The next update will be on Tuesday, June 9, at 8:30 PST
The WHO Pandemic Alert level remains at Phase 5.
Influenza A (H1N1) Cases and Deaths by Country (as of 8 AM PST, June 4th)
*Lab confirmed cases and deaths have been provided by the WHO’s Influenza A (H1N1) – Update #43, the CDC, and PHAC.
Local/National News
- On June 3rd, the Public Health Agency of Canada (PHAC) announced that 265 new cases of influenza A (H1N1) had been confirmed in the country since June 1st. Ontario still has the most cases in Canada (894), followed by Quebec (346), Saskatchewan (153), British Columbia (136), Alberta (141), Nova Scotia (74), Manitoba (38), Nunavut (5), PEI (3), New Brunswick (2), Northwest Territories (2), and the Yukon (1). Canada’s total case count is now at 1,795 with 98 hospitalizations and three deaths.
- Toronto Public Health has decided to cease updates to parents when other students in their children’s school contract the novel H1N1 flu virus. This move was prompted by observations of greater and more efficient spread of H1N1 outside of school settings. According to spokesman Susan Sperling, "We felt parents were getting a false sense of security. Just because someone else in their child's school hadn't been diagnosed with H1N1 didn't mean there were no concerns. In fact, we are finding the virus is more commonly spread in contact within the home." Toronto Sun
- A spokesman for Ontario's health minister has confirmed that a person who had been hospitalized with swine flu infection died Sunday afternoon. The unidentified person had a number of medical conditions and it is not clear how the infection with the novel H1N1 flu virus contributed to the death. This is Canada’s 3rd H1N1 related death. Canadian Press
- The H1N1 influenza virus is responsible for at least two cases of severe illness at St. Theresa Point, a first nations reserve in a remote part of Winnipeg. St. Theresa Point Chief David McDougall said there’s a total of 20 residents from the community in a Winnipeg hospital suffering from flu-like symptoms. Additionally, two Winnipeg paramedics who transported the patients from the reserve might have contracted the virus themselves. The Manitoba Government Employees Union (MGEU) said the two paramedics who picked up the patients at the airport in Winnipeg weren't given any advance warning about the possibly infectious disease and, consequently, weren't wearing the necessary protective gear. Winnipeg Free Press
- The British Columbia Centre for Disease Control (BCCDC) is now reporting the following confirmed cases across the province:
- 50 in Fraser Health
- 4 in Interior Health
- 26 in Northern Health
- 39 in Vancouver Coastal Health
- 17 in Vancouver Island Health
International News
- On June 2nd, The World Bank approved a $500 million program to offer developing and middle-income countries speedy access to funds to prevent and control novel H1N1 virus outbreaks. The amount will be added to an existing $500 million credit line established in January 2006 to help countries battle H5N1 avian influenza. The program helps governments buy items such as drugs and medical equipment and finance measures such as surveillance upgrades and communication campaigns. World Bank press release
- Chile's health ministry yesterday reported that a 37-year-old man who worked as a plumber has died of novel H1N1 influenza, the first death from the disease in South America. The report said he died of "massive respiratory failure" but did not mention if he had an underlying medical condition. Chile has the most cases in South America with 313, according to the WHO's latest count. AP story
- The White House is asking lawmakers to sign off on an additional $2 billion to respond to the H1N1 flu outbreak, with the bulk of that money going to boost vaccine stockpiles and expand federal detection efforts. In a letter to House Speaker Nancy Pelosi, President Barack Obama said, "These funds should be provided with maximum flexibility to allow us to address this emerging situation." Wall Street Journal
Why is it difficult to grade pandemics on severity?
The World Health Organization (WHO) announced Tuesday that they are close to moving the level of pandemic alert from Phase V to Phase VI, despite the relative mildness of Influenza A (H1N1). Due to the potential panic such an action might induce, many national governments have requested that the WHO transition to an alert level scale which takes the virus’ severity into account. However, severity is difficult to measure because what is meant by ‘mild’ and ‘severe’ is not a simple scale. Some of the factors which could be used to assess the severity of a pandemic are as follows:
- The Case Fatality Ratio: The likelihood that an infected person will die from their illness.
- Varying Rates of Illness in Certain Subsets of the Population: Historically, pandemics have lead to higher rates of infection in certain groups such as children, pregnant women, and young healthy adults.
- National Abilities: Severity often varies from country to country. In poorer nations with fewer doctors and deficient access to healthcare, the effects of a given virus may be more severe than in a richer country with more resources.
- Overall Case Load: The number of people falling ill with respiratory illnesses at one time and the associated pressure on the health services’ ability to deal with the increased load. This is expected to increase in the winter.
- Critical Service Impact: The peak percentage of people absent from work due to illness or because they are caring for others.
- Public and Media Perception: A certain virus may be perceived as severe by the public because it is receiving so much media attention, when in fact it is mild. On the other hand, the public may be too lax with regard to a more severe virus if it is not currently in the media spotlight.
In addition, severity may vary over time. Certain past pandemics, including the 1918 Spanish Flu, started off as mild and became more severe as time went on. European Centre for Disease Prevention and Control
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