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Volume 4 No 4; 29 January 2010
Pandemic H1N1 influenza: UK and international update
Global situation
Although much of the temperate northern hemisphere passed a peak of autumn and winter-time pandemic influenza activity between late October and late November 2009, virus transmission remains active in several later affected areas, particularly in North Africa, limited areas of eastern and southeastern Europe, and in parts of South and East Asia, according to the WHO's latest update of the global situation [1].
The WHO noted that:- In North Africa, limited data suggest that pandemic influenza virus transmission remains active and geographically widespread, particularly in Morocco, Algeria, Libyan Arab Jamahiriya, and in Egypt, although most countries in the region appeared to have recently passed a peak of activity during December 2009 or January 2010;
- In South Asia, pandemic influenza activity remains active but geographically variable. Recent peaks in activity were noted during late December and early January 2010 in northern India, Nepal, and Sri Lanka;
- In East Asia, transmission of pandemic influenza virus remains active, however, overall activity continued to decline in most countries;
- In south-east Asia, transmission of pandemic influenza virus persists, but current activity levels are low;
- In Europe transmission of pandemic influenza virus remains geographically regional-to-widespread in the central, eastern, and southeastern parts of the continent. However, overall activity continues to decline in most places. Several countries (Austria, Albania, Bulgaria, Slovakia, and the Russian Federation) reported slight increases in the levels of ARI or ILI activity, however in most, levels remain well below recent peaks in activity;
- In the Americas, both in the tropical and northern temperate zones, overall pandemic influenza activity continued to decline or remain low in most places. Of note, detections of RSV have increased in a few countries in the Americas, which may partially account for elevated ILI activity in those areas, particularly among young children;
- In temperate regions of the southern hemisphere, sporadic cases of pandemic influenza continued to be reported without evidence of sustained community transmission.
UK situation at 28 January 2010
Key points of the Health Protection Agency's Weekly National Influenza Report of 28 January (week 4) [2] covering the UK situation were as follows:
- Pandemic (H1N1) 2009 influenza activity was generally decreasing across the UK;
- In week 03 (ending 24 January), the weekly influenza-like illness consultation rate decreased or remained stable in all schemes across the UK;
- The National Pandemic Flu Service continued to issue antiviral drugs to people in England. This service will continue until 11 February 2010 [3], from this date onwards, antivirals will be authorised via health care professionals. The number of assessments and antiviral collections through this service have decreased over the past week;
- A decrease in respiratory syncytial virus detections has been observed recently and GP consultation rates for acute bronchitis continue to fall, especially in people aged under 5 years and 65 or over;
- The main influenza virus circulating in the UK continued to be the pandemic (H1N1) 2009 strain, with few influenza H1 (non-pandemic), H3 and B viruses detected. Thirty-six of 4,975 pandemic viruses tested have been confirmed to carry a mutation which confers resistance to the antiviral drug oseltamivir; three are phenotypically resistant to the drug but retain sensitivity to zanamivir;
- The majority of pandemic influenza cases continued to be mild. The cumulative number of deaths reported due to pandemic (H1N1) 2009 in the UK was 391 (figure for England to 21 January 10);
- The UK pandemic influenza vaccination programme continues for people at high risk of severe disease, health-care workers and healthy children aged between six months and five years. For further information see the Department of Health website.
References
1. WHO. Update no. 85 of 29 January 2010 (http://www.who.int/csr/don/en/).
2. HPA. Weekly National Influenza Report: week 4 (28 January 2010, PDF 435 KB), HPA website: www.hpa.org.uk/swineflu/surveillance&epidemiology.
3. Department of Health Central Alerting System. Pandemic H1N1 (2009) Influenza, 27 January 2010.
EFSA-ECDC zoonoses report for 2008
Campylobacteriosis remains the most commonly reported zoonosis in the European Union (EU), followed by salmonellosis and yersiniosis, according to the latest joint annual report from the European Food Safety Authority (EFSA) and the European Centre for Disease Prevention and Control (ECDC) [1].
Salmonellosis, the second most commonly recorded zoonosis, has continued to follow a statistically significant downward trend for five consecutive years, the report notes, as a result of intensified control of Salmonella in animal populations, particularly in poultry, and better hygiene throughout the food chain.
Also decreased was the number of confirmed cases of listeriosis in the EU. There were 11% fewer reported cases in 2008 (1,381) compared to 2007 (1,554), the foodstuffs most likely to have been implicated being ready-to-eat products (fish and meat), soft cheeses, salads and sandwiches.
Q-fever increased by 172% in 2008 (1594) compared with 2007(585) mainly due to several outbreaks in people entering areas with infected sheep and goats, in the Netherlands in particular. The report suggests that the occurrence of Q-fever in humans and animals may be seriously under-reported in Europe. Also increased were cases of Shiga-toxin/vero-toxin producing E. coli (STEC/VTEC), of which of 3,159 confirmed cases were reported in 2008, representing an 8.7% increase from 2007 (2,905 cases).
Reference
1. European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA). The Community Summary Report on trends and sources of zoonoses, zoonotic agents and food-borne outbreaks in the European Union in 2008 Stockholm, Parma; 2010. Available from: http://www.efsa.europa.eu/en/scdocs/scdoc/1496.htm