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Swine Flu H1N1 grips Indian cities
Swine flu is spreading to all corners of India. Starting from school-going Reeda Sheikh of Pune, half-a-dozen-people, including a four-year-old boy from Chennai and an Ayurvedic doctor from Pune, have succumbed to the disease. There are no effective vaccines to contain the swine flu. The government appears to be clueless on tackling the spread of the disease. People usually get swine influenza from infected pigs. The swine flu virus A (H1N1) spreads in the same way as seasonal influenza – through direct contact (within one metre of an infected person) or indirect contact (touching a contaminated surface). For A-to-Z of the Swine flu phenomenon, read on:
Latest headlines
- Azad slams State CMs for flu deaths
- Flu scare keeps Indian cities on their toes
- Nationwide toll touches 44
- Swine flu vaccine expected in Australia next month
- Death toll rises to 29
- Swine flu inspires new video game
- Despite flu, multiplex biz zooms during weekend
- Dahi Handi celebrations cancelled in Pune
- Teen boy dies in Raipur, toll mounts to 24
- Swine flu prompts low-key 'Dahi Handi' celebrations
- PM says don't panic
- Biz travelling not impacted by swine flu: Nasscom
- Delhi allows private hospitals to treat flu patients
- Modi wants involvement of private hospitals
- Baba Ramdev prescribes yoga as cure!
- Janmashtami sans 'dahi-handi' for Shiv Sena
- Mumbai schools to be closed for 7 days
- Toll rises to 15; 2 critical in Delhi hospital
- District authorities put on alert in Kerala
- Contact tracing can control spread of flu: Official
- Pune: 35 year old man 12th Swine Flu victim
- 11th Swine Flu death in India
- Journalists covering swine flu suspected to be infected
- Five more flu cases in Karnataka
- Those above 65 advised not to go for Haj
- Meghalaya: 17 year old tests positive
- Death toll rises to 10
- Health Minister Azad speaks to CMs on swine flu
- How to know, track and prevent Swine flu online
- CISF personnel at airports to be provided with masks
- Maharashtra decides to shut down public places over flu
- Allow pvt.hospitals to treat swine flu patients
- Merely closing schools won't contain swine flu: Azad
- Close schools to ward off swine flu: MSN India users
- Andhra on alert following swine flu deaths
- India to procure flu vaccine from abroad: Azad
- New wave of deadly H1N1 is ready to explode: Experts
- Eighth swine flu death: 13-year-old Pune girl
- Swine flu outbreak brings life to standstill in Pune
- Bangalore school closes for a week after Swine flu report
- Delhi schools panic; Chennai, Pune report flu deaths
- Maharashtra may allow private hospitals to treat patients
- Flu scare shuts Delhi school, 2 test positive
- Pune doc, Chennai boy latest victims
- PM reviews situation
- Family of first victim fumes at Azad
- 96 new swine flu cases in India, total now 712
- 14-year-old girl student dies of swine flu
- Victim's family to sue hospital for negligence
- 12 more suspected H1N1 cases in Mumbai
- Pune reports fresh cases, schools on alert
- People throng hospital for tests, two more cases confirmed
- Goa to invoke Epidemic Act once tourist season starts
- Pune wakes up to flu reality
- Private hospitals, labs gear up to fight swine flu
Govt speak
Medical views
- Experts advise on do's and don'ts of face masks
- Predicting future course of virus difficult: Researchers
- Ayurvedic centre claims it has cure for swine flu
- Homeopathy can cure swine flu, claims practitioner
- Tamiflu drug may affect children: Study
- 'Vaccine in four to seven months'
For your information:
- Five things you must know about H1N1 virus
- What parents need to know about swine flu
- What is swine flu?
From WHO:
- Manufacturing of H1N1 vaccine inadequate
- Two billion people may get infected by swine flu
- WHO declares US, Mexico swine flu a public health emergency
- Asia on alert after swine flu outbreak
Images:
- Hundreds panic as Pune reports swine flu death: Pics
- War against H1N1: Mumbai, Chennai schools permit masks
Videos:
- Don't panic, Dixit tells Delhiites
- Bangalore hospital runs out of testing kits
- Rapid response team all over India
- Report swine flu symptoms immediately: Azad
- Delhi CM: Do not panic over new H1NI cases
- A debate on Swine Flu threat to India
- New guidelines to counter swine flu
- Swine flu is global pandemic - WHO
Discuss:
All the six WHO regions have reported deaths from the pandemic, with the Americas reporting the largest death number of 1,876, the UN agency said in a latest update of the situation.
In southeast Asia, 139 deaths were recorded, followed by Europe with at least 85 deaths.
Deaths in the West Pacific, Africa and East Mediterranean stand at 64, 11 and 10 respectively.
The total number of lab confirmed swine flu cases reported worldwide is 209,438, but this actually understates the real number of cases as countries are no longer required to test and report individual cases, the WHO said.
The WHO warned that the H1N1 pandemic virus "has rapidly established itself and is now the dominant influenza strain in most parts of the world."
"The pandemic will persist in the coming months as the virus continues to move through susceptible populations," it said in a statement.
It advised countries in the northern hemisphere to prepare for a second wave of pandemic spread.
"Countries with tropical climates, where the pandemic virus arrived later than elsewhere, also need to prepare for an increasing number of cases," it added.
According to WHO experts, there are currently no signs that the H1N1 virus has mutated to a more virulent or lethal form.
Anti-diabetic effects of sodium tungstate unraveled
Uncovering the molecular mechanisms of tungstate activity in diabetes, researchers have now identified the pathways through which sodium tungstate improves pancreatic function and beta cell proliferation.
Led by Professor Ramon Gomis at the Hospital Clinic de Barcelona in Spain, the researchers studied the effects of sodium tungstate on pancreatic gene expression in a rat model of diabetes, in order to discover the mechanisms that control the partial pancreatic regeneration induced by this treatment.
"A detailed description of the pathways involved in the pancreatic effects of tungstate is provided in our paper. Essentially, tungstate improves pancreatic function through a combination of hyperglycemia-independent pathways and through its own direct and indirect effects. In addition, the MAPK pathway has a key role in the tungstate-induced increase of beta cell proliferation," he said.
Speaking about the results, Professor Gomis said: "We used sodium tungstate treatment of diabetic animals as a tool to search for genes and pathways implicated in pancreatic regeneration after an injury to the pancreas. This study identified genes with a key role in improving pancreatic plasticity, and these could be used as therapeutic targets for the future treatment of diabetes"
The study has been published in the open access journal BMC Genomics.
New tool may help predict mortality risk in COPD patients
Researchers have developed a new tool that would help predict a patient's risk of dying from chronic obstructive pulmonary disease (COPD).
What's more, it would also help determine the effective level of treatment.
Boffins have come up with an ADO index that can help physicians assess the severity of the illness.
Presently, the BODE index is used by chest physicians to estimate a patient's risk of death from COPD. It assesses body-mass index, airflow obstruction, dyspnea and exercise capacity.
However, the BODE index is rarely used in primary care settings where most patient treatment options are managed, because exercise capacity cannot be easily measured in the typical doctor's office.
"The burden from COPD is so enormous that we need to reach out to any doctors who care for COPD patients," The Lancet quoted Dr Milo A. Puhan, associate professor in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health and lead author of the study.
"The ADO index can be used in any setting and we hope that it will serve as a basis for more individualized treatment selection in the near future," Puhan added.
For the study, Puhan and colleagues developed a simplified BODE index and the ADO index, which included age, dyspnea and airflow obstruction.
The research team compared the predictions of the BODE index with the 3-year risk of all-cause mortality from 232 COPD patients from Switzerland.
The updated BODE index and the new ADO index were then validated with a cohort of 342 COPD patients from Spain.
The findings showed that updated BODE and ADO indices accurately predicted 3-year mortality compared to the original BODE index, which performed poorly at predicting 3-year risk of mortality.
Men with high testosterone levels 'more likely to have multiple wives'
Men with high testosterone levels are more likely to have multiple wives, according to a new study.
They also give less attention to their kids.
High testosterone levels have been linked to increased sexual activity, infidelity and marital conflict. However, after men become fathers, their bodies typically pump out less of the hormone.
"This is good for us, so we can adapt to social challenges very quickly," New Scientist quoted Alexandra Alvergne, an anthropologist at the University of Montpellier, France, and the University of Sheffield, UK, who led the new study, as saying.
In the study involving rural Senegalese villagers, the researchers underscored testosterone's critical role in a mating and parenting.
Lead researcher Alexandra Alvergne, an anthropologist at the University of Montpellier, France, and the University of Sheffield, UK measured testosterone levels in 21 polygynous fathers as well as 32 monogamous dads and 28 unmarried men without children.
The researchers also asked the men's wives about the time and money their husband spent to the family.
The findings revealed that no matter how many wives they had, fathers had lower testosterone levels than single men, on average.
It also showed that among fathers, those with more testosterone tended to invest less time in their wives and children.
And polygynous men under the age of 50 produced more testosterone than monogamous men, on average.
According to Alvergne, older men with more than one wife made less of the sex hormone than other men. While older men may make less testosterone, they typically enjoy more prestige in their villages, which could make it easier to find multiple wives.
The study appears in journal Hormones and Behavior.
Swine flu continues its surge, toll reaches 93
New Delhi: Swine flu continued its surge with four more persons including a three-year-old child dying of the pandemic, taking the nationwide toll due to the deadly virus to 93 even as 139 fresh cases were detected today across the country.
While the deadly contagion claimed three lives in Karnataka with two dying in Bangalore and one in Bijapur, another person succumbed to the virus at Nasik in Maharashtra.
A three-year-old boy Gowdappa Biradar became the youngest swine flu victim in Karnataka, health officials said in Bangalore.
Admitted to a private hospital at Bijapur with swine flu symptoms on August 23, Biradar died on August 26 but report of his throat swab confirming H1N1 status was received today, they said.
Two women - Sowbhagya (48) and Azra Kausar (35) also succumbed to the virus at a private hosptial in Bangalore.
Source: PTI
25/08/2009
Encephalitis kills 200 children in UP, reports BBC
London: Health officials have said that at least 200 children have died in an outbreak of Japanese encephalitis in northern India.
According to a report by BBC News, so far, 900 affected children have been admitted to hospitals in Uttar Pradesh state. Some patients have come from neighbouring Bihar state and Nepal.
Japanese encephalitis, which causes high fever, vomiting and can leave patients comatose, usually hits Uttar Pradesh state in July-August, during India's monsoon.
There is no specific cure for the mosquito-borne disease that has killed thousands in India since 1978.
Health experts complain that red tape has prevented development of an effective vaccination programme.
Doctors say children between the age of six months to 15 years are worst affected and most of the victims are poor people from rural areas.
"The attack of the encephalitis virus is extremely ferocious this year," said Dr Rashmi Kumar, an expert on Japanese encephalitis at Lucknow Medical College hospital.
"Children are developing a serious condition within a day or two of getting infected," she said.
Health officials in Lucknow, capital of the state of Uttar Pradesh (UP), say cases of acute encephalitis are being reported mostly from 14 districts of eastern UP in the foothills of the Himalayas.
The low-lying areas are prone to annual floods, and severe water-logging and a lack of sanitation provide a breeding ground for mosquitoes.
According to doctors, Gorakhpur town is the epicentre of the disease.
Last year, the government said it would spend 60 million rupees to upgrade facilities at Gorakhpur Medical College hospital.
But, according to doctors, the hospital does not have adequate numbers of medical staff to deal with the large numbers of patients.
Doctors say the children who survive will have to face lifelong problems as the disease has a crippling effect.
While there is no specific cure for the disease after it has been contracted, three vaccines are in use worldwide that have reportedly been successful in preventing the disease.
But India has so far failed to develop an effective vaccination programme.
After the disease killed 1,500 children in 2005, a public outcry forced the government to import vaccines from China and a mass vaccination project was started.
However, doctors say the vaccine coverage has not been satisfactory this year, with many parents of affected children saying no vaccination was done in their areas.
Source: ANI
29/08/2009
17-year-old cancer-stricken boy's crusade against disease
Chennai: Putting behind his own misfortune, a cancer-stricken 17-year-old boy is straining every sinew to help others afflicted with the disease and raise funds for research.
Eight months ago, Akash Dube was a vivacious teenager focusing on his studies at Sharjah but then his world turned topsy-turvy after he was diagnosed with 'acute lymphoblastic leukaemia.'
For so tender an age,it would have been shattering but the young NRI was made of sterner stuff.
From the age of 11, he was taking part in the 'Terryfox run', the marathon named after the Canadian athlete who died of cancer, to raise funds for cancer research.
His only disappointment when the news was broken was that he would not be able to take part in the run to be held at Dubai.
It is only when one does not have anything to do that he starts losing hope, he told PTI.
'But my mind was focused on the cause of raising funds for cancer research.Besides, I had the support of my family, friends and doctor,'' he said.
Supported by his family, friends and social workers, Akash decided to conduct the 'Terryfox run' in Chennai and obtained the requisite permission. It is being held here for the first time and scheduled for August 30.
Source: PTI
Stunt surgery: 14 breast operations in 3.5 hours!
Tamil Nadu never learns its lessons right when it comes to performing stunts in the medical field. Remember the boy surgeon in Madurai who performed hysterectomy surgeries and landed first in a soup and then into jail? Well, Madurai is back in the news, this time for performing a record number of 14 breast cancer surgeries in 3.5 hours to enter into the Guinness Book of World Record! Do a back of the envelope calculation and one will land at a figure of 12 minutes per surgery!
What is more shocking is that the surgeries were done in a government hospital, video taped and sent to the Guinness Book of World Record authorities without the State Government knowing anything about it.
A shocked, stunned and embarrassed state health ministry in Chennai has ordered a probe.
The surgeries were done by doctors at the Government Rajaji Hospital in Madurai.
At a press conference in Madurai, Rajaji hospital's head of oncology, Dr BKCR Mohan Prasad said he and his team comprising chief anaesthetist Dr R Chandrasekhar and surgeon Dr Gopinath had created a world record by operating non-stop on patients from 8.30am to noon on August 24. And then came a pat on the back: Hospital dean Dr S.M. Sivakumar proudly said that "nonstop lumpectomy on 14 women is a proof of the facilities available in the hospital".
And how did it all go? Here is Dr Prasad for you: "We opened four patients at one go. I would open the breast, remove the tumour and nodes and move on to the next patient. My assistant and a post-graduate student would close the wound. When I moved to the fourth patient, the first was ready to be sent to the recovery room and another patient would be wheeled in."
But hours later, stung by criticism, Dr Prasad did a somersault and said the team did not do the operations for the sake of setting a record.
"We have a large patient overload as I was on leave for 15 days. We decided to increase the number from the normal three to four surgeries a day to 14 in order to reduce the backlog. Later, when we looked up the internet, we realised that we were the first to do so many surgeries in so few hours. We then decided to send it to the Guinness Book of World Records through the government," he claimed.
Well, Prasad is not a one-off case in Tamil Nadu. Earlier, Coimbatore-based Dr C Palanivelu did 26 hernia operations in a day for a Guinness Book entry; Chennai-based Dr J. S. Rajkumar operated on 50 hernia patients in 24 hours in an attempt to enter the record books in 2006; Dr K Murugesan and Dr M. Gandhimathy allowed their 15-year-old son to perform a caesarean section in 2007.
Punishment: A ban from practicing for one year!
Swine flu kills six more, countrywide toll climbs to 83
New Delhi: Swine flu has claimed six more lives with IT hub Bangalore recording the highest fatalities of four, raising the nationwide toll to 83 today even as authorities in worst-hit Pune appealed to people to get on with their daily chores but avoid frequenting crowded places.
Flu fatalities rose to 25 in Pune with the death of a 35-year-old woman Shabana Sheikh who had been on a ventilator since August 22, hospital sources said.
Attendance in Pune schools and colleges, which reopened on Monday after a fortnight's closure due to the flu-scare, continued to be thin, officials said.
The district administration appealed to people to carry on with their daily activities without frequenting crowded places. Many Ganesh festival pandals displayed tableaux highlighting the do's and don'ts about the deadly disease.
In Mumbai, Sandeep Gaikwad, died late last night at L K Hiranandani Hospital in suburban Powai after testing positive for the virus, a municipal corporation official said today.
Four more persons succumbed to swine flu in Bangalore, pushing up the number of H1N1 fatalities in Karnataka to 19 even as 22 confirmed cases were reported today, health officials said.
All the four virus victims were from the country's IT hub which accounted for most of the deaths in Karnataka--the second worst swine flu-hit state after Maharashtra.
Meanwhile, 139 fresh swine flu cases were reported across the country taking the number of those infected with the virus to 3235.
Nagaraj (38), admitted to Sagar Hospital on Aug 15 with breathlessness, died in the wee hours today and 48 year-old Munirathnam in St Philomena's Hospital on Aug 22, officials said.
Pushpalatha Bhaktesh (35) and Venkatesh (45) succumbed to the virus at St Martha's Hospital and KIMS Hospital in Bangalore respectively on August 24, they said.
Munirathnam was hospitalised on August 22 and his swab samples were sent for analysis the same day but the results, which tested positive for H1N1, came late last night.
He died of cardio respiratory arrest as a result of acute liver disease, the officials said.
Pushpalatha, who was admitted on August 23, died the next day of Acute Respiratory Distress Syndrome (ARDS) as a result of Pneumonia. Her swab results also came late last night, they said.
Venkatesh, admitted on August 24, died the same day of ARDS.
With these deaths, the countrywide toll has risen to 83. Maharashtra now accounts for 43 fatalities-- 25 in Pune, nine in Mumbai, five in Nashik, two in Aurangabad and one each in Dhule and Latur.
Nineteen people have died in Karnataka, seven in Gujarat, three each in Tamil Nadu, Chhattisgarh and Delhi and one each in Kerala, Goa, Rajasthan, Uttarakhand and Haryana.
Source: PTI
Swine flu has claimed six more lives with IT hub Bangalore recording the highest fatalities of four, raising the nationwide toll to 83 today even as authorities in worst-hit Pune appealed to people to get on with their daily chores but avoid frequenting crowded places.
Flu pandemic claims two more lives, toll climbs to 71
Mumbai: A toddler and a middle-aged man have succumbed to swine flu in Maharashtra and Gujarat, pushing the nationwide toll due to the pandemic to 71 even as schools and colleges in Pune, which had been shut due to the spurt in the infection, reopened on Monday after nearly two weeks.
Over 100 more fresh cases of flu infection were reported from various states yesterday. The two-and-a-half year-old child, who was suffering from a liver disorder, was admitted to the Command Hospital in worst-hit Pune on August 21 after she tested positive for the virus, health officials said.
She passed away last night, they said. With toddler's death, the toll in Pune has risen to 23 and in Maharashtra to 39.
52-year-old Rajesh Udhad, who was admitted to Wockhardt Hospital in Rajkot on August 20 after he showed flu symptoms like fever, breathlessness and vomitting, died this morning, raising the virus toll in Gujarat to seven.
With the two deaths, fatalities due to the disease have climbed to 71. This includes Karnataka with 12, Tamil Nadu and Chhattisgarh with three each, Delhi two and Kerala, Goa, Rajasthan, Uttarakhand and Haryana with one each.
Meanwhile, schools and colleges in Pune reopened today after almost two weeks of closure effected by the authorities to prevent spread of the flu virus.
Agencies
| The truth about pandemics | ||
| ||
We are reeling under a surfeit of breaking news and scientific expert opinions about the swine flu pandemic. However, we need to remain focused and evaluate the statistics. The World Health Organization (WHO) says that there are approximately 1.2 million cases worldwide and around 1,000 deaths. In India, the fatalities are still in the double digits. In contrast, tuberculosis (TB) causes 4,00,000 deaths in India annually. In fact, it is the leading cause of death in the economically productive 15 to 45 age group. However, TB can be easily diagnosed and cured with proper medication. Around 450 out of 1,00,000 healthy young women die during childbirth. This is in contrast to China where the figure has fallen to 50. The WHO report states that the problem is magnified because the poor get inadequate care, while the rich demand and pay for caesarians and other non essential interventions. Nineteen-year-old Saina Nehwal made headlines when she developed chicken pox a couple of weeks before the August 10 world badminton finals. She is part of the 95 per cent of the world population that develops chicken pox at some time in the course of their lives. It is an extremely contagious infection which is not taken seriously, as it usually results in innocuous disease. It can, however, turn dangerous and cause complications like brain fever, blindness, pneumonia and sterility in 10 per cent of those affected. If it occurs in childhood, it usually passes off with about a month's absence from school. But if it occurs at a crucial stage in life like during your college finals or a public exam, it can cause much misery. The fact is such harassment is totally avoidable. The disease is preventable with a single dose of Varicella vaccine, which has to be administered after the age of one. Pneumococcal disease causes pneumonia, brain fever, ear infection, sinusitis and bronchitis. The infection is common and results in 1.6 million deaths every year. Of this, one million are children. The death toll can be eliminated with timely immunisation in childhood. Infective jaundice because of hepatitis A and B can also be prevented with immunisation. Hepatitis A is considered harmless and exposure inevitable in India. Although the number of fatalities is negligible, it causes morbidity, with a feeling of "weakness", lack of energy and ill health that persists for months. Hepatitis B is more dangerous. It can result in liver damage, chronic disease, cancer and even death. Again, both infections are preventable with immunisation. Rubella or German measles is another disease that is preventable through vaccination. If acquired during pregnancy, the affliction can result in a stillbirth or a mentally retarded child with multiple defects requiring a lifetime of care. There are more vaccine preventable diseases such as measles, brain fever (caused by H. Influenzae or the meningococcal bacteria), typhoid, rotor virus diarrhoea, polio and even cervical cancer (caused by the Human Papillovirus infection). Why then are we so focused on the swine flu epidemic? Flu has been around for centuries. Confirmed pandemics have been occurring with devastating regularity after 1918. The viruses responsible have a reservoir in birds and animals from where they mutate and transmigrate into humans. Since pigs share many genes with humans, the transition is this particular pandemic is very efficient. The rapid spread of the virus is helped by the lack of sunshine during the monsoon and in winter. It cannot survive long when exposed to our tropical sun, so in India the pandemic may be time bound. It is difficult to differentiate the symptoms of regular flu from that of swine flu. Both start with fever, body ache, headache, sore throat, nasal stuffiness and cough. There may be diarrhoea or vomiting. The symptoms are more severe with swine flu. Most healthy people recover spontaneously from either. Those at risk are children under five, old people above 65, pregnant women and those with underlying medical conditions such as cancer, diabetes or heart disease. Vaccines are available, but they have to be "upgraded" and "restructured" each time there is a new epidemic, as the genetic nature of the virus changes. The WHO anticipates that a vaccine to protect us against this pandemic will be available by October or November. But will there be enough vaccine to cover the entire world (or even Indian) population at risk? The diagnosis is confirmed by tests done on nasal and throat swabs or nasal aspirates. Blood tests can be done but they take five days and involve taking two different samples. Treatment too is available in government hospitals. The drug Tamiflu (oseltamivir) is administered once diagnosis is confirmed. The likelihood of infection is reduced by: • Washing hands with soap several times a day, especially after handling money • Cleaning surfaces like doorknobs with disinfectant • Using a face mask • Covering the face while coughing or sneezing • Not spitting. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in |
 Swine flu could hospitalise nearly 2 mn; kill 90K in US There are possibilities that swine flu could engulf a large part of US ending up in hospitalising two million people this winter and killing as much as 90,000 in the country.  Swine flu claims its third victim in Delhi National capital recorded its third death due to swine flu when a 44-year-old woman succumbed to the H1N1 virus.  Another swine flu death in Karnataka, toll climbs to 15 Swine flu death toll in Karnataka has climbed to 15 with a 28-year-old man succumbing to the virus, health officials said.  HINI pandemic: Four more succumb, death toll touches 67 Four persons, including a 21-year-old pregnant woman, succumbed to the deadly swine flu .  HINI pandemic: Seven more die, fatalities mount to 63 Seven more people, including a two-month-old baby, succumbed to the deadly swine flu since last evening, pushing the country-wide fatalities to 63.  Six more swine flu deaths in India, toll jumps to 54 Six more swine flu deaths were reported in India, taking the death toll due to the H1N1 virus to 54, the union health ministry said here Saturday.  HINI virus: Three more die, death toll crosses 50 mark Three more persons, including one in worst-hit Pune, succumbed to the swine flu today, pushing the country-wide fatalities from the HINI pandemic to 51.  42 more test positive for swine flu in K'taka As many as 42 persons tested positive for swine flu in Karnataka as state govt stepped up efforts to contain the pandemic.  12 more swine flu deaths take India's toll to 48 12 more swine flu deaths were confirmed in India on Friday, taking the total number of deaths from the H1N1 virus to 48, the union health ministry said.  Azad blames CMs for swine flu spread Lashing out at state governments for "forgetting their duty" and not doing enough to combat swine flu, health minister Ghulam Nabi Azad said the Centre was stretching itself to the maximum to contain the disease.  Flu claims 10 more lives, nationwide toll touches 44 In the highest number of casualties reported in a day, 10 people died of swine flu across the country taking the nationwide toll to 44 today as Karnataka recorded five deaths due to the deadly virus.  Flu claims two lives in Delhi, nationwide toll touches 38 Swine flu has claimed four more lives, including its first two victims in Delhi, taking the nationwide toll to 38.  Swine flu claims four more lives, toll up to 33 With the death of four people — two in Bangalore and one each in Aurangabad and Pune, the swine flu toll in the country mounted to 33.  Junk food reduces resistance to Swine flu Low immunity food items and diminishing proportions of turmeric in daily consumption especially in junk eatables, makes one more vulnerable to Swine flu like diseases.  Suspected swine flu death in Delhi A 35-year-old woman suspected to be suffering from swine flu died at the Ram Manohar Lohia hospital here, doctors said on Thursday. | ||
Basic care 'lacking' in hospitals
 The vast majority of patients receive good care, nurses' leaders say |
A patient lobby group is demanding an urgent review of basic hospital care after highlighting accounts of "appalling" NHS standards.
Relatives told the Patients Association how their loved ones, often elderly people, were left lying in faeces and urine and were not helped to eat.
The group's president Claire Rayner, an ex-nurse, called for "bad, cruel nurses" to be struck off.
The government said the cases were unacceptable but not representative.
The report focused on 16 stories from relatives of patients in England, which the association says are just a few of "hundreds and hundreds" of similar reports from across the UK.
It says self assessment allows too many health authorities to ignore problems that have been raised and is calling for regulator the Care Quality Commission to intervene.
Soiled bedding
The association insists accounts used in the report were reviewed critically before publication as it was aware complaints do "not necessarily reflect the reality".
But it stressed nearly all the accounts were concerned not about treatment but basic nursing and domiciliary care.
The Patients Association noted the latest inpatient survey found 43% rated the service they received as excellent, a significant increase from the previous year.
 |  It is important to note this is not representative of the picture across the NHS. The NHS treats millions of people every day and the vast majority of patients experience good quality, safe and effective care  Chris Beasley Government chief nursing officer |
But it stressed the 2% who deemed the service poor had not changed between 2002 and 2008, and that while the proportions were small they still represented thousands of patients.
Earlier this year, a report from the Healthcare Commission - now replaced by the Care Quality Commission - detailed grave lapses in standards of care at the Mid Staffordshire NHS Trust.
Families described "Third World" conditions, with some patients drinking water from vases and lying for hours in soiled bedding.
"Whilst Mid Staffordshire may have been an anomaly in terms of scale the Patients Association knew the kinds of appalling treatment given there could be found across the NHS," said Katherine Murphy, the association's director.
"This report removes any doubt and makes this clear to all. Two of the accounts come from Stafford, and they sadly fail to stand out from the others."
She said the stories were often about the most vulnerable elderly.
"We hope this report also encourages other people to get in touch with us and tell their stories. We plan to continue publishing accounts until we can be confident that every patient is secured dignity in their care," she continued.
| Two per cent is too many but we are concerned that this might undermine the public's confidence in the world-class care they can expect to receive from the NHS Dr Peter Carter Royal College of Nursing |
Relatives described how they found their loved ones dehydrated or lying in faeces, blood and urine, and told of problems in getting help from nurses. They also told how patients were left with sandwiches or drinks in packaging which they could not open.
Ron Kirk said his father, Leslie, was admitted to hospital in October 2007, having suffered a stroke, but that his treatment at the hands of some nurses amounted to cruelty.
His father had been fitted with the wrong catheter, leaving him in pain, but nurses took away his bedside alarm because they thought he was "pressing it too often", Mr Kirk said.
Claire Rayner said: "I am sickened by what has happened to some part of my profession of which I was so proud. These bad, cruel nurses may be - probably are - a tiny proportion of the nursing work force, but even if they are only one or two per cent of the whole they should be identified and struck off the Register."
Good 'overshadowed'
Government chief nursing officer Chris Beasley said: "All patients deserve the highest quality of care from the NHS and the poor care received in these cases is simply unacceptable."
But she said this was not representative of the picture across the NHS.
"The NHS treats millions of people every day and the vast majority of patients experience good quality, safe and effective care - the Care Quality Commission's recent patient experience survey shows 93% of patients rate their overall care as good or excellent."
The CQC said the registration system it was introducing for trusts next year would ensure they met key quality standards.
"It is absolutely right to highlight that standards of hospital care can vary from very good to poor," said chairman Barbara Young.
"Many people are happy with the care they receive, but we also know that there are problems.
"Matters related to the dignity of care are of particular concern to patients and their families.
"And poor basic nursing is a recurring theme in organisations that perform badly.
"I am in no doubt that many hospitals need to raise their game in this area."
Dr Peter Carter, chief executive of the Royal College of Nursing (RCN), said it would not condone nurses who behave in ways "that are contrary to the principles and ethics of the profession".
But he added: "This report is based on the 2% of patients who feel that their care was unacceptable.
"Two per cent is too many but we are concerned that this might undermine the public's confidence in the world-class care they can expect to receive from the NHS.
"Furthermore it could also dampen the morale of the millions of staff who work tirelessly to help their patients."
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http://news.bbc.co.uk/2/hi/health/8223710.stm
Warning to nurses after care report
Christine Beasley said the stories contained in a report from the Patients Association were distressing and should make "sombre reading for the nursing profession".
NHS nurses have come under fire for their "cruel" and "demeaning" treatment of some patients, in particularly the elderly.
TV agony aunt and former nurse, Claire Rayner, said she was "sickened" by what had happened to some parts of her profession and called for "bad" nurses to be struck off the medical register.
A report from the charity gave stories of people left lying in their own faeces and urine, having call bells taken away from them and being left without food or drink. One former nurse told of the substandard care she received as a patient herself, adding: "It's a scary world out in the wards."
Speaking on BBC Breakfast, Ms Beasley said the care offered to some of the patients was "clearly unacceptable."
She said she had read the stories, adding: "They make not only very distressing reading for patients but very sombre reading for the nursing profession. We should absolutely not condone any levels of care that some of the examples the Patients Association have given have demonstrated."
A statement from the Nursing and Midwifery Council (NMC), which maintains the nursing register and hold disciplinary hearings, said: "Poor care is never acceptable. We have shared a public platform with the Patients Association about this issue in the past.
"The Nursing and Midwifery Council exists to improve standards of care and anyone who has concerns about the conduct of a nurse or midwife should speak to the person in charge or contact us."
Dr Peter Carter, chief executive of the Royal College of Nursing (RCN), said: "The level of care described by these families is completely unacceptable, and we will not condone nurses who behave in ways that are contrary to the principles and ethics of the profession. However, we believe that the vast majority of nurses are decent, highly skilled individuals."
2009 flu pandemic by country
From Wikipedia, the free encyclopedia
This article deals with the status and efforts regarding the 2009 flu pandemic by country and continent/region.
| Pandemic (H1N1) 2009 by country Summary of official reports.‡‡ | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Country | Indicators | Cases | Deaths | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Spread-Trend/ Intensity/Impact‡ | Laboratory confirmed‡‡ | Confirmed (Suspected) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| ECDC total[1] | 268,609 | 2,873 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Reports Total | 289,788 | 3,021 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Brazil | R | = | * | mod | [2] | (5,856)[3] | 584[4] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| United States^ | W | - | * | low | [5] | (47,955)[6] | 556[7] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Argentina | W | - | ** | low | [8] | 8,240[8] | 465[8] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Mexico | W | - | *** | mod | [9] | 21,264[10] | 184[10](77)[11] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Australia | 34,467[12] | 150[12] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Chile | W | = | * | low | [13] | 12,194[13] | 121(8)[13] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Thailand | W | + | ** | mod | [14] | 14,976[15] | 119[15][1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| India | R | + | * | mod | [14] | 3,753[16] | 94[17] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Peru | W | + | * | low | [2] | 6,608[18] | 80[1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Canada | W | - | * | [19] | (12,038)[20] | 72[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Malaysia | 7,000[21] | 71[22] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| United Kingdom# | W | - | * | low | [23] [24] | (13,095)[25] | 66[25][26] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Paraguay | W | - | ** | mod | [5] | 430[27] | 41[1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Ecuador | W | = | * | mod | [9] | 1,382[28] | 36[28] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Costa Rica | W | - | ** | mod | [9] | (1,058)[29] | 33[29] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Uruguay | W | - | * | low | [19] | (343)[30] | 32[31] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Colombia | W | = | * | low | [9] | 507[32] | 29[1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| South Africa | 5,118[33] | 20[33] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Spain | L | = | * | [34] | (1,538)[1] | 20[35] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Bolivia | W | + | * | mod | [9] | 1,389[36] | 20[1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Saudi Arabia | 2,000[37] | 19[38] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Venezuela | W | - | * | low | [9] | 807[39] | 19 (2)[1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| El Salvador | W | - | ** | mod | [9] | 722[40] | 17[1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| New Zealand | W | - | * | low | [2] | 3,127[41] | 16[1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Israel | W | = | * | [42] | 2,670[43] | 16[43] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Singapore | (1,217)[44] | 13[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Guatemala | W | = | ** | mod | [9] | 720[45] | 12[1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| France~ | N | = | * | [42] | (1,487)[46][47] | 10[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Philippines | (3,207)[48] | 8[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Honduras | W | + | * | low | [9] | 373[32] | 8[32] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Dominican Republic | W | - | * | low | [19] | 230[49] | 8[50] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Japan | 7,544[51] | 7[52] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Indonesia | R | + | low | [14] | 1,033[53] | 6[53] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Oman | (763)[54] | 6[54] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Panama | W | - | * | low | [5] | 654[55] | 6[1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Taiwan | 1,730[56] | 5[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Mauritius | 69[57] | 5[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Hong Kong (PRC) | 11,247[58] | 4[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Kuwait | 1,336[59] | 4[60] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Nicaragua | W | [61] | 840[62] | 4[63] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Jamaica | W | - | * | low | [64] | 80[65] | 4[1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| South Korea | 3,312[66] | 3[67] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Vietnam | 2,412[68] | 2[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Netherlands+ | L | - | * | [69] | (1,473)[1] | 2[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Ireland | R | + | * | mod | [23] | (767)[1] | 2[1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Samoa | 138[47] | 2[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Belgium | L | = | * | low | [23] | 2,353 [70] | 1[1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Greece | N | = | * | [34] | 1,839[1] | 1[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Brunei | W | = | * | mod | [2] | 971[71] | 1[1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Egypt | 600[72] | 1[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Lebanon | 500[73] | 1[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Qatar | 350[74] | 1[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Iran | 285[75] | 1[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Malta | W | + | ** | [76] | (257)[1] | 1[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Laos | 242[77] | 1[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Hungary | N | - | * | low | [78] | (151)[1] | 1[1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Iraq | 136[79] | 1[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| United Arab Emirates | 125[56] | 1[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Palestinian Territories | 121[80] | 1[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Cayman Islands (UK) | na[81] | 100[25] | 1[1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Cook Islands (NZ) | 47[47] | 1[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Syria | 25[82] | 1[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Yemen | 21[83] | 1[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Tonga | 20[47] | 1[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Ghana | 8[57] | 1[1] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| St. Kitts and Nevis | N | = | * | low | [9] | 6[27] | 1[1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Other | 32,462 | 0 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
[edit] Overview
As the pandemic progresses, laboratory testing and confirmation may decrease. Confirmed figures for the United Kingdom, in particular, are only meaningful up to 2 July 2009, when routine testing stopped and presumed cases were treated without laboratory confirmation of diagnosis. Following the recommendations of the World Health Organization (WHO), most countries stopped issuing the numbers of the infected population, making this list inaccurate.
| The ten countries with most confirmed cases per capita | ||||
| Pos. | Country  | Population[note 1] | Confirmed cases | Confirmed cases per 10,000 inhabitants |
|---|---|---|---|---|
| 1 |  Brunei | 609,190 | 971 | 25.01 |
| 2 |  Australia | 21,262,641 | 33,844 | 15.92 |
| 3 |  New Zealand | 4,213,418 | 3,106 | 7.37 |
| 4 |  Chile | 16,601,707 | 12,030 | 7.25 |
| 5 |  Malta | 405,165 | 257 | 6.34 |
| 6 |  Samoa | 219,998 | 138 | 6.27 |
| 7 |  Iceland | 306,694 | 152 | 4.96 |
| 8 |  Kuwait | 2,691,158 | 1,072 | 3.98 |
| 9 |  Cyprus | 796,740 | 297 | 3.73 |
| 10 |  Canada | 33,487,208 | 12,038 | 3.59 |
| World | 6,790,062,216 | 287,537 | 0.423 |
- Hong Kong, a Special Administrative Region of the People's Republic of China, has 15.94 confirmed cases per 10,000 residents as of August 29, 2009. (Population estimated 7,055,071 in July 2009)
- Macau, a Special Administrative Region of the People's Republic of China, has 15.61 confirmed cases per 10,000 residents as of August 29, 2009. (Population estimated 559,846 in July 2009)
- Includes countries with over 100 confirmed cases only.
- ^ All population figures are estimates for July 2009 from the source: "CIA - The World Factbook". Central Intelligence Agency. https://www.cia.gov/library/publications/the-world-factbook/. Retrieved 2009-06-21.
[edit] Affected continents/countries
[edit] Africa
Deaths Confirmed cases Suspected cases No reported cases
5000+ confirmed cases 500+ confirmed cases 50+ confirmed cases 5+ confirmed cases 1+ confirmed cases
The Egyptian government ordered the mass slaughter of all pigs in Egypt on April 29,[119] even though the current strain is a human-human transmittable, human influenza that has already previously hybridized with avian and swine flu.[120] The World Organization for Animal Health called the swine killing "scientifically unjustified".[120]
The first case of the novel H1N1 virus was discovered in Cairo, Egypt on the second of June, in a 12-year-old girl coming from the USA with her mother. Only the girl was infected, and the officials caught the case before getting out of the airport. A second and third case were discovered on Sunday 7th of June, 2 students at the American University of Cairo.[121]
On June 11, 2 more cases were discovered, bringing the total number of swine flu cases to 12 in Egypt.[122]
The swine flu has been confirmed in 20 African countries: Egypt, South Africa, Morocco, Algeria, Tunisia, Ethiopia, Ivory Coast, Seychelles, Cape Verde, Libya, Kenya, Uganda, Botswana, Zimbabwe, Tanzania, Mauritius, Somalia, Sudan, Namibia Zambia and Gabon
[edit] Asia
50 000+ casos 5 000+ cases 500+ cases 50+ cases 5+ cases 1+ cases
Deaths Confirmed cases Suspected cases No reported cases
[edit] Western and Central Asia
On April 27, Azerbaijan imposed a ban on import of animal husbandry products from America.[123] AZAL took additional safety measures and a sanitary quarantine unit of the Health Ministry started to operate in Heydar Aliyev International Airport with all aircraft and passengers being checked.[124] On May 2 all checkpoints on borders with Russia passed to the medium security and disinfection barriers for both cars and pedestrians were installed at the Samur, Shirvanovka and Khan Oba checkpoints in Qusar and Khachmaz Raions.[125] The veterinary services at checkpoints intensified their activities while hog farms in the northern regions passed to the closed farming regime.[125]
Seventy-Seven cases have been confirmed in Israel.[126] In response to the outbreak, the Israeli Deputy Minister of Health, Yaakov Litzman, suggested out of respect for the religious sensibilities of Jews and Muslims, the flu should be called "Mexican Flu." This was done so as to not confuse the population into thinking that they could not acquire the virus if they did not eat pork.[127][128] The Israeli government retracted this proposal following Mexican complaints.[129]
The first confirmed cases of swine flu in Kuwait were reported on May 23, after about 18 people on U.S. military bases tested positive.[130]
On May 30, three cases of swine flu were confirmed in Lebanon, the first in the country. "One Lebanese man who was in Spain and two Canadians who arrived in Lebanon a week ago are suffering from swine flu," the health minister said. "We put them in quarantine and the blood samples we have taken every day have proven to be positive. The Lebanese man and the two visiting Canadians -- a woman and her daughter -- were given the proper medical treatment in time and they are well now." The Lebanese Health Minister had previously asked citizens to stop the social habit of kissing. He also requested that affected schoolchildren be kept at home and that travel to countries in which cases have been confirmed be avoided.[131] Beirut also banned the import of pork.[132]
In Saudi Arabia, the first case of swine flu, which affected a Filipino nurse working at King Faisal Specialist Hospital and Research Center, was confirmed on June 1. The Health Ministry in cooperation with King Faisal Specialist Hospital and Research Center has applied the national plan for the prevention of Swine Flu in a manner that matches with the recommendations of WHO. Accordingly, the patient was isolated and provided with the required medical treatment. Arrangements are underway to examine those who were in contact with the patient to get sure that they are not infected.[133]
[edit] Southern and Southeastern Asia
Since 8 July, 2009 a total of 207 cases of A(H1N1) flu have been reported in Brunei. According to the Health Ministry, those who have been confirmed with Influenza A H1N1 will be given treatment as soon as possible and their close contacts will also be given treatment to prevent the infection.[134] A 12-year-old girl who suffered from multiple chronic complications in Brunei became the first fatal case related to A(H1N1) in the country on July 2. [135]
Cambodia's health authorities remain alert but confident that the country is prepared for a swine flu pandemic. In terms of ensuring that infected pigs do not spread the disease to Cambodia, the Cambodian Pig Raiser Association said it has told the government it should ban live pig imports. But Khlauk Chuon, the deputy director of Camcontrol at the Ministry of Commerce, said they would only ban live pig imports from a country that has been hit with swine flu.[136]
All people entering India via the main airport hubs of Mumbai, New Delhi,Kolkata, Ahmedabad, Goa, Jaipur, Kochi, Chennai, Bangalore and Hyderabad are being screened. The primary focus is on passengers entering from the United States of America, The United Kingdom, Canada, Mexico, France, and New Zealand.[137] As of 12th August 2009, over 1000 cases have been confirmed in India with 17 deaths[138]
The Indonesian government halted the importation of pigs and initiated the examination of 9 million pigs in Indonesia.[139] Thermal scanners which can detect human body temperature have been installed at Indonesian ports of entry.[140]
The Lao government bought 10 thermal imaging machines to install at the country's major immigration border checkpoints. The Prime Minister Bouasone Bouphavanh said masks should be made available and health officials would be assigned to work at border checkpoints.[141] On 22 July, Laos recorded its first death from influenza A(H1N1).[142]
In Malaysia, health screenings were carried out on passengers traveling to and from Mexico via sea, air and land beginning April 17.[143][144] The Health Ministry's disease control division activated its operations room to monitor the swine flu situation and informed medical practitioners treating suspicious cases to inform the district health office immediately.[145] Thermal scanners were installed at Kuala Lumpur International Airport.[146] Screenings were imposed in Pengkalan Hulu, at the border with Thailand, in late April.[147] Quarantine rooms had been allocated in 28 hospitals,[148] and the country has stockpiled more than 2 million doses of Tamilflu, as of May 2009.[149] Schools were issued strict hygiene procedures on May 16 to contain any H1N1 outbreak among students and teachers.[150] On May 15, the Health Ministry confirmed Malaysia's first case of A (H1N1) infection of a male student who had arrived via air from Newark.[144][146][151][152] Malaysia recorded its first local infection of influenza A(H1N1) involving the 19th case as that person had no history of having traveled to a country that had the flu.[153] The first A(H1N1) related death was reported on 23 July, 2009. [154] As of August 11, 2009 there has been 2,253 confirmed cases in Malaysia.[155] The Health Ministry has announced that from August 12, 2009 they had discontinued the counting of the total number of H1N1 cases in line with guidelines issued by the World Health Organisation.[156] As of August 12, 2009 the total number of A(H1N1) related deaths in Malaysia stands at 44. [157]
In the Maldives, a ministerial committee has been established to supervise swine flu preventive measures to avoid an outbreak. All visitors arriving at the Malé International Airport on Hulhule Island and the country's three commercial seaports are being screened.[158]
In Myanmar, Chairman of Global Human Flu Prevention and Response Work Committee Deputy Minister for Health Dr Mya Oo inspected preventive measures against the human flu at Yangon International Airport on May 1. Myanmar reported the first case of flu A/H1N1 in the country on June 27 with the 13-year-old girl who developed the symptoms after coming back home from Singapore a day earlier. [159]
Pakistan has taken precautionary measures at the international airports to check passengers coming from swine flu affected countries.[160] Doctors are checking the incoming passengers and allow entry only to those with no flu symptoms. The major hospitals in all the big cities are on high alert.
In the Philippines, thermal imaging equipment at airports was implemented to screen passengers coming from the US for flu symptoms.[161][162] The Philippines may quarantine travelers arriving from Mexico with fevers.[163] Also, the importation of hogs from the U.S. and Mexico was manned, and the restriction of swine influenza vaccine use was retracted.[164] On May 18, 2009, a Filipina girl who arrived from Houston, USA was the first confirmed case of H1N1 virus in the Philippines.[165] As of June 15, 2009, there were 193 confirmed cases.[166] By June 22, first known death was reported.[167]
The first case of Influenza A (H1N1-2009) in Singapore was confirmed on May 27, 2009. It was announced on June 18, 2009 that Singapore appeared to have its first case of local infection of the A(H1N1) virus. [168] As of July 9, 2009 the Singapore Ministry of Health no longer tracks the total number of A(H1N1) infections. The action was taken after the World Health Organisation told several countries that they were no longer required to submit regular reports on confirmed cases and deaths.[169] As of July 7 there have been reported 1,217 confirmed cases of A(H1N1) in Singapore.[170] As of July 25, there were 4 confirmed deaths related to A(H1N1) virus in Singapore.[171][172]
On April 28, 2009, the Thai Public Health Ministry issued a warning for Thais to avoid visiting the United States and Mexico which had been hit by the swine flu outbreak. The Thai Government installed thermal scanners in Suvarnabhumi Airport and other key airports. Airport health officials began using thermal screening equipment to monitor passengers. Thailand raised its swine-flu preventive measures to "maximum", with all visitors entering the country subjected to thermal scanners and even dignitaries not exempt.
Vietnam's Ministry of Health released an emergency dispatch and urged agencies to take precautionary measures against swine flu.[173] Thermal imaging devices were dispatched to airports and border gates to screen passengers.[174] In response to WHO's warnings, Vietnam on April 30, 2009 raised its swine flu alert level to 4 which indicated a "threat of community level outbreaks" while local authorities have been executing precautionary measures.[175] On May 1, 2009 an Vietnam's Ministry of Industry and Trade official said that Ministry was considering a ban on pork import "under certain situations" to prevent swine flu from entering Vietnam.[176] As of May 31, 2009. The Government of Vietnam announced its First new case of A(H1N1) virus in the Country. A 23 years old Vietnamese student who recently returned from the United States has tested positive for swine flu. [177]
[edit] Eastern Asia
On April 26, it was announced that that visitors returning from flu-affected areas to China who experienced flu-like symptoms within two weeks would be quarantined.[178] May 2, the Chinese government suspended flights from Mexico to Shanghai.[179] Meanwhile, the Civil Aviation Administration of China also assigned a charter to transport stranded Chinese visitors back home.[180] The first suspected case found on mainland China was reported on May 10, 2009.[181]
On April 29, the Food and Health Bureau of Hong Kong[182] advised Hong Kong residents not to travel to Mexico unless absolutely necessary. The first case reported was a Mexican who flew in from Shanghai. The Bureau also escalated the alert level from "alert" to "serious",[183] which activated health protection measures in all ports of entry of Hong Kong. As such, temperature screening machines are used at all checkpoints to identify passengers with fever and respiratory symptoms. Any passenger who fails the temperature test and confirmed having a fever will be quarantined and sent to public hospital for further investigation.[184] Hong Kong also became one of the first jurisdictions to declare the swine flu as a notifiable disease, and much of the procedures against the spread of the swine flu were learned from the 2003 SARS outbreak, of which Hong Kong was the epicenter of the outbreak.[185][186] On May 1, one case became the first confirmed case of swine flu in Hong Kong and also the first in Asia. The Mexican patient arrived in Hong Kong on April 30. Metropark Hotel Wanchai, where the patient stayed, was quarantined..[187][188][189][190] After the first swine flu case was confirmed by laboratory, Hong Kong's response level was raised from "serious" to "emergency".[191]
In Japan, any live pigs being brought into the country were inspected to ensure they were not infected with the influenza.[192] Japanese Agriculture Minister Shigeru Ishiba appeared on television to reassure customers that it is safe to eat pork.[193] The Japanese farm ministry said that it would not ask for restrictions on pork imports because the virus was unlikely to turn up in pork, and would be killed by cooking.[194] On 8 May, the first three cases were confirmed. The infected patients had spent time in Canada and returned to Japan via Detroit.[195][196] The first domestic infection was confirmed on 16 May in Kobe.[197] As of 18 May, 130 cases had been confirmed.[198]
South Korea warned against travel to Mexico City and three Mexican states.[193] The government has also stepped up quarantine and safety checks on travelers arriving from the United States and Mexico, and pork imports from those countries. An emergency quarantine system is also in place, with simple tests conducted on people arriving with flu symptoms at airports.[178] On April 28, South Korea reported its first probable case of swine flu after positive preliminary tests on a nun who had recently returned from a trip to Mexico.[199] Several sources have informed that one case has been confirmed by lab in South Korea, on April 30.[200][201] On May 2, the first suspected woman turned out to be infected with the influenza A subtype H1N1. South Korea became the second infected nation in Asia.[202]
On May 20, 2009, the first case of the influenza has been confirmed in Taiwan[203] The government had previously taken several steps to prevent the possible outbreak of Swine Flu, including a command center set up, travel alerts for infected nations,[193] and more severe health check been conducted at international ports. Taiwan said visitors who came back from affected areas with fevers would be quarantined.[204] According to The Department of Health (DOH), Taiwan has a sufficient supply of surgical masks and vaccine to deal with the flu. The DOH also stated that they have 50 million to 60 million masks in stock and local manufacturers have the capability of producing 200,000 doses of the flu vaccine a month.[205] In an effort to prevent the entry of the swine influenza, the Centers for Disease Control has announced on April 28 that every flight from the Americas, specifically Canada and the United States, that arrives in Taiwan from April 29 and onward will be subject to a strict on-board screening procedure.[206]
On July 2, the first case of oseltamivir-resistant virus in Asia was announced in Japan, in a woman who had been taking Tamiflu prophylacticly. [207]
On July 18, 2009, Hong Kong had its first swine flu death.
On July 3, a case of Tamiflu-resistant virus was discovered in a woman suffering from the flu. The woman had not previously taken Tamiflu, so concern has been expressed that she may have contracted an already resistant virus from someone else. [208]
On 28 August 2009, Japanese Ministry of Health, Labour and Welfare announced estimated and assumable number that approximately 760,000 people to be infected and 46,400 to be hospitalized per day in peak time flame of October 2009, and 20% of total Japanese infected in country wise and 30% in city area.[209]
[edit] Europe
500+ cases 50+ cases 5+ cases 1+ cases
Deaths Confirmed cases Suspected cases No reported cases
On April 27, the Spanish Ministry of Health and Social Policy announced that a man in Castilla-La Mancha who had recently returned from Mexico had contracted the disease. The man, aged 23, had returned from Mexico on April 22 and had been quarantined on the 25th. This was the first confirmed case in Europe.[210]
On April 27, the European Union health commissioner advised Europeans not to travel to the United States or Mexico unless urgent. This followed the discovery of the first confirmed case in Spain.[211]
On June 14, It was reported that the United Kingdom had its first confirmed swine flu related death. The individual was a Scottish woman.
As of August 24, nine countries in the EU (Spain, the United Kingdom, France, Belgium, The Netherlands, Ireland, Greece, Malta and Hungary) have confirmed deaths due to swine flu. France has 10 confirmed deaths; Spain has 16 confirmed deaths; Ireland and The Netherlands has 2 confirmed deaths; Malta, Belgium, Hungary and Greece all have one confirmed death, and the United Kingdom has 61 confirmed deaths (the majority of these are in England) along with the British government suggesting 55000 new case of Swine Flu reported in the week up to the 16th of July 2009. The British government has also warned that deaths from swine flu this winter could be between 19,000 and 65,000 in the UK alone.
Hungary reported the first death in the country on 22 July.[212] Ireland reported its first death on 7 August.[213]
As of August 19, all European countries with the exception of the micro states San Marino and Vatican City have reported confirmed cases.
[edit] North America
Deaths Confirmed cases Suspected cases No reported cases
2000+ cases 500+ cases 100+ cases 1+ cases
In Canada, as of May 26, there has been 16 deaths and a further 6457 confirmed cases of swine flu, most of which was contracted in-country, have been confirmed in the country; 68 in Nova Scotia, 114 in British Columbia, 86 in Alberta, 284 in Ontario, 106 in Quebec, 2 in New Brunswick, 6 in Manitoba, 3 in Prince Edward Island, 49 in Saskatchewan, and 1 in Yukon Territory.[214][215][216][217] The country's first four cases, in Nova Scotian students who had traveled to Mexico, were confirmed on April 26.[214][218] On April 30, the first case of swine flu affecting someone who had not travelled to Mexico was confirmed in Nova Scotia.[219] On May 8, the first confirmed death from the H1N1 virus was reported in Alberta.[220]
Dr. José Ángel Córdova Villalobos, Mexico's Secretariat of Health, stated that since March 2009, there have been over 1,995 suspected cases and 149 deaths, with 20 confirmed to be linked to a new swine influenza strain of Influenza A virus subtype H1N1.[221][222] "'As many as 23,000 Mexicans were likely infected with the swine flu virus,' Neil Ferguson of Imperial College London and colleagues reported in the journal Science."[223] Soldiers mobilized by the government have handed out six million surgical masks to citizens in and around Mexico City.[224] On April 24, 2009, schools (from pre-school to university level) as well as libraries, museums, concerts and any public gathering place, were shut down by the government in Mexico City and the neighboring State of Mexico to prevent the disease from spreading further; the schools in Mexico City, the State of Mexico, and the state of San Luis Potosí will remain closed until at least May 5.[225] Marcelo Ebrard, Mexico City's mayor, has also asked all night-life operators to shut down their places of business for ten days to prevent further infections.[226] On April 25, President Felipe Calderón declared an emergency which granted him the power to suspend public events and order quarantines.[227] On April 26, the World Bank announced US$ 25 million in immediate aid loans to Mexico, an additional US$ 180 million for long-term assistance to address the outbreak, and advice on how other nations have responded to similar crises.[224] On April 27, the Secretariat of Public Education announced that all schools in Mexico will remain closed at least until May 6.[228] On April 28, the Mexico City government closed all restaurants and cinemas. The National History and Anthroplogy Institute also closed all its archaeological sites and museums, including the most famous Mayan and Aztec ruins, until further notice.
In the United States, initial reports of atypical flu in two individuals in southern California led to the discovery of the novel swine flu virus by the CDC in mid-April. More than a hundred cases were confirmed in the next two weeks, spread through a dozen states.[229] Outside of California and Texas, initial cases were all tied to recent travel to Mexico or close contact with those who had recently visited Mexico. St. Francis Preparatory School, a private school in New York, was the center of a large cluster of cases after a Spring Break trip by several students, and perforce one of the first U.S. schools to be closed as a public health measure during the early outbreak.[230] Most of the cases in California and Texas are not linked and may reflect localized outbreaks of this virus in those areas.[231] The disease was not as virulent outside of Mexico as within Mexico, for reasons not fully understood. The US declared a state of Public Health Emergency but this was said to be standard procedure in cases as divergent as the recent inauguration and flooding.[232] On April 29, the US suffered its first confirmed death of swine flu,[233] and on May 5 the first US citizen died from swine flu.[234] As of June 6, there were 17 confirmed deaths from swine flu in the US.[235] As of mid-May 2009 many states had abandoned testing for likely influenza cases unless serious illness and/or hospitalization were present.[236] Because reported numbers represent only confirmed cases, they are a "very great understatement" of the total number of cases of infection, according to the CDC.[237] The real number of swine flu cases in the United States could be 「upwards of 100,000,」 a top public health official estimated on Friday — far higher than the official count of 7,415 cases confirmed by laboratories.[238] The United States now has more than 25000 confirmed cases and more than 140 deaths due to swine flu.
[edit] Caribbean
In Aruba, all passengers arriving by airplane or cruise ship were required to fill out a health questionnaire beginning on April 27, 2009.[239] Hotels and resorts are required to report to authorities if any tourists are showing flu-like symptoms.[239] The government of Aruba also ordered antiviral medication and other supplies from the Netherlands and the United States.[239] No swine flu cases have been reported.[239]
In Barbados, the first confirmed case of the H1N1 virus occurred on June 3, 2009.[240] The second case was confirmed on June 6.[241] The third case was confirmed on June 10.[242] The fourth case was confirmed on June 17.[243] Twenty five outstanding samples have been sent to the Caribbean Epidemiology Center, the results of which would confirm if there is in-country transmission.[243]
Cuba suspended flights to and from Mexico for 48 hours.[244] The first case of swine flu in Cuba was confirmed in mid-May.[245]
The first two cases in the Dominican Republic were confirmed on May 27.[246] On June 5, a 17 year old pregnant girl infected with the AH1N1 virus died. 93 cases were confirmed to this date.[247]
As of 7 July 2009, there has been 33 confirmed cases of swine flu in Jamaica. Health Minister Ruddy Spencer told Parliament that the country has been placed on high alert. There has been heightened surveillance at health care facilities and port entry's.[248]
In Trinidad and Tobago, one female has been confirmed as having contracted the H1N1 influenza.[249]
In the Bahamas, ten students and teachers who arrived from Mexico in the last week of April are in quarantine.[250]
[edit] Central America
The first two cases of the 2009 flu pandemic in Costa Rica, both of whom had traveled to Mexico, were confirmed on April 28.[251][252] As a result of a surge in new cases that occurred by early July, the Ministry of Health announced a new strategy to deal with this peak that resulted in increased deaths. Beginning July 11, 2009, testing for the virus will be conducted only on patients with risk factors and critical cases, including those with fever above 39 oC and patients with respiratory difficulties, as the main objective now is to reduce mortality rather than avoid contagion.[253]
As of August 7 the Costa Rican Ministry of Health had 798 confirmed cases, 984 pending cases, and 4,630 already discarded,[254] and the official rate of infection is 17.9 per 100,000 people,[254] up from 8 per 100,000 inhabitants before the first week of July when the contagion surge began. However, the mortality rate is still considered low, at 0,5 deaths per 100,000 inhabitants.[255] As of August 14, authorities had confirmed 29 fatalities related to the virus.[256]
On July 31 local authorities announced that the country was selected among the sample countries that will be part of the test of the vaccine developed by Swiss pharmaceutical Novartis. The local sample will include 784 Costa Ricans ages 3 to 64. Besides Costa Rica, this vaccine prototype will be tested also in Mexico and the United States.[257] On August 11 was confirmed that Costa Rica's President, Óscar Arias Sánchez, was infected with the A(H1N1) virus, becoming the first head of state sick with the A(H1N1) virus. He will continue his regular work from home.[258][259]
Guatemala is checking all travelers arriving from Mexico for signs of flu and stopping anyone with symptoms of the virus at border crossings.[260] On May 5, in a meeting with Health Minister and the Vicepresident, it was announced that an 11-year-old girl was infected with the AH1N1 virus.[261] As of July 7 the Guatemala had 286 confirmed cases leading to two fatalities.[262]
Honduras reported its first confirmed case of A(H1N1) flu on 27 May, 2009. By June 7 the country had reported 67 cases, most of the cases on the city of San Pedro Sula and the Atlantic Coastline. There are few cases on other cities and areas. All airports and commercial sites as well as public events are monitored. As of July 7 there were 123 confirmed cases and one fatality.[262]
As on June 4, 179 confirmed cases had been reported by Panamanian health authorities.[263] Of these, 91 were male and 88 were female. Schools with positive cases are being disinfected. Thermal cameras had been deployed in Tocumen International Airport to identify sickness among arriving passengers.
As of July 7 El Salvador reported 319 confirmed cases, and Nicaragua 321. Panama and Nicaragua have not reported any fatalities.[262]
[edit] Oceania
[edit] Australia
The first confirmed case in Australia was reported on May 9.[264] As of July 3, 2009, Australia has 7,290 confirmed cases. The first Australian death was on June 19 and the total death toll has risen to 20.[265] The alert level has been lifted from "delay" to "contain", giving authorities in all states the option to close schools if students are at risk.[266] Australia has a stockpile of 8.7 million doses of Tamiflu and Relenza.[267] At the beginning of the outbreak airlines were required to report passengers from the Americas with influenza symptoms, and nurses were deployed at international airports.[267] Melbourne, the capital of the state of Victoria, is reporting the largest number of infections in the country, with Victoria having a higher per capita infection rate than either Mexico or the US.[268]
On May 30, New Zealand had 9 laboratory confirmed cases and 10 probable cases. All patients recovered. Over the month of June cases in New Zealand rose rapidly. On June 14 the Ministry of Health announced a 65% increase in cases in just 24 hours. On July 4, the Ministry of Health announced the first New Zealand deaths. There have been three confirmed deaths of patients who had tested positive for the flu, however two of them had known underlying medical conditions. The total number of confirmed cases has now reached 945.[269]
[edit] Islands and Antarctica
No cases have been reported in Antarctica. Two cases were confirmed in the Pacific Islands. Both cases were confirmed on June 15, one in the Solomon Islands and another in Samoa. [270][271]. 5 cases has been confirmed in Fiji as of June 24 and 1 case in Vanuatu.
[edit] South America
In Argentina, as of April 2009, passengers with influenza symptoms arriving from Mexico and United States were required fill out a form to be located should they experience any symptoms.[272] In addition, the government has also stepped up safety checks, and thermal scanners are being used on airports to detect passengers with fever and other influenza symptoms. Flights from Mexico were also temporarily suspended as a precautionary measure.[273] These measures however have proven to be largely ineffective. As of June 22, Argentina had 1,213 confirmed cases of swine flu and 10 confirmed deaths, [274] increasing to 52 confirmed deaths [275] and an estimated number of as many as 100,000 affected people on July 2, as confirmed by the then newly appointed Minister of Health Juan Luis Manzur. [276] As of July 14, the number of officially recognised cases skyrocketed, with 137 deaths, [277] making the death toll in Argentina the second highest in the world, only behind the United States and surpassing that of Mexico.
As of April 2009, Brazilian airports would monitor travelers arriving from affected areas, under the direction of the National Sanitary Surveillance Agency (ANVISA). Air crews were trained on signs and symptoms of swine influenza so that passengers displaying symptoms would receive guidance from ANVISA upon arrival.[278] As of June 4, there were 28 confirmed cases of swine flu in Brazil.
The first case of A(H1N1) flu in Chile was confirmed on May 17.[279] On May 29, the Chilean Health ministry confirmed the number of cases of A-H1N1 had risen to 224. [279], the same day two more cases were confirmed[280]. On June 3 Chile suffered its first confirmed death of swine flu, a 37-year-old man from Puerto Montt. [281]. To the date, and since the laboratory tests are no longer mandatory, the estimation of cases in Chile go up to 500.000 cases.[279]
On May 3, 2009, Minister Palacio confirmed the first case of A(H1N1) in Colombia,[282] in a 42-year-old person from Zipaquirá, who recently travelled to Mexico.[283] According to Palacio, only one out of 18 tests sent to Atlanta was positive. The patient was isolated and put under medical treatment. On the same day, Palacio stated there were 108 suspect cases in the country.[283] On April 27, the Government declared a "national disaster" state[284] in order to face the emergency, which allowed health authorities to have a special budget to do so.[285] The government purchased 400,000 oseltamivir (Tamiflu) doses, which will be distributed through the Social Protection ministry to the affected if there are confirmed cases.[286]
Health officials are carrying out checks on people with flu symptoms entering the country from sea or air.[287] On April 29, Ecuador closed its borders to Mexican citizens and foreigners of other nationalities arriving from Mexico for a period of 30 days.[288] On May 15, Health officials confirmed the first case of AH1N1 flu in Ecuador [289]. On May 20, the Health Department confirmed 7 more new cases of AH1N1, raising the total number of infected people to 8[290], the number has now risen to 41[291].
The first case of swine flu in Peru was confirmed on n May 14. On May 17, the second case was confirmed, an American-born man residing in Arequipa. He had returned from the US on May 12, not showing any symptoms until two days later.[18] On May 18 a new case was confirmed, a scholar returning from a trip to Dominican Republic, that studied in the Altair school. another case of a scholar from the same trip to Dominican Republic. Student had contact with 3rd victim and both studied in the same school. [292] The Governor of Callao ordered that all passengers from any infected country be checked before their arrival on Peruvian territory. Also, the Peruvian government must be warned of any case or symptom of fever. This step is in order to prevent any infections, since the main port and airport of Peru are located in Callao. Also, the government has prepared a special area at the Hospital "Daniel Alcides Carrión" to treat cases of this disease.[293] Efforts are being made to examine slaughterhouses and they are screening incoming passengers from problem areas.[294] All commercial flights from Mexico to Peru were suspended on April 29.
In Venezuela, controls have been raised at airports to prevent contagion from spreading. Travellers from the United States and Mexico with flu symptoms are being isolated until they are given the all clear. Pig farms in the country are being "closely inspected" and stockpiles of medicines built up.[287] On May 28 the Health Minister, Jesús Mantilla, confirmed the first case of the A/H1N1 flu in a Venezuelan citizen who arrived in a flight from Panama. He was isolated to the place he is receiving treatment and his condition is stable. [295]. The following day, a second case was confirmed from another person who also arrived from the same flight.[296]
[edit] Reporting bias
Epidemiologists caution that the number of cases reported in the early days of an outbreak can be very inaccurate and deceptive.[297] This can be due to several causes, including selection bias, media bias, and incorrect reporting by governments.
One selection bias in epidemiology pertains to authorities in different jurisdictions looking at different sets of patient populations. For example, doctors in Mexico may be concentrating on patients in hospitals, rather than the larger vulnerable population, which may in part explain the higher mortality recorded in the country.[297] Media bias in reporting swine flu cases and deaths may skew incidence maps based on these media reports. Countries with poor health care systems and poor laboratory facilities may take longer to identify suspected cases, analyse those cases, and report them.[298] Passive data collection methodologies (waiting for the patient to arrive at a health care facility) are considered inferior to active data collection techniques (performing random stratified sampling) due to various forms of selection bias.[299] and because laboratory facilities to perform swift genetic tests on patient samples are not widely available.[297] As of July 2009[update] there are no properly controlled epidemiological studies for the 2009 swine flu outbreak.
[edit] Notes
- ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af ag ah ai aj ak al am an ao ap aq ar as at au av aw ax ay az ba bb bc bd be bf bg bh bi bj bk bl bm bn bo bp bq br European Centre for Disease Prevention and Control: [1] Update:"ECDC Daily Update - Pandemic (H1N1) 2009 28 August 2009". 2009-08-28 17:00 UTC +2. http://www.ecdc.europa.eu/en/healthtopics/Documents/090828_Influenza_AH1N1_Situation_Report_1700hrs.pdf. Retrieved 2009-08-28.
- ^ a b c d e f g "Pandemic (H1N1) 2009 - update 62". Data Status Week 32 (August, 9). WHO. 2009-08-21. http://www.who.int/csr/don/2009_08_21/en/index.html. Retrieved 2009-08-21.
- ^ http://portal.saude.gov.br/portal/arquivos/pdf/informe_influenza_se_33_25_08_2009.pdf
- ^ "Brazil reports highest death toll of A/H1N1 flu in world". Xinhua. 2009-08-27. http://news.xinhuanet.com/english/2009-08/27/content_11951572.htm. Retrieved 2009-08-27.
- ^ a b c d e "Regional Update Pandemic (H1N1) 2009". Data Status Week 31 (August, 8). WHO PAHO. 2009-08-21. http://new.paho.org/hq/index.php?option=com_docman&task=doc_download&gid=2693&Itemid=. Retrieved 2009-08-22.
- ^ Sum of state reported confirmed and suspected cases; See US Swine Flu outbreak table for more information.
- ^ "Total U.S. Novel H1N1 Flu Hospitalizations and Deaths (Data reported to CDC by August 21, 2009, 11:00 AM ET)". CDC. 2009-08-21. http://www.cdc.gov/h1n1flu/update.htm#totalcases. Retrieved 2009-08-21.
- ^ a b c "H1N1: 465 deaths in Argentina". Buenos Aires Herald. 2009-08-28. http://www.buenosairesherald.com/BreakingNews/View/10384. Retrieved 2009-08-28.
- ^ a b c d e f g h i j k l m n "Regional Update Pandemic (H1N1) 2009". Data Status Week 32 (August, 15). WHO PAHO. 2009-08-21. http://new.paho.org/hq/index.php?option=com_docman&task=doc_download&gid=2693&Itemid=. Retrieved 2009-08-22.
- ^ a b "Mexico could have one million swine flu cases: minister". Indippia. 2009-08-28. http://www.indopia.in/India-usa-uk-news/latest-news/661826/International/2/20/2. Retrieved 2009-08-28.
- ^ "Mexico confirms 42 deaths of A/H1N1 flu". 2009-05-07. http://www.philstar.com/Article.aspx?articleId=465141&publicationSubCategoryId=200. Retrieved 2009-05-29. "Cordova said [...] 77 [early deaths] did not have usable samples, meaning that they would never be confirmed or ruled out."
- ^ a b "National H1N1 Influenza 09 Update 12 noon 28 August 2009". Department of Health and Ageing. http://www.healthemergency.gov.au/internet/healthemergency/publishing.nsf/Content/09FDF2052D820653CA25761C000CBC3D/$File/280809.pdf. Retrieved 2009-08-28.
- ^ a b c "A/H1N1 flu situation on Chile" (in Spanish). 2009-08-27. http://www.redsalud.gov.cl/portal/url/page/minsalcl/g_varios/influenza.html. Retrieved 2009-08-28.
- ^ a b c d e f g h i j "Summary of Situation of Pandemic (H1N1) 2009". Week of 17 August – 23 August 2009. WHO SEARO. 2009-08-24. http://www.searo.who.int/EN/Section10/Section2562.htm. Retrieved 2009-08-26.
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- ^ Sum of Canadian province-reported confirmed cases; See Canadian Swine Flu outbreak table for more information.
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Spread/Trend/Intensity from: "EuroFlu - Weekly Electronic Bulletin". Data Status Week 33 (August, 16). WHO/Europe. 2009-08-21. http://www.euroflu.org/cgi-files/bulletin_v2.cgi. Retrieved 2009-08-22.
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Spread/Trend from: "EuroFlu - Weekly Electronic Bulletin". Data Status Week 33 (August, 16). WHO/Europe. 2009-08-21. http://www.euroflu.org/cgi-files/bulletin_v2.cgi. Retrieved 2009-08-22.
Intensity from: "Pandemic (H1N1) 2009 - update 62". Data Status Week 32 (August, 9). WHO. 2009-08-21. http://www.who.int/csr/don/2009_08_21/en/index.html. Retrieved 2009-08-21. - ^ "More than seven hundred new swine flu cases in Belgium last week". Expatica.com. 2009-08-18. http://www.expatica.com/be/news/belgian-news/More-than-seven-hundred-new-swine-flu-cases-in-Belgium-last-week_55501.html. Retrieved 2009-08-23.
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Trend/Intensity from: "EISN Weekly electronic bulletin". Data Status Week 33 (August, 16). ECDC. 2009-08-21. http://ecdc.europa.eu/en/activities/surveillance/EISN/Newsletter/SUN_EISN_INFL_Bulletin_2009week33.pdf. Retrieved 2009-08-21.
Spread/Impact from: "Pandemic (H1N1) 2009 - update 62". Data Status Week 32 (August, 9). WHO. 2009-08-21. http://www.who.int/csr/don/2009_08_21/en/index.html. Retrieved 2009-08-21. - ^ "Swine flu on rise among US troops in Iraq". Press TV (Iran). 2009-08-15. http://www.presstv.ir/detail.aspx?id=103548§ionid=351020201. Retrieved 2009-08-15.
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Spread from: "EuroFlu - Weekly Electronic Bulletin". Data Status Week 33 (August, 16). WHO/Europe. 2009-08-21. http://www.euroflu.org/cgi-files/bulletin_v2.cgi. Retrieved 2009-08-22.
Trend/Intensity/Impact from: "Pandemic (H1N1) 2009 - update 62". Data Status Week 32 (August, 9). WHO. 2009-08-21. http://www.who.int/csr/don/2009_08_21/en/index.html. Retrieved 2009-08-21. - ^ "Situationseinschätzung zur Neuen Influenza" (in German). Robert Koch Institut. 2009-08-28. http://www.rki.de/cln_091/nn_200120/DE/Content/InfAZ/I/Influenza/IPV/Schweineinfluenza__Situation.html. Retrieved 2009-08-28.
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Trend from: "EuroFlu - Weekly Electronic Bulletin". Data Status Week 33 (August, 16). WHO/Europe. 2009-08-21. http://www.euroflu.org/cgi-files/bulletin_v2.cgi. Retrieved 2009-08-22.
Spread/Intensity from: "EISN Weekly electronic bulletin". Data Status Week 33 (August, 16). ECDC. 2009-08-21. http://ecdc.europa.eu/en/activities/surveillance/EISN/Newsletter/SUN_EISN_INFL_Bulletin_2009week33.pdf. Retrieved 2009-08-21. - ^ "Türkiye Cumhuriyeti Sağlık Bakanlığı (Ministry of Health)". 2009-08-19. http://www.grip.saglik.gov.tr/19082009-tarihli-aciklama-id323-8.html. Retrieved 2009-08-24.
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Spread/Trend/Intensity from: "EuroFlu - Weekly Electronic Bulletin". Data Status Week 33 (August, 16). WHO/Europe. 2009-08-21. http://www.euroflu.org/cgi-files/bulletin_v2.cgi. Retrieved 2009-08-22.
Impact from: "Pandemic (H1N1) 2009 - update 61: Qualitative indicators (Week 31: 27 July - 2 August 2009)". WHO. 2009-08-12. http://www.who.int/csr/don/2009_08_12/en/index.html. Retrieved 2009-08-13. - ^ A combination of two sources:
Trend/Intensity from: "EuroFlu - Weekly Electronic Bulletin". Data Status Week 33 (August, 16). WHO/Europe. 2009-08-21. http://www.euroflu.org/cgi-files/bulletin_v2.cgi. Retrieved 2009-08-22.
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- ^ "Ensayo de vacuna contra virus AH1N1 incluirá a Costa Rica" (in Spanish). La Nación. 2009-07-31. http://www.nacion.com/ln_ee/2009/julio/31/pais2043450.html. Retrieved 2009-08-01.
- ^ "Presidente Arias contagiado con gripe AH1N1" (in Spanish). La Nación. 2009-08-11. http://www.nacion.com/ln_ee/2009/agosto/11/pais2056024.html. Retrieved 2009-08-11.
- ^ "Costa Rican president sick with swine flu". CNN. 2009-08-11. http://edition.cnn.com/2009/WORLD/americas/08/11/costa.rica.president.h1n1.flu/index.html. Retrieved 2009-08-11.
- ^ "Guatemala tests patient for suspected swine flu". Reuters. 2009-04-29. http://uk.reuters.com/article/latestCrisis/idUKN27528938. Retrieved 2009-04-30.
- ^ http://www.elperiodico.com.gt/es/20090505/pais/99779/
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- ^ http://www.msal.gov.ar/htm/site/alerta-epidemiologico.asp
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- ^ Ecuador restringe por un mes vuelos a México, El Universal, 29 Apr 2009.
- ^ , ECUADOR HABRIA CONFIRMADO PRIMER CASO DE GRIPE AH1N1
- ^ http://eluniverso.com/2009/05/20/1/1384/EF26D2D8E533454B8918EAC264EFE819.html
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- ^ "Confirman el primer caso de gripe A/H1N1 en Venezuela" (in Spanish). Gobierno Bolivariano de Venezuela: YVKE Mundial. 2009-05-28. http://www.radiomundial.com.ve/yvke/noticia.php?25372. Retrieved 2009-05-28.
- ^ "Min. Salud confirma segundo caso de influenza A/H1N1 en el país" (in Spanish). Gobierno Bolivariano de Venezuela: YVKE Mundial. 2009-05-29. http://www.radiomundial.com.ve/yvke/noticia.php?25458. Retrieved 2009-05-29.
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[edit] External links
 | Wikimedia Commons has media related to: 2009 swine flu outbreak maps |
 | Wikinews has related news: Swine flu |
- Influenza: H1N1 at the Open Directory Project
- Swine influenza, at the World Health Organization
- WHO's current Pandemic Influenza Phase
| Wikimedia Commons has media related to: Swine flu |
- Centres for Disease Control and Prevention (CDC): Swine Influenza (Flu)
- Medical Encyclopedia Medline Plus: Swine Flu
- Medical Encyclopedia WebMD: Swine Flu Centre
- H1N1 Statistics and Confirmed Worldwide Cases
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