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Published Date: 2009-05-07 22:00:05
Subject: PRO/AH/EDR> Influenza A (H1N1) - worldwide (16): case counts
Archive Number: 20090507.1715

INFLUENZA A (H1N1) - WORLDWIDE (16): CASE COUNTS
***********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[Please note that there may be discrepancies between the various
sources of information due to different times of "closure" of daily
figures reported. Times of daily report closures when known are
listed in the table of contents below. Oftentimes, a newswire will
mention a confirmed case in a location that has not been on the
official reporting entity list, as the confirmation arrived after
closure of the day's report. - Mod.MPP]

In this update:
[1] WHO - global update (16:00 GMT)
[2] PAHO - Americas regional update (13:00 GMT-4)
[3] CDC - USA update (11:00 GMT -4)
[4] Mexico - MOH update (08:45 GMT -5)
[5] Canada - Health Protection Agency (14:00 GMT -4)
[6] News briefs

******
[1] WHO - global update (16:00 GMT)
Date: 7 May 2009
Source: WHO Epidemic and Pandemic Alert and Response (EPR) [edited]
<http://www.who.int/csr/en/>

a. Influenza A(H1N1) - update 19 - 7 May 2009
<http://www.who.int/csr/don/2009_05_07/en/index.html>

As of 06:00 GMT, 7 May 2009, 23 countries have officially reported
2099 cases of influenza A(H1N1) infection.

Mexico has reported 1112 laboratory confirmed human cases of
infection, including 42 deaths. The United States has reported 642
laboratory confirmed human cases, including 2 deaths.

The following countries have reported laboratory confirmed cases with
no deaths: Austria (1), Canada (201), China, Hong Kong Special
Administrative Region (1), Colombia (1), Costa Rica (1), Denmark (1),
El Salvador (2), France (5), Germany (9), Guatemala (1), Ireland (1),
Israel (4), Italy (5), Netherlands (1), New Zealand (5), Portugal
(1), Republic of Korea (2), Spain (73), Sweden (1), Switzerland (1)
and the United Kingdom (28).

b. Influenza A(H1N1) - update 20 - 7 May 2009
<http://www.who.int/csr/don/2009_05_07a/en/index.html>

7 May 2009 - As of 18:00 GMT, 7 May 2009, 24 countries have
officially reported 2371 cases of influenza A (H1N1) infection.

Mexico has reported 1112 laboratory confirmed human cases of
infection, including 42 deaths. The United States has reported 896
laboratory confirmed human cases, including 2 deaths.

The following countries have reported laboratory confirmed cases with
no deaths: Austria (1), Canada (201), China, Hong Kong Special
Administrative Region (1), Colombia (1), Costa Rica (1), Denmark (1),
El Salvador (2), France (5), Germany (10), Guatemala (1), Ireland
(1), Israel (6), Italy (5), Netherlands (2), New Zealand (5), Poland
(1), Portugal (1), Republic of Korea (3), Spain (81), Sweden (1),
Switzerland (1) and the United Kingdom (32).

Summary table of cases reported to WHO 30 Apr 2009 / 1 May / 2 May /
3 May / 4 May / 5 May / 6 May / 7 May
----------------
Country: No. cases (deaths) 30 Apr 2009 / 1 May / No. cases (deaths)
2 May / 3 May / 4 May / 5 May / 6 May / 7 May

Austria: 1 / 1 / 1 / 1 / 1 / 1 / 1
Canada: 19 / 34 / 51 / 85 / 101 / 140 / 165 / 201
China, Hong Kong, SAR: 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Costa Rica: 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1
Colombia: 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1
Denmark: 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1
El Salvador: 0 / 0 / 0 / 0 / 2 / 2 / 2 / 2
France: 0 / 0 / 2 / 2 / 4 / 4 / 5 / 5
Germany: 3 / 4 / 6 / 8 / 8 / 9 / 9 / 10
Guatemala: 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1
Ireland: 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1
Israel: 2 / 2 / 3 / 3 / 4 / 4 / 4 / 6
Italy: 0 / 0 / 0 / 1 / 2 / 5 / 5 / 5
Mexico: 97(7) / 156 (9) / 397 (16) / 506 (19) / 590 (25) / 822 (29) /
942 (29) / 1112 (42)
Netherlands: 1 / 1 / 1 / 1 / 1 / 1 / 1 / 2
New Zealand: 3 / 4 / 4 / 4 / 6 / 6 / 5 / 5
Poland: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1
Portugal: 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1
Republic of Korea: 0 / 0 / 1 / 1 / 1 / 2 / 2 / 3
Spain: 13 / 13 / 13 / 40 / 54 / 57 / 73 / 81
Sweden: 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1
Switzerland: 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
United Kingdom: 8 / 8 / 15 / 15 / 18 / 27 / 28 / 32
United States: 109 (1) / 141 (1) / 160 (1) / 226 (1) / 286 (1) / 403
(1) / 642 (2) / 896 (2)

Total No. countries reporting cases: 11 / 13 / 16 / 18 / 21 / 21 / 23 / 24
Total cases reported: 257 (8) / 367 (10) / 658 (17) / 898 (20) / 1085
(26) / 1490 (30) / 1893 (31) / 2371 (44)

--
Communicated by:
ProMED-mail Rapporteur Marianne Hopp

******
[2] PAHO - Americas regional update (13:00 GMT-4)
Date: 7 May 2009
Source: PAHO H1N1 flu website [edited]
<http://new.paho.org/hq/index.php?option=com_content&task=view&id=1324&Itemid=569>

Update. Influenza A (H1N1) Regional Report (7 May 2009)
Epidemiological Alerts Vol. 6, No. 23

Up to 6 May 2009, the total of confirmed cases of influenza A (H1N1)
recorded is 2214, including 44 deaths, in 7 countries of the Americas
(Mexico, United States, Canada, Costa Rica, Colombia, El Salvador and
Guatemala).

To date, the United States has confirmed a total of 896 human cases
of influenza A (H1N1), including 2 deaths, in 41 States: 4 in
Alabama, 48 in Arizona, 106 in California, 17 in Colorado, 4 in
Connecticut, 38 in Delaware, 5 in Florida, 3 in Georgia, 3 in Hawaii,
1 in Idaho, 204 in Illinois, 15 in Indiana, 5 in Iowa, 7 in Kansas, 2
in Kentucky, 7 in Louisiana, 4 in Maine, 4 in Maryland, 71 in
Massachusetts, 1 in Michigan, 1 in Minnesota, 4 in Missouri, 4 in
Nebraska, 5 in Nevada, 2 in New Hampshire, 7 in New Jersey, 8 in New
Mexico, 98 in New York, 7 in North Carolina, 5 in Ohio, 1 in
Oklahoma, 15 in Oregon, 2 in Pennsylvania, 2 in Rhode Island, 17 in
South Carolina, 2 in Tennessee, 91 in Texas, 8 in Utah, 11 in
Virginia, 23 in Washington and 26 in Wisconsin. Other suspected cases
are being investigated.

From [1 Mar 2009 to 5 May 2009], Mexico has reported 1112 confirmed
cases of influenza A (H1N1), including 42 deaths, in 28 of 32 states.
The states with the highest number of confirmed cases are Distrito
Federal, Estado de Mexico, San Luis Potosi and Hidalgo. The majority
of these have occurred in previously healthy young adult people.

In Canada to date, 201 human cases of influenza A (H1N1) have been
confirmed in 8 of 13 provinces: 30 in Alberta, 54 in British
Columbia, 2 in New Brunswick, 53 in Nova Scotia, 10 in Quebec, 1 in
Manitoba, 49 in Ontario and 2 in Prince Edward Island, some of them
with recent travel history to Mexico. All the cases developed a mild
form of influenza-like illness. Some of the cases presented, in
addition, gastrointestinal symptoms. Indigenous transmission is not
discarded, since not all the confirmed cases have trip history to Mexico.

On [2 May 2009], Costa Rica notified one confirmed case of influenza
A (H1N1). On [3 May 2009], Colombia reported one confirmed case of
influenza A (H1N1), while El Salvador reported 2 confirmed cases of
influenza A (H1N1). On [5 May 2009], Guatemala notified one confirmed
case of influenza A (H1N1) in a person that has traveled to Mexico.
Various countries of the region are reporting suspected and probable
cases. This indicates that surveillance enhancement is producing results.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

******
[3] CDC - USA update (11:00 GMT -4)
Date: 7 May 2009
Source: CDC H1N1 flu website [edited]
<http://www.cdc.gov/h1n1flu/>

H1N1 Flu (Swine Flu)
--------------
State: Cumulative no. of lab. confirmed cases (Deaths) 30 Apr 2009 /
1 May / 2 May / 3 May / 4 May / 5 May / 6 May / 7 May 2009
Alabama: 0 / 0 / 0 / 1 / 4 / 5 / 4 / 4
Arizona: 1 / 4 / 4 /18 / 17 / 17 / 48 / 48
California: 14 / 13 / 24 / 26 / 30 / 49 / 67 / 106
Colorado: 0 / 2 / 2 / 4 / 7 / 6 / 17 / 17
Connecticut: 0 / 0 / 1 / 2 / 2 / 2 / 4 / 4
Delaware: 0 / 4 / 4 / 10 / 20 / 20 / 33 / 28
Florida: 0 / 0 / 2 / 3 / 5 / 5 / 5 / 5
Georgia: 0 / 0 / 0 / 0 / 0 / 1 / 3 / 3
Hawaii: 0 / 0 / 0 / 0 / 0 / 0 / 3 / 3
Idaho: 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1
Illinois: 0 / 3 / 3 / 3 / 8 / 82 / 122 / 204
Indiana: 1 / 3 / 3 / 3 / 3 / 3 / 15 /15
Iowa: 0 / 0 / 0 / 1 / 1 / 1 / 1 / 5
Kansas: 2 / 2 / 2 / 2 / 2 / 2 / 2 / 7
Kentucky*: 0 / 1 / 1 / 1 / 1 / 1 / 2 / 2
Louisiana: 0 / 0 / 0 / 0 / 7 / 7 / 7 /7
Maine: 0 / 0 / 0 / 0 / 0 / 1 / 1 / 4
Maryland: 0 / 0 / 0 / 0 / 4 / 4 / 4 / 4
Massachusetts: 2 / 2 / 8 / 7 / 6 / 6 / 45 / 71
Michigan: 1 / 2 / 2 / 2 / 2 / 2 / 8 / 9
Minnesota: 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Missouri: 0 / 0 / 1 / 1 / 1 / 1 / 2 / 4
Nebraska: 0 / 1 / 0 / 1 / 1 / 1 / 4 / 4
Nevada: 1 / 1 / 1 / 1 / 1 / 1 / 5 / 5
New Hampshire: 0 / 0 / 0 / 1 / 1 / 1 / 2 / 2
New Jersey: 0 / 5 / 7 / 7 / 7 / 6 / 7 / 7
New Mexico: 0 / 0 / 0 / 1 / 1 / 1 / 3 / 8
New York: 50 / 50 / 50 / 63 / 73 / 90 / 97 / 98
North Carolina: 0 / 0 / 0 / 0 / 1 / 1 / 7 / 7
Ohio: 1 / 1 / 1 / 3 / 3 / 3 / 5 / 5
Oklahoma: 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1
Oregon: 0 / 0 / 0 / 0 / 3 / 15 / 15 / 15
Pennsylvania: 0 / 0 / 0 / 0 / 1 / 1 / 1 / 2
Rhode Island: 0 / 0 / 0 / 1 / 1 / 1 / 2 / 2
South Carolina: 10 / 16 / 13 / 15 / 15 / 16 / 16 / 17
Tennessee: 0 / 0 / 0 / 1 / 1 / 2 / 2 / 2
Texas: 26 (1) / 28 (1) / 28 (1) / 40 (1) / 41 (1) / 41 (1) / 61 (2) / 91 (2)
Utah: 0 / 0 / 0 / 1 / 1 / 1 / 1 / 8
Virginia: 0 / 2 / 2 / 3 / 3 / 3 / 3 / 11
Washington: 0 / 0 / 0 / 0 / 0 / 0 / 9 / 23
Wisconsin: 0 / 0 / 0 / 3 / 3 / 3 / 6 / 26

Total number of states: 11 / 19 / 21 / 30 / 36 / 38 / 41 / 41

Total counts, cases (deaths): 109 (1) / 141 (1) / 160 (1) / 226 (1) /
279 (1) / 403 (1) / 642 (2) / 896 (2)

*Case is resident of KY but currently hospitalized in GA.

[For a map of number of cases by state, see
<http://www.cdc.gov/h1n1flu/update.htm>.
- Mod.MPP]

--
Communicated by:
ProMED-mail <promed@promedmail.org>

******
[4] Mexico - MOH update (08:45 GMT -5)
Date: 7 May 2009
Source: Secretaria de Salud website (MOH) [trans. Mod.MPP, edited]
<http://portal.salud.gob.mx/contenidos/noticias/influenza/estadisticas.html>

Case counts: 29 Apr 2009 / 1 May / 2 May / 3 May / 4 May / 5 May / 6
May / 7 May
Number of confirmed cases: 99 / 397 / 443 / 506 / 727 / 866 / 1112 / 1204
Number of deaths: 8 / 16 / 16 / 19 / 26 / 26 / 42 / 44

[To download the 7 May 2009 graphics on the status of the epidemic,
click on the link 07/Mayo/2009
<http://portal.salud.gob.mx/opencms/opencms/sites/salud/descargas/pdf/influenza/situacion_actual070509.pdf>
Situacion actual de la Epidemia. There is an epidemic curve, age
distribution data, and number of cases by state with current map
available at this link. - Mod.MPP]

Age distribution: No. cases (percent) / deaths (percent) /
case-fatality rate (CFR)
0-9 years: 316 (26.2) / 2 (4.8) / 6.3
10-19 years: 303 (25.2) / 2 (4.8) / 6.6
20-29 years: 243 (20.2) / 16 (38.1) / 4.1
30-39 years: 130 (10.8) / 9 (21.4) / 6.9
40-49 years: 105 (8.7) / 5 (11.9) / 4.8
50-59 years: 76 (6.3) / 4 (9.5) / 5.3
60 and older: 26 (2.2) / 4 (9.5) / 15.4
ND (not determined) 5 (0.4)

Total: 1204 (42)

[The epidemic curve available at the given link shows a rapid
decrease in the number of confirmed cases by date of onset beginning
approximately 27 Apr 2009, with no cases effectively reported since 5
May 2009. This may change with time, but the curve is highly
suggestive that the epidemic is ending.

Calculating the overall confirmed case fatality rate, with today's (7
May 2009) report of 44 deaths, the rate is 3.7 percent. Of interest
are the higher case fatality rates by age group, which may be a small
number phenomenon. To date, information on results of investigations
into the actual clinical courses of the fatal cases has not been
available for review. - Mod.MPP]

--
Communicated by:
ProMED-mail <promed@promedmail.org>

******
[5] Canada - Health Protection Agency (14:00 GMT -4)
Date: 7 May 2009
Source: Health Protection Agency [edited]
<http://www.phac-aspc.gc.ca/alert-alerte/swine-porcine/surveillance-eng.php>

Province: Cumulative confirmed cases of human swine influenza as of
30 Apr / 1 May / 2 May / 3 May / 4 May / 5 May / 6 May / 7 May 2009

Alberta: 6 / 8 / 15 / 18 / 24 / 26 / 30 / 33
British Columbia: 11 / 15 / 22 / 29 / 39 / 46 / 54 / 54
Manitoba: 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1
Nova Scotia: 8 / 14 / 16 / 33 / 38 / 48 / 53 / 53
New Brunswick: 0 / 1 / 1 / 1 / 2 / 2 / 2 / 2
Ontario: 8 / 12 / 14 / 16 / 31 / 36 / 49 / 56
Prince Edward Island: 0 / 0 / 0 / 0 / 2 / 2 / 2 / 2
Quebec: 1 / 1 / 2 / 3 / 3 / 4 / 10 / 11
Saskatchewan: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 2

Total no. Provinces with cases: 5 / 6 / 6 / 7 / 8 / 8 / 8 / 9
Total: 34 / 51 / 70 / 101 / 140 / 165 / 201 / 214

As of [6 May 2009], half the cases are 22 years of age or younger
(median: 22 years; range: 2-66 years). To date, 3 cases have been
hospitalized, and no deaths have been reported. The most recent date
of onset of illness is [3 May 2009].

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[There is an epidemic curve available at
<http://www.phac-aspc.gc.ca/alert-alerte/swine-porcine/surveillance-eng.php>.
The graph illustrates the course of the current H1N1 Flu Virus (Human
Swine Flu) outbreak in Canada. It shows the date when symptoms of
H1N1 Flu Virus (Human Swine Flu) began for each of the
laboratory-confirmed cases (see Number of Laboratory-Confirmed H1N1
Flu Virus (Human Swine Flu) Cases in Canada by Date of Onset as
Reported to the Public Health Agency of Canada as of 7 May 2009 1500
EDT (N=158*).
*date of onset pending for 43 cases - Mod.MPP]

******
[6] News briefs
Date: 7 May 2009

[Below are links to newswires with information on confirmed cases in
countries not included in official updates from 6 May 2009 and other
events of potential interest. The newswires are full of reports of
suspected cases in many countries. Reports have been filtered and
discarded as more information becomes available during the day. - Mod.MPP]

Americas:
Argentina - 1st case confirmed, history of travel to Mexico
Brazil - 4 cases confirmed, history of travel to Mexico and USA (Florida)
<http://www.google.com/hostednews/ap/article/ALeqM5gPYC3gsptoxwNPywo6McGzdu7KmAD981MNC04>

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[To summarize the current situation as of 7 May 2009, there have been
a total of 2371 cases and 44 deaths of influenza A (H1N1) infection
officially reported to WHO/PAHO coming from 24 countries, up from
1893 confirmed cases and 31 deaths from 23 countries yesterday (5 May
2009). The newly added country is Poland. (According to newswires,
Brazil and Argentina have confirmed 4 cases and one case,
respectively, and will probably appear on tomorrow's (8 May 2009)
official reports).

The USA has officially reported 896 laboratory confirmed cases coming
from 41 states (compared with 642 cases from 41 states on 6 May
2009), and 2 deaths (one in a Mexican child visiting in the USA and a
2nd in a resident of Texas with known pre-existing illness). Canada
has reported 214 cases from 9 provinces with no deaths, up from 201
cases from 8 provinces on 5 May 2009. Mexico has reported 1204
confirmed cases with 44 deaths (compared with 1112 cases and 42
deaths on 4 May 2009.

According to data available, the overall reported case fatality rate
in Mexico has been 3.7 percent, but higher CFRs have been observed by
age groups. Results of further studies on the fatal cases are not
presently available to permit a better understanding of what may have
transpired in Mexico. Questions still remain as to whether there was
primary viral pneumonia, acute respiratory distress syndrome, or
secondary bacterial pneumonia and possible overwhelming sepsis as the
contributing factors to the fatal outcomes following H1N1 infection.

For a map of reported confirmed cases worldwide as of 18:00 GMT 7 May 2009, see
<http://www.who.int/csr/don/GlobalSubnationalMaster_20090507_1800.png>.

For an interactive map of reported confirmed cases in the Americas as
of 13:00 GMT -4 showing burden of disease by state/province, see
<http://ais.paho.org/flu/sm/en/atlas.html>.
For a static map of reported cases in the Americas as of 13:00 GMT -4, see
<http://new.paho.org/hq/swine_files/mapeng.htm>.
- Mod.MPP]

See Also