Global's Pandemic (H1N1) 2009 Update - July 9, 2009

GMS Pandemic (H1N1) 2009 Update as of July 9th, 2009

(0830 HRS PST)

The next update will be on Tuesday July 14th, at 08:30 PST.

The WHO Pandemic Alert level remains at Phase 6

PLEASE NOTE: The World Health Organization (WHO), the Food and Agriculture Organization of the United Nations (FAO), and the World Organization for Animal Health (OIE) have decided to use "Pandemic (H1N1) 2009" for the name of the novel influenza virus currently circulating globally.

• On Monday, the World Health Organization released its latest case count for novel Pandemic (H1N1) 2009 influenza worldwide: 94,512 cases and 429 deaths in over 100 countries, up 4,591 cases and 47 deaths from Friday, July 3rd. Countries reporting the greatest increase in laboratory-confirmed cases since Friday were Argentina (898), Australia (730), Thailand (662),) Peru (378), Japan (344) and China (226). WHO

Local/National News

• On July 8th, the Public Health Agency of Canada (PHAC) announced that the number of confirmed cases of Pandemic (H1N1) 2009 influenza since July 3rd has risen to 9,429 from 8,883. Of the Canadian cases thus far, 878 required hospitalization and 37 deaths have occurred. PHAC


• Two farm workers in Saskatchewan have become infected with a new flu virus, health officials said on Tuesday, stressing the strain was not related to Pandemic (H1N1) 2009. The two workers have fully recovered. Reuters


• Health officials have isolated a unit on the third floor of the Alberta Children's Hospital in Calgary because of three Pandemic (H1N1) 2009 flu cases. The hospital has stopped admitting new patients to the unit, which usually treats children with kidney problems, because one staff member and two children are confirmed to have Pandemic (H1N1) 2009 flu. Patients already there have been isolated, and only their parents or close family are being allowed to visit them. CBC


• About 200 infectious disease experts have gathered in Toronto to discuss the Pandemic (H1N1) 2009 flu virus. The meeting is aimed at sharing information from across the country and setting up research collaborations. Canadian Press


• A dancer from one of the troupes taking part in The Halifax International Tattoo has tested positive for the Pandemic (H1N1) 2009 flu. Tattoo marketing manager Thomas Grotrian said organizers were told the case was nothing to worry about, and the final show will go ahead as scheduled. The Chronicle Herald

International News

• In an upcoming study, Dr. Michael Gracey, a medical adviser to Unity of First People of Australia, an aboriginal non-profit organization, suggests that the world's almost 400 million indigenous peoples — including about 1.2 million in Canada — are especially at risk for contracting Pandemic (H1N1) 2009 flu because they often live in remote, impoverished communities with limited access to medical infrastructure. Moreover, according to Gracey, “indigenous people are susceptible to infections because they have low immunity, they're often undernourished, and they often have pre-existing illnesses." Canwest News


• Chile's health ministry recently cancelled a large religious festival, set to converge on a small town in the southern part of the country, in an effort to slow the spread of Pandemic (H1N1) 2009. The dance and music celebration typically brings 200,000 visitors to the town of La Tirana. The World Health Organization said yesterday Chile has confirmed 7,376 Pandemic (H1N1) 2009 cases. Santiago Times


• The WHO said yesterday that it will soon advise most countries to ease the volume of testing for Pandemic (H1N1) 2009 influenza and move toward larger surveillance indicators such as influenza-like illnesses or pneumonia hospitalizations. CIDRAP


• Pandemic flu fears and the global economic crisis are taking their toll on bookings at hotels in the city of Mecca, two months before the start of a minor pilgrimage (Umra) that attracts up to two million Muslim pilgrims. Globe and Mail


• Many local health departments in the United States were slow to alert residents to the public health threat posed by the new Pandemic (H1N1) 2009 influenza virus in April. Researchers at the non-profit, research organization Rand Corp said only a third of 153 local health departments surveyed posted information about the new influenza virus on their websites within the first 24 hours after federal health officials declared a public health emergency. Reuters

Antiviral News

• Over the past week Public health authorities in in Denmark, Japan and Hong Kong have reported a total of three cases of Pandemic (H1N1) 2009 in which the virus was resistant to a key antiviral drug. "Right now this looks like spontaneous mutation in these patients," Dr. Keiji Fukuda of WHO, said at a press conference on Tuesday. He said all three patients had the same mutation and all three had "uncomplicated" disease from which they made full recoveries. WHO

Guidance and Recommendations

• The American College of Emergency Physicians (ACEP) recently released a plan to help emergency departments, first responders, and public health departments manage a surge in pandemic flu cases that many experts predict will happen this fall. The 16-page plan defines critical capabilities and suggests ways to achieve them. CIDRAP


• The Centers for Disease Control and Prevention (CDC) has released interim guidance for preventing and managing novel Pandemic (H1N1) 2009 infections in obstetric settings. Severe illnesses in pregnant women and infants have been a feature of the flu pandemic. The new guidance says areas where prenatal care, labour, and delivery services are delivered should be separated from areas where the sick are handled. CDC


• The Centers for Disease Control and Prevention (CDC) has released Recommendations for State and Local Planning for a 2009 H1N1 Influenza Vaccination Program. The purpose of this document is to describe planning scenarios for state and local governments to target high-priority populations for vaccination in order to reduce the health and societal impact of the pandemic.

Today’s Key Question

What are the recommendations for pregnant women?

The US CDC has been highly active in its recommendations for pregnant women, publishing several guidance documents. The following is a high-level summary of these recommendations:

• Pregnant women with influenza-like symptoms and cough / sore throat, in the absence of a known cause other than influenza, should be treated as thought they have influenza.


• Pregnant women with confirmed / probable / suspected H1N1 illness should take considerations to minimize the potential for exposure when delivering their infants, as infants are assumed to have a higher risk of complications from H1N1. As such they should:
  

• Be given antivirals as soon as possible;


• Be isolated from health pregnant women;


• Don a surgical mask during labor and delivery;


• Be placed in isolation, avoiding contact with her newborn, following delivery; and


• Be encouraged to express milk but the milk will be given to the newborn by a non-ill individual.


• The mother can resume caring for her child when she has been receiving antivirals for 48 hours, her fever has resolved, and she can control coughs and secretions,


• Breastfeeding should be protected and supported at all times because of the protection from respiratory infection that breast milk provides to the infant.

• The newborns of ill mothers should be considered as potentially infected and should be closely monitored for signs and symptoms of the flu. If symptoms of influenza develop, oseltamivir treatment should be considered.


• For pregnant women who have been exposed to, or are close contacts of, clinicians with laboratory-confirmed Pandemic (H1N1) 2009 can consider post-exposure antiviral chemoprophylaxis.