Swine Flu

The countries and overseas territories that have newly reported their first pandemic (H1N1) 2009 confirmed case(s) as of 13 August 2009 are:
Ghana, Zambia and Tuvalu.

As of this week, there have been more than 182000 laboratory confirmed cases of pandemic influenza H1N1, 1799 deaths, in 177 countries and territories. As more and more countries have stopped counting individual cases, the case number is significantly lower than the actually number of cases that have occurred. The rates of influenza illness continue to decline in the temperature regions of the southern hemisphere, except in South Africa where it appeared slightly later than the other countries of the region. Active transmission is still seen in some parts of Australia, Chile and Argentina.

Areas of tropical Asia are reporting increasing rats of illness as they enter monsoon season, as represented by India, Thailand, Malaysia and Hong Kong. Tropical regions of Central America, represented by Costa Rica and El Salvador, are also seeing very active transmission.

In the northern temperature zones, overall rates are declining in both North America and Europe though virus is still found across a wide area throughout both regions. High activity of the pandemic is being reported in 3 U.S. states and few countries of Western Europe.

It has been noted throughout the temperature zones of the southern hemisphere , wich are no passing out their winter season, that when pandemic began to circulate ,the relative importance of seasonal strains, represented by H3N2 in nearly all countries, rapidly diminished and pandemic H1N1 became the dominant strain.

Health services have been impacted in several countries. I n Australia, severe H1N1 cases are occupying a significant number of ICU beds, in some cases causing elective surgery lists o be postponed. In Chile, health services have been strained. A “Healthy Emergency” was declared in Argentina in early July, and the country has reported an unusually high case fatality rate compared to other nations. This continues to be a worry, although it might be attributable to reporting processes. It’s possible the nation is counting all community-acquired pneumonia deaths as due to pandemic flu, thereby over estimating deaths due to influenza.

The total global vaccine production of around 1 billion doses is now being expanded. Human testing has begun at least in Australia and China. However significant quantities of H1N1vacine will not be available until the northern hemisphere is well into the expected fall/winter epidemics.

Te Vaccine is likely to cause greater levels of immunity than H5N1 vaccine because most people have some “immune memory” to H1N1 family of viruses. One aspect of this immune memory is that it directs itself towards the 1st member of the H1N1 family that the person had encountered. A rather negative consequence could be that new vaccine stimulates ‘old’ H1N1 antibodies rather than new antibodies to the particular Swine component.

Vaccine efficacy studies are now also underway in the UK involving several hundred volunteers; A possible novel use of vaccine is to vaccinate children in attempts to break the chain of infection leading onwards to older siblings, pregnant women 1 million and NHS employees 1 million