Global's Pandemic (H1N1) 2009 Update - July 23, 2009

GMS Pandemic (H1N1) 2009 Update as of July 23rd , 2009

(0830 HRS PST)

The next update will be on Tuesday July 28th, at 08:30 PST.

The WHO Pandemic Alert level remains at Phase 6

Pandemic (H1N1) 2009 Cases and Deaths

• Citing the questionable usefulness of reporting pandemic H1N1 case counts and the burden it puts on countries experiencing widespread transmission, the World Health Organization (WHO) announced late last week that it will no longer issue regular reports of confirmed global case totals. WHO statement


• A World Health Organization (WHO) official told reporters the H1N1 virus has killed more than 700 people, well above the 429 deaths listed in the WHO's last official update on Jul 6,. The official, Alphaluck Bhatiasevi, said confirmed cases have reached 125,000, far above the 94,000 mentioned in the Jul 6 update. Reuters report

Local/National News

• As of July 21st the total number of deaths associated with the Pandemic H1N1 virus in Canada is now 50. PHAC


• Two Canadian Food Inspection Agency inspectors appear to have contracted Pandemic H1N1 flu while investigating an outbreak of the virus in pigs on an Alberta farm in late April, the agency confirmed Tuesday. The cases appear to be the first reports of people catching the Pandemic H1N1 virus from pigs. The men did not use proper safety techniques while in the barn, apparently removing the N-95 respirators that covered their noses and mouths because they were hot. CP


• B.C. doctors will have to purchase the masks, gowns, gloves and antiviral drugs they need to protect themselves and their patients in their offices during a flu pandemic. B.C.’s provincial health officer, Dr. Perry Kendall, said in a statement published in the B.C. Medical Journal that the province will not follow Ontario’s decision to supply such items, “it is properly the responsibility of the physician to ensure that infection control practices are in place in these offices”. Vancouver Sun


• According to Dr. Patricia Daly, chief medical officer for Vancouver Coastal Health, there are no plans to quarantine or close 2010 Olympic events if there is a severe flu outbreak. “I can tell you right now there is not a lot of evidence they are of any benefit, we have no plans to do any of those things for H1N1. We will not be cancelling any of the Olympic events as a result of the pandemic.” Vancouver Sun

International News

• A special meeting of the US Centers for Disease Control and Prevention's (CDC's) Advisory Committee on Immunization Practices (ACIP) will be held Jul 29 in Atlanta to discuss novel H1N1 flu issues. The group will discuss epidemiology, vaccine development and formulations, and communications, and will hear a report from the FDA's Vaccines and Related Biological Products Advisory Committee. CDC


• Faith groups in Britain are adapting their religious rites in a bid to prevent the spread of the H1N1 virus during worship. Some churches, mosques and temples are encouraging less personal contact between worshippers, and adapting rites such as sharing of vessels or chalices during ceremonial practices across Britain. In addition, those vulnerable to the virus are being discouraged by imams from attending this year's haj Muslim pilgrimage. Reuters

Vaccine News

• Trials of the experimental new H1N1 swine flu vaccine will start at eight university medical centers and clinics next month, starting with vaccines made by Sanofi Aventis and CSL Ltd, U.S. health officials said on Wednesday. The first round of tests will be in adults, but will quickly move to children. Reuters


• Human trials of a vaccine to protect against the pandemic H1N1 flu virus have begun in Australia. Vaxine and CSL have both started injecting volunteers this week, but it will be at least six weeks before the initial results are known. BBC


• Two Chinese pharmaceutical firms kicked off two-month clinical tests on the country's H1N1 influenza vaccines Wednesday. More than 2,000 volunteers have been recruited and during the two-month clinical test, the volunteers would have antibody tests for four times. China View

Antiviral News

• Canada has recorded a case of Tamiflu-resistant swine flu virus, in a Quebec man who had been given the drug to prevent infection. The Quebec man, 60, was given the flu antiviral after his son fell ill with the pandemic virus. It's believed the resistance arose in the man and there is no evidence he transmitted resistant virus to anyone else. "It appears to be an isolated case," said Jirina Vlk, spokesperson for the Public Health Agency of Canada. CP


• Japan revealed Tuesday it had found a second case of Tamiflu resistance, in a person who has no ties to the country's earlier reported case. This case is the fifth globally since the H1N1 virus was discovered in April. CP

Today’s Key Question

How effective are school closures in combating a Pandemic

In a recent review, published in the medical journal the Lancet, researchers evaluated the value and effectiveness of school closures in combating a pandemic.

By reviewing historically data, they found that the effectiveness of school closures depends heavily on the characteristics of a pandemic. For example, it appears that school closures where effective in the 1957 pandemic when much of the virus transmission took place among children. However, they were less effective in the 1968 pandemic when the illness rates were similar among children and adults.

So far in the H1N1 pandemic, a large proportion of cases have been among children and the large numbers of case clusters in schools suggest that school closures will reduce the number of cases.

However, this intervention has a high economic cost. Estimates range from a 1% to 6% decrease in GDP from a 12 week school closure. Moreover, schools also provide a variety of social services such as meal programs to the underprivileged.

The authors conclude that the decision to close schools must be made on the basis of the severity of the pandemic. In addition, it should be considered in combination with a combination of other available interventions, such as antiviral drugs, vaccines, and other non-pharmaceutical interventions. As the H1N1 pandemic could become more severe the current approach of not necessarily recommending school closure might need reappraisal in the autumn.