Global's Daily Influenza A (H1N1) Update - May 2, 2009

Current WHO Pandemic Alert Phase: 5

Please note that the World Health Organization (WHO) and other government agencies have begun referring to “swine flu” as influenza A (H1N1) due to the fact that the virus is now a human strain being spread from person-to-person. The WHO also continued to stress that there is no risk of infection from the H1N1 virus from eating well-cooked pork and pork products.

H1N1 A Influenza Cases by Country

Country	Cases		Deaths
	Lab Confirmed*	Increase from May 1, 2009	Lab Confirmed*	Increase from Yesterday
Mexico	397	241	16	7
US	141	0	1	0
Canada	51**	17**	0	0
UK	13	5	0	0
Spain	13	0	0	0
New Zealand	4	1	0	0
Germany	4	0	0	0
Israel	2	0	0	0
Austria	1	0	0	0
Netherlands	1	0	0	0
Switzerland	1	0	0	0
Denmark	1	0	0	0
France	1	1	0	0
Hong Kong	1	0	0	0
Rep. of Korea	1	1	0	0
TOTALS	632	266	17	7

*The number of confirmed cases and deaths follows the daily tally provided by the WHO (Update 9 – 2 May 2009): http://www.who.int/csr/don/2009_05_02/en/index.html. Recent news reports, however, suggest that Mexico may soon lower their case and death count following a revised assessment of cases numbers and data.

**Please note that this number of confirmed cases in Canada has not yet been recognized by the WHO (as of 2 May 2009 @ 0600 hrs GMT).

Local/National News

• Health officials in Quebec confirmed a new case of H1N1 influenza on Friday, May 1, bringing the total number of cases in Canada to 52 (still to be confirmed by the WHO).
• To date, there are:

- 15 confirmed cases in British Columbia

- 14 confirmed cases in Nova Scotia

- 12 confirmed cases in Ontario

- Eight confirmed cases in Alberta

- Two confirmed cases in Quebec

- One confirmed case in New Brunswick

• The Public Health Agency of Canada (PHAC) has launched a public information campaign to help Canadians avoid contracting the H1N1 virus.
• British Columbia’s Health Authorities, along with the Ministry of Health Services, have also posted web sites or alert pages to provide ongoing updates on the spread of H1N1 across the province:

- BC Ministry of Health Services: http://www.gov.bc.ca/govt/swine_flu.html

- BC Centre for Disease Control: http://www.bccdc.org/news.php?item=290& PHPSESSID=ba536e1720194818950bc259497219d5

- Vancouver Coastal Health: http://vch.ca/

- Fraser Health: www.fraserhealth.ca

- Interior Health: http://www.interiorhealth.ca/

- Northern Health: http://northernhealth.ca/

- Vancouver Island Health Authority: http://www.viha.ca/mho/public_health_alerts/

International News

• The WHO continues to advise member states against imposing regular travel restrictions or border closures. However, WHO officials consider it prudent for people who are ill to delay international travel and for those developing symptoms following international travel to seek medical attention.
• Mexican health authorities are claiming that the spread of the H1N1 virus is showing signs of slowing down in that country, according to a report in Saturday’s online edition of the Globe and Mail. The overall death toll was lowered from 176 to 101 after dozens of test samples came back negative. The country’s health ministry was also reporting that fewer patients with severe flu symptoms were checking into hospitals, suggesting that the infection rate was falling.
• Other countries, however, moved forward with varied mitigation efforts. For example, Hong Kong police quarantined a hotel with 200 guests and 100 staff on Friday, May 1, after a Mexican visitor was confirmed with influenza A H1N1.
• Singapore announced a week-long quarantine for anyone arriving from Mexico; travel bans to Mexico were also imposed by Ecuador, Argentina, and Cuba.
• Meanwhile, in Britain, a new public information campaign (“Catch it, Bin it, and Kill it”) was launched in an effort to improve respiratory etiquette and hand hygiene across the population.
• Preliminary data from cases in the United States show a virus attack rate of influenza A H1N1 in the 25% to 30% range, which is consistent with seasonal influenza.
• However, hospitals and clinics across the United States, including New York, California, and Alabama, were reporting a surge of the “worried well” on Friday (i.e., patients who have minor symptoms but major worries about influenza A H1N1). For example, a pediatric hospital in San Diego recently saw up to 50% more patients than usual. (AP report)
• The U.S. Education Department confirmed on Friday that over 430 schools had closed, affecting 245,000 in 18 states.
• A recent opinion poll from the Harvard School of Public Health revealed that about 77% of Americans are paying somewhat or very close attention to flu outbreak news and that 59% are washing their hands or using hand sanitizer more often.

Latest Guidance from the WHO, the U.S. CDC, and the PHAC

• The WHO has released a new guidance documents on preparedness and mitigation strategies for those communities who could be facing limited resources or access to supplies.
• The U.S. CDC has released new guidance documents for Schools (K – 12) and Childcare Facilities and Institutions of Higher Education. Additional materials can be found on their guidance for professionals’ web site.
• PHAC has also released a set of guidelines for clinicians and other responders who may have to deal with the screening and/or treatment of H1N1 cases in health care settings.
• Lastly, PHAC has also developed and posted a pandemic influenza exercise toolkit for responders and planning leaders.

Today’s Key Question (and Possible Answer)

Where did the H1N1 outbreak actually start?

The virus may have mutated into its current form months or even a year ago, and it happened, well, somewhere in the world.

The first symptoms started to show up in early March in the Mexican state of Veracruz, an area with a number of pig farms. The earliest confirmed case was a 5-year-old boy, one of hundreds of people in the town of La Gloria whose flu symptoms left them struggling to breathe.

People from La Gloria kept going to jobs in Mexico City despite their illnesses, and could have infected people there.

Still, there is no guarantee the virus came into existence in Veracruz. It spreads so easily, it could have made its way to Mexico from just about anywhere.

Some Mexican officials have offered some other suggestions of places where the virus may have begun, such as China, Pakistan or Bangladesh. But the fact is that the flu's origin remains a mystery.

Fortunately, it also doesn't really matter — the outbreak has made its way around the world, and nothing can be done now at the point of origin to slow it down.