InfluenzaA (H1N1) Virus: Spread and Response

Influenza Outbreak in the Americas:Influenza Outbreak in the Americas:

International Cooperation in International Cooperation in Response to the Spread of H1N1 FluResponse to the Spread of H1N1 Flu

5 May 20095 May 2009

Jarbas Barbosa, MD MPH PhDManagerHealth Surveillance and Disease Prevention and ControlPan American Health Organization - PAHO\AMROWorld Health Organization - WHO

• New virus. Population not previously exposed.

• Can infect humans.

• Sustained person-to-person transmission.

Preconditions for a pandemicPreconditions for a pandemicPreconditions for a pandemicPreconditions for a pandemic

Influenza A (H1N1)Influenza A (H1N1)

Influenza A (H1N1)Influenza A (H1N1)

• Sustained transmission in at least 2 countries in the same region (Mexico and U.S.).

• Phase 6 requires sustained transmission in at least 1 country in another region.

• Majority of cases seem to be mild, but need to monitor the virus.

Pandemic Phase 5:Pandemic Phase 5: What does it mean?What does it mean?

Influenza A (H1N1)Influenza A (H1N1)Pandemic Phase 5:Pandemic Phase 5: What does it mean?What does it mean?

Reported cumulative number of confirmed cases of influenza A (H1N1) virus by countries, as of 05 May 2009, 13:00 ET

Number of Cases Reported by the WHO

Countries Confirmed

Cases 1 Deaths

America

Mexico 822 29

United States 403 1

Canada 140 0

El Salvador 2 0

Colombia 1 0

Costa Rica 1 0

Guatemala 1 0

Subtotal 1,370 301 Number of deaths is already included in the number of casesUpdate 14 as of 12:00 GMT, 5 May 2009

Number of Cases Reported by the WHO

1 Number of deaths is already included in the number of casesUpdate 14 as of 12:00 GMT, 5 May 2009

Countries Confirmed

Cases 1 Deaths

Europe

Spain 54 0

United Kingdom 18 0

Germany 8 0

France 4 0

Italy 2 0

Austria 1 0

Ireland 1 0

Denmark 1 0

Netherlands 1 0

Portugal 1 0

Switzerland 1 0

Subtotal 92 0

Number of Cases Reported by the WHO

1 Number of deaths is already included in the number of casesUpdate 14 as of 12:00 GMT, 5 May 2009

Countries Confirmed

Cases 1 Deaths

Rest of the world

Israel 4 0

China (Hong Kong) 1 0

Republic of Korea 1 0

New Zealand 6 0

Subtotal 12 0

Global: 1,474 30

Technical units

WHO Technical Units and other

programmes/sources

Existing information flows, through PWR, technical units, programs and networks are preserved, and technical units participate in Risk Assessment

Event Management Group

• All events are documented and assessed by a joint Event Management Group (EMG)• EMG collects information from all sources in a single forum

IHR Operations

HQ staff

RO staff

MoH

PWR

DGO/RD

Expert Roster

Emergency Committee

IHS

National IHR Focal Point

WHO REGIONAL24/7 Contact

Point

PAHO Regional Contact Point 24/7 Contact Point and NFP ensure that PAHO/WHO can send and receive information at all times

Primary information channel is through the PAHO/WHO Country Office

Influenza A (H1N1)Influenza A (H1N1)

• PAHO is tracking the regional situation and working with WHO in global monitoring and sharing of information.

• Distributing diagnostic kits through Collaborating Centers to National Influenza Centers.

• PAHO has been working with countries since 2004 on pandemic preparedness and on the International Health Regulations.

• PAHO has mobilized 27 experts in Mexico in epidemiology, virology, laboratory analysis, infection control, emergency response, logistics, communication.

• EOC at PAHO Headquarters working 24/7 since April 23..

What is PAHO doing?What is PAHO doing?

Influenza A (H1N1)Influenza A (H1N1)

• Ministers of Health of the Americas convened by PAHO via teleconference on April 28 and May 4 to exchange technical information and address questions.

• WHO is leading the global scientific community to increase knowledge.

• WHO is taking decisions on PHEIC, pandemic phases and recommendations.

• Mobilizing additional resources.

What is PAHO/WHO doing?What is PAHO/WHO doing?

Influenza A (H1N1)Influenza A (H1N1)

• PAHO is deploying a stockpile of oseltamivir (Tamiflu) to countries in the Region. 479,000 doses have been already dispatched.

• PAHO in dialogue with pharmaceutical industry to ensure oseltamivir availability.

AntiviralsAntivirals

Influenza A (H1N1)Influenza A (H1N1)

• PAHO recommends increased uptake of seasonal influenza vaccine in countries using it, and introduction in countries that have not used it before.

• WHO is working with pharmaceutical industry to develop vaccine for new virus and speed production.

VaccinesVaccines

Influenza A (H1N1)Influenza A (H1N1)

• Countries updating and implementing national pandemic preparedness plans.

• Much better prepared than five years ago.

• Step up surveillance and infection control to identify and treat cases and trace contacts.

• Communicate messages on individual and collective public health measures.

• Be on high alert for cases; notify PAHO/WHO under International Health Regulations.

Member States’ responseMember States’ response

Influenza A (H1N1)Influenza A (H1N1)Influenza A (H1N1)Influenza A (H1N1)

• No restrictions on travel and no border closings.

• People who are ill should delay travel. Returning travelers who become ill should seek medical advice.

Travel recommendationsTravel recommendations

Influenza A (H1N1)Influenza A (H1N1)Influenza A (H1N1)Influenza A (H1N1)

• Be aware; get information.

• Take precautions: wash hands, cough and sneeze on tissues or sleeve, stay at home if ill. (Don’t go to work if sick.)

• If you think you have influenza, call first for medical advice.

• You cannot get influenza from any type from eating pork.

• Do not self-medicate. Do not use Tamiflu to prevent illness.

What should people do?What should people do?

Influenza A (H1N1)Influenza A (H1N1)Influenza A (H1N1)Influenza A (H1N1)

Americas Interactive atlas

For updated information on current situation of the influenza A (H1N1) please visit:www.paho.org

www.who.int