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Archive Number 20090802.2713
Published Date 02-AUG-2009
Subject PRO/AH/EDR> Influenza pandemic (H1N1) 2009 (23): (China, Taiwan), co-circ. H3N2
INFLUENZA PANDEMIC (H1N1) 2009 (23): (CHINA AND TAIWAN), CO-CIRCULATING H3N2
****************************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
[1] Taiwan - H3N2
[2] China (Hong Kong S.A.R.) - H3N2
[3] Asymptomatic cases

********
[1] Taiwan H3N2
Date: Fri 31 Jul 2009
Source: RTI (Radio Taiwan International) [edited]
<http://english.rti.org.tw/Content/GetSingleNews.aspx?ContentID=83697>


H3N2 brings new influenza threat
--------------------------------
Taiwan announced 2 more cases of influenza virus on Friday [31 Jul 
2009]. One is down with the H1N1 swine flu [influenza pandemic (H1N1) 
2009] virus, and the other is infected as influenza A virus subtype 
H3N2. As of Friday [31 Jul 2009], Taiwan has 6 cases of H1N1 and 2 
H3N2 cases. The [Taiwan] Center for Disease Control said that Taiwan 
is faced with threats of 2 flu types. The center said among the 6 
H1N1 cases, one has died. In addition, the center said that in the 
month of July [2009] alone, there had been 10 cases of H1N1 cluster 
infections. There are at least 58 confirmed cases of H1N1.

The deputy director-general of the center, Lin Ting, said that since 
most of the infected are men in their 30s, these men are being 
considered possibly for receiving the vaccines as well. Head of the 
physical education department of the education ministry Wang 
Jun-chuan said on Friday [31 Jul 2009] that schools have the right to 
decide whether to stop classes if cases were to appear in schools.

"We have been in touch with the [Taiwan] Centers of Disease Control. 
If a school were to have one infected case, we have agreed that the 
school can discuss with the county government and the health 
department about whether to stop classes for up to 7 days. But if the 
situation is serious, this can extended to 10 days. Secondly, if the 
county happens to have more than 2 cases in a school or a case of 
cluster infection, then the health department can decide for all 
schools in the district or nearby region to be shut down," said Wang.

Head of Taiwan's Health Department Yeh Jin-chuan will be traveling to 
Hong Kong in August to discuss the pandemic with Hong Kong officials.

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

[For the interactive HealthMap/ProMED map for Taiwan, see: 
<http://healthmap.org/r/00DX> - CopyEd.EJP]

******
[2] China (Hong Kong S.A.R.) H3N2
Date: Fri 31 Jul 2009
Source: China view, Xinhua News Agency [edited]
<http://news.xinhuanet.com/english/2009-07/30/content_11803913.htm>


H3N2 brings new influenza threat
--------------------------------
Hong Kong's health authorities announced Wednesday [29 Jul 2009] that 
a new variant of the H3N2 seasonal influenza virus has been found in 
the city. The Brisbane strain has been the prevalent circulator of 
H3N2 in the past year, and the new variant is its direct descendent, 
said Thomas Tsang, controller of Hong Kong's Center for Health 
Protection (CHP). "However, it has some genetic changes 
distinguishing it from the old Brisbane strain," he said. He said it 
is normal for viruses to go through changes, adding that overseas 
health authorities, including those in Canada, Britain and Australia, 
had also found the new variant.

Tsang said although vaccines provided for the northern hemisphere may 
not be a direct match for this new variant, they will still provide 
some protection against it. Noting that vaccines will be widely 
available in Hong Kong in a month, Tsang appealed to high-risk 
groups, such as those with chronic diseases, the elderly and 
children, to get flu shots.

According to the CHP, H3N2 accounts for 43 percent of flu viruses 
circulating in Hong Kong, while A/H1N1 accounts for 49 percent.

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

[For the interactive HealthMap/ProMED map for Hong Kong, see: 
<http://healthmap.org/r/00aZ> - CopyEd.EJP]

******
[3] Asymptomatic cases
Date: Fri 31 Jul 2009
From: Dr. Steve Berger
<mberger@post.tau.ac.i



A comment on ProMED post:
Influenza pandemic (H1N1) 2009 (20): Peru, 33 percent asymptomatic 
20090730.2668
--------------------------------------------------------------------------------
If a many persons infected by H1N1 are indeed asymptomatic, much of 
the current approach to reporting and containment will have to be revised.

Screening in airports, emergency rooms, etc., begins with the 
assumption of a febrile patient. Infection without overt signs will 
be neither reported nor restricted, and could presumably promote 
spread of the virus to others. The existence of many unrecognized 
infections will also reduce our current assessment of case / fatality rate.

--
Steve Berger
Geographic Medicine
Tel Aviv Medical Center
mberger@post.tau.ac.il


[see also:
Seasonal influenza (H3N2) virus - potential vaccine mismatch  20090724.2623
Influenza pandemic (H1N1) 2009 (20): Peru, 33 percent 
asymptomatic  20090730.2668
Influenza A (H1N1) - worldwide (11): coincident H3N2 variation  20090505.1679]
........................mmp/cp/ejp/mpp

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