 14/2009 was 875, of which 167 (19%) were positive for influenza virus: 70 type A (21 subtype H3, four subtype H1 and 45 not subtyped) and 97 type B. In addition, 306 non-sentinel source specimens (e.g. specimens collected for diagnostic purposes in hospitals) were reported positive for influenza virus: 204 type A (94 subtype H3, 53 subtype H1 and 57 not subtyped) and 102 type B.

-- Cumulative virological situation - 2008-2009 season (weeks 40/2008-14/2009):

Of 28158 virus detections (sentinel and non-sentinel) since week 40/2008, 24261 (86%) were type A (10681 subtype H3, 1272 subtype H1 and 12308 not subtyped) and 3897 (14%) were type B.

Based on the antigenic and/or genetic characterisation of 3220 influenza viruses, 2268 (70%) were reported as A/Brisbane/10/2007 (H3N2)-like, 154 (5%) as A/Brisbane/59/2007 (H1N1)-like, 33 (1%) as B/Florida/4/2006-like (B/Yamagata/16/88 lineage) and 765 (24%) as B/Malaysia/2506/2004-like (B/Victoria/2/87 lineage).

More detailed antigenic and genetic analyses have shown that B/Victoria/2/87 lineage viruses were either B/Malaysia/2506/2004-like or B/Brisbane/60/2008-like, the prototype vaccine strain recommended by WHO for inclusion in the 2009-10 vaccine (WER 2009; 84(9): 65-76).

Influenza virus isolates from 19 countries were assessed for antiviral drug susceptibility.

All influenza A(H3N2) viruses tested were sensitive to oseltamivir and zanamivir, and all but one of those tested were resistant to M2 inhibitors.

Ninety-eight percent of influenza A(H1N1) viruses analysed were resistant to oseltamivir while all those tested against zanamivir were sensitive.

One A(H1N1) virus was M2 inhibitor-resistant, but sensitive to the neuraminidase inhibitors.

The small number of influenza B viruses analysed were sensitive to oseltamivir and zanamivir.

-- Comment:

Influenza activity in Europe is coming to an end. Only two regions of Russia (Northwestern and Urals) reported high influenza activity in week14/2009. In all other countries (and regions), influenza activity is declining and in many areas of Europe (e.g. Western Europe) the seasonal epidemic is effectively over with consultation rates for ILI and/or ARI at baseline levels.Influenza A(H3N2) has been the dominant virus in Europe, accounting for an estimated 77% of total viruses typed/subtyped this season.

Detections of influenza A virus peaked in week 04/2009 and influenza B virus detections peaked around week 11/2009. Of influenza B viruses that have been antigenically and/or genetically characterised, 96% (765/798) were B/Victoria lineage.

With the exception of these B/Victoria lineage viruses, most of the viruses characterised are similar to the three components - A(H1N1), A(H3N2) and B/Yamagata lineage - included in the 2008/2009 Northern Hemisphere influenza vaccine. The mismatch of these B/Victoria/2/87 lineage viruses with the current vaccine is unlikely to be of public health significance and vaccine used this season is expected to have been effective.

-- Background:

The Weekly Electronic Bulletin presents and comments on influenza activity in the 53 countries that report to EISS. Of these countries, 32 reported both clinical and virological data, four reported virological data and four reported clinical data only to EISS in week 14/2009. The spread of influenza viruses and their epidemiological impact in Europe are being monitored by the network under the aegis of the European Centre for Disease Prevention and Control in Stockholm (Sweden) and the WHO Regional Office for Europe in Copenhagen (Denmark), in collaboration with the WHO Collaborating Centre for Reference and Research on Influenza in London (UK).

-- Other bulletins:

The EISS bulletin is prepared using reports from GP consultations and other sources, depending on individual country arrangements. It is important to recognise that different health care systems and types of measurement should also be considered when assessing the impact of influenza.

-- Map

The map presents the intensity of influenza activity and the geographical spread as assessed by each of the networks in EISS.

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From MAPS</td></tr></tbody></table>

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From MAPS</td></tr></tbody></table>

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From MAPS</td></tr></tbody></table>

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From MAPS</td></tr></tbody></table>

Europe Year 2009 / Week 14

A = Dominant virus A
H1N1 = Dominant virus A(H1N1)
H3N2 = Dominant virus A(H3N2)
H1N2 = Dominant virus A(H1N2)
B = Dominant virus B
A & B = Dominant virus A & B
= : stable clinical activity
+ : increasing clinical activity
- : decreasing clinical activity
Low = no influenza activity or influenza at baseline levels
Medium = usual levels of influenza activity
High = higher than usual levels of influenza activity
Very high = particularly severe levels of influenza activity
No activity = no evidence of influenza virus activity (clinical activity remains at baseline levels)
Sporadic = isolated cases of laboratory confirmed influenza infection
Local outbreak = increased influenza activity in local areas (e.g. a city) within a region,or outbreaks in two or more institutions (e.g. schools) within a region. Laboratory confirmed.
Regional activity = influenza activity above baseline levels in one or more regions witha population comprising less than 50% of the country's total population. Laboratory confirmed.
Widespread = influenza activity above baseline levels in one or more regions with a population comprising 50% or more of the country's population. Laboratory confirmed.
Finland : Where available, the epidemiological data are provided by a health-care district in South-Western Finland (the health-care district serves 54,000 inhabitants i.e. approximately onepercent of the Finnish population).

-- Network comments (where available)

- Italy. Low influenza activity is reported. During this week 2 A/H3 and 5 B influenza viruses have been detected.

- The former Yugoslav Republic of Macedonia. Mandatory data

- Russian Federation. On the week 14 morbidity decrease was observed in all regions of Russia, that was partly connected with school holidays. However, in 2 regions of the country, the Urals and the North-West, morbidity was qualified as high, because its level exceeded 900 cases per 100 000 of population.

- Slovenia. Higher number of influenza A/H1 in week 14 are due to the localized outbreak in one nursing facility for the handicapped children. No A/H1 was detected outside this facility.
-

<cite cite="http://www.eiss.org/cgi-files/bulletin_v2.cgi">EISS - Bulletin Review</cite>

**Commonground** · April 14, 2009, 06:48 PM

Re: Seasonal Flu 2008 - 2009

14.04.2009

Onishchenko told about the epidemic of influenza

Influenza epidemic in Russia is declining, and its recurrence is unlikely. Such information-sharing supervisor Rospotrebnadzor, Chief State Sanitary Doctor of Russia Gennady Onishchenko.

"Incidence of influenza in Russia's regions has continued to fall. Excess epidemic threshold is currently observed in the 11 cities and three Russian regions. As compared to last week, so at nine cities and two smaller entity," - he said.

There are currently exceeding a threshold incidence of epidemic influenza noted in Ryazan, Barnaul, Astrakhan, Ulyanovsk, Irkutsk, Arkhangelsk, Chelyabinsk, Nizhny Novgorod, Ivanovo, Tula, Chelyabinsk Oblast and Belgorod, Smolensk, and Kemerovo.

In Ryazan, where the epidemic period of recovery lasted for 4 weeks - from mid-February to mid-March - the reduction of morbidity began with the 3rd decade of March and the end of the month the situation was characterized as neepidemicheskaya.

According to Rospotrebnadzor of the Chelyabinsk region, last week was nearly 23 thousand cases of respiratory infections. Of these, 641 cases of influenza. High levels of morbidity continues to occur in Chelyabinsk. They noted the excess of thresholds for all age groups except for children aged 7-14 years. In the regional center registered 10.7 thousand cases of ARI. In medical institutions admitted 77 people, including 72 children.

According to Onishchenko, in St. Petersburg exceeded the epidemic threshold is saved at the expense of morbidity in children. "In Moscow, the situation with influenza is calm," - said Onischenko. He noted that the medical prognosis, the epidemic of influenza in Russia will be completed in April, said Interfax.

http://74.125.93.132/translate_c?hl=en&ie=UTF-8&sl=ru&tl=en&u=http://itsnow.ru/nws/news:197810&prev=_t&usg=ALkJrhjg5w6SZisV-PiLsB8p5rSnbuwfQw