A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
In this update:
[1] Europe
[2] Israel
[3] Yemen
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[1] Europe
Date: Thu 16 Dec 2010
Source: Eurosurveillance, Volume 15, Issue 50 [edited]
<http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19753>
The influenza season 2010-11 in Europe has started with increasing
transmission in 11 countries [1]. The currently circulating strains
are predominantly the 2009 pandemic influenza A(H1N1) and influenza B
viruses [1], strains that are included in the current trivalent
seasonal influenza vaccine.
The United Kingdom (UK), so far the most
affected country, has seen a number of outbreaks. Although the
majority of cases in the UK are mild, a significant number of severe
hospitalised cases and several deaths have occurred, some in patients
belonging to risk groups, including pregnant women [2]. This has
resulted in an increased demand for intensive care treatment and
respiratory support including extracorporeal membrane oxygenation
(ECMO). Most patients are under 65 years of age.
In the past, epidemics have most often progressed from west to east in
Europe [3]. There is a rapidly closing window of time during which
public health and clinical interventions can mitigate the impact of
this season's influenza epidemics on morbidity and mortality.
Countries should be prepared for increased demand for healthcare
assistance and promote early sample collection and testing for
patients with influenza-like-illness.
Influenza vaccination with the 2010 trivalent seasonal influenza
vaccine is the most effective prevention measure and is recommended in
particular for those at risk of developing severe disease [4]. There
is strong evidence suggesting that the A(H1N1) component of the
seasonal vaccine will be highly effective against influenza-like
illness caused by the pandemic influenza A(H1N1) virus. Good
protection was achieved as early as 8 days after vaccination [5].
Early use of antiviral drugs for individuals belonging to risk groups
will also be of value. The currently circulating variant can be
expected to be sensitive to oseltamivir and zanamivir, as the old
oseltamivir-resistant influenza A(H1N1) virus has been displaced by
the pandemic strain, and very few viruses so far have been reported as
being resistant [6]. However, isolates should be monitored for the
emergence of antiviral resistance, particularly in immunocompromised
patients.
References
----------
(1) Weekly influenza surveillance overview. Stockholm: European Centre
for Disease Prevention and Control; 10 Dec 2010. Available from:
<http://ecdc.europa.eu/en/publications/Publications/101210_SUR_Weekly_Influenza_Surveillance_Overview.pdf>.
(2) HPA Weekly National Influenza Report - week 49. London: Health
Protection Agency; 9 Dec 2010; Available from:
<http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1287146267647>.
(3) The 2009 A(H1N1) pandemic in Europe. Stockholm: European Centre
for Disease Prevention and Control; 2010; Available from:
<http://www.ecdc.europa.eu/en/publications/Publications/101108_SPR_pandemic_experience.pdf>.
(4) Start of the Influenza season 2010/11 in Europe - severe influenza
cases in the UK. Stockholm: European Centre for Disease Prevention and
Control; 15 Dec 2010. Available from:
<http://www.ecdc.europa.eu/en/activities/sciadvice/Lists/ECDC%20Reviews/ECDC_DispForm.aspx?List=512ff74f-77d4-4ad8-b6d6-bf0f23083f30&ID=987&RootFolder=%2Fen%2Factivities%2Fsciadvice%2FLists%2FECDC%20Reviews>.
(5) Kissling E, Valenciano M, Moren A, Ciancio B. Estimates of
pandemic influenza vaccine effectiveness in Europe, 2009-10: results
of the I-MOVE multicentre case-control study. European Scientific
Conference on Applied Infectious Disease Epidemiology; 2010; Lisbon.
Abs N 43; Available from:
<http://ecdc.europa.eu/en/ESCAIDE/ESCAIDE%20Presentations%20library/ESCAIDE2010_Parallel_Session11_05_Ciancio.pdf>.
(6) Global Alert and Response. Influenza update. Geneva: World Health
Organization; 2 Dec 2010; Available from:
<http://www.who.int/csr/disease/influenza/2010_12_03_GIP_surveillance/en/index.html>.
[Byline: The Influenza Team of the European Centre for Disease
Prevention and Control (ECDC), Stockholm, Sweden]
--
Communicated by:
ProMED-mail <promed@promedmail.org>
******
[2] Israel
Date: Thu 16 Dec 2010
Source: The Jerusalem Post [edited]
<http://www.jpost.com/Headlines/Article.aspx?id=199764>
50 cadets at the IDF's [Israel Defense Force] Officer Training School
-- known as Bahd 1 -- were diagnosed on Thursday [16 Dec 2010] with
swine flu [influenza A/(H1N1) virus infection].
The soldiers, who were staying at Har Gilo for an education seminar,
complained in recent days of flu-like symptoms, and after being tested
were found to all be sick with H1N1, otherwise known as swine flu
[influenza A/(H1N1) virus infection].
The IDF Medical Corps has launched an investigation to locate the
source of the flu in the IDF.
[Byline: Yaakov Lappin]
--
Communicated by:
ProMED-mail <promed@promedmail.org>
[The HealthMap/ProMED-mail interactive map of Israel can be accessed
at <http://healthmap.org/r/00aH>. - Mod.CP]
******
[3] Yemen
Date: Tue 14 De 2010
Source: Yemen Post [edited]
<http://www.yemenpost.net/Detail123456789.aspx?ID=3&SubID=2871&MainCat=3>
New influenza (H1N1) virus infection cases have been detected in
Yemen, raising fears the pandemic could strike again after its end
early this year [2010] was not so clear.
The News Yemen [website] quoted sources at a private hospital as
saying that 9 people were admitted to the hospital and diagnosed with
influenza (H1N1) virus infection in early November [2010]. Four of the
9 have died so far, the website said, but did not publish the name of
the hospital.
The National H1N1 Monitoring and Surveillance Commission said it had
received reports about the cases, adding: "We called the commission,
but it did not confirm or deny H1N1 cases had been detected in the
country."
The hospital contacted the commission over the cases, but it was told
to keep them secret while Yemen was preparing for hosting the 20th
Gulf Soccer Cup, it said.
The commission also visited the infected and supplied the hospital
with necessary medications, the sources were quoted as saying.
[Byline: Yemen Post Staff]
--
Communicated by:
HealthMap Alerts via
ProMED-mail <promed@promedmail.org>
[In the case of the outbreak in Yemen, it is likely that the H1N1
virus detected is the influenza A/(H1N1) 2009 pandemic strain rather
than the previously circulating seasonal H1N1 strain. The final match
of the 20th Gulf Soccer Tournament (between Kuwait and Saudi Arabia)
was held before a crowd of 55 000 fans in Aden on Sun 5 Dec 2010, so,
presumably, the patients had been hospitalised and diagnosed with H1N1
influenza prior to that date, and the information has only now been
released. The HealthMap/ProMED-mail interactive map of Yemen can be
accessed at: <http://healthmap.org/r/01Gk>.
It is clear that the influenza season is now upon us in parts of
Europe and the Middle East and that the predominant virus is the
influenza (H1N1) 2009 strain. It is too soon to assess whether it has
retained its relative virulence, but that should become clear very
shortly. - Mod.CP]
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