WASHINGTON, DC -- April 28, 2009 -- Confirmed cases of A/H1N1 influenza infection have now been confirmed in Israel and New Zealand, bringing the total number of affected countries to 7. Mexico remains the only country with confirmed deaths related to this new strain of influenza, which is also commonly called swine influenza.
Israel has confirmed 1 case, and New Zealand has confirmed 3 cases. The other countries affected include Canada (13 cases), Mexico (26), Scotland (2), Spain (2), and the United States (64). In Mexico, 7 deaths related to A/H1N1 have been confirmed, though more are suspected.
Most cases outside of Mexico appear to be benign, many resolving without treatment; nonetheless, health officials around the world have been warning the situation could change very quickly.
In response to the 7 new cases reported in Canada today, Minister of Health Leona Aglukkaq said: "Today's new cases were anticipated by public health officials, and they do not change our course of action. We recognise that the Canadian cases have been mild to date, but we are taking this situation very seriously."
Richard Besser, MD, acting director of the Centers for Disease Control (CDC), Atlanta, Georgia, echoed these sentiments at a press briefing today. "We are dealing with a new strain of influenza. We are very concerned, and we are acting very aggressively. … We fully expect we will see deaths in the United States."
The tally of confirmed cases in the United States jumped to 64 today, largely due to more cases confirmed in New York. All cases remain in the 5 states originally affected: California (10 cases), Kansas (2), New York (45), Ohio (1), and Texas (6). An additional 4 cases have been reported -- all pending CDC confirmation -- bringing the US total to 68.
Monday, the Director-General of the World Health Organization (WHO) raised the influenza pandemic alert from phase 3 to phase 4, indicating the likelihood of a pandemic is increased, though not inevitable. WHO based their decision on the available data on confirmed outbreaks of A/H1N1 influenza in the United States, Mexico, and Canada. The Committee also considered reports of possible spread to additional countries.
Around the world, health agencies are acting very aggressively to mitigate the outbreak. "Containment is not feasible," said Dr. Besser, explaining that the A/H1N1 influenza outbreaks are "diffuse and widespread."
That said, WHO has not issued any travel restrictions or border closures; however, the agency recommends people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention.
The A/H1N1 virus is susceptible to the prescription antiviral drugs oseltamivir and zanamivir. According to Anne Schuchat, MD, the CDC's Interim Deputy Director for Science and Public Health Program, treatment should begin within 48 hours of onset. However, she stressed that many of the US cases have recovered without treatment.
No vaccine for this strain of influenza is available, and development of the vaccine for seasonal influenza is ongoing. When asked if the A/H1N1 strain could be added to the seasonal vaccine under development, Dr. Besser said that solution would be attractive. "If possible, it would be great," he said in today's media briefing, "but seasonal flu production is moving along and we don't want to delay it." As an alternative, the CDC is investigating how long it would take to develop a monovalent vaccine for this particular strain.
SOURCES: Center for Disease Control and Prevention, Health Canada, European Centre for Disease Prevention and Control
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