Regional Update. Pandemic (H1N1) 2009. (published on August 7, 2009)

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This report was prepared based on the indicators in the document Human infection with pandemic (H1N1)2009 virus: updated interim WHO guidance on global surveillance available at this link.

The qualitative indicators for surveillance of the Pandemic (H1N1) 2009 are described in Table 3 of this report. The information presented herein has been obtained through the official sites of the Ministries of Health of the countries in the Region as well as official reports submitted by the International Health Regulation (IHR) National Focal Points.

Update on the Qualitative Indicators

For epidemiological week 30 (EW 30, July 26 to August 1) 16 countries have reported updated information to the Pan American Health Organization (PAHO) regarding the qualitative indicators to monitor the pandemic (H1N1) 2009 . Data from the most recent week of notification is considered for the purposes of the analysis below (EW 27 – 30).

Currently, 22 countries in the Region report having widespread geographical distribution of the pandemic (H1N1) 2009 virus. Three more countries (Colombia, Panama and Saint Lucia) have been added to this group during EW 30 Dominica reports no pandemic (H1N1) 2009 activity during EW 30 (Map 1).

Regarding the trend of respiratory disease, seven countries report an increasing trend, namely Belize, Bolivia, Guatemala, Haiti, Paraguay, Peru, and Saint Lucia. From these countries, Saint Lucia is the only country which reported a change in trend when comparing with the previous epidemiological week (Map 2).

Regarding the intensity of acute respiratory disease, seven countries (Argentina, Canada, Cuba, El Salvador, Guatemala, Mexico, and Paraguay) inform having high intensity when comparing to the same period in previous years. The number of countries reporting high intensity remains the same as last epidemiological week.

Argentina and El Salvador have reported a change from very high to high intensity; while Chile and Uruguay have changed from high to low/moderate intensity (Map 3).

No countries report severe impact on health-care services, however, 7 countries (Argentina, Bolivia, Cuba, Ecuador, El Salvador, Guatemala and Paraguay) reported experiencing moderate impact and fifteen inform low impact on health care services (Map 4).

Of all 35 countries of the Region, Guatemala and Paraguay inform having higher levels of the qualitative indicators this week, with widespread geographic distribution, increasing trend, high intensity and moderate impact.

Conversely, El Salvador reports experiencing a lower category for trend, intensity and impact on health care services. Similarly, Chile and Uruguay lowered their indicators for intensity and impact on health care services.

The World Health Organization (WHO) does not recommend any restrictions to travel or the closing of borders due to pandemic (H1N1) 2009.

Update on the number of cases and deaths

As of August 7, 2009, a total of 102,905 confirmed cases have been notified in all 35 countries in the Americas Region. A total of 1,274 deaths have been detected among the confirmed cases in 20 countries of the Region.

In addition to the figures displayed in Table 2, The following overseas territories have confirmed cases of pandemic (H1N1) 2009: American Samoa, U.S. Territory (8); Guam, U.S. Territory (1); Puerto Rico, U.S. Territory (20); Virgin Islands, U.S. Territory (49); Bermuda, UK Overseas Territory (1); Cayman Islands, UK Overseas Territory (14); British Virgin Islands, UK

Overseas Territory (2); Turks and Caicos Islands (3); Martinique, French Overseas Community (15); Guadeloupe, French Overseas Community (11); Saint-Martin, French Overseas Community (1); Netherlands Antilles, Aruba (13); Netherlands Antilles, Bonaire (27); Netherlands Antilles, Curaçao (39)[1]; Netherlands Antilles, St. Eustatius (1); and Netherlands Antilles, St. Maarten (14).

The distribution of cases and deaths at the first sub-national level can be found in the interactive map available through the following link: http://new.paho.org/hq/images/atlas/en/atlas.html

Update on the Virologic Situation

Virological data obtained from Ministry of Health websites, from Ministry of Health reports sent to PAHO and notifications from National Influenza Centers (NICs) is included below.

For the purposes of this analysis, only countries that differentiated between sub-typed influenza A results were selected. We excluded from the calculations of the percentages results from samples of influenza that were not subtyped or were un-subtypeable.

Virological information for countries that provided that level of detail is included below in Table 3.

Among viruses that were subtyped as influenza A (seasonal H1, H3 or pandemic (H1N1) 2009), the predominant virus is pandemic (H1N1) 2009. Nevertheless, in Colombia there still appears to be circulation of seasonal influenza A viruses (28.3% H1 and 30.4% H3).

Geographical spread: refers to the number and distribution of sites reporting influenza activity.
No activity:	no laboratory confirmed case(s) of influenza, or evidence of increased or unusual respiratory disease activity.
Localized:	limited to one administrative unit of the country (or reporting site) only.
Regional:	appearing in multiple but <50% of the administrative units of the country (or reporting sites).
Widespread:	appearing in ≥50% of the administrative units of the country (or reporting sites).
No information available:	No information available for the previous 1 week period.
Trend of respiratory disease activity compared to the previous week:refers to changes in the level of respiratory disease activity compared with the previous week.
Increasing:	evidence that the level of respiratory disease activity is increasing compared with the previous week.
Unchanged:	evidence that the level of respiratory disease activity is unchanged compared with the previous week.
Decreasing:	evidence that the level of respiratory disease activity is decreasing compared with the previous week.
Generalizada:	Occurring in ≥ 50% of the administrative units in the country(or reporting sites)
No information available.
Intensity of Acute Respiratory Disease in the Population: is an estimate of the proportion of the population with acute respiratory disease, covering the spectrum of disease from influenza‐like illness to pneumonia.
Low or moderate:	a normal or slightly increased proportion of the population is currently affected by respiratory illness.
High:	a large proportion of the population is currently affected by respiratory illness.
Very high:	a very large proportion of the population is currently affected by respiratory illness.
No information available.
Impact on Health-Care Services: refers to the degree of disruption of health‐care services as a result of acute respiratory disease.
Low:	demands on health-care services are not above usual levels.
Moderate:	demands on health-care services are above the usual demand levels but still below the maximum capacity of those services.
Severe:	demands on health care services exceed the capacity of those services.
No information available.

The data and information in this report will be updated on a weekly basis and available here.

This report was prepared based on the indicators in the document Human infection with pandemic (H1N1) 2009 virus: updated interim WHO guidance on global surveillance available here.

The information presented herein has been obtained through the official sites of the Ministries of Health of the countries in the Region as well as official reports submitted by the International Health Regulation (2005) National Focal Points.

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icon Regional Update. Pandemic (H1N1) 2009. (published on August 7, 2009)

Last Updated on Tuesday, 02 March 2010 05:38