Current WHO Pandemic Alert remains at Phase 5
Influenza A (H1N1) Cases and Related Deaths by Country (as of 8 AM PST May 14th)
| WHO Regions & Country | Lab Confirmed Cases | Lab Confirmed Deaths | ||
| Cases Confirmed on May 13th | Total Cases | Deaths Confirmed on May 13th | Total Deaths | |
| AMERICAS | ||||
| Mexico | 387 | 2446 | 4 | 60 |
| US | 343 | 3352 | 0 | 3 |
| Canada | 31 | 389 | 0 | 1 |
| El Salvador | 0 | 4 | 0 | 0 |
| Costa Rica | 0 | 8 | 0 | 1 |
| Columbia | 1 | 7 | 0 | 0 |
| Guatemala | 0 | 3 | 0 | 0 |
| Brazil | 0 | 8 | 0 | 0 |
| Panama | 0 | 29 | 0 | 0 |
| Argentina | 0 | 1 | 0 | 0 |
| Cuba | 0 | 1 | 0 | 0 |
| EUROPE | ||||
| UK | 3 | 71 | 0 | 0 |
| Spain | 2 | 100 | 0 | 0 |
| Germany | 0 | 12 | 0 | 0 |
| France | 1 | 14 | 0 | 0 |
| Austria | 0 | 1 | 0 | 0 |
| Netherlands | 0 | 3 | 0 | 0 |
| Switzerland | 0 | 1 | 0 | 0 |
| Denmark | 0 | 1 | 0 | 0 |
| Ireland | 0 | 1 | 0 | 0 |
| Italy | 0 | 9 | 0 | 0 |
| Portugal | 0 | 1 | 0 | 0 |
| Sweden | 0 | 2 | 0 | 0 |
| Poland | 0 | 1 | 0 | 0 |
| Norway | 0 | 2 | 0 | 0 |
| Finland | 0 | 2 | 0 | 0 |
| EASTERN MEDITERRANEAN | ||||
| Israel | 0 | 7 | 0 | 0 |
| WESTERN PACIFIC | ||||
| China (incl. Hong Kong) | 1 | 4 | 0 | 0 |
| New Zealand | 0 | 7 | 0 | 0 |
| Australia | 0 | 1 | 0 | 0 |
| Japan | 0 | 4 | 0 | 0 |
| SOUTH-EAST ASIA | ||||
| Rep. of Korea | 0 | 3 | 0 | 0 |
| Thailand | 0 | 2 | 0 | 0 |
| TOTALS | 769 | 6497 | 4 | 65 |
Lab confirmed cases and deaths have been provided by the WHO’s Influenza A (H1N1) – Update #28.
Local/National News
- On May 13th, the Public Health Agency of Canada announced that 31 additional cases of Influenza A (H1N1) had been confirmed. Ontario still has the most cases in Canada (119), followed by British Columbia (92), Nova Scotia (65), Alberta (61), Quebec (26), Saskatchewan (16), Manitoba (4), PEI (3), New Brunswick (2), and the Yukon (1). Canada’s total case count is now at 389. PHAC
- The British Columbia Centre for Disease Control (BCCDC) is now reporting the following confirmed cases across the province:
- 35 in Fraser Health
- 2 in Interior Health
- 19 in Northern Health
- 24 in Vancouver Coastal Health
- 12 on Vancouver Island
- Canadian officials are weighing an Alberta hog farmer's request to cull 2,200 pigs that were exposed to the novel H1N1 influenza virus. The farmer believes the swine flu stigma will bar him from selling the herd and he is requesting $500,000 in compensation. However, officials from Canada's food safety agency have said culling the entire herd may not be warranted and that they would meet with the farmer again to discuss a solution. CanWest News
- Japan’s women’s soccer team has cancelled three friendly matches in Canada and the United States owing to fears over swine flu, the American soccer federation revealed on Tuesday. “This is an unfortunate situation, but one that we had absolutely no control over,” said U.S. Soccer president, Sunil Gulati. National Post
International News
- Yesterday, Sylvie Briand, acting director of the World Health Organization’s (WHO) Global Influenza Programme, signaled that the agency is stepping back from plans to develop a way to grade pandemic severity. She noted that this was recommended by WHO experts because they believe severity will vary from place to place, making the development of an index difficult and its use impractical. She said severity is based on three components: the virulence and transmissibility of the virus, the vulnerability of the population, and the capacity of a country to fight the disease. All three components can vary across countries and pandemic waves, Briand said. "This is why it's hard to have an index." CIDRAP
- Many people who have novel H1N1 influenza don't experience fever, which could make the illness difficult to identify, according to infectious disease expert Richard P. Wenzel of Virginia Commonwealth University. During recent consultations at two Mexican hospitals, he found about a third of the patients screened had no fever, but nearly all had a cough and malaise. About 12% had diarrhea, and he said passage of the virus in stools would present infection control problems. New York Times
- Yesterday, Chinese authorities confirmed that the 2nd case in mainland China was from Canada. The Health Ministry said the man, identified only by his surname, Lu, tested positive for the Type A H1N1 virus and was being treated in isolation in the eastern city of Jinan. Mr. Lu arrived in Beijing aboard an Air Canada flight Friday and spent three days untracked in the capital before leaving Monday by train for Jinan, by which time he had a fever, sore throat, and headache. Globe and Mail
- Mexico says Peru has agreed to lift its ban on direct flights from Mexico, but three other Latin American nations — Cuba, Ecuador and Argentina — still have such measures in place. Associated Press
Vaccine News
- According to a poll by Zogby International and the University of Texas Health Science Center, less than a third of U.S. adults would get a vaccination especially made to protect against the new H1N1 virus. The poll also found that that 38 percent were not vaccinated for annual influenza, nor did they follow recommendations to wash or clean their hands frequently to prevent infection and restrict travel to Mexico. Reuters
Latest Guidance from the WHO, U.S. CDC, PHAC, and BCCDC
- The Public Health Agency of Canada (PHAC) released a formal update to the national pandemic plan’s annex on antiviral use. The Canadian Pandemic Influenza Plan for the Health Sector (CPIP), which has only received minor updates since 2006, now outlines the general parameters and assumptions behind Canada’s antiviral stockpile, its use (largely for treatment purposes), and the focus on next steps. However, some officials have already identified discrepancies between the new antiviral annex and the most recent PHAC guidance on the use of antivirals when dealing with H1N1 cases in Canada. PHAC
- Recently, the U.S. CDC published an H1N1 Flu PowerPoint Presentation. Businesses can freely use this PowerPoint presentation to provide general information about H1N1 flu to employees, constituents, and other partners.
Today’s Key Question
Have antivirals helped prevent the spread of the novel H1N1 strain?
It has been noted that the extent of emergence of the novel H1N1 virus has not been as widespread in Europe and Asia as it has been in North America. In a press conference today, the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) noted that this may be due to the fact that the disease had spread widely in North America before being detected, whereas Europe and Asia had some degree of warning, and were able to implement certain containment measures. These measures have included:
- The close monitoring of travelers returning from North America;
- Forced isolation of certain patients; and,
- The provision of antivirals to those infected as well as their close contacts.
Some believe it is this last measure, the extensive use of antivirals, which is making all of the difference. While European and Asian countries have been using antivirals aggressively, North American countries have been more discriminate and have generally reserved antiviral treatment for severe cases, and for those who are at greater risk from the virus due to underlying health problems. According to Dr. Nikki Shindo, head of the clinical team at the WHO Global Influenza Programme, there is no data that can prove that the antivirals have been able to lessen the virus’ severity and spread; however, studies have shown that the virus is currently not resistant to the drugs. Science Insider
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