Global's H1N1 Update - 05/18/10

The next update will be on Thursday, May 18th, at 0830 hrs PST.

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 May 9, 2010

National News

H1N1 claims the life another Canadian

A Quebecois man who recently returned from a trip to Cuba has died after contracting the H1N1 virus. The man passed away in a Montreal hospital after transferring from Shawinigan, near his home. Quebec health authorities say the death does not mark the beginning of a third pandemic wave. "We know now that there are many flu cases in Cuba," said Dr. Gilles Grenier, a public health director in the Shawinigan region. "The hypothesis is that he got the virus over there, so it's really an isolated case." The man, who was in his fifties, suffered from asthma and had not been vaccinated against H1N1. CBC News

International News

India approves its first H1N1 vaccine supplier

The Drug Controller General of India has approved pharmaceutical company Zydus Cadilia to market its own H1N1 vaccine. The nod makes Zydus Cadilia the first company in India to domestically launch an H1N1 vaccine. The Ahmedabad-based company will use Vaxxicare, its preventative medication division, to sell the vaccine under the trade-name VaxiFlu-S. “With the development and launch of vaxiflu-s, Zydus now has proven capabilities in researching, developing, and manufacturing of safe and efficacious vaccines,” said Pankaj Patel, the company’s chairman and managing director. He went on to say that he expects Zydus Calilia to soon produce vaccines for other viral, bacterial and protozoal infections. Hindustan Times

Researchers say the benefits of H1N1 prophylaxis must be quantified against side-effects

A study published in the European science journal Eurosurveillance reports that side-effects are a significant factor in the dispensing of the anti-viral drug oseltamivir as a mass, preventative antiviral blanket. Of the students and staff at a British elementary school given the drug in June 2009 as a prophylactic measure, 42% reported adverse side-effects and 15% did not complete the course of oseltamivir due to adverse effects. The authors of the study call for an assessment of each patient’s likelihood of infection to avoid unnecessary treatment. Eurosurveillance

Global's Daily Influenza A (H1N1) Update - May 18th, 2009

Please note that GMS Influenza A (H1N1) Daily Updates will be posted before 1200 hrs PST over the May long weekend (May 16-18).

The WHO Pandemic Alert remains at Phase 5.

Influenza A (H1N1) Cases and Deaths by Country (as confirmed by the WHO by 1130 hrs PST, May 18th)

Local/National News

• The Public Health Agency of Canada (PHAC) noted on May 17th that there were no new H1N1 cases confirmed in Canada over the long weekend. Ontario still has the most cases in the country (187), followed by British Columbia (100), Alberta (67), Nova Scotia (66), Quebec (47), Saskatchewan (19), Manitoba (4), PEI (3), New Brunswick (2), and the Yukon (1). Canada’s total case count remains at 496. PHAC
• The British Columbia Centre for Disease Control (BCCDC) continues to report the following confirmed cases across the province: 20 in Northern Health; 2 in Interior Health; 13 on Vancouver Island Health; 27 in Vancouver Coastal Health; and, 38 in Fraser Health.

International News

• China, Britain, Japan, and other countries urged the World Health Organization (WHO) on Monday to be very cautious about declaring the arrival of a pandemic, fearing that a premature announcement could cause worldwide panic and confusion. As the agency opened its annual meeting, WHO Director-General Dr. Margaret Chan said she had listened carefully to the concerns of member states and would follow their instructions. Health experts from dozens of countries also urged WHO to change its standards for declaring a pandemic, saying it should take into account whether the virus was causing severe or mild illness, not just how quickly it was spreading. "We need to give (the WHO) team more flexibility as to whether we move to phase 6," said British Health Secretary Alan Johnson. Associated Press
• A high school assistant principal has become the first New York City death linked to the outbreak of influenza A (H1N1). He had been sick for nearly a week before his school was closed on Thursday (please note that additional cases confirmed by the U.S. Centers for Disease Control and Prevention [CDC], in addition to this fatality, have not yet been confirmed by the WHO, hence the discrepancy between this story's totals and the case count table above). Associated Press
• A wave of new confirmations sent the number of swine flu cases in Japan soaring to 135, health officials say, prompting the government to order the closure of nearly 2,000 schools and the cancelation of community events (please note that 10 of these cases in Japan have yet to be confirmed by the WHO, hence the discrepancy between this story's totals and the case count table above). Associated Press
• Chile confirmed its first two cases of H1N1 in two women who arrived from the Dominican Republic over the long weekend. The women, ages 25 and 32, are hospitalized and in good condition, Health Minister Alvaro Erazo said (please note that only one of Chile's cases have been confirmed by the WHO, hence the discrepancy between this story's totals and the case count table above). Associated Press
• President Barack Obama's appointment of New York City Health Commissioner Thomas Frieden to lead the U.S. CDC drew enthusiastic applause late last week from public health organizations and disease experts. Frieden, a tuberculosis expert, is credited with achievements as varied as helping improve tuberculosis control in India, driving trans-fats out of New York City restaurants, and reducing smoking in that city. Dr. Richard Besser, who has served as acting CDC director since early in the Obama administration, will continue in his regular role as head of the CDC's Coordinating Office for Terrorism Preparedness and Emergency Response, the White House announced. Frieden will assume the CDC post in early June. CIDRAP

Today's Key Question

What does the vaccine manufacturing process look like and how long could it take for an H1N1 vaccine to be developed?

The following diagram provides a succinct overview of the key agencies and activities required for the vaccine manufacturing process, along with general timelines over a 12-month period. Nature