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Since the beginning of 2011, in the region of the Americas, there have been significant outbreaks of influenza A (H1N1) 2009, that while geographically limited, have generated a significant demand on health services.
For instance, there have been outbreaks in Ecuador (January 2011), Mexico and Venezuela (March 2011). In the past three weeks (SE 13-15), the Dominican Republic’s National Influenza Centre has detected an increase in the positive samples of influenza A(H1N1) 2009. In the last month, other sporadic detections have occurred in Cuba, Colombia, Honduras, Jamaica and El Salvador.
This situation is not unexpected. Since the end of the pandemic (2009-2010), the influenza A (H1N1) 2009 virus, continues to circulate on a global level like a seasonal strain, periodically causing important outbreaks in various continents.
In Europe in the winter of 2010-2011 the influenza A (H1N1) 2009 virus was the predominant strain. In some countries the morbidity rate was similar to that observed during the pandemic. On the other hand, in North America where during the pandemic, the transmission of A (H1N1) 2009 was much higher than what was expected, the predominant strains that circulated this winter were influenza A/H3N2 and influenza B.
In the Americas, the level of circulation and the impact caused by the influenza A (H1N1) 2009 virus, during the pandemic varied. In the countries of the Southern Cone and the southern region of Brazil the circulation of the virus was very intense during the pandemic, then resulting in a low detection of the virus during the 2010 winter. In other places of the tropical regions, where the predominance is not as defined, the circulation of the virus was not as intense; consequently, the proportion of the population susceptible is still high and this favors the appearance of geographically limited sporadic outbreaks.
Considering the possibility of an outbreak occurring on account of the influenza A (H1N1) 2009 virus in the countries of the Region, national authorities should be prepared to mitigate the resulting impact. It is recommended that all of the countries activate their National Preparedness Plans for the pandemic and follow the WHO and PAHO recommendations. The PAHO’s Technical Area for Health Surveillance and Disease Prevention and Control is available to offer the necessary technical support as requested. - 1 -
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n light of this situation, PAHO/WHO recommends:
Implementing the recommended measurements of the national preparation plan for prevention of an influenza pandemic.
Implement a risk communication plan to prevent and/or reduce the population’s anxiety. The press has a key role in disseminating information. It is necessary to inform (disseminate) that the large majority of infections are asymptomatic or present non-specific symptoms. Only a fraction of those affected develop a medical case that requires seeking medical assistance. An even smaller fraction develops difficulty breathing which requires hospitalization. Deaths are very infrequent.
The population must be informed that the primary form of transmission is via interpersonal contact. Washing ones hands is the most efficient way to diminish transmission. An understanding of “respiratory hygiene and cough etiquette” also helps to avoid transmission. Persons with fever should avoid going to their workplace or to public places until their fever has disappeared
Certain population groups require special attention because they are more susceptible to developing severe infection: pregnant women, persons suffering from chronic conditions, especially lung and heart related. These patients should be treated with antivirals (oseltamivir) at the onset of symptoms.
All patients admitted for health services with respiratory difficulties should begin treatment with antivirals immediately. Laboratory confirmation is not