Global's H1N1 Update - 05/20/10

The next update will be on Thursday, May 25th, 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

International News

In the face of criticism, some powerful support steps forward for the WHO

There is no shortage of criticism for the World Health Organization’s (WHO) handling of the H1N1 outbreak. Chat forums and web logs are rife with accusations of collusion with the pharmaceutical industry. Almost a third of the European Union’s members of parliament have signed a petition criticizing the WHO’s handling of the influenza pandemic and calling for an investigation.

This week the World Health Assembly, the decision-making arm of the WHO, convenes to discuss a range of global health issues including the H1N1 pandemic response. At the first day of the gathering, France, India, and the US gave public statements in support of the WHO’s efforts. French Health Minister, Roselyne Bachelot went so far as to issue a point-by-point rebuttal of the criticisms saying the UN agency had been “taken to task in an unjust manner,” and that “the vaccine, which was the answer to a real danger, turned into a source of risk in the collective mind. The effects of this smear campaign are potentially devastating.”

In her opening address to the assembly, WHO Director-General Margaret Chan said that the news regarding the pandemic is mostly good, and while public health successes are usually owed to political commitment, adequate resources and cooperation, this time we were “just plain lucky.” For India’s part, this seems to either represent a 180° change in their position, or that their earlier criticism was a political gambit. Agence France-Presse

H1N1 response review committee holds its first press conference

On May 19 the external review committee for the WHO’s pandemic response held a press conference to discuss the findings of their first meeting. The group’s final report will be a public document and is under no restrictions on scope of their recommendations. Dr. Harvey Fineberg, chair of the review committee, outlined their mandate saying they were looking to into any aspect that bears on lessons for the future saying, “We want to offer recommendations that are keyed to the problems we find. We want to offer recommendations that enable the world, WHO and the nations, to do better the next time, and we are confident there will be a next time.”

The committee plans to measure the WHO’s response in term of 5 issues: preparedness, alert, response, communication and International Health Regulations performance. To facilitate its investigation, the committee will have access to confidential WHO documents and data. While the report will be public, Dr. Fineberg said that the group will have no authority to compel confidential documents into the public view. When asked what types of confidential information the group had, he described it as mostly letters of agreement and contracts with private industry. World Health Organization

Global's Daily Influenza A (H1N1) Update - May 20, 2009

GMS INFLUENZA A (H1N1) Daily Update as of May 20, 2009(830 HRS PST)

The WHO Pandemic Alert level remains at Phase 5.

Influenza A (H1N1) Cases and Deaths by Country (as of 8 AM PST May 20th)

*Lab confirmed cases and deaths have been provided by the WHO’s Influenza A (H1N1) – Update #34.

Local/National News

• On May 19th, the Public Health Agency of Canada (PHAC) did not announce that any new cases of Influenza A (H1N1) had been confirmed in the country.


• The British Columbia Centre for Disease Control (BCCDC) continues to report the following confirmed cases across the province:




• 38 in Fraser Health


• 2 in Interior Health


• 20 in Northern Health


• 27 in Vancouver Coastal Health


• 13 on Vancouver Island Health

International News

• The U.S. Centers for Disease Control and Prevention (CDC) reported on Tuesday that an early look at trends in patients who have been hospitalized with novel influenza A (H1N1) infections showed that all but one of a group of 30 patients presented with fever and that about two thirds of them had an underlying medical condition. The CDC's review, based on California patients who were hospitalized from April 20 through May 17, highlighted that the majority of patients recovered without problems after short hospitalizations, though some had severe illness with prolonged complications and remain hospitalized. CIDRAP


• The influenza A (H1N1) outbreak has switched from one initially linked to schools or travelers to one with true community-wide spread in much of the United States, said the CDC’s, Dr. Anne Schuchat. Twenty-two states are reporting widespread or regional flu activity, particularly in the Southwest and Midwest. Associated Press


• The U.S. strategic inventory of pandemic supplies contains only 39 million surgical masks, far short of the 27 billion federal officials say would be needed in a serious influenza pandemic,Time reported on May 19th. The nation's supply of respirators is also well below the estimated requirement of 3 billion . Moreover, most of the masks are now made in Mexico or China, leaving many officials to wonder if the few U.S.-based companies could make-up the difference during a serious outbreak.Time


• Japanese officials have closed more than 4,400 schools in two prefectures that have reported dozens of novel H1N1 cases, which is up from about 2,000 closures reported on Monday. The affected areas are Osaka and Hyogo, in the central part of Honshu, which is Japan's main island. The country now has nearly 200 confirmed cases, and experts said the virus has probably already spread to Tokyo, the world's most populated urban area. In a related development, Japaneses officials also said the country will begin to phase out airport quarantine checks. Agence France-Presse and Associated Press

Vaccine News

• On Tuesday, the World Health Organization (WHO) said drug manufacturers won't be able to start making a vaccine for the H1N1 influenza virus until mid-July at the earliest. The virus isn't growing very fast in laboratories, making it difficult for scientists to get a key vaccine ingredient. Associated Press


• WHO officials also urged drug manufacturers to reserve some of their influenza A (H1N1) vaccine for poor countries. WHO argued for companies to donate at least 10 per cent of their production or offer reduced prices to poor countries that could otherwise be left without vaccines if there is a sudden surge in demand. The only major drug maker that publicly agreed to the WHO request was Britain's GlaxoSmithKline PLC, which said it would donate 50 million doses in a pandemic and offer more doses that the WHO could buy at a discount for poor countries. Associated Press

Latest Guidance from the WHO, U.S. CDC, PHAC, and BCCDC

• Yesterday, WHO’s Strategic Advisory Group of Experts on Influenza A (H1N1) Vaccines released their recommendations, namely that:




• It is premature to recommend the immediate start of commercial‐scale production of influenza A (H1N1) vaccine.


• The WHO Secretariat, in close coordination with its Collaborating Cent res and the Essential Regulatory Laboratories of the WHO Global Influenza Surveillance Network, should recommend which vaccine viruses ought to be used for vaccine development as soon as possible.

Today’s Key Question

How do influenza vaccines work?

When a healthy person becomes infected with a particular flu virus for the first time, that person’s immune system takes several days to identify the infecting virus and attack it. Special immune system proteins known as antibodies recognize and then attach to the virus. Additionally, T cells further this process by encouraging the production of antibodies, and also destroying cells infected with the virus to rid the body of it.

Upon repeat infection with a particular virus, the immune system “remembers” the virus and produces a stronger and more efficient attack, eradicating the virus in the early stages of infection. Therefore, the symptoms of this subsequent infection are less severe, if present at all, and the virus is less likely to be transmitted to others. Vaccines work by this very same principle. A vaccine generally contains a “killed” or weakened form of the virus which, when introduced into the body, mimics the presence of the real virus. The immune system is then primed and ready for rapid action if or when the virus were to infect that individual. Nature