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The next update will be on Thursday, April 29th, at 0830 hrs PST.

The WHO Pandemic Alert level remains at Phase 6

Influenza A (H1N1) Cases and Deaths*

WHO Map 04.04.10

*Cases reported by The World Health Organization (WHO) are as of April 4, 2010

National News

Overall influenza activity has continued to be low for at least 17 consecutive weeks.  Only one specimen (out of 1,379) tested positive for pandemic H1N1 2009 in the third week of April.  No new H1N1-related hospitalizations and deaths have been reported this week.  To date, only 14 hospitalizations and two deaths have occurred across Canada since the beginning of 2010.  As of week 14, influenza activity level in the Southern Hemisphere continues to be low in general.  Of note, however, in Chile, there was evidence of early localized pandemic influenza virus transmission in advance of the usual start of the southern hemisphere winter influenza season.  PHAC FluWatch

International News

Australian Broadcasting Corporation (ABC) has reported that the number of children in West Australia who had convulsions or fever and vomiting after receiving a seasonal flu vaccine that covers the pandemic strain has grown to 251.  Officials say the immunizations likely came from multiple batches.  Queensland is also investigating the possibility of adverse reactions in children, and police in Brisbane are probing the death of a recently vaccinated 2-year-old, according to other ABC reports.  ABC

The next update will be on Thursday, April 27th, 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 April 4, 2010

International News

After a quiet start to the year, Bangladesh is reporting rapid spread of pandemic flu this month and has placed health officials across the country on alert. “The virus sustained at a lower level in Bangladesh during January-March period, but it showed rising trend since the beginning of this month,” a health official said, adding that April through September is typically the busiest season for flu.  He did not specify case numbers.  Balita

Nigeria has yet to receive any H1N1 pandemic vaccine and is concerned that cases may grow as nearby Ghana is reporting an outbreak.  Nigeria has confirmed 11 cases and 2 pandemic deaths.  The story quoted unnamed experts as saying global demand for the vaccine has outpaced supply, making it difficult for developing countries to obtain doses.  Nigeria Bulletin

In the biggest and most detailed look yet at pandemic flu infections in pregnant women, researchers from the US Centers for Disease Control and Prevention (CDC) have reported that early antiviral treatment was linked to fewer intensive care unit (ICU) admissions and that severe illnesses and deaths are more likely to occur during the third trimester.  The CDC researchers, along with a Pandemic H1N1 Influenza in Pregnancy Working Group made up of health officials from several U.S. states, based their findings on reports of pregnant women who were sick with pandemic H1N1 infections through August plus more recent reports of women who were admitted to ICUs.  The findings appear in the Apr 21 issue of the Journal of the American Medical Association (JAMA).  CIDRAP

The next update will be on Tuesday, April 22nd, 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), as of April 4, 2010

National News

Canadian researchers have reported that patients who became severely ill with H1N1 swine flu last year often developed kidney failure, which worsened their illness and raised costs.  Doctors should be on the lookout for kidney damage in patients who are hospitalized with the virus, they told a meeting of the National Kidney Foundation.  “It’s concerning that so many people got some form of kidney injury, although it was reversible in the majority of them,” Dr. Manish Sood of the University of Manitoba in Winnipeg said in a statement.  Sood’s team looked at the cases of 47 critically ill patients with confirmed H1N1 infections who were admitted to one of seven intensive care units in Manitoba.  National Post

International News

Just weeks before it hosts the World Cup, South Africa is reporting a shortage of H1N1 vaccine.  Doctors and pharmacies have run out of the vaccine, imported from Australia, and say no more is available.  The country received 1.3 million doses, which are being used for “front line” port-of-entry workers and certain HIV patients.  A further 3.5 million doses donated by the World Health Organization (WHO) will be used on pregnant women and others at high risk.  West Cape News

Health officials in Chile are concerned that only 600,000 of a hoped-for 4 million people have received the H1N1 vaccine in a country that saw 300,000 cases and 1,800 hospitalizations last year.  And this year a Feb 27 earthquake destroyed 5,000 hospital beds in the central region.  One university faculty member explained that getting the shot early is essential to prevent overloading of hospitals, because immunity takes about 2 weeks to build.  Santiago Times

The next update will be on Thursday, April 15th, 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 April 4, 2010

National News

The premature expiry of a batch of adjuvanted H1N1 vaccine has prompted the Alberta government to ask manufacturer GlaxoSmithKline for a refund.  The vaccines were supposed to last for 18 months, based on scientific evidence at the time; however, Health Canada has announced a new expiry date of only six months, after tests found the vaccine’s potency declined after that time period.  Alberta has around 650,000 to 700,000 doses of the affected vaccine, worth $2.2 million.  CBC

International News

U.S. researchers recently presented a study at the American Academy of Neurology’s annual meeting that showed reports of Guillain-Barré Syndrome associated with H1N1 vaccination in the U.S. were extremely low.  For every 10 million H1N1 vaccinations administered in the U.S. last year, officials received about six reports of people developing Guillain-Barré Syndrome, a rare neurological disorder.  But memories of problems during a 1976 immunization campaign and public anxiety during last year’s H1N1 pandemic stoked fears that mass inoculation using a new vaccine would result in a rash of serious side effects, health problems and even deaths.  Now that the peak of the pandemic has passed and researchers are looking back at the response, signs indicate many of those public fears were exaggerated, or even unfounded.  Globe and Mail

The American College Health Association (ACHA) has said that flu activity at U.S. colleges has dropped to its lowest level since August when surveillance began.  The increases seen in southeastern states in February and March are also easing.  The attack rate last week was 1 case per 10,000 students, a decrease of 38% from the previous week.  No hospitalizations or deaths were reported, and the ACHA saw no evidence of sustained transmission. Vaccine uptake held at 8%, where it has been for several weeks.  ACHA

A laboratory in Namibia recently confirmed the country’s first pandemic H1N1 case, a patient who had traveled with a group to Thailand.  The illness is also suspected in a second patient who was with the group.  Namibia’s health minister expressed disappointment that the finding was first reported in the media before the case was reported to health officials.  The country expects to launch its vaccine campaign in May with 220,000 doses from the WHO.  Nambian

News from Global Consulting and Global Medical Services

The Situation is Changing and so is the Blog

When we started this blog in 2009, we wanted to help people educate themselves about pandemic influenza.  As the journal approaches its first birthday (coming in April), the writing staff has looked back over a lot of stories covered this past year: from the first Canadian outbreaks in B.C. and Nova Scotia, through the public response and media coverage, to the controversy of a fast-tracked vaccine and the receding of the pandemic tide.  We’ve also taken a look ahead to try and catch a glimpse of what the future of H1N1 may hold.

Flu season is approaching in the southern hemisphere, as people there brace against the risk of a second pandemic wave.  But this year they have a vaccine to break the wave if it comes.  Outbreaks threaten in Eastern Europe, Sub-Saharan Africa and elsewhere as H1N1 continues to circulate, but not as aggressively as we saw in October.  The pandemic seems to be winding down. The virus may integrate into the regular flu cycle and become another feature of the seasonal influenza landscape.  For now, the risk has diminished.

At Global Consulting, we believe that some element of risk is inherent in life.  This is nothing to live in fear of.  At a personal level, life is risky and welcome to it.  On a larger scale, societal risk is unavoidable.  When we can rise to these challenges – if we are prepared – they make us better able to care for ourselves and those around us.  They can be opportunities for each of us to more fully realise our potential.

Global Consulting has

guarded against many more threats than H1N1.  We want to take this opportunity to widen the blog’s focus and offer you a more complete picture of what we do.  We’d like to invite you along to explore the latest developments around the world and some of the projects we’re working on in the fields of medical education, emergency medical care and emergency preparedness.  And of course, we’ll continue to keep an eye on H1N1 resurgence as we examine some of the indirect repercussions of the pandemic.

Stay tuned.

National News

Canadians trust their doctors, and have high expectations

At crunch-time, Canadians trust their public health officials to make tough decisions according to a poll conducted by the University of Toronto Joint Centre for Bioethics.  The poll processed telephone responses from almost 560 random participants across the country. Other findings included strong support for the obligation of health care workers to accept facing elevated risks during a pandemic, and for Canada’s provision of assistance to poorer countries even if the assistance reduces resources for Canadians.  BioMed Central

International News

CDC reports H1N1 moves slowly except through children

A new study from the American Centers for Disease Control and Prevention has released a study that finds the H1N1 virus spreads more slowly than the seasonal flu, and that this particular influenza strain disproportionately affects children who go on to further transmit the virus.  This last finding is in line with another study we reported on earlier.  The full report will be published in the April edition of the Journal of Emerging Infectious Diseases.  BusinessWeek

Influenza B may be beginning to displace H1N1

Some East Asian and African nations are reporting increased Influenza B activity to the point where the virus is crowding out the pandemic H1N1 strain.  Surveillance information from the World Health Organization reports that Influenza B circulation is moving westward through Russia and Sweden.  Both countries say that the virus is now co-circulating with H1N1. Influenza B viruses in general cause less severe disease than influenza A, such as H1N1, and are associated illnesses in younger people.  University of Minnesota CIDRAP

CBC News

The United Nations will rush supplies and support to Chile to help deal with the aftermath of last Saturday’s earthquake, a UN spokeswoman says.

The 8.8-magnitude earthquake killed more than 700 people and damaged at least 500,000 homes, Chilean officials said.

UN humanitarian spokeswoman Elisabeth Byrs told the Associated Press that Chile made an official request for assistance Monday, two days after the quake struck about 325 kilometres south of the capital, Santiago.

In Santiago, people started returning to work Monday, but schools were closed. Meanwhile, rescue crews in Concepcion — a city about 115 kilometres from the epicentre of Saturday’s quake — were still searching for survivors.

Officials across Chile have struggled to assess the damage caused by the massive earthquake and the more than 100 aftershocks that have rumbled through the country since Saturday.

On Sunday, President Michelle Bachelet said Chile needs field hospitals and temporary bridges, water purification plants and damage assessment experts — as well as rescuers to help relieve exhausted workers.

“We are confronting an emergency without parallel in Chile’s history,” Bachelet said.

Thousands of people have been forced to move out of their homes into tents set up in parks and on grassy highway medians.

Read more at CBC.

Pneumonia is worse when mixed with H1N1

Researchers at the University of Chicago have discovered that the pandemic H1N1 flu virus has the intrinsic ability to cause more severe pneumonia than seasonal H1N1 flu. This ability is a measure of a flu virus’s pandemic potential. They found pandemic H1N1 caused a pneumonia in certain patients that was intermediate in severity between seasonal H1N1 and the highly pathogenic H5N1. University of Chicago Journal of Infectious Diseases

H1N1 Evolution

Scientists at the University of Hong Kong have isolated the first reported genetic reassortment of the H1N1 virus. The reassortment is a hybrid of the original swine flu and the human pandemic H1N1 virus. Reassortments occur when a single host is infected by more than one strain of virus, and the mixed virus particles assemble themselves into something new. The Chinese Department of Agriculture released a statement saying that the new virus does not pose a public health risk or food-safety issue. University of Minnesota CIDRAP

H1N1 Adds Risk to Pregnancy

An Australian study has found that pregnant women can be particularly vulnerable to H1N1 especially if the mothers are asthmatic, diabetic, or obese. However, effects of H1N1 on the fetus are less well understood. Doctors recommend flu shots for pregnant women, but many women are reluctant to receive immunizations or take drugs during pregnancy. The researchers note there is evidence that doctors’ lack of awareness may be “a major contributor, with good acceptance by mothers when the risks and benefits are explained.” Reuters