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| |  Influenza A (H1N1) Updates: New Cases; Vaccine in Development WASHINGTON, DC -- May 1, 2009 -- Preparation to develop a vaccine against influenza A (H1N1) "should proceed" and is underway, Marie-Paule Kieny, PhD, Director of the World Health Organization Initiative for Vaccine Research, said today. It is too much of a public health "gamble" to wait and see how severe the outbreak becomes, she said, adding that the vaccine would be available in 4 to 6 months. Meanwhile, the number of confirmed cases increased today as more US states and more countries confirmed their first cases. In the United States, 8 more states confirmed influenza A (H1N1) cases, bringing the US total to 141, according to the Centers for Disease Control and Prevention (CDC). The newly affected states are Colorado (2), Delaware (4), Illinois (3), Kentucky (1), Minnesota (1), Nebraska (1), New Jersey (5), and Virginia (2). The other affected states are: Arizona (4), California (13), Indiana (3), Kansas (2), Michigan (2), Nevada (1), New York (50), Ohio (1), South Carolina (16), and Texas (28). The CDC continues to take aggressive action to respond to the expanding outbreak caused by influenza A (H1N1). According to the World Health Organization (WHO), Mexico has reported 156 confirmed cases, including 9 deaths. This counters the 312 confirmed cases and 12 deaths reported by the European Centre for Disease Prevention and Control (ECDC), today. According to the ECDC, the Ministry of Health in Mexico confirmed the higher number of cases and deaths. Canada confirmed 15 more cases, today, which brings the total number of cases in Canada to 34 with 11 cases in British Columbia, 6 in Alberta, 8 in Ontario, 1 in Quebec, and 8 in Nova Scotia. Health Canada reports that all cases are the same strain of influenza A (H1N1) virus that has been found in the United States and Mexico, and that all of the confirmed cases, to date, have been mild. Four other countries reported their first confirmed case of influenza A (H1N1): China, Hong Kong, Special Administrative Region (1), Denmark (1), The Netherlands (1), and Switzerland (1). The 6 other countries affected include: Austria (1), Germany (5), Israel (2), New Zealand (4), Spain (13), and United Kingdom (15). According to the ECDC, the number of confirmed cases in New Zealand has decreased from the 16 reported yesterday to 4 confirmed and 12 probable. Probable cases also have been reported in France (2), Ireland (1), Lithuania (1), and the United Kingdom (2). ECDC reports that Peru and Costa Rica have been removed from the list of affected countries, pending validation of the previously reported cases. In the European Union (EU) and European Economic Area (EEA)/European Free Trade Association (EFTA) countries, all confirmed cases have a history of travel to Mexico, except for 1 case in Spain, where transmission may have occurred within the household from a person who travelled to Mexico. Based on information from 13 of the 27 confirmed cases in the EU/EEA/EFTA area, the age range of those affected is 3 to 41 years. Both males and females are equally affected. ECDC confirms that the clinical presentation of cases in the EU and EEA/EFTA countries continues to be mild. Most cases are adults younger than 50 years of age, probably reflecting the age profile of people travelling to Mexico. Hence, the ECDC says that "it is premature to characterise this epidemic in terms of attack rate and age distribution in Europe, on the basis of such few cases among returning travellers." There is no evidence of sustained human-to-human transmission in the EU or EEA/EFTA countries to date. However, at a press briefing today, Prof. Angus Nicoll, Head of ECDC's Influenza Programme, estimated that at least 50% of Europeans would become infected. Of those, 25% to 35% would present with symptoms, and only 4% would require hospitalisation. These estimations are based on what is known about other influenza viruses, explained Prof. Nicoll. Until sustained human-to-human transmission is demonstrated outside the United States and Mexico, the WHO pandemic alert level will likely remain at phase 5. WHO continues to advise against regular travel restrictions and border closures. Instead, WHO is encouraging people who are ill to delay international travel and those who develop symptoms following international travel to seek medical attention. The CDC also encourages people who are sick "to stay home from work or school and to avoid contact with others, except to seek medical care." In response to the rapidly evolving situation in the United States, CDC continues to issue and update interim guidance daily. Today, CDC provided interim guidance on school closures. Supplies from CDC's Division of the Strategic National Stockpile (SNS) are being sent to all 50 states and US territories to help them respond to the outbreak. In addition, the US government and manufacturers have begun the process of developing a vaccine against this new virus. CDC notes that while response actions are aggressive, "they may vary across states and communities depending on local circumstances. Communities, businesses, places of worship, schools and individuals can all take action to slow the spread of this outbreak."
SOURCES: Centers for Disease Control and Prevention, European Centres for Disease Prevention and Control, Health Canada, World Health Organization
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