Links to more information sites

Yesterday, CDC was showing an H1N1 infection count of 282 confirmed cases for California.  Today, that count has dropped to 191; 91 fewer cases.  Just something to be aware of if you are reporting statistics to your management.  If anyone hears anything about the source of the apparent discrepancy please let us know.

Thanks to one of our members for pointing this out.

Count for 5/10/2009

Count for 5/11/2009

INFLUENZA A (H1N1) - WORLDWIDE (22): CASE COUNTS
************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[Please note that there may be discrepancies between the various sources of
information due to different times of "closure" of daily figures reported.
Times of daily report closures where known are listed in the table of
contents below. Oftentimes a newswire will mention a confirmed case in a
location that has not been on the official reporting entity list as the
confirmation arrived after closure of the day's report. - Mod.MPP]

In this update:
[1] WHO - global update (07:30 GMT)
[2] PAHO - Americas regional update (17:00 GMT-4)
[3] CDC - USA update (11:00 GMT -4)
[4] Mexico - MOH update (none 10 May 2009)
[5] Canada - Health Protection Agency (15:00 GMT -4)
[6] News briefs

******
[1] WHO - global update (07:30 GMT)
Date: Sun 10 May 2009
Source: WHO Epidemic and Pandemic Alert and Response (EPR) [edited]
<http://www.who.int/csr/en/>


Influenza A (H1N1) - update 24 -- 10 May 2009
<http://www.who.int/csr/don/2009_05_10/en/index.html>


As of 07:30 GMT, 10 May 2009, 29 countries have officially reported 4379
cases of influenza A (H1N1) infection.

Mexico has reported 1626 laboratory confirmed human cases of infection,
including 45 deaths. The United States has reported 2254 laboratory
confirmed human cases, including 2 deaths. Canada has reported 280
laboratory confirmed human cases, including one death. Costa Rica has
reported 8 laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no
deaths - Argentina (1), Australia (1), Austria (1), Brazil (6), China, Hong
Kong Special Administrative Region (1), Colombia (1), Denmark (1), El
Salvador (2), France (12), Germany (11), Guatemala (1), Ireland (1), Israel
(7), Italy (9), Japan (4), Netherlands (3), New Zealand (7), Panama (3),
Poland (1), Portugal (1), Republic of Korea (3), Spain (93), Sweden (1),
Switzerland (1), and the United Kingdom (39).

******
Summary table of cases reported to WHO 30 Apr -- 10 May 2009
----------------
Country: no. cases (deaths) 2009 Apr: 30 / May: 1 / 2 / 3 / 4 / 5 / 6 / 7 /
8 / 9 / 10
Argentina: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1
Australia: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1
Austria: 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Brazil: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 4 / 6 / 6
Canada: 19 / 34 / 51 / 85 / 101 / 140 / 165 / 201 / 214 / 242 (1) / 280 (1)
China, Hong Kong, SAR: 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Colombia: 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Costa Rica: 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 8 (1)
Denmark: 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
El Salvador: 0 / 0 / 0 / 0 / 2 / 2 / 2 / 2 / 2 / 2 / 2
France: 0 / 0 / 2 / 2 / 4 / 4 / 5 / 5 / 12 / 12 / 12
Germany: 3 / 4 / 6 / 8 / 8 / 9 / 9 / 10 / 11 / 11 / 11
Guatemala: 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1
Ireland: 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Israel: 2 / 2 / 3 / 3 / 4 / 4 / 4 / 6 / 7 / 7 / 7
Italy: 0 / 0 / 0 / 1 / 2 / 5 / 5 / 5 / 6 / 6 / 9
Japan: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 3 / 4
Mexico: 97(7) / 156 (9) / 397 (16) / 506 (19) / 590 (25) / 822 (29) / 942
(29) / 1112 (42) / 1204 (44) / 1364 (45) / 1626 (45)
Netherlands: 1 / 1 / 1 / 1 / 1 / 1 / 1 / 2 / 3 / 3 / 3
New Zealand: 3 / 4 / 4 / 4 / 6 / 6 / 5 / 5 / 5 / 5 / 7
Panama: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 2 /3
Poland: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1
Portugal: 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Republic of Korea: 0 / 0 / 1 / 1 / 1 / 2 / 2 / 3 / 3 / 3 / 3
Spain: 13 / 13 / 13 / 40 / 54 / 57 / 73 / 81 / 88 / 88 / 93
Sweden: 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1
Switzerland: 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
United Kingdom: 8 / 8 / 15 / 15 / 18 / 27 / 28 / 32 / 34 / 34 / 39
United States: 109 (1) / 141 (1) / 160 (1) / 226 (1) / 286 (1) / 403 (1) /
642 (2) / 896 (2) / 1639 (2) / 2254 (2)
Total No. countries reporting cases: 11 / 13 / 16 / 18 / 21 / 21 / 23 / 24
/ 25 / 29
Total cases reported: 257 (8) / 367 (10) / 658 (17) / 898 (20) / 1085 (26)
/ 1490 (30) / 1893 (31) / 2371 (44) / 2500 (46) / 4379 (49)

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******
[2] PAHO - Americas regional update (17:00 GMT-4)
Date: Sun 10 May 2009
Source: PAHO H1N1 flu website [edited]
<http://new.paho.org/hq/index.php?option=com_content&task=view&id=1336&Itemid=569>


Today 10 May [2009] USA reports a new death due to influenza A (H1N1) in
the state of Washington and Panama has increased to 15 the number of
confirmed cases.

As of 10 May 2009, the total number of confirmed cases of influenza A
(H1N1) recorded is 4476, including 53 deaths, in 10 countries of the
Americas (Argentina, Brazil, Canada, Colombia, Costa Rica, El Salvador,
Guatemala, Mexico, Panama, and the United States).

To date the United States has confirmed a total of 2532 cases of influenza
A (H1N1), including 3 deaths (2 in Texas and one in the state of
Washington), in 44 States (including the District of Columbia): 4 in
Alabama, 182 in Arizona, 282 in California, 39 in Colorado, 24 in
Connecticut, 44 in Delaware, 53 in Florida, 3 in Georgia, 6 in Hawaii, 1 in
Idaho, 466 in Illinois, 39 in Indiana, 43 in Iowa, 36 in Kansas, 3 in
Kentucky, 9 in Louisiana, 4 in Maine, 23 in Maryland, 88 in Massachusetts,
114 in Michigan, 7 in Minnesota, 10 in Missouri, 13 in Nebraska, 9 in
Nevada, 4 in New Hampshire, 7 in New Jersey, 30 in New Mexico, 190 in New
York, 7 in North Carolina, 6 in Ohio, 14 in Oklahoma, 17 in Oregon, 10 in
Pennsylvania, 7 in Rhode Island, 32 in South Carolina, 1 in South Dakota,
54 in Tennessee, 108 in Texas, 63 in Utah, 1 in Vermont, 16 in Virginia,
102 in Washington, 4 in Washington DC, and 357 in Wisconsin. Other
suspected cases are being investigated.

 From [1 Mar 2009 to 9 May 2009], Mexico has reported 2062 confirmed cases
of influenza A (H1N1), including 48 deaths, in 30 of 32 states. The states
with the highest number of confirmed cases are the Federal District (Mexico
City), State of Mexico, San Luis Potosi, and Hidalgo. In Canada, up to 10
May [2009] 284 human cases of influenza A (H1N1) have been confirmed,
including 1 death in Alberta, in 9 of 13 Provinces (48 in Alberta, 79 in
British Columbia, 2 in New Brunswick, 56 in Nova Scotia, 15 in Quebec, 1 in
Manitoba, 76 in Ontario, 3 in Prince Edward Island and 4 in Saskatchewan).

To date Costa Rica has reported 8 confirmed cases of influenza A (H1N1)
including 1 death. On 3 May [2009], Colombia reported 1 confirmed case of
influenza A (H1N1), while El Salvador reported 2 confirmed cases of
influenza A (H1N1). On 5 May [2009], Guatemala notified 1 confirmed case of
influenza A (H1N1). On 8 May [2009], Argentina reported 1 confirmed case of
influenza A (H1N1). To date Brazil has reported 6 confirmed cases of
influenza A (H1N1), and Panama has confirmed 15 cases.

Various countries of the Region are reporting suspected and probable cases.
This indicates that surveillance enhancement is producing results.

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******
[3] CDC - USA update (11:00 GMT -4)
Date: Sun 10 May 2009
Source: CDC H1N1 flu website [edited]
<http://www.cdc.gov/h1n1flu/>


H1N1 flu (swine flu)
--------------------
States: cumulative no. of lab. confirmed cases (deaths) 2009 Apr: 30 / May:
1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10
Alabama 0 / 0 / 0 / 1 / 4 / 5 / 4 / 4 / 4 / 4 / 4
Arizona: 1 / 4 / 4 /18 / 17 / 17 / 48 / 48 / 131 / 182 / 182
California: 14 / 13 / 24 / 26 / 30 / 49 / 67 / 106 / 107 / 171 / 282
Colorado: 0 / 2 / 2 / 4 / 7 / 6 / 17 / 17 / 25 / 41 / 39
Connecticut: 0 / 0 / 1 / 2 / 2 / 2 / 4 / 4 / 4 / 14 / 24
Delaware: 0 / 4 / 4 / 10 / 20 / 20 / 33 / 28 / 39 / 44 / 44
Florida: 0 / 0 / 2 / 3 / 5 / 5 / 5 / 5 / 6 / 43 / 53
Georgia: 0 / 0 / 0 / 0 / 0 / 1 / 3 / 3 / 3 / 3 / 3
Hawaii: 0 / 0 / 0 / 0 / 0 / 0 / 3 / 3 / 5 / 6 / 6
Idaho: 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Illinois: 0 / 3 / 3 / 3 / 8 / 82 / 122 / 204 / 392 / 421 / 466
Indiana: 1 / 3 / 3 / 3 / 3 / 3 / 15 / 15 / 29 / 39 / 39
Iowa: 0 / 0 / 0 / 1 / 1 / 1 / 1 / 5 / 5 / 43 / 43
Kansas: 2 / 2 / 2 / 2 / 2 / 2 / 2 / 7 / 12 / 12 / 36
Kentucky*: 0 / 1 / 1 / 1 / 1 / 1 / 2 / 2 / 3 / 3 / 3
Louisiana: 0 / 0 / 0 / 0 / 7 / 7 / 7 / 7 / 7 / 9 / 9
Maine: 0 / 0 / 0 / 0 / 0 / 1 / 1 / 4 / 4 / 4 / 4
Maryland: 0 / 0 / 0 / 0 / 4 / 4 / 4 / 4 / 4 / 23 / 23
Massachusetts: 2 / 2 / 8 / 7 / 6 / 6 / 45 / 71 / 83 / 89 / 88
Michigan: 1 / 2 / 2 / 2 / 2 / 2 / 8 / 9 / 49 / 103 / 114
Minnesota: 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 7
Missouri: 0 / 0 / 1 / 1 / 1 / 1 / 2 / 4 / 9 / 10 / 10
Nebraska: 0 / 1 / 0 / 1 / 1 / 1 / 4 / 4 / 4 / 13 / 13
Nevada: 1 / 1 / 1 / 1 / 1 / 1 / 5 / 5 / 8 / 9 / 9
New Hampshire: 0 / 0 / 0 / 1 / 1 / 1 / 2 / 2 / 3 / 4 / 4
New Jersey: 0 / 5 / 7 / 7 / 7 / 6 / 7 / 7 / 7 / 7 / 7
New Mexico: 0 / 0 / 0 / 1 / 1 / 1 / 3 / 8 / 8 / 30 / 30
New York: 50 / 50 / 50 / 63 / 73 / 90 / 97 / 98 / 174 / 190 / 190
North Carolina: 0 / 0 / 0 / 0 / 1 / 1 / 7 / 7 / 7 / 7 / 7
Ohio: 1 / 1 / 1 / 3 / 3 / 3 / 5 / 5 / 6 / 12 / 6
Oklahoma: 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1 / 4 / 4 / 14
Oregon: 0 / 0 / 0 / 0 / 3 / 15 / 15 / 15 / 15 / 15 / 17
Pennsylvania: 0 / 0 / 0 / 0 / 1 / 1 / 1 / 2 / 2 / 10 / 10
Rhode Island: 0 / 0 / 0 / 1 / 1 / 1 / 2 / 2 / 7 / 7 / 7
South Carolina: 10 / 16 / 13 / 15 / 15 / 16 / 16 / 17 / 29 / 42 / 32
South Dakota: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1 / 1
Tennessee: 0 / 0 / 0 / 1 / 1 / 2 / 2 / 2 / 36 / 46 / 54
Texas: 26 (1) / 28 (1) / 28 (1) / 40 (1) / 41 (1) / 41 (1) / 61 (2) / 91
(2) / 93 (2) / 110 (2) / 108 (2)
Utah: 0 / 0 / 0 / 1 / 1 / 1 / 1 / 8 / 24 / 60 / 63
Vermont: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1
Virginia: 0 / 2 / 2 / 3 / 3 / 3 / 3 / 11 / 14 / 16 / 16
Washington: 0 / 0 / 0 / 0 / 0 / 0 / 9 / 23 / 33 / 83 / 102
Washington, DC: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1 / 4 / 4
Wisconsin: 0 / 0 / 0 / 3 / 3 / 3 / 6 / 26 / 240 / 317 / 357
Total number of states: 11 / 19 / 21 / 30 / 36 / 38 / 41 / 41 / 43 / 44 / 44
Total counts, cases (deaths): 109 (1) / 141 (1) / 160 (1) / 226 (1) / 279
(1) / 403 (1) / 642 (2) / 896 (2) / 1639 (2) / 2254 (2) / 2532 (3)
*Case is resident of KY but currently hospitalized in GA.

[For a map of number of cases by state, see
<http://www.cdc.gov/h1n1flu/update.htm>. - Mod.MPP]

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******
[4] Mexico - MOH update (none 10 May 2009)
Date: Sun 10 May 2009
Source: Secretaria de Salud website (MOH) [in Spanish, trans. Mod.MPP, edited]
<http://portal.salud.gob.mx/contenidos/noticias/influenza/estadisticas.html>


No update available for 10 May 2009
Case counts: 2009 Apr: 29 / May: 1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9
Number of confirmed cases: 99 / 397 / 443 / 506 / 727 / 866 / 1112 / 1204 /
1364 / 1626
Number of deaths: 8 / 16 / 16 / 19 / 26 / 26 / 42 / 44 / 45 / 48

[For the updated 9 May 2009 graphics on the status of the epidemic with
epidemic curve and geographic distribution of cases, a link to the
downloadable *pdf file can be found by following the link for 09/Mayo/2009
"situacion actual de la Epidemia available at
<http://portal.salud.gob.mx/contenidos/noticias/influenza/estadisticas.html>.
- Mod.MPP]

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******
[5] Canada - Health Protection Agency (15:00 GMT -4)
Date: Sun 10 May 2009
Source: Health Protection Agency [edited]
<http://www.phac-aspc.gc.ca/alert-alerte/swine-porcine/surveillance-eng.php>


Cumulative confirmed cases (deaths) of human swine influenza by province
and date
Province: Apr: 30 / May: 1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10
Alberta: 6 / 8 / 15 / 18 / 24 / 26 / 30 / 33 / 42 (1) / 46 (1) / 48 (1)
British Columbia: 11 / 15 / 22 / 29 / 39 / 46 / 54 / 54 / 60 / 79 / 79
Manitoba: 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Nova Scotia: 8 / 14 / 16 / 33 / 38 / 48 / 53 / 53 / 56 / 56 / 56
New Brunswick: 0 / 1 / 1 / 1 / 2 / 2 / 2 / 2 / 2 / 2 / 2
Ontario: 8 / 12 / 14 / 16 / 31 / 36 / 49 / 56 / 61 / 76 / 76
Prince Edward Island: 0 / 0 / 0 / 0 / 2 / 2 / 2 / 2 / 3 / 3 / 3
Quebec: 1 / 1 / 2 / 3 / 3 / 4 / 10 / 11 / 15 / 15 / 15
Saskatchewan: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 2 / 2 / 2 / 4
Total no. provinces with cases: 5 / 6 / 6 / 7 / 8 / 8 / 8 / 9 / 9 / 9 / 9
Total: 34 / 51 / 70 / 101 / 140 / 165 / 201 / 214 / 242 (1) / 280 (1) / 284 (1)

[An epidemic curve available at the URL link above illustrates the course
of the current H1N1 flu virus (human swine flu) outbreak in Canada. It
shows the date when symptoms of H1N1 flu virus (human swine flu) began for
each of the laboratory-confirmed cases.

Provinces not submitting reports today (10 May 2009) are: British Columbia,
Ontario, Nova Scotia, Quebec, and Northwest Territories. - Mod.MPP]

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******
[6] News briefs
Date: Sun 10 May 2009


[Below are links to newswires with information on confirmed cases in
countries not yet included in official updates, and other events of
potential interest. The newswires are full of reports of suspected cases in
many countries. Reports have been filtered and discarded as more
information becomes available during the day. - Mod.MPP]

Asia:
China - 1st confirmed case on mainland, history of travel to USA
<http://news.xinhuanet.com/english/2009-05/11/content_11352085.htm>

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[Before presenting the summary of the status of reported cases of influenza
A (H1N1) infection as of 10 May 2009 it is important to mention that many
of the reporting units did not have reports from today (10 May 2009) so it
is highly likely that there may be a backlog of specimens to be processed
on 11 May 2009 that may result in an "artificial" increase in reports as
this backlog is processed on 11 May 2009.

To summarize the current situation, as of 10 May 2009 a total of 4379 cases
and 49 deaths of influenza A (H1N1) infection have been officially reported
to WHO/PAHO from 29 countries, up from 3440 confirmed cases and 48 deaths
from 29 countries yesterday (9 May 2009). There are no newly added
countries in the past 24 hours. According to newswires published on 9 May
2009 there is a confirmed case in Norway, and newswires published on 10 May
2009 mention a confirmed case in mainland China.

The USA has officially reported 2532 laboratory confirmed cases coming from
44 states (compared with 2254 cases from 44 states on 9 May 2009), and 3
deaths (one in a Mexican child with pre-existing illness visiting in the
USA, a 2nd in a resident of Texas with known pre-existing illness, and a
3rd in Washington State with known pre-existing illness). Canada has
reported 284 cases from 9 provinces with 1 death in an individual with
pre-existing illness, up from 280 cases and one death reported from 9
provinces on 9 May 2009. Mexico has reported 2062 confirmed cases with 48
deaths (compared with 1626 cases and 48 deaths on 9 May 2009.

For a map of reported confirmed cases, worldwide, as of 07:30 GMT 10 May
2009, see
<http://www.who.int/csr/don/GlobalSubnationalMaster_20090510_0800.jpg>. For
an interactive map of reported confirmed cases in the Americas, as of 13:00
GMT -4 (8 May 2009) showing burden of disease by state/province, see
<http://ais.paho.org/flu/sm/en/atlas.html> . - Mod.MPP]


INFLUENZA A (H1N1) - WORLDWIDE (23)
***********************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
[1] Outbreak analysis
[2] UK perspective

******
[1] Outbreak analysis
Date: Mon 11 May 2009
Source: Science Express [edited]
<http://www.sciencemag.org/cgi/content/abstract/1176062>


Pandemic Potential of a Strain of Influenza A (H1N1): Early Findings By:
Christophe Fraser 1, Christl A. Donnelly 1, Simon Cauchemez 1, William P.
Hanage 1, Maria D. Van Kerkhove 1, T. Deirdre Hollingsworth 1, Jamie
Griffin 1, Rebecca F. Baggaley 1, Helen E. Jenkins 1, Emily J. Lyons 1,
Thibaut Jombart 1, Wes R. Hinsley 1, Nicholas C. Grassly 1, Francois
Balloux 1, Azra C. Ghani 1, Neil M. Ferguson 1*, Andrew Rambaut 2, Oliver
G. Pybus 3, Hugo Lopez-Gatell 4, Celia M Apluche-Aranda 5, Ietza Bojorquez
Chapela 4, Ethel Palacios Zavala 4, Dulce Ma. Espejo Guevara 6, Francesco
Checchi 7, Erika Garcia 7, Stephane Hugonnet 7, Cathy Roth 7. The WHO Rapid
Pandemic Assessment Collaboration (All authors are members of this
collaboration. Correspondence to Neil M. Ferguson
<neil.ferguson@imperial.ac.uk >). 1 MRC Centre for Outbreak Analysis &
Modelling, Department of Infectious Disease Epidemiology, Imperial College
London, Faculty of Medicine, Norfolk Place, London W2 1PG, UK. 2 Institute
of Evolutionary Biology, University of Edinburgh, Ashworth Laboratories
Edinburgh EH9 3JT, UK. 3 Department of Zoology, University of Oxford, South
Parks Road, Oxford OX1 3PS, UK. 4 Directorate General of Epidemiology, FCO.
De P. Miranda 177 5th Floor, Mexico City, 01480, Mexico. 5 National
Institute of Epidemiological Diagnosis and Reference, Prolongacion Carpio
No. 470 (3 piso), Col Santo Tomas, Mexico City, C.P. 11340, Mexico. 6
Secretaria de Salud - Servicios de Salud de Veracruz Soconusco No. 36
Colonia Aguacatal C.P. 910 Xalapa, Veracruz, Mexico State. 7 World Health
Organization, 20 Av. Appia, 1211 Geneva, Switzerland.

A novel influenza A (H1N1) virus has spread rapidly across the globe.
Judging its pandemic potential is difficult with limited data but
nevertheless is essential to inform appropriate health responses. By
analyzing the outbreak in Mexico, early data on international spread, and
viral genetic diversity, we make an early assessment of transmissibility
and severity. Our estimates suggest that 23 000 (range 6000-32 000)
individuals had been infected in Mexico by late April 2009, giving an
estimated case fatality ratio (CFR) of 0.4 per cent (range 0.3 to 1.5 per
cent) based on confirmed and suspect deaths reported up to that time. In a
community outbreak in the small community of La Gloria, Veracruz, no deaths
were attributed to infection, giving an upper 95 per cent bound on CFR of
0.6 per cent. Thus, while substantial uncertainty remains, clinical
severity appears less than that seen in 1918 but comparable with that seen
in 1957. Clinical attack rates in children in La Gloria were twice those in
adults (less than 15 years of age: 61 per cent, 15: 29 per cent). Three
different epidemiological analyses gave R0 estimates in the range 1.4-1.6,
while a genetic analysis gave a central estimate of 1.2. This range of
values is consistent with 14 to 73 generations of human-to-human
transmission having occurred in Mexico to late April 2009. Transmissibility
is therefore substantially higher than seasonal flu and comparable with
lower estimates of R0 obtained from previous influenza pandemics.

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******
[2] UK perspective
Date: Mon 11 May 2009
Source: BBC-News [edited]
<http://news.bbc.co.uk/1/hi/health/8044299.stm>


Ten new cases of swine flu have been confirmed in England, taking the total
number in the UK to 65, the Health Protection Agency has said. Another 7
adults and 3 children have been diagnosed with the virus. The news comes as
a UK analysis concludes that the World Health Organization was right to
raise the alert over a potential global flu pandemic. It says the latest
outbreak is likely to be comparable to the pandemics of the 20th century.

The study, led by Professor Neil Ferguson, of Imperial College, London, is
published in the leading journal Science [see preceding report]. It finds
that -- as suspected -- the virus is more infectious than normal. Seasonal
flu normally infects one in 10 of the population. So far, swine flu has
infected 1/3rd of the people that have come into contact with it in Mexico.
However, Professor Ferguson admitted it was difficult to quantify the
impact on human health at this stage. His study suggests that swine flu
could kill between 4 in every 1000 infected people and 14 in every 1000.
Professor Ferguson said: "The World Health Organization was correct in its
judgment that this is a virus that should not be ignored, but these figures
suggest at this stage it is not going to be catastrophic."

Of the new cases in England, 4 are in eastern England, and 3 are in the
north west. Three more are in London, including a pupil at Hampton School
in south west London. The school has been closed for a week from Monday [11
May 2009] as a precaution. Four other schools in England have reopened.
Hampton School, which is an independent boys' secondary, shut its doors
after a Year 7 pupil fell ill after traveling overseas. The school said the
boy was recovering well at home, and GCSE and A level exams, the bulk of
which commence this week, would continue as planned. It is offering
antiviral drugs to all children in Year 7, any staff who had close contact
with the pupil, and any other children who shared school coach journeys
with him. These include some girls from the nearby Lady Eleanor Holles
School in Hampton.

A Department of Health spokesman said on Monday [11 May 2009] that all
infections in the UK so far had been "mild". Thanks to early diagnosis and
treatment with antivirals, the spread of the virus is being limited and
symptoms reduced. "But it is right to prepare for the possibility of a
global pandemic. The UK's arrangements are continuing to ensure that we are
well-placed to deal with this new infection." The 2 cases in London are
both connected with Alleyn's School in Dulwich, which was closed on 4 May
2009 after 5 pupils were confirmed with the virus. NHS London said the 2
latest cases were a 12 year old pupil and a parent. Despite the
development, the school reopened on Monday [11 May 2009], and the Health
Protection Agency stressed that because of the time taken to diagnose swine
flu, all 10 newly-confirmed patients may already have recovered and may be
symptom-free. NHS East of England said the 4 cases in its area included a
man from North Weald, Essex who had close contact with an already confirmed
case and a child from Canvey Island, also in Essex, who recently visited
Mexico. Another case involved a man from Lowestoft, Suffolk, who recently
visited Florida, and the 4th was a woman from the Huntingdonshire district
in Cambridgeshire. Investigations are continuing into the origin of her
infection. In the north west, 2 of those infected are adults who have
returned from abroad, and the 3rd adult is a case of close contact.

Meanwhile, holiday companies Thomson and First Choice said they were
cancelling all flights to the Mexican resorts of Cancun and Cozumel up to
and including 18 May 2009. They also said that their last holiday makers
still in Mexico would be returning home on Monday [11 May 2009].

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[see also:
Influenza A (H1N1) - worldwide (22): case counts 20090511.1759
Influenza A (H1N1) - worldwide (21) 20090510.1749
Influenza A (H1N1) - worldwide (20): case counts 20090510.1741
Influenza A (H1N1) - worldwide (19) 20090509.1733
Influenza A (H1N1) - worldwide (18): case counts 20090509.1728
Influenza A (H1N1) - worldwide (17) 20090508.1722
Influenza A (H1N1) - worldwide (16): case counts 20090507.1715
Influenza A (H1N1) - worldwide (15) 20090507.1709
Influenza A (H1N1) - worldwide (14): case counts 20090507.1702
Influenza A (H1N1) - worldwide (13) 20090506.1695
Influenza A (H1N1) - worldwide (12): case counts 20090505.1681
Influenza A (H1N1) - worldwide (11): coincident H3N2 variation 20090505.1679
Influenza A (H1N1) - worldwide (10): case counts 20090504.1675
Influenza A (H1N1) - worldwide (09) 20090504.1673
Influenza A (H1N1) - worldwide (08): case counts 20090503.1660
Influenza A (H1N1) - worldwide (07) 20090503.1658
Influenza A (H1N1) - worldwide (06): case counts 20090502.1654
Influenza A (H1N1) - worldwide (05) 20090503.1657
Influenza A (H1N1) - worldwide (04): case counts 20090501.1648
Influenza A (H1N1) - worldwide (03) 20090501.1646
Influenza A (H1N1) - worldwide (02): case counts 20090430.1638
Influenza A (H1N1) - worldwide 20090430.1636]

...................cp/msp/sh


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