INFLUENZA (32): PAN AMERICAN HEALTH ORGANIZATION ALERT
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A ProMED-mail post
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International Society for Infectious Diseases
<http://www.isid.org>
Date: Wed 20 Apr 2011
Source: PAHO Epidemiological Alert [edited]
<http://new.paho.org/hq/index.php?option=com_content&task=view&id=5291&Itemid=1091&lang=en>
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. 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. Considering the
possibility of outbreaks 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.
Current situation
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There have been outbreaks in Ecuador (January 2011), Mexico and
Venezuela (March 2011). In the past 3 weeks, 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 [2010-2011] 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.
Implementing the recommended measurements of the national preparation
plan for prevention of an influenza pandemic:
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- 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 the public 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. Hand washing 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
and persons suffering from chronic conditions, especially lung and
heart related. These patients should be treated with antivirals (i.e.
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 necessary. The sooner oseltamivir is
administered, the greater the chance of success.
For technical information on influenza, access the following link:
<http://new.paho.org/hq/index.php?option=com_content&task=view&id=3353&Itemid=2470&to=2250&lang=en>.
--
Communicated by:
ProMED-mail <promed@promedmail.org>
[It seems likely that influenza virus (H1N1) 2009 virus infection
will predominate in the impending winter influenza epidemic in the
southern hemisphere and that the currently available influenza vaccine
will be adequate for control of the epidemic. - Mod.CP]
[see also:
Influenza (31): Europe update 20110420.1235
Influenza (29): WHO update 20110408.1104]
.................................................cp/msp/jw
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