Pandemic (H1N1) 2009 - Update #84 from WHO

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http://www.who.int/csr/don/2010_01_22/en/index.html

Pandemic flu on the wane in the Americas, still ongoing in eastern Europe, and Asia. Looks like very little seasonal flu, with only the sporadic detection of Type A H3N2, but Type A seasonal H1N1 and Type B are not mentioned in this report at all.

Are they looking for seasonal flu particularly Type A? Absolutely, yes. We do need to know if novel H1N1 has displaced the two seasonal Type A influenzas, H3N2 and H1N1. That information will be important to determine the next flu vaccines needed.

The overall situation in largely unchanged since last week. The most intense transmission of pandemic influenza virus continues to occur in North Africa, South Asia, and in limited areas of Eastern Europe. Overall pandemic influenza activity in the temperate northern hemisphere peaked between late October and late November 2009 and has continued to decline since.

In North Africa, limited data suggest that transmission of pandemic influenza virus remains geographically widespread and active throughout the region, but has likely recently peaked in most places. During early January 2010 only the Libyan Arab Jamahiriya reported an increasing trend in respiratory diseases activity. Egypt is now reporting a declining trend after increases in respiratory diseases activity throughout December 2009, suggesting a recent peak in activity during early January 2010. In West Asia, limited data suggests pandemic influenza virus transmission remains geographically widespread however overall activity has been declining in most places during December and January.

In South Asia, active transmission of pandemic influenza virus persists in the northern and western parts of the subcontinent, however overall activity has recently peaked. In India, influenza activity has been largely confined to the northern and western states; activity in the northern states peaked during mid December 2009 and in the western states during early January 2010. In Nepal, active transmission of virus persists, and the trend in respiratory diseases activity remains unchanged since the previous week after reporting continuous increases in activity since late October 2009.

In Europe, pandemic influenza virus transmission remains geographically widespread across parts of western, central, and southeastern Europe, however overall influenza activity continued to decline or remain low in most countries. The areas of most intense transmission currently include Poland, Austria, Estonia, Romania, Hungary, and Moldova; however, in all but Romania, ILI activity has declined significantly since peaking in November. The overall rate of specimens testing positive for influenza fell to 20% in Europe after reaching a peak of 45% during early November 2009. Pandemic H1N1 2009 virus continues to be predominant circulating influenza virus in the European region with only sporadic detections of seasonal influenza viruses.

In East Asia, pandemic influenza activity remains widespread but continues to decline in most places. Mongolia reported a very high intensity of respiratory diseases during early January 2010; rates of ILI have been elevated above expected seasonal levels since late October 2009 but are well below a significant peak of activity observed during November 2009. In Japan, overall influenza activity continued to decline since peaking at the end of November 2009, however regional increases in activity were observed during late December on the southern island of Okinawa. In China, Hong Kong SAR, and Chinese Taipei pandemic influenza activity remains widespread but continues to decline or remain stable. Pandemic H1N1 continues to be the predominant circulating virus in the region but seasonal H3N2 viruses continue to circulate in very small numbers in northern China.

In the Americas, both in the tropical and northern temperate zones, overall pandemic influenza activity continued to decline or remain low in most places.

In temperate regions of the southern hemisphere, sporadic cases of pandemic influenza continued to be reported without evidence of sustained community transmission.

I have been wondering if anyone has introduced vaccine into camps in the earthquake zone. A lot of countries say they have more than they need. People in refuge camps are sitting ducks for this sort of thing.

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