Main developments in past 72 hours
-The number of confirmed deaths reported by EU & EFTA countries as due to the pandemic rose by two thirds in one week to 169;
- Routine surveillance reports from primary care indicate that almost all European countries reported intensity above baseline levels. Seventeen countries showed increasing trends mostly counties in Eastern Europe. But some countries are now reported decreasing trends;
- EMEA's Committee on Human Medical Products has strengthened its previous statement that a single injection of the vaccines Focetria and Pandemrix may be sufficient to protect children over age 10 and adults to age sixty;
- EMEA also sees no evidence to date that any of the licensed vaccines have side effects more than those expected from the clinical trials;
- A mutation in the Haemagglutinin gene of the pandemic virus has been reported from Norway;
- Two clusters of possible transmission of oseltamivir resistant Pandemic Influenza A(H1N1)v among hospitalized patients in the United Kingdom and United States;
- Episouth update from countries of the Mediterranean and the Balkans included.
This report is based on official information provided by national public health websites or through other official communication channels. An update on the number of confirmed fatal cases is presented in Table 2 - as of 22 November 2009 - 16:00 hours CEST, for the world, and 23 November 2009 - 09:00 hours CEST, for Europe.
Epidemiologic update
The Weekly Influenza Surveillance Report
All 27 EU and 4 EFTA countries are reporting cases of pandemic (H1N1) 2009 influenza. A total of 670 deaths have been reported since April 2009 (Table 2). Since week 41 the numbers of deaths each has shown a steady increase almost doubling every fortnight over the last six weeks. While the most deaths have to date been in Western Europe there are increasing numbers of deaths being reported from Central and Eastern Europe. Latest new and confirmed fatal pandemic (H1N1) cases outside the EU/EFTA area are presented in Table 2 as well. Available updates on hospital admissions, per Member State, can be found in Table 1.
The Weekly Influenza Surveillance Overview was published in November 20th for week 46/2009, Twenty seven countries reported epidemiological data, the highest total to date this pandemic. For the activity intensity indicator—national network levels for ILI and/or ARI— Italy, Norway and Sweden reported very high intensity; Bulgaria, Denmark, Germany, Iceland, Ireland, Lithuania, Luxembourg, Poland and Portugal reported high intensity; medium intensity was reported by 14 countries and one country reported low intensity.
For the geographic spread indicator, increases were noted compared to the previous week with 15 countries reporting widespread activity. Nine countries reported regional activity. The other countries reported sporadic or no activity. Seventeen countries reported an increasing trend of influenza activity compared to twenty in the previous week. Countries in Central and Eastern Europe were especially experiencing rising trends. Seven countries, Belgium, Bulgaria, Iceland, Ireland, Luxembourg, Norway and parts of the UK (Northern Ireland), reported decreasing trends. Belgium, Iceland and the UK (Northern Ireland), reported decreasing trends in week 45 as well. In most countries where influenza activity has risen above baseline levels, the most affected group includes those younger than 15 years. Virological data indicate that there remains very viruses apart from the pandemic strain. The proportion of sentinel specimens that are confirmed influenza is 45%, a high level normally only seen during the peaks of previous winter influenza epidemics.
