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Hospitals are no longer carrying out tests for H1N1, even though the flu strain is still turning up in the Emirates. Medical experts say it is now considered no more dangerous than regular strains of seasonal influenza.

H1N1 has now become the dominant strain of seasonal flu in the Middle East, accounting for 30 to 70 per cent of flu-like infections in the region, according to the World Health Organisation (WHO).

"We are not testing everyone for H1N1," said Dr Ali Al Marzouqi, the head of public health and safety at the Dubai Health Authority. "We are giving them the same medication as everyone else.

"Sometimes we are just advising them to take a rest and a few days off work."

According to a paper published in this month's edition of the journal Emerging Infectious Diseases, 26 people died and there were 934 confirmed infections in the UAE during the height of the H1N1 crisis in 2009-2010.

The paper, published by Health Authority Abu Dhabi (HAAD) officials, reported that there was a sharp decline in the number of H1N1 cases from the beginning of last year.

The decline can be attributed to a decision to abandon a rigorous testing regime, said the report's co-author, Dr Jamal al Mutawa, the section head of communicable diseases at HAAD.

"At the start we felt we should test every case," he said. "That's why the numbers accumulated. But we found that it was not practical, so by the end we stopped doing that."

Those who developed complications from H1N1 were most likely to have had underlying medical conditions, such as diabetes or hypertension, he added.



Pregnant women in particular were found to be vulnerable, with six pregnant women among those who died.

The figure of 934 confirmed infections might be only a fraction of the total number of infections across the country, said Dr Rayhan Hashmey, the head of the Division of Infectious Diseases at Tawam Hospital in Al Ain.

"It could be that 90 per cent of the people who had H1N1 weren't diagnosed," he said. "The number of infections could have been as high as 90,000 people."

He said that H1N1 was a common type of flu in his hospital. Only in severe cases do staff test for the disease, he said.

The change comes six months after the WHO formally declared an end to the H1N1 pandemic.

Kristen Kelleher, a spokeswoman for the organisation, said that attitudes toward the virus in the Emirates reflected global sentiment.

"In general, H1N1 is acting as a seasonal influenza now," she said.



Shortly after declaring an end to the pandemic, WHO issued a notice advising governments to adopt close surveillance of emerging viruses. While neighbouring countries such as Oman and Kuwait have national referral laboratories capable of doing this sort of work, the UAE has no such institution. HAAD has since entered discussions about setting up a limited surveillance programme, he said. "We would prefer that there [be] a public health referral laboratory," he said. "We hope that in the future we can get one."

That was a view shared by Dr Mansour al Zarouni, the chairman of infection control at Al Qassimi Hospital in Sharjah.

"It's necessary for the prevention of any outbreak of other infectious diseases," he said. "Not only new forms of influenza, but diseases which are more dangerous, like tuberculosis.

"Without this thing we are working blind. We cannot wait and see what other countries will do."

mcroucher@thenational.ae

http://www.thenational.ae/news/uae-news ... er-flu-bug

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www.twitter.com/hniman

Yes, H1N1 is now a seasonal influenza virus.

Europe has almost passed the peak of the first post-pandemic H1N1 wave and there weren't reports of severe impact on the health care systems in general, excepting some weeks in the U.K (Only some parts of the country), but most of those cases were mild as in 2009.

We can see Asia and North Africa where they are experiencing a mild-moderate flu season and in most cases the peak has been reached. No severe impacts on the health care system were reported. Excepting for some days in Israel where a high bed occupancy was seen, but in general terms Israel has seen a mild flu season, both in morbidity and mortality.

H1N1 also commonly known as swine flu is now evolving as a seasonal virus, so we don't need to worry about potential internationally catastrophic outcomes (H1N1), anymore. People have gained enough immunity to prevent significant outbreaks in the population. We might see some significant outbreak locally with no major impact in the world.

We have been very cautious some months after the announcement of the end of the pandemic and the results make it very clear; the pandemic has largely run its course and it will not have any major impact on the world's health.

Governments must continue with routinary surveillance as they do in regular flu seasons.






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WHO recommendations to health authorities during the post-pandemic period

Monitoring of respiratory disease activity

WHO recommends that surveillance during the post-pandemic period include:

monitoring for unusual events, such as clusters of severe respiratory illness or death;

investigating severe or unusual cases, clusters or outbreaks to facilitate rapid identification of important changes in the epidemiology or severity of influenza;

maintaining routine surveillance, including for influenza-like illness and cases of severe acute respiratory infections;

continuing to use routine channels of data transmission, such as FluID, FluNet, and EUROFlu, to transmit data from the routine surveillance of respiratory disease;

notifying WHO (including, where appropriate, notifications under the International Health Regulations) immediately if any of the following changes are detected:

sustained transmission of antiviral-resistant H1N1 2009 influenza
human cases of infection with any influenza virus not currently circulating in human populations

any notable changes in the severity or other epidemiological or clinical characteristics of the H1N1 2009 virus, including changes in the age distribution, the clinical appearance, proportion of cases requiring intensive management, or unexpected increases in numbers of cases.

monitoring the H1N1 2009 virus for important genetic, antigenic or functional changes, such as antiviral drug sensitivity

Read more (WHO recommendations): http://www.who.int/csr/disease/swineflu ... index.html

Thank you!