ECDC DAILY UPDATE Pandemic (H1N1) 2009 Update 20 October 2009, 09:00 hours CEST

excerpt:

Updates from U.S.A. and Canada
United States
Update Data as of 16 October 2009, for week ending 10 October 2009 (Week 40)

Virology: 100% of all subtyped influenza A viruses reported to CDC were 2009 influenza A (H1N1) viruses. 99.6% of all specimens were type A and 0.4% were type B. 2009 influenza A (H1N1) viruses continue to be similar to the strain chosen for the vaccine. Since September 1, 2009, four infections with oseltamivir resistant 2009 influenza A (H1N1) viruses have been identified in the United States, and a total of 13 cases have been identified in the U.S. since April 2009 (10 viruses identified by CDC and three viruses identified by additional laboratories).

The 13 cases represent an increase of one case over the previous week. All tested viruses retain their sensitivity to the neuraminidase inhibitor zanamivir. Eleven patients (including nine of the viruses detected at CDC and two viruses identified by the additional laboratories) had documented exposure to oseltamivir treatment or chemoprophylaxis, and the remaining two patients are under investigation to determine exposure to oseltamivir.

Since the emergence of the 2009 influenza A (H1N1), all isolates tested have been resistant to the adamantanes (amantadine and rimantadine). Currently, adamantane antiviral susceptibility testing has been suspended at CDC to allow a focus on neuraminidase inhibitors. Because of the low level of circulation of seasonal influenza A (H1N1), A (H3N2), and influenza B viruses, no samples collected since September 1, 2009 were available for antiviral resistance testing.

Mortality Surveillance:
Pneumonia and Influenza Hospitalization and Deaths: From 30 August – 10 October 2009, 4,958 laboratory-confirmed influenza associated hospitalizations, 292 laboratory-confirmed influenza associated deaths, 15,696 pneumonia and influenza syndrome-based hospitalizations, and 2,029 pneumonia and influenza syndrome-based deaths, were reported to CDC.

Pneumonia and Influenza (P&I) Mortality Surveillance:
During week 40, 6.7% of all deaths reported through the 122-Cities Mortality Reporting System were due to P&I. This percentage was above the epidemic threshold of 6.5% for week 40.

Influenza-associated Pediatric Deaths: Influenza-Associated Pediatric Mortality:
Eleven influenza-associated pediatric deaths were reported to CDC during week 40. Ten of these deaths were associated with 2009 influenza A (H1N1) virus infection and one was associated with an influenza A virus for which the subtype is undetermined. These deaths occurred between 30 August and 10 October 2009. Since 30 August 2009, CDC has received 43 reports of influenza-associated pediatric deaths that occurred during the current influenza season. (A total of 86 deaths in children associated with 2009 H1N1 virus have been reported to CDC.) Among the 43 deaths in children, 28 children had specimens collected for bacterial culture from normally sterile sites and seven (25.0%) of the 28 were positive; Staphylococcus aureus was identified in five (71.4%) of the seven children.

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http://www.nlm.nih.gov/medlineplus/staphylococcalinfections.html

Staphylococcal Infections

Also called: Staph

Staph is short for Staphylococcus, a type of bacteria. There are over 30 types, but Staphylococcus aureus causes most staph infections (pronounced “staff infections”), including

• Skin infections
• Pneumonia
• Food poisoning
• Toxic shock syndrome
• Blood poisoning (bacteremia)

Skin infections are the most common. They can look like pimples or boils. They may be red, swollen and painful, and sometimes have pus or other drainage. They can turn into impetigo, which turns into a crust on the skin, or cellulitis, a swollen, red area of skin that feels hot.

Anyone can get a staph skin infection. You are more likely to get one if you have a cut or scratch, or have contact with a person or surface that has staph bacteria. The best way to prevent staph is to keep hands and wounds clean. Most staph skin infections are easily treated with antibiotics or by draining the infection. Some staph bacteria are resistant to certain antibiotics, making infections harder to treat.