H5N1

Vietnam: 52 deaths

Via Viet Nam News: 2 infants die from swine flu.

Two more 3-year-old children died after contracting the A/H1N1 flu in Ha Noi and Thanh Hoa Province, bringing the nation’s total fatalities to 52. 

There had been more than 11,000 reported A/H1N1 flu cases, said Director of the Preventive Medicine and Environment, the Ministry of Health, Nguyen Huy Nga. 

Nga also added that the pandemic would be unpredictable in the coming time. Nga made the remarks at the National Steering Committee for A/H1N1 Pandemic Prevention meeting yesterday. 

"Scientists have worried about the risk of a combination between the A/H1N1 and the A/H51N1, which would make the virus more dangerous and possibly fatal. The A/H5N1 virus has been discovered in Dien Bien, Thai Nguyen, Cao Bang and Ca Mau Provinces", stressed Nga.

Pakistan: 9 deaths

Via IRIN News: PAKISTAN: Nine swine flu deaths prompt fear. Excerpt:

The death of at least nine people from H1N1 influenza since May 2009 has led to rising public fear and concern, and experts are calling on the government to introduce more preventative measures. 

Screening was introduced at airports during the summer but little else has been done to combat the disease. 

“The authorities are not taking effective measures to check the disease. There is no strategy in place for this,” Ashraf Nizami, president-elect of the Pakistan Medical Association in Punjab, said. Nine cases have now been confirmed in the province. 

Experts say one of the factors behind the recent rise in H1N1 cases has been the return from Saudi Arabia at the end of November of thousands of pilgrims who had gone on the Haj pilgrimage. 

“The return of 150,000 pilgrims in cold, dry weather raises the risk of swine flu as in these conditions the virus spreads rapidly,” Rafiq Khanani, president of the Infection Control Society of Pakistan, said at a seminar in Karachi. 

He suggested thermal scanners should have been placed at all airports before the Haj pilgrim influx began. 

Rashid Jooma, director-general of health for the federal government, said there were 76 confirmed cases and nine deaths. 

Twenty-six other people have been tested positive by the Aga Khan University Hospital in Karachi, which also reported two additional deaths in the city. Under government policy, all positive samples need to be sent to the National Institute for Health for confirmation.

UK: 58 deaths in Scotland

Via the Evening Telegraph: First swine flu death in Tayside. Excerpt:

Tayside has had its first swine flu death since the outbreak of the H1N1 virus, the Scottish Government confirmed today (writes Jennifer Cosgrove and Graham Huband). 

The announcement was made by Health Secretary Nicola Sturgeon. The Scottish swine flu death toll now stands at 58. 

The patient, who is understood to have died in the last 24 hours, was said to have significant underlying health problems. 

Ms Sturgeon said, “My deepest sympathy is with the patient’s family and friends. I continue to urge all those in the at-risk groups to take up the vaccine invitation from their GPs.”

New mothers also at risk from H1N1

Via the Winnipeg Free Press, a report from the Associated Press: Study finds swine flu is a threat to new mothers, not just pregnant women. Excerpt:

Swine flu is not only dangerous to pregnant women, but it's a threat to new mothers too, the first study to document this risk shows. 

An analysis of pregnant women and new mothers who were hospitalized with swine flu in California found that those who had a baby in the previous two weeks were at higher risk of severe flu complications. 

The swine flu threat to pregnant women has been well-documented, and public health officials urged them to get vaccinated. Previous research showed expectant mothers infected with the virus are more likely to be hospitalized and face a greater risk of death than the general population. 

The new report, released Wednesday by the New England Journal of Medicine, is the first to look at the risk to women who recently gave birth and highlights "the continued high risk immediately after pregnancy," the researchers wrote. 

As a result of the research, the Centers for Disease Control and Prevention recently revised its guidelines, recommending that flu drugs be given to women who show signs of the flu soon after they give birth.

Hong Kong: Not only H1N1 and H5N1 but also H9N2 (updated)

Via Xinhua: Hong Kong girl infected with rare but mild A/H9N2 flu virus. Excerpt:

A 3-year-old girl in Hong Kong was recently infected with influenza A/H9N2, a mild form of avian influenza rarely found in human beings, local health authorities said Wednesday.     

The Center for Health Protection (CHP) of the Department of Health, the Hong Kong Special Administrative Region (HKSAR) government, said the girl developed cough and fever and had a running nose since late November. She was admitted to a local hospital.     

Influenza A/H9N2 was "detected in the patient's respiratory specimen," the center said.     

The girl was discharged on Dec. 11 and has now recovered.     

The center said the investigation was going on, adding that the Department of Health would inform the World Health Organization.     

Influenza A/H9 has been isolated from duck and chicken for many years. Infection in humans is rare, and appears to lead to a mild disease, it said, adding that Hong Kong has previously reported six human cases of the H9 viruses since 1999.

Update: The Hong Kong government has provided some details about this case. 

Turkey: No more H1N1 death reports

Via Hurriyet: Health Ministry to provide no more new data on swine flu deaths. Excerpt:

The Turkish Health Ministry decided this week to stop releasing the number of deaths due to swine flu, a decision some experts criticized, saying it could erode transparency and confidence. 

Other experts, however, suggest the move might be designed to stop spreading fear over the disease. 

Instead of providing information on the numbers of deaths, the ministry said it will focus its energy on vaccinating more people. It will, however, continue informing the World Health Organization, or WHO, about fatality statistics. 

“The ministry was doing the right thing. I do not understand why it decided to stop disclosing numbers. It’s bizarre,” said Dr. Önder Ergönül of Marmara University Medical School’s infectious diseases branch.   

Not disclosing the numbers might also increase panic, said Dr. Ali Özyurt, secretary of the Turkish Medical Association’s Scientific Advisory and Watch Board for Pandemics. “Transparency and confidence are critical,” he added. 

Özyurt suggested the ministry might have chosen to stop providing the statistics because the number of deaths in Turkey has now exceeded 450, more than the ministry originally expected. He added that government pressure might also have been a factor in the decision. 

The Health Ministry has denied allegations that the government or Prime Minister Recep Tayyip Erdoğan demanded to remove swine flu from the media’s agenda. The decision was made by a scientific board for pandemics, ministry officials said. 

At the onset of the flu outbreak, the ministry said 400 people would die, even if all necessary measures were taken. The fact that the death toll has already exceeded 400 indicates the failure to take necessary measures, Özyurt said. 

“Some 43 million doses of vaccine were ordered, but only 2 million people were vaccinated,” he added.

India: Over 800 deaths

The Indian government's Press Information Bureau says that today's total H1N1 deaths have reached 811. Sify.com says the total is 815.

WHO: Update 80

WHO has just published Pandemic (H1N1) 2009 - update 80. It reports at least 11,516 H1N1 deaths worldwide. Excerpt:

In the temperate zone* of the northern hemisphere, transmission of pandemic influenza virus remains active and geographically widespread, however overall disease activity has recently peaked in much of the hemisphere. There continues to be increases in influenza activity in later affected areas of central and eastern Europe, and in parts of west, central, and south Asia. 

In United States and Canada, influenza activity continues to be geographically widespread but overall levels of ILI** have declined substantially to near the national baseline level in the US and below the seasonal baseline in Canada. 

Although numbers of hospitalizations and death in US have declined steadily since their peak over 6 weeks ago, the proportional mortality due to pneumonia and influenza (P&I mortality) remains elevated above the epidemic threshold for the 11th consecutive week. 

In Canada, rates of ILI, numbers of outbreaks, and proportions of samples testing positive for influenza have declined substantially since peaking six weeks ago. Approximately 53% of hospitalized cases in Canada had an underlying medical condition; cases with underlying medical conditions tended to be older (compared to those without), and were at increased risk of hospitalization and death. 

Also from Canada, a smaller proportion of hospitalized cases during the winter transmission season compared with those hospitalized cases during the summer transmission season, were persons of aboriginal origin (3.9% vs. 20.3%). 

In Europe, geographically widespread and active transmission of pandemic influenza virus continued to be observed throughout the continent, however, overall pandemic influenza activity appears to have recently peaked across a majority of countries. 

At least ten countries reported that 30% or more of their sentinel respiratory specimens had tested positive for influenza. Greater than 98% of subtyped influenza A viruses detected in Europe were pandemic H1N1 2009, however, seasonal influenza viruses (H1N1, H3N2, and type B) continue to be detected at low levels. 

Of note, a few countries are experiencing increasing disease activity and have yet to peak (Hungary and Montenegro ), while several others are experiencing a resurgence in activity (Serbia, Ukraine, Georgia, and Turkey). 

Rates of ILI have returned to near seasonal baselines in the earlier affected areas of western Europe (Belgium, the Netherlands, Ireland, and Iceland) and a substantial decline in activity has been observed in much of northern Europe over the past month. 

In central and southern Europe, where influenza virus transmission has been most active recently, disease activity in most places has either plateaued (Albania, Czech Republic, Estonia) or begun to decline (Austria, Germany, Poland, Latvia, Croatia, Slovakia, and Greece). 

Further east, influenza activity appears to be variable, with the Russian Federation reporting a steady decline in rates of ARI after a recent peak three weeks ago; while several other countries are reporting increases in rates of ILI/ARI (Ukraine and Georgia). 

In Europe, the highest rates of ILI have been recorded among children 0-4 years of age (in 15 countries) and among older children 5-14 years of age (in 18 countries). Detections of RSV in Europe continued to increase over the past six weeks, partially accounting for elevated ILI activity among young children in some countries. 

In Western and Central Asia, limited data suggest that influenza virus circulation remains active throughout the region, however disease trends remain variable. Increasing respiratory diseases activity continued to be reported in Kazakhstan and in Egypt; while several others countries, Israel and Oman, have been reporting declining trends of respiratory diseases activity after recording a peak of activity approximately one month ago. 

In East Asia, the situation remains similar to last week; influenza transmission remains active but appears to be declining overall. Influenza/ILI activity has recently peaked and continues to decline in Japan, in northern and southern China, Chinese Taipei and in Mongolia. 

In southern Asia, influenza activity continues to increase in the northern India, Nepal, and, Sri Lanka. 

In the tropical region of Central and South America and the Caribbean, influenza transmission remains geographically widespread but overall disease activity has been declining or remains unchanged in most parts, except for in Barbados and Ecuador, were recent increases in respiratory diseases activity have been reported. 

In the temperate region of the southern hemisphere, sporadic cases of pandemic influenza continued to be reported without evidence of sustained community transmission.

Mexico: 67,982 cases and 800 deaths

I missed the Mexican Health Secretariat's December 21 update when it was published. On November 20, the number of confirmed cases was 64,322, and the number of deaths was 573. So Mexico has seen 227 H1N1 deaths in a month.

Israel: 73 deaths

Via the Jerusalem Post: 28-year-old pregnant woman dies of swine flu in Beersheba hospital.

A 28-year-old pregnant woman who was not suffering from any other serious health ailments died from the H1N1 virus Wednesday afternoon. 

The woman died at Beersheba's Soroka University Medical Center. 

The death marks the 73rd fatality in Israel attributed to the swine flu.

Czech Republic: 10 deaths in past week

Via CeskeNoviny.cz: Ten people with swine flu die in CzechRep in past week. Excerpt:

Ten people who had swine flu died in the past week and 48 have died altogether in the Czech Republic since late October, Health Ministry spokesman Vlastimil Srsen said. 

The Czech National Reference Laboratory for Flu has registered 1207 people who got infected with the H1N1 virus so far. In the past week 80 new cases of infection were confirmed. 

Vaccination against swine flu started a month ago, on November 23. Some 40,000 doses of the vaccine have been applied so far. 

Roman Prymula, head of the Czech vaccinological association, said though most swine flu cases are not serious, the number of highly serious cases is increasing in Czech hospitals. 

Most of those who died with swine flu were people from the risk groups to whom the state offers vaccination for free, Prymula said. 

He said the problem was that a number of patients do not want the vaccine, partly because some Czech doctors stated that they would not get vaccinated themselves.

China reports 91 more deaths from H1N1 flu

Via China Daily: China reports 91 more deaths from H1N1 flu. Excerpt:

The Chinese mainland has reported 91 deaths from the H1N1 influenza in the week from December 14 to 20, the Ministry of Health announced Wednesday. 

A total of 6,129 H1N1 flu cases were reported during the period. H1N1 accounted for 87.5 percent of flu cases, a minor drop from the week before last, said the notice on the ministry's official website. 

Pregnant women accounted for 8.7 percent of severe cases of the H1N1 influenza and 15.7 percent of deaths during this period, it said.

The story doesn't give a national total of H1N1 deaths in China, but the latest ECDC update reports 441 deaths. 

A personal note

Of course the holiday season is taking up a lot of my family's time, but we are also dealing with a medical crisis in the family. It has nothing to do with H1N1, but it is literally a life or death problem.

I will try to keep the flu posts coming, but if they don't, it's because my family and I are concerned with personal issues. 

Canada’s cure for the common cold: H1N1

Via The Globe and Mail: Canada’s cure for the common cold: H1N1. Excerpt:

An unexpected positive outcome of the H1N1 pandemic is that common colds and food-borne illnesses are on the wane compared to other years, says Canada’s Chief Public Health Officer David Butler- Jones. 

“Other infectious diseases, other respiratory diseases like colds are spread very similarly (like H1N1) in terms of rubbing hands, rubbing eyes, nose, mouth, putting our fingers in our mouth as well as food borne illnesses,” says Dr. Butler-Jones in an interview today. 

“So the food borne outbreaks, we seem to be seeing fewer.” 

He said that he has no statistics. Yet monitoring is being done, which shows that fewer Canadians seem to be suffering from the common cold and also from food poisoning. “It’s one of those things though that is difficult to prove but it is something that we’ve seen,” he said. 

“Every morning we look at diseases and outbreaks around the world and what is happening in Canada and there just doesn’t seem to be as much.”

Indonesia: Swine flu biggest challenge for health ministry

Via the Jakarta Globe, a fascinating report: Swine Flu the Biggest Challenge For Indonesia Health Ministry in 2009. The last sentence is especially fascinating. Excerpt:

The H1N1 swine flu virus easily caused the most worries for the Health Ministry in 2009, following its spread across 25 of the country’s 33 provinces and the initial unfamiliarity with the disease’s symptoms, an official said on Tuesday. 

“H1N1 influenza, or swine flu, was definitely the outbreak that caused the biggest scare in the country this year. People were unfamiliar with the virus and its ability to spread quickly from human to human, so we had a serious panic situation on our hands,” Rita Kusriatuti, the ministry’s director for management of animal-related communicable diseases, told the Jakarta Globe. 

 More than 1,000 people in the country were infected by the virus — which first emerged in Mexico and the United States in April — which reportedly claimed 10 lives. Of those infected, 6 percent were foreign nationals. 

“For the first time in more than 40 years, the World Health Organization declared a pandemic. Of course, the whole world immediately went on alert. The issue became very sensitive and suspicions were everywhere,” Rita said. 

Former Health Minister Siti Fadillah Supari, according to media reports, tried to downplay the situation by claiming the virus was unlikely to spread in Indonesia because it could not survive the “tropical heat.” The controversial minister’s claim almost immediately turned out to be incorrect when, in June, tourists in Bali were rushed to hospital after developing flu-like symptoms. 

The virus quickly spread and the government had to resort to upgrading health security measures in international airports and seaports. Thermal scanners were installed to screen people with high temperatures in an attempt to arrest the spread of the virus. 

“We did everything we could. We isolated all suspected patients even after WHO told us to stop because the prevention measures seemed not to be working,” Rita said. 

However, the Ministry eventually claimed that H1N1 was rarely fatal and could be treated as any other kind of influenza. 

“People began to understand that although they may have contracted the virus, they would be fine after undergoing standard treatment,” she said. 

She said that Indonesia was now more prepared to deal with outbreaks of viral infections because of its experiences with H1N1 and the H5N1 avian flu virus. 

“We have 100 hospitals ready for the H5N1, which is similar to swine flu, but far more dangerous,” Rita said, adding that since 2003, the bird flu virus had claimed 119 lives in Indonesia across 30 provinces.

That last sentence is very interesting. WHO has been kept officially uninformed about H5N1 cases in Indonesia for a couple of years, and its official tally lists 141 cases and 115 deaths.

Study: One dose may be enough for children

Via the New England Journal of Medicine: One Dose of H1N1 Vaccine May Be Enough for Children. Excerpt:

A single dose of vaccine may be sufficient to protect most infants and children against 2009 H1N1 influenza, according to a JAMA study released online, but editorialists say the data are not compelling enough to change the current U.S. recommendation for two doses for younger patients.

Click through to the NEJM story to find links to the JAMA report and the editorialists.

Australia risks swine flu outbreak: MBF

Via The Age: Australia risks swine flu outbreak: MBF. Excerpt:

Australia risks a serious swine flu outbreak because 65 per cent of people say they are unlikely to get vaccinations during 2010, the private health insurance firm MBF says. 

The firm, now part of the British-based BUPA group, says that although the number of domestic cases has waned since last winter, the disease is still a major threat, particularly because cases are increasing in the northern hemisphere. "

"The number of cases and deaths from this disease is increasing at an alarming rate into the winter months in the northern hemisphere, with more than 22 million people in the USA infected and 10,500 people dying from the disease," BUPA Australia's chief medical officer Dr Christine Bennett says. 

She said the number of Australians travelling overseas and visitors to Australia in coming months could help spread the illness. 

Research conducted for MBF showed of those planning to travel to the northern hemisphere on holiday 71 per cent did not intend to get vaccinated against swine flu. 

A total of 65 per cent of Australians who are currently unprotected against the disease also say they do not plan to get vaccinated, the MBF research showed. 

Less than half of those surveyed with existing underlying illnesses such as asthma or diabetes - putting them at higher risk from swine flu - had been vaccinated.

Egypt confirms four new AH1N1 flu deaths

Via Egypt News.com: Egypt confirms four new AH1N1 flu deaths.

Egypt's Health Ministry reported Monday that four more deaths of the Influenza AH1N1 pandemic (Swine Flu) which pushed to 93 the death toll since the first outbreak of the disease in the country in last April. 

A pregnant 23-year-old woman succumbed to the illness after being quarantined at a Cairo hospital due to swine flu-like symptoms, according to a press release by the ministry.

Another lady, 26 years, suffering from acute respiratory problems, breathed her last at a hospital in Al-Qalyubyah Governorate, north Cairo. She was attached to a breathing assistance apparatus but died later on, the statement said. 

A 40-year-old man in Qena Governorate, south Cairo, who used to suffer from cardiac rheumatoid fell victim to the fatal swine flu disease. 

The 93rd fatally belongs to a 14-year-old girl in Cairo who used to suffer from a chronic chest disease and underwent an open heart surgery, it noted. 

Meanwhile, up to 6,981, out of the country’s 7,330 laboratory-confirmed swine flu cases recovered from the fatal disease with the recovery rate hitting 95.2 percent, the statement added.

WHO: Comparing deaths from pandemic and seasonal influenza

WHO has published Briefing Note 20: Comparing deaths from pandemic and seasonal influenza. Excerpt:

Comparisons of deaths from pandemic and seasonal influenza do not accurately measure the impact of the pandemic for another reason. Compared with seasonal influenza, the H1N1 virus affects a much younger age group in all categories – those most frequently infected, hospitalized, requiring intensive care, and dying. 

WHO continues to assess the impact of the influenza pandemic as moderate. Accurate assessments of mortality and mortality rates will likely be possible only one to two years after the pandemic has peaked, and will rely on methods similar to those used to calculate excess mortality during seasonal influenza epidemics.

Romania: 3 new deaths

Via HotNews.ro: Swine flu causes three more deaths in Romania and brings another 50 cases. Excerpt:

Romania recorded another three deaths in patients infected both with the A H1N1 virus and associated diseases during the last 24 hours, the Romanian Health Ministry informs. Plus, another 50 people have been diagnosed with swine flu. 

Most cases recorded during the last 24 hours were in Bucharest - 14, Cluj (Central-West) - 13,  Brasov (Central) - 5 and Sibiu (Central) - 4. Since the new epidemic outbreak, Romania diagnosed with swine flu 5,297 patients.