Global's Daily Influenza A (H1N1) Update - May 23, 2009

GMS INFLUENZA A (H1N1) Daily Update as of May 23, 2009(1200 HRS PST)

The WHO Pandemic Alert level remains at Phase 5.

Influenza A (H1N1) Cases and Deaths by Country (as of 8 AM PST May 23rd)

*Lab confirmed cases and deaths have been provided by the WHO’s Influenza A (H1N1) – Update #37.

Local/National News

• On May 22nd, the Public Health Agency of Canada (PHAC) announced that 86 new cases of influenza A (H1N1) had been confirmed in the country since Wednesday (May 20^th). Ontario still has the most cases in Canada (294), followed by Quebec (143), British Columbia (115), Alberta (94), Saskatchewan (77), Nova Scotia (70), Manitoba (6), PEI (3), New Brunswick (2), and the Yukon (1). Canada’s total case count is now at 805.
• The British Columbia Centre for Disease Control (BCCDC) now reports the following confirmed cases across the province:

- 43 in Fraser Health

- 3 in Interior Health

- 22 in Northern Health

- 32 in Vancouver Coastal

Health

- 15 in Vancouver Island

Health

International News

• The World Health Assembly ended yesterday with no indication that the World Health Organization (WHO) would raise the pandemic alert level from 5 to 6. Dr. Keiji Fukuda, the WHO's assistant director-general for health security, told reporters that some countries aired concerns during the health assembly that raising the pandemic alert level to 6 would unduly alarm the public, given the mild degree of illness seen in most patients who have had the novel H1N1 virus. Fukuda also said decisions about raising the alert level require a degree of flexibility. "There's nothing like reality to tell you if something is working or not. Rigidly adhering to something is not useful—you have to adapt to the situation," he said. CIDRAP
• Two Rome high schools have been ordered closed for a week after four students caught the H1N1 flu virus on a school trip to New York, Italy's Health Ministry said on Friday. Four boys who returned from the United States this week went to hospital after showing flu symptoms. Reuters
• Some influenza experts suspect that the number of novel H1N1 influenza cases may be higher than reported in Britain, the Associated Press reported on Friday. The country is reportedly trying to contain the virus by blanketing suspect cases and their contacts with oseltamivir, which several experts, such as Michael T. Osterholm, PhD, MPH, at the University of Minnesota, said won't work. According to the AP, Britain and Spain are also testing only those who have a travel history or are case contacts.
• Australia's health ministry raised its pandemic alert to the "containment" phase on Friday, as the number of novel H1N1 influenza rose to 11 and the country detected its first instance of community transmission of the virus, Bloomberg News reported. Two schools closed for a week after student cases were confirmed, and health officials are testing 28 more suspected cases. The government also said it was considering ordering an H1N1 vaccine to be developed by Australia-based CSL Ltd.

Vaccine News

• U.S. Health and Human Services (HHS) Secretary, Kathleen Sebelius, announced on Friday that she was allocating about $1 billion in existing funds toward clinical vaccine studies this summer and for commercial-scale production of both antigen (active ingredient) and adjuvant (which boosts a person's immune response) for a novel H1N1 influenza vaccine. "The actions we are taking today will help us be prepared if a vaccine is needed," Sebelius said in a news release. HHS News Release

Today’s Key Question

How does Tamiflu® work?

The WHO, multiple nations, and many corporations have opted to stockpile the antiviral, Tamiflu, for prophylaxis and/or treatment of a novel influenza virus during a pandemic. But what is Tamiflu and how does it work?

When a flu virus infects a human cell, it invades the cell and replicates inside of it, creating many progeny (offspring) viruses. After replicating, a viral surface protein, known as neuraminidase, helps the virus to act on the cell in such a manner that the progeny viruses are released into the body, and can go on to infect other cells.

Tamiflu is in a class of antiviral medications known as the neuraminidase inhibitors. Tamiflu acts by inhibiting neuraminidase and blocking its ability to release progeny viruses from the cell, thereby limiting the spread of infection. This is why the earlier Tamiflu is administered after the onset of infection in a patient, the better as it does not kill the virus as much as inhibit its ability to spread. Medscape