Friday, January 1, 2010

Egypt: 5 More Deaths - Total 141

Friday, January 1st, 2010 - 20:55

Minister of Health

The Ministry of Health for the deaths of five new cases of HIV, "eh HP 1 The 1" is known internationally as the swine flu, bringing the total number of deaths in Egypt since the emergence of the disease and so far 141 cases.

The Ministry of Health - in a statement on Friday -

(case) No. 137 that the situation of a woman at the age of 40 years from Qalyoubia province,

and case No. 138 a man from the Governorate of Cairo at the age of 54,

Case No. 139 of a lady 77 years old from the province Alexandria.

The statement added that the situation of (case number) 140 men aged 67 years of Alexandria Governorate

and the situation of the (case number) 141 men aged 52, from Alexandria.
hat-tip Twall

Thursday, December 31, 2009

Egypt: Deaths #130 - #133

My edits are in (blue)

4 new deaths of swine influenza virus
Thursday, December 31st, 2009 - 20:15

The swine flu deaths continue to rise started Amira Abdel-Salam

The Ministry of Health said in a statement today, Thursday, and the death of 4 new cases of swine flu virus, bringing the total deaths to 133 cases.

The statement said that the situation of (case number) 130 Egyptian woman, aged (37 years), from Kafr El-Sheikh,

and the situation of (case number) 131 Egyptian woman, aged (48 years) from the Cairo governorate,

and the situation of (case number) 132 Egyptian woman, aged (40 years), from Alexandria,

and the situation (case number) 133 of the Egyptian man old (65 years) from Monofia. (Menoufia)

Hat tip: Twall
Comment: [Will add the information for case number 127,128 129,130,131 and 132 when i locate it.
This is sixteen deaths reported in a single twenty four hour period based on the moh information.]

Study: H1N1 not highly contagious in households

Dec 30, 2009 (CIDRAP News) – People living in the same household were less likely to catch H1N1 influenza from a sick family member than they would have been in past pandemics or during a normal flu season, a team from University College London and the Centers for Disease Control and Prevention report today in the New England Journal of Medicine.

Drawing on a database of information gathered about patients with lab-confirmed H1N1 during the pandemic’s early stages, the researchers found the new flu was not very contagious. There were secondary infections in 27% of 216 households and 13% of 600 household residents, compared to secondary attack rates that rose to 20% in the 1957 and 1968 pandemics and up to 40% in some flu seasons. Children and teenagers were twice as susceptible as adults.

The database was assembled from reports filed by state health departments in April and May 2009, while the CDC was still requesting case counts. The reports were written up for any patients whose flu infections were lab-confirmed either as H1N1 flu, or as neither of the H1 and H3 strains that circulated in the 2008-09 flu season.

The reports, filled out during telephone interviews, included information about household size and any other cases in the household. Influenza in the secondary cases was not confirmed by lab tests, however; it was merely described on the basis of symptoms as either “acute respiratory illness” (fever, cough, sore throat and/or runny nose) or “influenza-like illness” (fever and cough or sore throat).

In 72% of the 216 households, no one caught flu from a family member. In 21%, one person did, and in 6%, two or more did. The median age of all 600 household members was 26, but the median age of those who contracted flu from someone was 14.5 to 16.5, depending on how their symptoms were recorded.

The age of the person who brought flu into the household, however, had no effect on their contagiousness; toddlers, teenagers and adults all transmitted flu to others.

The time that it took for flu to pass to a family member—technically, the mean serial interval, between the start of symptoms in the index case and in the first secondary case—was 2.6 days. No one symptom could be linked to H1N1’s being more or less infectious, except that almost all of the patients reported coughing.

For reasons the authors could not explain, the probability of household transmission decreased as the number of household members increased. Among two-person households, 28% of contacts developed flu within 7 days of the first patient’s symptoms starting, but in households with six or more members, only 9% did. “These differences … highlight the fact that the sociologic, environmental, and biologic mechanisms available to explain the relationship between secondary attack rates and household size are still limited,” they said.

The study is significant, the authors said, because so little work has been done on risk factors for flu transmission at home, despite public health recommendations that people who contract flu stay home until 24 hours after their fever subsides. In addition, they said, the findings confirm the observation that children and teenagers are more vulnerable to H1N1 flu than adults.

Cauchemez S, Donnelly CA., Reed C, et al. Household transmission of 2009 pandemic influenza A (H1N1) virus in the United State. N Engl J Med 2009;361(27):2619-27 [Full text]

Indonesia reports 20 H5N1 cases -- 19 fatal -- since January

Robert Roos * News Editor

Dec 30, 2009 (CIDRAP News) – Indonesia's Ministry of Health, updating information on H5N1 avian influenza for the first time since January, quietly reported this week that the country has had 20 human cases so far this year, with 19 of them fatal—a 95% case-fatality rate (CFR).

A terse notice from the Ministry of Health on Dec 28 listed the figures and said the latest reported case was identified in South Jakarta on Sep 23. Indonesia's cumulative H5N1 toll since 2005 is now 161 cases with 134 deaths, for a CFR of 83%.

The World Health Organization (WHO) updated its chart of H5N1 cases and deaths today to include the new numbers from Indonesia, but it posted no report on the cases. The global H5N1 total is 467 cases with 282 deaths, a CFR of 60%. Indonesia is the hardest-hit country overall, though Egypt has had more cases this year—39, with just 4 deaths.

Indonesia's then–health minister, Siti Supari, announced in June 2008 that the government would stop issuing prompt reports of new H5N1 cases and instead offer only periodic updates. The announcement raised concern about the world's ability to track the virus's evolution and impact.

Supari also stirred controversy in 2007 by clamping down on sending samples from H5N1 patients to the WHO, saying viruses from the samples are used to make vaccines that enrich pharmaceutical companies but are too expensive for Indonesia and other developing countries.

Since the June 2008 announcement, Indonesia has issued few official reports of H5N1 cases. The WHO posts H5N1 situation updates based on reports from governments; the last time the agency gave an update on Indonesia was Jan 22, reporting two cases. A press report quoting an Indonesian official in early March noted four more cases, all fatal, but they were not registered by the WHO at the time.

The health ministry's notice this week gave no details on any of the recent cases.

The WHO's H5N1 tally for this year to date includes 72 cases with 32 deaths, compared with 44 cases with 33 deaths in 2008. Besides Egypt and Indonesia, countries that have reported cases and deaths this year are China (7 and 4), Vietnam (5 and 5), and Cambodia (1 and 0).

The often deadly H5N1 virus has not yet gained the ability to spread easily from person to person, though it has circulated widely in birds for the past 6 years. Disease experts still fear that it could gain transmissibility through mutation or by reassorting with another flu virus.

See also:

WHO chart of H5N1 cases and deaths

Dec 30 Bird Flu Information Corner blog entry on the Ministry of Health statement

Jun 5, 2008, CIDRAP News story "Indonesia quits offering prompt notice of H5N1 cases"

Wednesday, December 30, 2009

Egypt: Death #118 - #122

[Edits by Twall]

World Health Organization announced that the mutation of a pandemic virus question difficult to predict and no follow-up and the vigilance of the Organization after skipping the swine flu epidemic of all standards in terms of casualties and the number of deaths.
Dr.. Hussein Algerian director of the Regional Office of the World Health Organization Eastern Mediterranean that the production of vaccines against swine flu has increased, and manufacturers can produce the quantities that are sufficient to meet the needs of the epidemic .. He pointed out that the optimism on the Elimination of the epidemic is unlikely during this period and must be wary of the disease.
On the other hand the Ministry of Health for the death of 5 new cases of swine flu, bringing the number of deaths in Egypt so far to 212 cases.
Five cases, starting from the 118 case of a woman at the age of 61 years of Giza 119 and the situation of a woman at the age of 48 years of the Governorate of Alexandria and the situation of 120 women, aged 35, from Kafr El-Shaikh.
121 case of a woman, aged 34, from Damietta, 122 case of a woman at the age of 23 years of appreciation (Qalyoubia = )
hat-tip Twall|en&u=

WHO: Pandemic (H1N1) 2009 - update 81 - Weekly update

30 December 2009

As of 27 December 2009, worldwide more than 208 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including at least 12220 deaths.

WHO is actively monitoring the progress of the pandemic through frequent consultations with the WHO Regional Offices and member states and through monitoring of multiple sources of data.

Situation update:

The most active areas of pandemic influenza transmission currently are in central and eastern Europe. Focal increases in rates of ILI/ARI during recent weeks were reported in at least three eastern European countries, Georgia, Montenegro, and Ukraine.

A high intensity of respiratory diseases activity with concurrent circulation of pandemic influenza persists in parts of southern and eastern Europe, particularly in Greece, Poland, Bulgaria, Serbia, Ukraine, and the Urals Region of the Russian Federation.

In Western Europe, influenza transmission remains active and widespread, but overall disease activity has peaked. At least 13 of 21 countries (testing more than 20 sentinel samples) reported that 30% or more of sentinel specimens were positive for influenza, down from a peak of over 70%. All were influenza viruses detected in Western Europe were pandemic H1N1 2009, however, very small numbers of seasonal influenza viruses, making up less than 1% of all influenza viruses detected, were reported in Russia.

In addition, limited available data indicates that active, high intensity transmission is occurring in Northern African countries along the Mediterranean coast (Algeria, Tunisia, and Egypt).

In Central Asia, limited data suggest that influenza virus circulation remains active, but transmission may have recently peaked in some places.

In West Asia, Israel, Iran, Iraq, Oman, and Afghanistan also appear to have passed their peak period of transmission within the past month, though both areas continue to have some active transmission and levels of respiratory disease activity have not yet returned to baseline levels.

In East Asia, influenza transmission remains active but appears to be declining overall. Influenza/ILI activity continued to decline in Japan, in northern and southern China, Chinese Taipei, and Hong Kong SAR (China). Slight increases in ILI were reported in Mongolia after weeks of declining activity following a large peak of activity over one month ago.

In southern Asia, influenza activity continues to be intense, particularly in northern India, Nepal, and, Sri Lanka. Seasonal influenza A (H3N2) viruses are still being detected in very small numbers in China making up about 2.5% of the influenza A viruses detected there.

In North America, influenza transmission remains widespread but has declined substantially in all countries. In the US, sentinel outpatient ILI activity has returned to the seasonal baseline, and indicators of severity, including hospitalizations, paediatric mortality, and P&I mortality have declined substantially since peaking during late October. Rates of hospitalization among cases aged 5-17 years and 18-49 year far exceeded rates observed during recent influenza seasons, while rates of hospitalizations among cases aged >65 years were far lower than those observed during recent influenza seasons.

In the tropical regions of Central and South America and the Caribbean, influenza transmission remains geographically widespread but overall disease activity has been declining or remains unchanged in most parts, except for focal increases in respiratory disease activity in a few countries.

In the temperate regions of the southern hemisphere, sporadic cases of pandemic influenza continued to be reported without evidence of sustained community transmission.

The Global Influenza Surveillance Network (GISN) continues monitoring the global circulation of influenza viruses, including pandemic, seasonal and other influenza viruses infecting, or with the potential to infect, humans including seasonal influenza.

For more information on virological surveillance and antiviral resistance please see the weekly virology update (Virological surveillance data, below).
hat-tip Ironorehopper

May take a year to conquer H1N1 flu pandemic: WHO

GENEVA (Reuters) - The H1N1 flu pandemic may not be conquered until 2011 and continued vigilance is required against the virus which can still mutate, the head of the World Health Organization said on Tuesday.

WHO Director-General Margaret Chan also warned that although countries have shored up their defenses against the first influenza pandemic in more than 40 years, they remain ill-prepared for mass outbreaks of the deadlier bird flu virus.

"It is still premature and too early for us to say we have come to an end of the pandemic influenza worldwide. It would be prudent and appropriate ... to continue to monitor the evolution of this pandemic for the next six to 12 months," Chan told a year-end news conference.

"The one thing we need to guard against is a sense of complacency," she added.

Countries including Britain, Canada and the United States have passed peaks of a second wave of H1N1, but outbreaks are intensifying in India, Egypt and elsewhere, according to Chan.

H1N1 has now spread to more than 200 countries, with nearly 12,000 deaths confirmed in laboratory, but it will probably take two years to establish the true death toll, she said.

Millions of people have been infected with the virus which emerged in April, most recovering without special treatment.

But young people, pregnant women and people with underlying health conditions such as heart or lung disease are more vulnerable and often require intensive care in hospital.

Influenza viruses are notoriously unpredictable and can mutate into more severe forms, according to the WHO chief.
Chan, who admitted she had not received her own H1N1 flu shot yet but would have it soon, said: "I am a bit more relaxed, but I will never let down my guard."


Rich countries and drug companies have pledged to donate 190 million doses of H1N1 vaccine for use in some 90 developing countries, she said.

Her United Nations agency plans to start distributing the first doses in Azerbaijan and Mongolia in early January, to be followed by Afghanistan, she added.

On recalls of some H1N1 vaccine -- by AstraZeneca's MedImmune unit and Sanofi-Aventis SA -- she said they were because they were not as potent as they should be but posed no risk.

"The recalls are not related to safety of vaccines," she said, saying the issue had been dealt with in an "ethical way."

Chan, noting the world's financial crisis and weak health systems in some countries, said: "The fact that the long overdue influenza pandemic is so moderate in its impact is probably the best health news of the decade."

But Chan, who fought avian flu and SARS while serving as
health director in her native Hong Kong, said the world was still not ready to combat a pandemic of the H5N1 bird flu virus, noting it was "more toxic and deadly."

"No, the world is not ready for a pandemic to be caused by H5N1," she said.
hat-tip Pathfinder

Egypt: Allocate 5% of the beds in the lake for patients with influenza

December 30th, 2009

Decided to Major General Mohamed Shaarawy, the allocation of 5% of the family all hospital centers and cities of the lake for the reception and treatment of patients with avian flu and swine, with the emphasis on health directorate managers aware of maintaining hospitals and doctors, and so regularly, how to handle suspected cases in the reception the disease and how to deal with patients and to provide the medications used to treat these cases, and compliance with the Minister of Health on the disposition of the drug, according to the needs of the pathological condition, and coordination with the education and education in dealing with suspected cases of schoolchildren.

Sharawi stressed during the meeting of the Executive Council of the province on the need to intensify campaigns to market existing cities to prevent the sale of live poultry and poultry farms to close within the residential blocks and the need for health systems and hospitals, the analysis of regular citizens who stayed in the district maintaining foci of infection and visitors to hospitals, suffering from high temperature and suspected of contracting avian and swine influenza.

Sharawi also decided to cut off utilities (water and electricity) from the shops that still sell live poultry, until the activity and make it easier for these stores to change this activity to another activity.

Indonesia: Health Minister Reports 20 Confirmed H5N1, 19 deaths, for 2009

Avian Flu Situation In 2009
28 Dec 2009

From January 1 to December 28, 2009, there were 20 cases of H5N1 in Indonesia, 19 people died. The first H5N1 case occurred on January 9, in Bogor, while the last case was found on September 23, 2009 in South Jakarta.

Thus, cumulatively, the total number of H5N1 cases [in Indonesia] since the year 2005 to 2009 amounted to 161 cases of 134 people died.

This information is published by the Center for Public Communication, Secretariat General of the Ministry of Health. For further information please contact via telephone numbers: 021-52907416-9, fax: 52921669, Call Center: 021-30413700, or e-mail address puskom.publik @, info@puskom.depkes.go. id,
hat-tip dbg

New Brunswick: Tamiflu Resistant Case

N.B. records 8th H1N1 death
Young Quispamsis man fought flu for a month

Tuesday, December 29, 2009 | 8:52 PM AT
CBC News

New Brunswick public health officials are reporting the province's first death related to a drug-resistant H1N1 strain.

A 27-year-old Quispamsis man died in hospital on Monday after nearly a month in intensive care, public health officials said. Doctors tried treating him with the anti-viral drug Tamiflu but those efforts failed.

The man was the eighth person in New Brunswick to die with the H1N1 virus.

“He was suffering from a number of underlying conditions that predisposed him to having a very severe case of the disease,”
said Dr. Paul Van Buynder, the province's deputy chief medical health officer.

According to Van Buynder, the H1N1 strain the man contracted was resistant to drugs such as Tamiflu that are used to fight the virus.

Vaccine available

Van Buynder said it's unlikely the victim had received an H1N1 shot. Had he been vaccinated, the man would have been safe from the virus — even the drug-resistant strain, Van Buynder said.

Health officials said they have not found a second case linked to the most recent H1N1 flu victim.

About two-thirds of New Brunswick residents have received the H1N1 shot.

Van Buynder encouraged those who haven't been vaccinated to get a shot as possible.

Although mass vaccinations have ended, shots are still available in VON (Victorian Order of Nurses) clinics, public health clinics and from certain family doctors.
hat-tip Shiloh

India: Bird flu scare returns in Bengal village [poultry]

Wednesday, Dec 30, 2009

West Bengal is in again in the grip of bird flu or avian influenza scare. More than 2,000 birds, including domestic poultry, were found dead in the remote village of Durmoth at Mongolkot in Burdwan district, prompting the state animal resources development department to send a team to collect samples. The result will be announced within the next few days.

The district administration has started an awareness campaign in the village, which was one of the areas hit when bird flu broke out in January 2008. At that time the state had incurred a loss of Rs 500 crore and 4 million birds had to be culled. Thirteen districts were hit by the bird flu menace at that time.

“There is no need to panic. The samples have been sent for testing. Birds have died, but there can be a number of reasons behind it. We are prepared to tackle any outbreak,” said Narayan Biswas, state Animal Resource Development Minister.

“Our team visited the area on Tuesday and collected samples of dead birds from the village and its periphery. We have sent the samples to the testing laboratory in Belgachhia. We have started an awareness campaign in the area and have asked the villagers to dispose of the carcasses of the birds in a pit,” said Udaybhanu Gangopadhyay, Deputy Director of district ARD.
hat-tip Pathfinder

Tuesday, December 29, 2009

Egypt: 3 More Deaths - Total 120

Tuesday, December 29th, 2009 - 20:23

Dr. Abdel Rahman Shahin, official spokesman of the Ministry of Health
Abdul Salam wrote Princess

The Ministry of Health said in a statement today, the death of three new cases of swine influenza virus, raising the total deaths to 120 HIV cases.

The ministry said in a statement that the situation of (case number) 118 Egyptian woman, aged 61, from Giza Governorate, the situation of (case number) 119 Egyptian woman, aged (48 years), from Alexandria, and the situation of (case number) 120 Egyptian woman, aged (35 years), from Kafr El-Sheikh.
hat-tip Twall

Egypt: Two deaths raise influenza Total of 117

December 29th, 2009
The Ministry of Health on Monday, the death of two new cases of HIV, "eh HP 1 The 1" is known as "swine flu" in order to increase the number of deaths in Egypt since the emergence of the disease and so far 117 cases.

The Health Ministry said in a statement issued late yesterday that the two deaths to the new man and a woman of the governorates of Cairo and Sohag.

The ministry pointed out that the case of death of 116 men from Cairo Governorate at the age of 28 years, and No. 117, death of a woman from Sohag Governorate, at the age of 36 years.

hat-tip Twall

Vietnam: Patient mortality after 13 days treatment Tamiflu

December 29, 2009
(AFP) - A male patients (aged 64) in the Mexican Department, Van Giang, Hung Yen [Mễ Sở, Văn Giang, Hưng Yên] died after 13 days continuous treatment Tamiflu and antibiotics. This is the first 53 deaths across the country related to influenza A/H1N1.

Am December 29, Nguyen Huy Nga, Director of Department of Preventive Health and Environment (Ministry of Health) said, patients onset disease with symptoms of fever on June 12, 2009 [12/6] hot, thorny malaria, cough white sputum. Patient self-treatment at 3 days but does not help, then visit and enter the hospital with 108 TU army [TƯ Quân đội 108] diagnosed severe pneumonia.
Here, patients are antibiotic treatment and PCR test results positive for influenza A/H1N1 virus. Patients treated antiviral drug (Tamiflu) 6 on the condition should not support as of December 18, 2009, the patient be forwarded to the tropical disease hospital TU [Bệnh viện Bệnh nhiệt đới TƯ]
Here, patients continued treatment Tamiflu and antibiotics immediately after admission. However, severe disease continued progress, the situation did not improve and pneumonia patients die today December 25, 2009, after 13 consecutive days were treated with Tamiflu. Patients also have a history of high blood pressure 8 years now.

Monday, December 28, 2009

Lessons learned from a decade of epidemics

December 28, 2009

When the last millennium came to an end, the Y2K bug was grabbing attention. As the first decade of this one neared an end, a pandemic bug was in the spotlight.

In the past 10 years, fear has accompanied new viruses, including bird flu, or H5N1, severe acute respiratory syndrome, or SARS, and most recently, the virus formally known as 2009 pandemic influenza A, or H1N1.

But much can be learned from the decade's experience with these viruses, experts say.

For public health officials, the challenge in a pandemic is to inform people about how they can protect themselves without causing panic.

Worldwide, governments set up their pandemic plans based on bird flu, a highly pathogenic virus that infected a relatively small number of people, mainly in China and Southeast Asia, where it has had a case-fatality rate of about 60 per cent. Evan Frustaglio, a 13-year-old hockey player from Toronto, died on the eve of the H1N1 vaccine becoming available. Demand for the vaccine jumped overnight.Evan Frustaglio, a 13-year-old hockey player from Toronto, died on the eve of the H1N1 vaccine becoming available. Demand for the vaccine jumped overnight. (Facebook)

The worst-case scenario is a virus that is both highly pathogenic and highly transmissible, meaning it causes serious disease and spreads easily from person to person.

While both bird flu and SARS were highly pathogenic, neither was particularly transmissible. The opposite is the case with H1N1, which is very transmissible but is not very pathogenic, said Sir Roy Anderson, a professor of infectious disease epidemiology at Imperial College in London.

When H1N1 first emerged in Mexico in April 2009, the fatality rate seemed about one in 100, but this turned out to be too high, since only the serious cases came to the attention of health authorities. The death rate is now estimated to be about one in many tens of thousands or perhaps one in a 100,000 — in the same ballpark as typical seasonal flu.

"At the start, the media messages were on average balanced but a little bit alarmist because everybody thought this was the big one, with a totally novel strain of the virus with a high case fatality," Anderson said.

By early fall, the news media started reporting on a much smaller fraction of people sickened with serious illness from H1N1.

Another reason the case fatality rates were overestimated for H1N1, Anderson said, is that it is a difficult disease to diagnose. Influenza causes similar symptoms to cold virus, including chest secretions and a rapid rise in temperature.

Problems in diagnosing H1N1 show the need for more sophisticated ways of telling if someone has been exposed, he said.

The H1N1 flu pandemic also taught the importance of monitoring flu viruses for mutations that occur when someone is infected with two viruses at the same time and the viral genetic codes get jumbled.

Panic from pandemic alert?

That's how bird flu could become more transmissible or swine flu could become more pathogenic — changes scientists worldwide are watching for closely. They are also looking for any evidence that flu viruses are becoming resistant to antiviral medications such as Tamiflu and Relenza.

When the World Health Organization raised its alert level for H1N1 from three to four, then to five and finally six — a full-blown pandemic that is widespread geographically — the changes were meant to signal to governments to put their pandemic plans into place, not to cause panic in the public.

When the public is told to "be vigilant" during an alert for example, governments need to put out accurate, balanced views of what's happened and be frank if there's uncertainty, Anderson said. The design of protective masks to protect health-care workers improved after the SARS outbreak in 2003 that killed 800 people around the world, including 44 in Toronto.The design of protective masks to protect health-care workers improved after the SARS outbreak in 2003 that killed 800 people around the world, including 44 in Toronto. (Kevin Frayer, Canadian Press Picture Archive)

"Sometimes [alerts] help, sometimes they induce panic," said Clive Seale, a professor of medical sociology at Queen Mary, University of London, who edited a book titled Health and the Media.

Those now-familiar steps — washing your hands, avoiding touching your face, coughing and sneezing into your sleeve, reducing mixing, staying home when sick, early treatment with antivirals, and getting vaccinated — probably did make a difference in stemming the spread of H1N1.

But researchers won't be able to tell until next year, when they're able to analyze the pattern of the pandemic, as they do with seasonal flu outbreaks.

Attention to details

Health Minister Leona Aglukkaq made the same point during her year-end news conference on H1N1. She said it was important to deal with facts of confirmed cases when the virus emerged during the spring of 2009. Doing otherwise could have diverted resources to where they weren't needed, she said.

Canada's pandemic plan clearly outlined the roles and responsibilities for each jurisdiction, applying one of the lessons learned from SARS, Aglukkaq said.More outbreaks of infectious diseases such as H5N1 bird flu may occur as livestock continue to be brought into densely populated cities.More outbreaks of infectious diseases such as H5N1 bird flu may occur as livestock continue to be brought into densely populated cities. (AP Photo)

But after governments started drafting pandemic plans in response to bird flu, in Anderson's view, they focused on generalities without paying enough attention to logistics and details.

Details such as how to get antiviral drugs to people within 48 hours of infection, deciding on who should be in priority groups for the vaccine, and how to get the vaccine into arms are all important steps that governments should work out in advance, rather than during a pandemic, Anderson said.

SARS also highlighted to hospitals why it's so important to focus on infection-control procedures, since the infection persisted for a long period and caused serious illness for nurses and doctors working in the institutions. The outbreak also led to the development of new facemasks that were more effective and easier to breathe in, Anderson said.

More outbreaks are "somewhat inevitable," he said, given that the world's population continues to grow and live in densely populated cities. To serve these urban residents, livestock are brought into cities, where infections are likely to spread from animals to humans in the future.

The reality of today's world means that when new viruses emerge, air travel largely dictates its spread early on in the outbreak. In the cases of both severe acute respiratory syndrome in 2003 and H1N1 in 2009, air travellers spread the infection from its origin to major cities around the world.

Egypt: 3 More Deaths - Total 115

The death of 3 influenza and high total to 115 cases

Monday, December 28, 2009
Ministry of Health announced the death of three new cases of disease, swine flu h1n1, bringing the number of deaths to 115 cases since the disease from entering Egypt.

The Health Ministry said in a statement today, the situation No. 113 for the old man 55 years of Suez Governorate, in the case of 114 female, 37 years old, from Fayoum.

The statement pointed out that the situation of the 115 old woman 41 years of Red Sea Governorate.

Vietnam: H1N1 Deaths


19 yo From: Ben Tre Onset: 9/3 Adm: 9/5 DOD: 9/12

46 yo From: Dak Lak [u/c] Adm: 9/16 DOD: 9/17

42 yo From: Binh Phuoc [u/c] Onset: 9/15 Adm: 9/18 DOD: 9/19

59 yo From: Ben Tre [u/c] Onset: 9/16 Adm: 9/16 DOD: 9/24

23 yo [36 wk pregnant] From: Dak Lak Onset: 9/20 DOD: 9/25

30 yo From: Ho Chi Minh City [u/c] Adm: 9/21 DOD: 9/24

13 yo From: Mekong Delta, Long An [late treatment] DOD: 9/25

49 yo From: Australia Ho Chi Minh City Adm: 9/13 DOD: 9/25

21 yo [28 wk pregnant] From: Can Gio Dist., HCMC. Adm: 9/22 DOD: 9/27

15 yo [39 wk pregnant, baby lived] From: Dong Nai. Adm: 9/25. DOD: 9/29.

25 yo [24 wk pregnant] From: Khanh An, U Minh, Ca Mau Onset: 9/22 Adm: 9/22 DOD: 9/27.

47 yo From: Phu Tan Dist., Cau Mau Onset: 9/24 Adm: 9/27

DOD: 9/30

29 yo From: District 12, HCMC [u/c] Adm: 9/29 DOD: 10/2.

63 yo From Phu Son, Thanh Hoa [u/c] Onset: 9/10 Adm: 9/20 DOD: 9/21.

51 yo From: Ca Mau Adm: 9/29 DOD: 10/3 (?) Tests Pending.

#21: 14 yo From: Bla Village, Dak Song, Kong Chro district, Gia Lai Province. Adm: 10/5 DOD: 10/8

#22: 36 yo From: Binh Phu, Ho, Ben Tre, Ben Tre Province. Onset: 10/2. Adm: 10/4 DOD: 10/5

#23: 19 yo From: Ngo Quyen Bac Giang City, Bac Giang Province. Onset: 10/4 Adm: 10/5 DOD: 10/7

#24 29 yo [39 wk pregnant] From: An Huu Hoai An dist., Binh Dinh Province. Adm: 10/10 for caesarean section. 10/14: respiratory distress, high fever, severe pneumonia. DOD: 10/15.

#25 60 yo From: Son Dong, Bac Giang [u/c] DOD: Approx. 10/14 (art. Dated 10/21).

#26 20 mo old From: Hai Chau district, Da Nang. Onset: 10/12. Adm: 10/14 DOD: 10/20.

#27 27 mo old From Nam Mo Cay, Ben Tre. Onset: 9/26. Adm: 9/30 DOD: 10/16

#28 25 yo [9 mos pregnant] From: Nien Phong Vill., Hoa Thang com. Phu Hoa, Phu Yen Prov. Adm: 10/19 DOD: 10/20

#29 48 yo From: Ha Thai vill., Chu Pong, Chu Se dist., Gia Lai Prov. [u/c] Adm: 10/12 DOD: 10/20

#30 24 yo [7 mos pregnant] from Me Xuan Vill., Ia Me Comm., Chu Prong Dist., Gia Lai Prov. Onset: 10/10. Adm: 10/18 DOD: 10/21.

#31 2 yo From: Tan Ha, Lam Ha, Lam Dong Prov. [u/c] Onset: 10/14 Adm: 10/16 DOD: 10/22.

#32 21 yo [6 mos pregnant] From: Son Tay, Thach, Hanoi. Onset: 10/15. Adm: 10/17. DOD: 10/21

#33 10 mo old From: Social Housing Bong, Ea Kar, Dak Lak Adm: Trans. 10/21 DOD: 10/26

#34 41 yo [civil engineer at hydro power plant] From: Thanh Thuy, Thanh Binh Ward, Hai Chau district, Da Nang Province. Onset: 10/17 10/18: back in Da Nang. Adm: 10/21 DOD: 10/24

#35 27 yo From: Cu Kuin district, Dak Lak province. [u/c]

Adm: 10/9 DOD: 10/15

#36 31 yo [37 wk pregnant] From: Krong Pac district, Dak Lak. Onset: 10/11 Adm: 10/14 DOD: 10/17.

#37 17 yo From: An Giang Onset: 5 days @ home. DOD: 10/29.

Red eye (note in article dengue stat, hemorrhagic fever-3 deaths).

#38 38 yo From: Yen Vien, Hanoi. [u/c] Onset: 10/2.

Adm: 10/5 Test Results: 10/6 pos. 10/10: Test Neg. DOD: 10/31. Resistant to all antibiotics.

#39 32 yo From: Hoa Binh province [worked in Tay Ninh province] Onset: ? Adm: 10/23 Adm: 10/24 HCMC 10/25: tested positive. 10/30: tested negative. DOD: 11/3 No underlying conditions.

#40 54 yo From: Mai Son district, Son La province. Onset: 10/20. Adm: 10/27. DOD: 11/2. Tested positive on 10/27. Tested negative after 5 days of treatment.

#41 17 yo From: Dong Anh, Hanoi. Adm: 11/5. DOD: 11/7.

#42 16 yo [6 months pregnant]From: Vinh Quang, Rach Gia, Ho Chi Minh City, Kien Giang, Mekong Delta. Onset: 11/3. Adm: 11/7. Transferred: 11/8. DOD: 11/9.

#43 23 yo From: Binh Tan, Phuoc Ninh, Phuoc Long, Binh Phuoc Province. Adm: 10/30 Tested positive. DOD: 11/12. 6 days of treatment. Tested Negative.

#44 20 yo [27 wk pregnant] From: Khanh Son, Khanh Hoa province. Onset: 11/12. Transferred 11/19. DOD: 11/24.

#45 59 yo From: Binh Lieu, Quang Ninh. Onset: 11/5. DOD: 11/26. Misdiagnosed for Malaria, and treated as such. No Tamiflu until 11/15.

#46 17 yo From: Thoai Son, An Giang province. Onset: 10/21. Went to clinic, no help. Adm: 10/25 An Giang Hosp. Deep coma, severe respiratory distress. DOD: 10/29.

#47 33 yo From: Long Xuyen, An Giang province. Onset: 11/15. Adm: 11/16 An Giang Military hospital. 11/19 trans. To General Hospital, An Giang. DOD: 11/20.

#48 57 yo From: Phuong Lien ward, Dong Da District, Hanoi. Onset: 11/22, fever headache. 11/14 returns, gets flu drug treatment. Fever first two days, then fever left. Periodic fever for the next 8 days, treated himself at home. Adm: 11/29. DOD: 11/30 or 12/1. Diag: malaria. 12/7: Blood tests reveal confirmed H1N1.

#49 23 yo [33 wks pregnant] From: Hai Duong, Hai Hau, Nam Dinh. Onset: 5 days at home, sym’s of high fever, sore throat, aggressive cough. 3 days blood & sputum, increasing difficulty breathing. Included in the TB & Lung Disease Hosp. Trans. To Hospital for Tropical Central on 12/7, diagnosed with pneumonia virus. 12/8: miscarriage & confirmed H1N1. DOD: 12/12:

#50 28 yo [6 months pregnant] From: Tan Dinh village, Vinh Linh district, Quang Tri Prov. DOD: 12/10-16/09

Onset: 11/28. Went to Station Family Health, outpatient treatment. 12/3 trans. To Vinh Linh Hospital, diagnosed w/pneumonia. Continue outpatient treatment. Adm: 12/4 Provincial Hospital [Quang Tri Gen.], then transferred to hospital from Hue. Conf: 12/4. DOD: 12/10.

#51: 3 yo From: Yen Dinh, Thanh Hoa. Onset: 11/22 [fever,vomiting, diarrhea]. 11/23 taken to Yen Dinh dist. Hospital. Transferred that day to Children’s Hospital of Thanh Hoa. 11/27: Transferred to Central Pediatrics Hospital in comatose condition. Test given, positive for H1N1. DOD: 12/3

#52: 34 mos From: Ba Dinh District, Hanoi. [u/c]. Onset: 12/1 [fever, runny nose, diarrhea, treated outpatient unit of Central Children’s Hosp.]. Adm: 12/5 Central Children’s Hospital [fatigue, shortness of breath, rapid breathing, heart shock, respiratory insufficiency] Treated active resuscitation, respiratory support/vent, cardiovascular support. 12/13: pneumonia, tested positive, started treatment on Tamiflu. DOD: 12/14.

Egypt: 3 Deaths - Total 112

Monday, December 28, 2009
The Ministry of Health on Sunday evening, the death of three new cases infected with A (H 1, that 1) the world-renowned swine flu, bringing the total number of deaths to 112 cases.

According to a statement issued by the ministry yesterday, the situation of the 110 men (61 years) from the Cairo governorate, and the situation of the 111 men (40 years), and the situation of 112 young (34 years) and two of the Giza Governorate.

The Ministry of Health that the total number of HIV cases in Egypt, has reached 10056 case so far. The ministry said in a statement issued today, the total number of confirmed cases of swine flu in schools from the academic year and until now, the 3990 case.

The statement pointed out that the total number of confirmed cases in universities from the academic year and so far amounted to 529 cases.

The statement added that the number of confirmed cases infected outside schools and universities was the case until today 5537.

He noted that the total number of cases of recovery from bird (er HP 1 that 1) The 9828 case .. He pointed out that there are currently 119 cases under hospital treatment.

Sunday, December 27, 2009

Egypt: 3 more deaths reported - total 109

Sunday, December 27th, 2009 - 21:13

Hatim the Minister of Health
The Ministry of Health for the death of three new cases of disease, swine flu, bringing the number of deaths to 109 cases since the disease from entering Egypt.

The Health Ministry said in a statement on Sunday that the situation (case) No. 107 Egyptian woman at the age of 55 years of Dakahlia Governorate.
Case No. 108 is of a woman at the age of 66 years from Qalyoubia province, as was the case (No.) 109 and according to the statement of a woman at the age of 35 years of Assiut Governorate

hat-tip Twall

Egypt: 22 deaths of swine flu in Cairo

Sunday, December 27th, 2009 - 12:04

Dr.. Abdel-Azim Wazir Governor of Cairo that deaths resulting from the swine flu case hit 103 nationwide, including 22 cases in Cairo, including 3 cases of school.

The Minister has been closed 153 schools in the school reopening 92 of them, and the closure of 336 chapters have been re-opened 219 chapters, and the rise in incidence, but less than the expected number before the start of the school year.

The Minister issued strict instructions to the Directorate of Education and not to slacken by the committee formed to follow up and ensure the cleanliness and maintenance of schools, both internally and externally and the presence of doctors and disinfectants, and the full implementation of preventive measures, and the emphasis on school managers, the immediate shutdown of schools upon the arrival of the decision of closing down and transmit the Director to investigate the case of failure or inaction in implementation, and in the case of the failure of managers of private schools are taking action and signing of financial and administrative supervision of the Directorate of Education.