Global's Influenza A (H1N1) Update - June 11, 2009

GMS INFLUENZA A (H1N1) Update as of June 11, 2009

(0830 HRS PST)

The next update will be on Friday, June 12, at 08:30 PST

The WHO Pandemic Alert level has been raised to Phase 6.

Today, the World Health Organization (WHO) raised its pandemic alert level from Phase 5 to Phase 6 as a result of the ongoing spread of the novel influenza A (H1N1) virus. Phase 6 is the official WHO declaration that a pandemic is underway. It is characterized by human-to-human spread of the virus in at least two countries in one WHO region, as well as community-level outbreaks in at least one other country in a different WHO region. Human-to-human spread of the virus in Mexico, Canada and the United States, as well as community-level outbreaks in Australia and other Asia-Pacific countries have led to this declaration.

What does this mean?

Raising the WHO pandemic alert level to Phase 6 does not mean that the H1N1 virus has become more deadly. In fact, current reports of death and illness, when compared with previous pandemics, indicate that we are experiencing a pandemic of lesser severity. What this does mean is that the virus has been officially recognised as widespread around the world and will most likely continue to spread globally over several more weeks. That said, the H1N1 virus is unpredictable and we can anticipate that as we get closer to our own annual flu season, we will be hearing from authorities to begin increasing our vigilance in North America in response to the possibility that the virus mutates and becomes more severe in a second wave (late 2009, early 2010).

In addition, it is unlikely that the WHO will recommend member states activate strict containment measures, such as border closures or quarantine efforts. Instead, focus ought to be on treatment (e.g., efficient and focused use of antiviral stores), with some community-level mitigation strategies in place for those countries only now seeing a surge in cases.

What should Canadian and American organizations be doing?

As was the case when the WHO raised its pandemic alert level to 4, and then 5, it is expected that media and public interest in this latest development will be substantial. Anxiety and concern may increase as a result of misinformation or poor communication. For your organization, clear and concise communication with employees and stakeholders should be a priority. Beyond communication, organizations may require the activation of their pandemic response measures should the pandemic become more severe in North America.

Influenza A (H1N1) Cases and Deaths by Country (as of 8 AM PST, June 11th)

*Lab confirmed cases and deaths have been provided by the WHO’s Influenza A (H1N1) – Update #46 and PHAC.



Local/National News

• Health Minister Leona Aglukkaq announced recently that Canadian health officials have created a network of 80 scientists from 30 research and public health institutions to speed up influenza research, and test new vaccines against the H1N1 flu. The network, led by Dr. Scott Halperin, director of the Canadian Center for Vaccinology in Halifax, has received C$10.8 million in funding, and links the Canadian Institutes of Health Research and the Public Health Agency of Canada. Reuters


• Political tensions are flaring over pandemic flu planning for Canada’s First Nations, as a remote Manitoba reserve struggles to deal with a possible outbreak of the H1N1 virus. St. Theresa Point First Nation has confirmed three cases of H1N1and more than 20 residents of the community have been flown to Winnipeg Hospital suffering from flu-like symptoms. Manitoba Health Minister Theresa Oswald is claiming that the Manitoba government has offered Ottawa help with First Nations pandemic planning, but was repeatedly turned down. Federal Health Minister Leona Aglukkaq is denying the claim, stating that she has daily conversations about the H1N1 virus with health ministers across the country, but that Manitoba Health Minister Theresa Oswald never brought up the matter. The Vancouver Sun


• Dr. Isaac Sobol, Nunavut’s Chief Medical Health Officer, is disputing remarks made recently by Dr. Keiji Fukuda of the World Health Organization (WHO), citing a disproportionate number of serious cases occurring in Inuit communities in Canada. The WHO’s concerns came after Nunavut confirmed 28 new cases of H1N1 influenza Tuesday, more than doubling the total in the territory from 25 to 53. Sobol maintained that the severity of illness in Canada's North is the same as that found in other jurisdictions across Canada. CBC


• Nova Scotia Health Officials have recently confirmed the province’s first hospitalized case of H1N1. The province's total number of documented cases of the H1N1 influenza A virus is 77. In its statement, the Health Promotion and Protection Department said other cases are mild, and those affected are recovered or recovering. CBC


• On June 10th, the Public Health Agency of Canada (PHAC) announced that the number of confirmed cases of influenza A (H1N1) which had been confirmed in the country since June 8th was had risen to 2978 from 2446. Ontario still has the most cases in Canada (1562), followed by Quebec (611), Saskatchewan (221), Alberta (195), British Columbia (151), Nunavut (96), Nova Scotia (78), Manitoba (56), PEI (3), New Brunswick (2), Northwest Territories (2), and the Yukon (1). Of the Canadian cases, 121 required hospitalization and four deaths occurred. PHAC


• The British Columbia Centre for Disease Control (BCCDC) is now reporting the following confirmed cases across the province:




• 58 in Fraser Health


• 5 in Interior Health


• 28 in Northern Health


• 42 in Vancouver Coastal Health


• 18 in Vancouver Island Health

International News

• The recent surge in Influenza A (H1N1) cases in Australia has pushed the World Health Organization (WHO) to declare the first influenza pandemic since 1968. WHO influenza chief Keiji Fukuda said the agency was concerned about the potential harmful effects of moving the alert from its current status of phase 5 to the highest level, phase 6, indicating a full pandemic. Fukuda cited concerns over possible panic among the public or inappropriate steps taken by governments. Dr. Margaret Chan, the WHO’s director general has stated that, in her opinion, the world is in a pandemic. However, she believed it was crucial to verify that H1N1 had become established beyond North America before a pandemic was officially declared. ABC News


• The number of confirmed H1N1 cases in Australia has reached 1,211, the highest number outside of the Americas. The southeastern state of Victoria continues to be the worst-hit region in Australia with 1,011 confirmed cases. Australia has canceled its Grand Prix, scheduled for later this month in the Victorian capital, Melbourne, due to the risk of H1N1 flu and quarantine procedures. Additionally, several professional rugby league players may have to miss matches this weekend over fears they have contracted the virus. Bloomberg


• According to his office, Ray Nagin, the mayor of New Orleans, has been released from quarantine in Shanghai following an H1N1 scare. Nagin was detained after a fellow passenger on his flight fell ill with a suspected case of the virus. AFP


• As of June 10th, 74 countries have officially reported 27,737 cases of influenza A/H1N1 infection, including 141 deaths. WHO

Vaccine News

• On Tuesday, Hong Kong's government endorsed a plan to immunize 2.5 million people with a novel flu vaccine that it expects to be available no earlier than October. According to the plan, four groups will receive free vaccination: healthcare workers, children between 6 months and 6 years old, those older than age 65, and people who have chronic medical conditions. The government will stockpile enough doses for an additional 500,000 people. Hong Kong Standard

Latest Guidance from the WHO, the US CDC, PHAC, and the BCCDC

The World Health Organization (WHO) has recently released the following guidance documents:

• Influenza A(H1N1) patient care checklist


• Gene sequences of the reassortant candidate vaccine viruses for the novel influenza A (H1N1)

The U.S. CDC has recently released the following materials:

• Interim guidance for use of 23-valent pneumococcal polysaccharide vaccine during novel influenza A (H1N1) outbreak


• Audio Public Service Announcements, regarding:




• Leaving your home or hotel room if you’re sick with flu-like symptoms


• Changing your travel plans if you’re sick with flu-like symptoms

Today’s Key Question

How can Global Consulting help?

Global Consulting will continue to provide analysis regarding the pandemic through our regularly updated blog and free planning resources on our website, as we have been since the onset of the novel H1N1 virus. Additionally, Global has developed a Pandemic Advisory Service to provide timely and effective guidance to help organizations maintain and enhance operations during this global public health emergency.

Our team can also address your needs by:

• Providing concise updates on the status of the Influenza A (H1N1) virus as it relates to the number of cases, incubation periods, infectivity, and anticipated actions.


• Presenting a medical and pandemic planning context that can assist in the immediate development of pandemic policies and procedures.


• Helping you implement comprehensive infection control policies at your workplace.


• Offering clarification and guidance on the numbers and types of items to be included in personal protective equipment (PPE) stockpiles.


• Ensuring that your efforts are grounded in pandemic preparedness best practices.