(0830 HRS PST)
The next update will be on Tuesday, June 30th, at 08:30 PST.
The WHO Pandemic Alert level remains at Phase 6
Influenza A (H1N1) Cases and Deaths 
- Yesterday, the World Health Organization released its latest case count for novel H1N1 influenza worldwide: 55,160 cases and 238 deaths in over 80 countries, up 3,707 cases and 7 deaths from Monday's numbers. Countries reporting the greatest increase in laboratory-confirmed cases since Monday were Canada (747), Australia (421), the United Kingdom (399), Mexico (223), Argentina (203), Brazil (203), China (167), and Uruguay (159). WHO
Local/National News
- On June 24th, the Public Health Agency of Canada announced that the number of confirmed cases of influenza A (H1N1) since June 22nd has risen to 6,732 from 6,457. Of the Canadian cases thus far, 423 required hospitalization and 19 deaths have occurred. PHAC
- The Assembly of Manitoba Chiefs (AMC) has declared a state of emergency in Manitoba First Nations over the H1N1 pandemic. Grand Chief Ron Evans said the H1N1 influenza virus is spreading rapidly through native communities with supplies taking nearly a month to be delivered. By declaring a state of emergency, First Nations can divert money from other programs to help fight the outbreak. The AMC also wants the provincial and federal governments to ensure plans are in place to protect people when the fall flu season starts. CBC
- Health Canada delayed the delivery of alcohol-based hand sanitizers to some First Nations communities affected by H1N1 flu because of concerns the alcohol content might be abused. According to Anne-Marie Robinson, assistant deputy minister of Health Canada's First Nations and Inuit Health Branch, First Nations chiefs were involved from the beginning in discussions on pandemic planning and measures such as the use of alcohol-based sanitizers. CBC
- When speaking to the Canadian Senate earlier this week, Dr. Kim Barker called for an independent task force to study flu outbreaks in First Nations and report back with recommendations for a seamless approach across the country before the fall flu season. CBC
- A new report on corporate risk and pandemic preparedness touts the benefits of having business plans in place for a global outbreak of flu. The report by Amin Mawani of the Schulich School of Business at Toronto's York University says companies that can prevent absenteeism during a pandemic will be well-positioned to take customers and market share from those that can't. Globe and Mail
International News
- Over the past few days, several countries have reported their first case of the H1N1 virus, including Antigua and Barbuda, Cape Verde, Cote d'Ivoire, Ethiopia, Indonesia, Cambodia, Montenegro, Latvia, Tunisia Vanuatu, Serbia, and Iraq. Reuters
- In a recent report on effects of the economic downturn, the World Bank said the severity and impact of the current pandemic seems to resemble the Hong Kong influenza pandemic of 1968-69, which could mean a drop in gross domestic product of 0.7%. The World Bank said developing countries are most vulnerable to pandemic effects because of high population density, weak health care systems, and high prevalence of chronic diseases. Jun 22 World Bank report
- The H1N1 influenza virus could cost Delta Air Lines $250 million in revenue this year, which the world's largest airline will offset by cutting capacity, its chief executive said on Monday. "The steps we are taking have essentially involved capacity because the flu has decreased demand," said Delta CEO Richard Anderson at the company's annual shareholders’ meeting. Reuters
- Argentina’s health ministry reported on Tuesday that seven more people in the country have died of novel H1N1 influenza, raising the total to 17, the most in South America. All the deaths occurred in or near Buenos Aires, where a city health official said non-essential surgeries would be postponed to free up hospital beds. Argentina currently has 1,213 novel flu cases, an increase of 203 from the last WHO report. AP
Vaccine News
- The US government has granted Protein Sciences Corp. (PSC) of Meriden, Conn., a $35 million contract to develop its technique for making influenza vaccines by growing flu virus proteins in insect cells, an approach said to be faster than traditional methods. PSC's approach involves extracting a gene from a flu virus and inserting it into a baculovirus, which infects insects but not people. The recombinant baculoviruses multiply quickly in insect cells, producing many copies of the flu gene, which are then purified and used to make a vaccine. The contract could be extended up to 5 years at a total cost of about $147 million. CIDRAP
Antiviral News
- A disease-control specialist in Australia's Northern Territory said today that the government's recent decision to restrict oseltamivir (Tamiflu) to "critical case criteria" should be relaxed for aboriginal patients who have suspected pandemic flu symptoms. The expert said that 50% of people in the communities have chronic health conditions and that broader antiviral use could reduce the risk of disease transmission to vulnerable people. ABC
Today’s Key Question
Did arsenic play a role in the severity of H1N1 flu in Mexico?According to researchers at the Marine Biological Laboratory (MBL) at Dartmouth Medical School, chronic exposure to arsenic compromises the immune response to infection, which may explain why H1N1 flu cases in Mexico have been so severe.
Dr. Joshua Hamilton, MBL’s chief academic and scientific officer, recently asserted, “One thing that did strike us, when we heard about the recent H1N1 outbreak, is Mexico has large areas of very high arsenic in their well water, including the areas where the flu first cropped up.” Dr. Hamilton further stated, “We don’t know that the Mexicans who got the flu were drinking high levels of arsenic, but it’s an intriguing notion that this may have contributed.”
Subsequently, Hamilton’s team of researchers studied the effects of arsenic exposure on respiratory influenza A (H1N1) virus infection in mice. The mice were exposed to arsenic in their drinking water for five weeks and then infected with a sub-lethal dose of the virus. The study found that arsenic was associated with a number of significant changes in response to the virus including an increase in morbidity, including weight loss, and higher levels of the virus in the lungs of the mice. This second finding is particularly interesting as the inability to properly clear virus from the lungs is correlated with an increased risk of unfavorable outcomes in influenza patients.
“These results also suggest that chronic arsenic exposure, particularly in areas of Southeast Asia and Mexico, may be a factor that could enhance the potential impact of a pandemic strain of influenza, should this emerge in the human population,” Dr. Hamilton’s group concluded.
A report of the study was published online in May, in the journal Environmental Health Perspectives.
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