WHO Moves to Pandemic Alert Level 6

Following a meeting of the WHO Emergency Committee this morning, the decision was taken to raise the Pandemic Alert level to level 6 for the first time in 41 years.

Director General, Margaret Chan, explained that Influenza A(H1N1) is significantly different from seasonal flu in that it preferentially infects people with a mean age <25 years. Two percent of cases result in severe illness and a progression to pneumonia. These cases tend to be adults between 30-50 years of age. One-third to one-half of cases occur in previously healthy people though, some underlying health conditions do present additional risk (e.g. respiratory diseases, cardiovascular disease, autoimmune disorders, diabetes and obesity).

Dr. Chan said the move to level 6 does not indicate an increase in severity, but rather reflects sustained transmission (not simply due to travel related cases) globally and the need for countries to activate their pandemic plans. She cautioned that we need to be vigilant in tracking the virus in the developing world where differences in surveillance, underlying health conditions and available medical care may mean the virus will take a trajectory different to that we have witnessed thus far. At this time, the WHO is not recommending any travel restrictions or border closures.

A link to Dr. Chan's statement: http://www.who.int/mediacentre/news/statements/2009/h1n1_pandemic_phase6_20090611/en/index.html

With 25 new cases confirmed today, the UK case count now totals 822. England - 502, Scotland - 311, Northern Ireland - 7, Wales - 2

UK Case Count Continues to Climb

My skill with alliterative post titles aside, the A(H1N1) case count is continuing to climb steadily here in the UK. Specifically, there are now 750 confirmed cases with a further 607 possible cases currently under investigation. According to the HPA confirmed case numbers, that is 264 new cases in 5 days (see our post from Friday, 5 June).
http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1244617876260?p=1231252394302
5 schools are closed in England and a further 5 are closed in Scotland.
http://news.bbc.co.uk/2/hi/uk_news/8093665.stm

Australian Four-Fold Increase May Tip WHO Pandemic Balance

In the last week, Australia has seen a four-fold increase in cases of A(H1N1) influenza (greater than 1200 confirmed cases). Taken together with the number of cases in North America, the WHO are seriously considering a move to level 6 in their Pandemic Alert system. (http://www.who.int/csr/disease/avian_influenza/phase/en/index.html)
The Southern Hemisphere is currently experiencing it's Autumn/Winter 'flu season' and the Australian cases are largely concentrated in Victoria and Melbourne.
The WHO will hold a conference call with governments tomorrow before deciding whether or not to change the pandemic alert level.
http://news.bbc.co.uk/2/hi/asia-pacific/8092474.stm

Hospitals Missing True Extent of Swine Flu

Speaking at the Cheltenham Science Festival last Friday, Centre Director Neil Ferguson told the audience of his concern that the true extent of Influenza A(H1N1) was being missed due to current surveillance strategies. He suggested that the UK would benefit from a shift to testing young adults hospitalised with respiratory disease. This is currently the surveillance model employed in the US where the outbreak is more advanced.
Read the article in The Times summarising Prof. Ferguson's talk here:
http://www.timesonline.co.uk/tol/life_and_style/health/article6450267.ece
And further commentary on the point of underestimation by Professor Hugh Pennington of Aberdeen University in Scotland:
http://news.bbc.co.uk/1/hi/uk/8087213.stm

A(H1N1) gets a foothold in Scotland

A last minute update from the BBC...
http://news.bbc.co.uk/1/hi/scotland/8086128.stm
Scottish confirmed case number reaches 41, including 2 doctors at the Royal Alexandra Hospital in Paisley.

UK Confirmed A(H1N1) Case Count Nears 500

According the the HPA , the total number of confirmed Influenza A(H1N1) cases in the UK has risen to 486 with 27 new cases recorded today.
http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1244188831739?p=1231252394302

The CDC in Atlanta reported a total of 13,217 probable and confirmed cases and 27 deaths in 52 states (including the District of Columbia and Puerto Rico). Puerto Rico is newly mentioned as there is now 1 confirmed case there.
http://www.cdc.gov/h1n1flu/update.htm
These figures are are up sharply from Monday's estimate with 3,164 new probable and confirmed cases and 10 additional deaths.

Globally, the situation looks like this:
http://www.who.int/csr/don/Map_20090605_1000.png
According to the WHO, the cumulative total of global confirmed cases is 21, 940 with 125 deaths.
http://www.who.int/csr/don/2009_06_05/en/index.html

And finally, my mother would like you all to to know that in my hometown of Livingston, New Jersey, USA, there are 6 confirmed cases of A(H1N1). Three are 16 year old males, 1 is a 12 year old female and 1 is a 46 year old male. Thanks Mom!

Centre Researchers Publish Paper in New England Journal of Medicine

In collaboration with Mark Lipsitch (Harvard Unniversity) and Steven Riley (Univ. of Hong Kong) Centre researchers Neil Ferguson (Director), Azra Ghani and Simon Cauchemez were co-authors on a paper published last week (27 May 09) in the New England Journal of Medicine.
http://content.nejm.org/cgi/content/full/NEJMp0904380
The paper focuses on the the early stages of an influenza pandemic and the challege of balancing the need for answers to guide action with the paucity of data available to inform such decisions. The need for and benefits of international cooperation and collaboration are highlighted.
Nice work, guys!

Swine Flu Spreads Amongst Football Fans

Thirteen new cases (11 from the Dunoon area of Scotland) of A(H1N1) were found amongst Scottish Premier League fans who travelled to Dundee on the 24th of May to watch Glasgow Rangers win the league title. A further 19 cases were confirmed in England and Scotland yesterday taking the UK total to 278.
http://news.bbc.co.uk/1/hi/uk/8077784.stm

As of 11am yesterday (EST), the CDC in Atlanta reported 10,053 confirmed and probable cases and 17 deaths in 51 U.S. states (including the district of Columbia).
http://www.cdc.gov/h1n1flu/update.htm

Confirmed A(H1N1) cases in Australia jumped markedly over the weekend, passing the 400 mark. Oz is now ranked fourth behind the US, Canada, and Mexico in the Swine Flu league table!
http://www.google.com/hostednews/afp/article/ALeqM5iJvQQux5LC30ih-2yfWqikG8iKFg

Confirmed cases of A(H1N1) rise to 705 in Asia-Pacific
http://news.xinhuanet.com/english/2009-06/01/content_11471304.htm

Case Count Rises in Britain

Yesterday, 15 new cases of Influenza A(H1N1) were reported in the UK by the HPA bringing the UK total to 244 cases.

http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1243771211786?p=1231252394302

14 of the new cases are in England and 1 is in Wales.
Two children and 1 adult from the West Midlands are among the new cases and were linked to previous outbreaks.
Of the 8 new cases confirmed in the South East, 6 are travel related and 2 are linked to an on-going school outbreak.