Influenza A(H1N1) infection - Update 31 May 2009

Main developments in past 24 hours

• Thirty-two new confirmed cases in EU and EFTA countries;
• First confirmed case reported from Cyprus;
• One case each reported from Ireland, Finland and Sweden, 2 from Belgium, 5 from Germany, 6 from France, and 15 from the UK.
  

This report is based on official information provided by the national public health websites, or through other official communication channels. In addition, outside of the EU and EFTA countries, media reports from credible sources are included when quoting national authorities. An update on the number of confirmed cases as of 30 May, 17:00 hours CEST, is presented in Table 1 and Table 2.

Disclaimer: the number of confirmed cases reported is based on laboratory test results, except for the US. Depending on the national laboratory testing policies, the actual number of cases by country may therefore be higher.


Epidemiological update

In the past 24 hours, 32 new cases were confirmed in the EU and EFTA countries.

Cyprus reports its first case: a woman who travelled from New York to Cyprus through London on the 27th of May. She developed influenza-like symptoms (fever, headache, sore throat, cough, muscle pains and malaise) during the leg from London to Cyprus.

In addition to Cyprus, Finland, Ireland and Sweden report 1 new case each, Belgium 2, Germany 5, France 6 and the UK 15. One German case and 8 of the UK cases are reported as in-country transmissions.

A total of 557 confirmed cases are now reported from 24 EU and EFTA countries (Table 1).

Outside of the EU and EFTA countries, a total of 16,838 cases are currently reported. Two countries are reporting their first cases: Bahamas (1) and Lebanon (3). A major increase is seen in Australia, which has almost doubled its case count in the last 48-hour period, from 168 to 298.

No more deaths have been reported today; the total remains at 115 (Table 2).


Assessment and response in the EU and EFTA countries

24 out of the 31 EU/EFTA countries have now reported cases, but the assessment for the EU and EFTA countries does not change: no sustained community transmission has yet been declared.

ECDC, in collaboration with the Member States, the European Commission and the World Health Organisation, continues to closely monitor this rapidly evolving situation, and provide daily updates on its website.


Transmissibility vs. virulence

The terms transmissibility and virulence are not seldom confused, but they denote two quite different characteristics of a pathogen. Transmissibility measures how efficiently a disease is passed on from an infectious to a susceptible person (another word for this is ‘attack rate’). Virulence denotes how severe the infection becomes in a patient, once he/she has become infected. A pathogen may be highly transmissible, but have low virulence (for example common cold), or the reverse (for example Ebola). These terms should not be mixed up when talking about the new influenza A(H1N1) outbreak.


Table 1: Reported cumulative number of confirmed cases and of in-country transmission of influenza A(H1N1) as of 31 May 2009, 17:00 hours (CEST) in EU and EFTA countries

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Cumulative number of in-country transmission]

1. Austria ... - 1 - ...
2. Belgium 2 - 12 - 3
3. Cyprus 1 - 1 - ...
4. Czech Republic ... - 1 - ...
5. Denmark ... - 1 - ...
6. Estonia ... - 1 - ...
7. Finland 1 - 4 - ...
8. France 6 - 32 - ...
9. Germany 5 - 28 - 6
10. Greece ... - 4 - ...
11. Hungary ... - 1 - ...
12. Iceland ... - 1 - ...
13. Ireland 1 - 4 - ...
14. Italy ... - 26 - 2
15. Netherlands ... - 3 - ...
16. Norway ... - 4 - ...
17. Poland ... - 4 - ...
18. Portugal ... - 1 - ...
19. Romania ... - 3 - 1
20. Slovakia ... - 2 - 1
21. Spain ... - 167 - 57
22. Sweden 1 - 6 - ...
23. Switzerland ... - 6 - ...
24. United Kingdom 15 - 244 - 158

• Total 32 - 557 - 228
  

Note: cases reported in the EU and EFTA countries correspond to the EWRS notifications by Member States or Ministry of Health websites.


Table 2: Reported cumulative number of confirmed cases and deaths of influenza A(H1N1) as of 31 May 2009, 17:00 hours (CEST) outside of the EU and EFTA area

[Country - Confirmed cases reported in the last 24h - Cumulative number of confirmed cases - Deaths among confirmed cases*]

• WHO EURO REGION

1. Israel ... - 14 - ...
2. Russian Federation ... - 3 - ...
3. Turkey ... - 2 - ...

• WHO AMRO REGION

1. Argentina 20 - 100 - ...
2. Bahamas 1 - 1
3. Bolivia ... - 2 - ...
4. Brazil 1 - 16 - ...
5. Canada ... - 1336 - 2
6. Chile 26 - 250 - ...
7. Colombia 3 - 20 - ...
8. Costa Rica ... - 37 - 1
9. Cuba ... - 4 - ...
10. Dominican Republic ... - 2 - ...
11. Ecuador ... - 35 - ...
12. El Salvador ... - 27 - ...
13. Guatemala ... - 11 - ...
14. Honduras ... - 2 - ...
15. Mexico ... - 5029 - 97
16. Panama ... - 107 - ...
17. Paraguay ... - 5 - ...
18. Peru ... - 36 - ...
19. Uruguay 9 - 11 - ...
20. USA** 1047 - 8976 - 15
21. Venezuela ... - 1 - ...

• WHO EMRO REGION

1. Bahrain ... - 1 - ...
2. Kuwait ... - 18 - ...
3. Lebanon 3 - 3 - ...
4. United Arab Emirates ... - 1 - ...

• WHO SEARO REGION

1. India ... - 1 - ...
2. Thailand 1 - 3 - ...

• WHO WPRO REGION

1. Australia 44 - 298 - ...
2. China 12 - 41 - ...
3. Japan 8 - 378 - ...
4. Malaysia ... - 2 - ...
5. New Zealand ... - 9 - ...
6. Philippines ... - 6 - ...
7. Republic of Korea ... - 33 - ...
8. Singapore 1 - 5 - ...
9. Taiwan 1 - 11 - ...

• Total 131 - 16838 - 115
  

Note: cases reported in non-EU and EFTA countries correspond to cases published on Ministry of Health websites, or through WHO, or through credible media source quoting national authorities. Therefore, some of these cases may be taken out at a later stage if not validated.

(*) Deaths are included in the cumulative number of confirmed cases

(**) Cases in the US include both probable and confirmed cases. Cases reported from the US include confirmed cases from Puerto Rico.