Published Date: 2009-12-03 22:00:03
Subject: PRO/AH/EDR> Influenza pandemic (H1N1) 2009 (120): Canada, Haiti, Italy, USA
Archive Number: 20091203.4127
INFLUENZA PANDEMIC (H1N1) 2009 (120): CANADA, HAITI, ITALY, USA
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A ProMED-mail post
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ProMED-mail is a program of the
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In this update:
[1] Canada: age spectrum
[2] Haiti: case count
[3] Italy: oseltamivir resistance
[4] USA: vaccine reaction
******
[1] Canada: age spectrum
Date: Thu 3 Dec 2009
Source: The Chronicle Herald, Canadian Press report [edited]
<http://thechronicleherald.ca/Canada/1155771.html>
H1N1 taking toll on much younger group than seasonal flu
--------------------------------------------------------
Details of who [pandemic] H1N1 is sending to hospitals and who it is
killing show how different this flu virus is from seasonal influenza,
said the head of the Public Health of Canada. Dr David Butler-Jones
said that where seasonal flu mainly kills the elderly, the pandemic
virus is taking its worst toll on those far down the age spectrum.
"Those most seriously affected by H1N1 are 23 to 45 years younger than
what we see with seasonal flu," Butler-Jones said during a media
briefing. To make the point, he compared data on hospitalizations,
intensive care unit admissions, and deaths caused by [pandemic] H1N1
to those seen during the 2007-08 flu season, using the latter as a
proxy for seasonal [influenza] in general.
Butler-Jones used median ages -- the midway point between the youngest
and oldest person affected -- to draw the comparison. As of 21 Nov
2009, the median age of a person hospitalized with H1N1 in Canada is
26 years old. That's 45 years younger than the median age of people
hospitalized during the 2007-08 flu season, he said. And the median
age of people admitted to ICUs in the country is 45 years old -- 23
years younger than the median age of 68 seen in the 2007 flu season.
The median age of Canadians who have died from H1N1 infections is 54
years old, compared to the median age of 82 from that earlier flu
season. To date 329 people have died from H1N1 infections. About two
thirds have had medical conditions that increased their risk of death,
but one third did not. Butler-Jones, Canada's chief public health
officer, said children under 5 years old have had the highest rate of
admission to ICUs with this flu, followed by adults 45 to 64.
He warned it is too soon to know if Canada is past the peak of this
wave of infection, though it appears that there has been a plateauing
of transmission in most parts of the country. Still, with likely more
than half of Canadians still susceptible to the virus, more people
will become ill -- and some will die -- before [pandemic] H1N1 runs
its course, Butler-Jones said, reiterating his plea for Canadians to
get vaccinated.
[Byline: Helen Branswell]
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
******
[2] Haiti: case count
Date: Wed 2 Dec 2009
Source: Haiti Press Network [in French, trans.CP, edited]
<http://www.haitipressnetwork.com/news.cfm?articleID=12970>
Haiti: 92 cases of influenza and no deaths so far
-------------------------------------------------
Dr Gabriel Timothy, the director general of the Department of Public
Health of Haiti, announced that the Department of Epidemiological
Surveillance has identified 92 cases of influenza pandemic (H1N1) 2009
virus infection in Haiti. No deaths have been reported.
The good news is that according to Dr Timothy the country has enough
medicine [neuraminidase inhibitors?] to treat all persons who might be
affected by the pandemic (H1N1) virus. Dr Timothy stated that people
infected with influenza (H1N1) virus were treated similarly
irrespective of their condition and place of residence. The 92 cases
include both foreigners and Haiti nationals. The majority of people
exposed to pandemic (H1N1) virus infection reside in the West
department and are mostly aged between 15 and 35 years.
The director general of the Department of Public Health has so far not
announced initiation of a massive vaccination campaign against
pandemic (H1N1) virus infection in Haiti. However, he said that
vaccine is available for care-providers, pregnant women, and other
groups at risk.
['Influenza A virus' has been translated as 'pandemic (H1N1) 2009
virus' throughout on the presumption that the pandemic influenza A
(H1N1) 2009 virus is the subject of this report. - Mod.CP]
--
Communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>
[The HealthMap/ProMED-mail interactive map of Haiti is available at
<http://healthmap.org/r/00*N>. - Sr.Tech.Ed.MJ]
******
[3] Italy: oseltamivir resistance
Date: Thu 3 Dec 2009
From: Isabella Donatelli <isabella.donatelli@iss.it>
Pandemic influenza A (H1N1) 2009 virus, oseltamivir resistance
--------------------------------------------------------------
On 18 Nov 2009, the 1st case of oseltamivir resistant influenza A
(H1N1) 2009 virus in Italy was reported by the Virology Unit of
Policlinico San Matteo in Pavia, one of the laboratories belonging to
the NIC [National Influenza Centre] Italian virological network. The
resistant virus strain was identified in the nasal swab of a
2-year-old female, hospitalized for [ALL (acute lymphoblastic
leukemia)] at the Pediatric Oncohaematology Unit of the same Hospital.
The patient had developed influenza (H1N1) 2009 virus infection on 27
Oct 2009 and was submitted to oseltamivir (Tamiflu) treatment (30 mg
twice a day) starting from 29 Oct 2009. On 16 Nov 2009, a nasal swab
from the patient was still positive for influenza (H1N1) 2009 virus v
RNA and emergence of a drug-resistant virus strain was suspected. NA
sequence analysis showed the presence of the H274Y (N1 numbering)
mutation, which is associated with resistance to oseltamivir.
Sequencing of samples collected at baseline showed the absence of drug
resistance-associated mutations before oseltamivir administration.
Beside the reported resistant strain, more than 100 pandemic (H1N1)
2009 virus strains, representative of those circulating from May to
November 2009 in different geographical areas in Italy, have been
analyzed so far for antiviral susceptibility in Italy. All strains
have been shown to be susceptible to both neuraminidase inhibitors,
oseltamivir and zanamivir.
(These data are the results of a collaboration between the Italian NIC
and the Virology Unit of Policlinico San Matteo in Pavia, as specified
below.
Giulia Campanini1, Antonio Piralla1, Francesca Rovida1, Elena
Percivalle1, Franco Locatelli2, Simona Puzelli3, Marzia Facchini3,
Domenico Spagnolo3, Laura Calzoletti3, Fausto Baldanti1, and Isabella
Donatelli3
1 Virology Unit, 2 Pediatric Oncohaematology Unit, Policlinico San
Matteo, Pavia, 3 National Influenza Centre-ISS, Rome, Italy.)
--
Dr Isabella Donatelli
Director National Influenza Centre
Istituto Superiore di Sanita
Viale Regina Elena, 299
00161 Rome
Italy
<isabella.donatelli@iss.it>
[The HealthMap/ProMED-mail interactive map of Italy is available at
<http://healthmap.org/r/00*O>. - Sr.Tech.Ed.MJ]
******
[4] USA: vaccine reaction
Date: Thu 3 Dec 2009
From: David Price <price16@llnl.gov>
Re: ProMED-mail Influenza pandemic (H1N1) 2009 (112): Canada (MB),
vaccine reaction 20091121.4009
----------------------------------------------------------------------
Normal reactions to influenza vaccines include a sore arm and mild
flu-like symptoms for a short period of time after injection of the
vaccine. In general influenza vaccines, including the pandemic (H1N1)
2009 virus vaccine, are cultured in eggs, and in very rare cases there
may be an anaphylactic reaction to egg protein.
A portion of the people who have repeated anaphylactic reactions to
influenza vaccines (including my wife) are reacting to antibiotics,
which are sometimes used to suppress bacterial growth in the culture,
rather than reacting to the egg protein.
Many data sheets for influenza vaccines list the antibiotic as an
ingredient, but this is not true in all cases in which it is used. So
for someone with severe allergy to tetracycline and penicillin an
influenza vaccine shot can be a very risky affair.
--
David E Price SRO, CHMM
Senior Consequence Analyst for Special Projects, CBRNE
(Nuclear, Chemical, Biological, and Explosives Accident/Safety Analyses)
Counterproliferation & Operational Intelligence Support, Z Program
Global Security Directorate
Lawrence Livermore National Laboratory
<price16@llnl.gov>
[This is a very relevant observation and something that requires close
monitoring during vaccine production and in vaccine administration.
From personal experience I can confirm that reaction to penicillin
can be life-threatening. - Mod.CP]
See Also
Influenza pandemic (H1N1) 2009 (119): China, Japan, USA (NM) 20091203.4116Influenza pandemic (H1N1) 2009 (118): USA (AK) ethnicity 20091201.4108
Influenza pandemic (H1N1) 2009 (117): Japan, encephalopathy 20091129.4089
Influenza pandemic (H1N1) 2009 (116): origin 20091126.4052
Influenza pandemic (H1N1) 2009 (115): USA (WV) repeat infection 20091125.4047
Influenza pandemic (H1N1) 2009 (114): USA (WV), repeat infection 20091124.4039
Influenza pandemic (H1N1) 2009 (113): Saudi Arabia, Hajj fatalities
20091122.4013
Influenza pandemic (H1N1) 2009 (112): Canada (MB), vaccine reaction
20091121.4009
Influenza pandemic (H1N1) 2009 (111): Norway, mutants 20091121.4005
Influenza pandemic (H1N1) 2009 (110): UK (Wales), Tamiflu resistance
20091120.4000
Influenza pandemic (H1N1) 2009 (100): Ukraine (DT) 20091114.3940
Influenza pandemic (H1N1) 2009 (90): Venezuela, Yanomami 20091105.3820
Influenza pandemic (H1N1) 2009 (80): Ukraine susp. RFI 20091031.3764
Influenza pandemic (H1N1) 2009 (70): Nepal 20091016.3563
Influenza pandemic (H1N1) 2009 (60): bacterial coinfection 20090930.3410
Influenza pandemic (H1N1) 2009 (50): oseltamivir-resistance 20090917.3260
Influenza pandemic (H1N1) 2009 (40): global update 20090906.3138
Influenza pandemic (H1N1) 2009 (30): assumptions 20090813.2879
Influenza pandemic (H1N1) 2009 (20): Peru, 33 percent asymptomatic
20090730.2668
Influenza pandemic (H1N1) 2009 (10): vaccine 20090720.2577
Influenza pandemic (H1N1) 2009 - Viet Nam: patient data 20090708.2450
........................................cp/mj/jw
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