The WHO Pandemic Alert level remains at Phase 6
Influenza A (H1N1) Cases and Deaths
*Cases reported by The World Health Organization (WHO) are as of November 29th 2009
National News
Within the last 20 days, WorkSafeBC. has investigated four refusals for unsafe work in school districts, including two in Victoria, with each case involving pregnant teachers who didn't want to work because they said it was unsafe due to the potential to contract H1N1 while at work. WorkSafeBC. concluded that the H1N1 risk for employees will likely be lower than the risk in the general community. B.C. Public School Employers' Association has advised school districts that based on the WorkSafeBC. findings, "it will not be deemed to be unsafe for a pregnant teacher to go to work in the classroom where the potential to contract H1N1 exists." Canada.com
Nearly 10 per cent of Manitobans who were on ventilators with a severe H1N1 illness last spring had a history of tuberculosis. Manitoba's chief medical officer Dr. Joel Kettner said there is no clear evidence that suggests there is a higher rate of H1N1 severe illness among people with TB. However, he said many of the risk factors for both diseases overlap, including living in remote northern communities, poverty, and substance abuse. Kettner said there is a possibility people with active TB could have damaged lungs or a weakened immune system that may make them more susceptible to H1N1. Winnipeg Free Press
International News
Influenza activity continues to increase in much of Central Europe in the region between the Baltic and Balkan countries and from Germany to Romania. In Western and Central Asia, disease activity continues to increase in Kazakhstan, Kyrgyzstan, Uzbekistan, Iran, and Iraq. In East Asia, increasing respiratory disease activity has been reported in Southern China and Japan. Influenza activity continues to increase in the north-western parts of India, Nepal, Sri Lanka, and Cambodia. In Africa, pandemic H1N1 2009 virus continues to be isolated from all parts of the continent, and there is evidence of continued co-circulation of pandemic (H1N1) 2009 and seasonal H3N2 viruses. WHO
The number of deaths from the H1N1 flu virus has hit 100 in Japan as a 74-year-old man died after infection. Flu transmission is still active in East Asia and it remains "stably elevated in Japan," but may be decreasing slightly in cities there, according to the World Health Organization. Reuters
Kenya and Togo would be the first African countries to receive the vaccine from WHO. Health workers, medical and nursing students, pregnant women, children who are malnourished, and those with chronic diseases such as diabetes and lung diseases are high risk targets. However, this first consignment of 730,000 doses to Kenya would be enough for two percent of the population while the remaining eight percent would be made available by March. Capital News
The Korea Centers for Disease Control and Prevention has published a report saying that influenza A (H1N1) virus is more threatening to lung disease patients because it is difficult to distinguish flu symptoms from their chronic illnesses. Its analysis of the 117 deaths suspected to be linked to the H1N1 virus showed that of them, cancer patients represented the largest number at 30. Chronic lung disease patients suffering from chronic obstructive pulmonary disease, bronchiectasis, and other ailments came next and diabetes and chronic heart disease patients followed. Korea Times
Vaccine News
The Public Health Agency of Canada says there have been 48 cases of a severe allergic reaction reported in people who have had H1N1 shots. As of the week of Nov. 20, nearly 12.3 million doses of vaccine had been distributed across the country. The rate of anaphylactic reactions is 0.39 per 100,000 doses, which the agency says doesn't exceed the normal rate seen for the administration of vaccines. Winnipeg Free Press
Vaccination clinics across Ontario are closing their doors because fewer people are getting the H1N1 shot and clinic employees need to return to their regular programs. Hamilton's associate medical officer, Christopher Mackie, said the city no longer needs the public clinics because there has been a decline in illness rates. Other large health districts across the country do not plan to shut their vaccination clinics in the immediate future. Halifax, Vancouver, and Winnipeg are all planning to keep their clinics open until mid-December, or depending on need. Globe and Mail
The Strategic Advisory Group of Experts on immunization, that reports to the Director-General of WHO, has reported that H1N1 cases continue to occur mostly in teenagers and young adults, with rates of hospitalization highest in very young children. Mathematical modelling conducted on southern hemisphere data suggests a 20 – 40% infection attack rate. SAGE recommended that public health considerations support the use of a single-dose of vaccine in adults and in adolescents aged greater than 10 years. WHO
With H1N1 poised to enter history as the least deadly of four global flu pandemics, some experts are calling for an end to Canada's mass vaccination program. H1N1's "reproductive number" — the number of people each infected person passes the virus to — was above one when the epidemic began, which led to the explosive initial increase in cases. According to Dr. Fisman, a University of Toronto expert in infectious disease dynamics, the recent drop in cases suggests Canada has hit the critical fraction of the population that needs to be vaccinated to control the pandemic. Despite that view, Chief public health officer David Butler-Jones said that, while 30 per cent of the population is now immune to H1N1, "millions" of people are still at risk of infection. The Gazette
Second half-dose H1N1 immunizations for eligible children will begin December 7th at all the H1N1 immunization sites in Saskatoon. The second half-dose dose is required only for children aged 6 months to less than 3 years and for children over 3 years of age and less than 10 years who have a high risk medical condition. Parents, whose children need an additional dose, should wait at least 21 days after the child's first dose before getting the booster shot. Saskatoon News
The European Medicines Agency warns that data from GlaxoSmithKline PLC showed a higher number of children aged six months to 3 years had a fever after their second dose of GSK’s Pandemrix vaccine. Kids were also more likely to have side effects like muscle pain, drowsiness, and irritability. The European regulator recommends children get two doses of H1N1 flu vaccine though GSK says one dose is enough. GSK’s vaccine contains an adjuvant, a chemical compound to boost the immune response. It is sold across Europe and Canada. Associated Press
Premier Jean Charest is urging Quebecers who haven't yet been inoculated to get their H1N1 flu shot. Charest was vaccinated on December 6th at an inoculation centre in his home riding of Sherbrooke. Public health officials say there are still four million Quebecers who haven't been vaccinated. CBC
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