Influenza pandemic

Pandemic flu viruses have some avian flu virus genes and usually some human flu virus genes. Both the H2N2 and H3N2 pandemic strains contained genes from avian influenza viruses. The new subtypes arose in pigs coinfected with avian and human viruses and were soon transferred to humans. Swine were considered the original "intermediate host" for influenza, because they supported reassortment of divergent subtypes. However, other hosts appear capable of similar coinfection (e.g., many poultry species), and direct transmission of avian viruses to humans is possible.The Spanish flu virus strain may have been transmitted directly from birds to humans.

In spite of their pandemic connection, avian influenza viruses are noninfectious for most species. When they are infectious they are usually asymptomatic, so the carrier does not have any disease from it. Thus while infected with an avian flu virus, the animal doesn't have a "flu". Typically, when illness (called "flu") from an avian flu virus does occur, it is the result of an avian flu virus strain adapted to one species spreading to another species (usually from one bird species to another bird species). So far as is known, the most common result of this is an illness so minor as to be not worth noticing (and thus little studied). But with the domestication of chickens and turkeys, humans have created species subtypes (domesticated poultry) that can catch an avian flu virus adapted to waterfowl and have it rapidly mutate into a form that kills in days over 90% of an entire flock and spread to other flocks and kill 90% of them and can only be stopped by killing every domestic bird in the area. Until H5N1 infected humans in the 1990s, this was the only reason avian flu was considered important. Since then, avian flu viruses have been intensively studied; resulting in changes in what is believed about flu pandemics, changes in poultry farming, changes in flu vaccination research, and changes in flu pandemic planning.

H5N1 has evolved into a flu virus strain that infects more species than any previously known flu virus strain, is deadlier than any previously known flu virus strain, and continues to evolve becoming both more widespread and more deadly causing Robert Webster, a leading expert on avian flu, to publish an article titled "The world is teetering on the edge of a pandemic that could kill a large fraction of the human population" in American Scientist. He called for adequate resources to fight what he sees as a major world threat to possibly billions of lives.Since the article was written, the world community has spent billions of dollars fighting this threat with limited success.

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Pandemic (H1N1) 2009 - update 58

Laboratory-confirmed cases of pandemic (H1N1) 2009 as officially reported to WHO by States Parties to the International Health Regulations (2005)
6 July 2009 09:00 GMT
The breakdown of the number of laboratory-confirmed cases is given in the following table and map.
Map of the spread of pandemic (H1N1) 2009: number of laboratory confirmed cases and deaths [png 190kb]

Country, territory and area Cumulative total Newly confirmed since the last reporting period
Cases Deaths Cases Deaths
Algeria 5 0 0 0
Antigua and Barbuda 2 0 0 0
Argentina 2485 60 898 34
Australia 5298 10 730 1
Austria 19 0 4 0
Bahamas 7 0 1 0
Bahrain 15 0 0 0
Bangladesh 18 0 6 0
Barbados 12 0 0 0
Belgium 54 0 5 0
Bermuda, UKOT 1 0 0 0
Bolivia 416 0 133 0
Bosnia and Hezegovina 1 0 0 0
Brazil 737 1 0 0
British Virg Islands,UKOT 2 0 0 0
Brunei Darussalam 124 0 39 0
Bulgaria 10 0 0 0
Cambodia 7 0 0 0
Canada 7983 25 0 0
Cap Verde 3 0 0 0
Cayman Islands, UKOT 14 0 0 0
Chile 7376 14 0 0
China 2040 0 226 0
Colombia 118 2 17 0
Cook Island 1 0 1 0
Costa Rica 277 3 50 1
Cote d'Ivoire 2 0 0 0
Croatia 1 0 1 0
Cuba 85 0 12 0
Cyprus 109 0 39 0
Czech Republic 15 0 0 0
Denmark 66 0 3 0
Dominica 1 0 0 0
Dominican Republic 108 2 0 0
Ecuador 204 0 41 0
Egypt 78 0 11 0
El Salvador 319 0 66 0
Estonia 13 0 0 0
Ethiopia 3 0 0 0
Fiji 2 0 0 0
Finland 47 0 4 0
France 310 0 10 0
French Polynesia, FOC 4 0 2 0
Guadaloupe, FOC 2 0 2 0
Martinique, FOC 3 0 1 0
New Caledonia, FOC 12 0 6 0
Saint Martin, FOC 1 0 1 0
Germany 505 0 35 0
Greece 151 0 42 0
Guatemala 286 2 32 0
Guyana 2 0 2 0
Honduras 123 1 0 0
Hungary 11 0 0 0
Iceland 4 0 0 0
India 129 0 25 0
Indonesia 20 0 12 0
Iran, Islamic Republic 1 0 0 0
Iraq 12 0 1 0
Ireland 74 0 23 0
Israel 681 0 104 0
Italy 146 0 16 0
Jamaica 32 0 0 0
Japan 1790 0 344 0
Jordan 23 0 1 0
Kenya 15 0 3 0
Korea, Republic of 202 0 0 0
Kuwait 35 0 0 0
Laos 5 0 2 0
Latvia 1 0 0 0
Lebanon 49 0 2 0
Libya 1 0 1 0
Lithuania 3 0 0 0
Luxembourg 6 0 2 0
Macedonia 2 0 2 0
Malaysia 112 0 0 0
Malta 24 0 22 0
Mauritius 1 0 0 0
Mexico 10262 119 0 0
Montenegro 10 0 1 0
Morocco 17 0 0 0
Myanmar 1 0 0 0
Nepal 5 0 0 0
Netherlands 135 0 1 0
Netherlands, Aruba 5 0 0 0
Nether Antilles, Curaçao 8 0 0 0
Nether Anti,Sint Maarten 7 0 0 0
New Zealand 1059 3 147 3
Nicaragua 321 0 13 0
Norway 41 0 0 0
Oman 4 0 1 0
Palau 1 0 0 0
Panama 417 0 0 0
Papua New Guinea 1 0 0 0
Paraguay 106 1 3 1
Peru 916 0 378 0
Philippines 1709 1 0 0
Poland 25 0 6 0
Portugal 42 0 15 0
Qatar 23 0 13 0
Romania 41 0 5 0
Russia 3 0 0 0
Saint Lucia 1 0 0 0
Samoa 1 0 0 0
Saudi Arabia 114 0 25 0
Serbia 15 0 0 0
Singapore 1055 0 177 0
Slovakia 18 0 0 0
Slovenia 14 0 9 0
South Africa 18 0 6 0
Spain 776 1 16 0
Sri Lanka 19 0 2 0
Suriname 11 0 0 0
Sweden 84 0 10 0
Switzerland 76 0 4 0
Syria 1 0 1 0
Thailand 2076 7 662 4
Trinidad and Tobago 65 0 12 0
Tunisia 5 0 2 0
Turkey 40 0 0 0
Uganda 1 0 0 0
Ukraine 1 0 0 0
United Arab Emirates 8 0 0 0
United Kingdom 7447 3 0 0
Guernsey, Crown Dependen 5 0 0 0
Isle of Man, Crown Depen 1 0 0 0
Jersey, Crown Dependency 11 0 0 0
United States of America 33902 170 0 0
Puerto Rico 18 0 18 0
Virgin Islands 1 0 1 0
Uruguay 195 4 0 3
Vanuatu 2 0 0 0
Venezuela 206 0 2 0
Viet Nam 181 0 50 0
West Bank andGaza Strip 60 0 30 0
Yemen 8 0 1 0
Grand Total 94512 429 4591 47
Chinese Taipei has reported 61 confirmed cases of pandemic (H1N1) 2009 with 0 deaths. Cases from Chinese Taipei are included in the cumulative totals provided in the table above.
Cumulative and new figures are subject to revision

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Contamination & Cleaning

How long can influenza virus remain viable on objects (such as books and doorknobs)?
Studies have shown that influenza virus can survive on environmental surfaces and can infect a person for up to 2-8 hours after being deposited on the surface.
What kills influenza virus?



Technorati Profile

Influenza virus is destroyed by heat (167-212°F [75-100°C]). In addition, several chemical germicides, including chlorine, hydrogen peroxide, detergents (soap), iodophors (iodine-based antiseptics), and alcohols are effective against human influenza viruses if used in proper concentration for a sufficient length of time. For example, wipes or gels with alcohol in them can be used to clean hands. The gels should be rubbed into hands until they are dry.

What surfaces are most likely to be sources of contamination?
Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk, for example, and then touches their own eyes, mouth or nose before washing their hands.

How should waste disposal be handled to prevent the spread of influenza virus?
To prevent the spread of influenza virus, it is recommended that tissues and other disposable items used by an infected person be thrown in the trash. Additionally, persons should wash their hands with soap and water after touching used tissues and similar waste.

Photo of cleaning suppliesWhat household cleaning should be done to prevent the spread of influenza virus?
To prevent the spread of influenza virus it is important to keep surfaces (especially bedside tables, surfaces in the bathroom, kitchen counters and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.

How should linens, eating utensils and dishes of persons infected with influenza virus be handled?
Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first.
Linens (such as bed sheets and towels) should be washed by using household laundry soap and tumbled dry on a hot setting. Individuals should avoid “hugging” laundry prior to washing it to prevent contaminating themselves. Individuals should wash their hands with soap and water or alcohol-based hand rub immediately after handling dirty laundry.

Eating utensils should be washed either in a dishwasher or by hand with water and soap.
Response & Investigation

What is CDC doing in response to the outbreak?
The agency’s goals are to reduce transmission and illness severity, and provide information to help health care providers, public health officials and the public address the challenges posed by the new virus. CDC is working with state and local health departments to enhance surveillance in the United States and to collect and analyze data to assess the impact of the virus and determine the groups at increased risk of complications. In addition, CDC continues to issue new and updated interim guidance for clinicians, public health professionals and the public for the prevention and treatment of this new virus.

To expand the national and international laboratory capacity for detecting novel H1N1 influenza, CDC has developed and distributed new influenza diagnostic kits and reagents to more than 350 laboratories, including laboratories in 131 countries. CDC’s Division of the Strategic National Stockpile (SNS) continues to send antiviral drugs, personal protective equipment, and respiratory protection devices to all 50 states and U.S. territories to help them respond to the outbreak.

The U.S. Government also is aggressively taking early steps in the process to manufacture a novel H1N1 influenza vaccine, working closely with manufacturing. CDC has isolated the new H1N1 virus, made a candidate vaccine virus that can be used to create vaccine, and has provided this virus to industry so they can begin scaling up for production of a vaccine, if necessary.

What epidemiological investigations are taking place in response to the recent outbreak?
CDC works very closely with state and local officials in areas where human cases of new H1N1 flu infections have been identified. CDC has deployed staff to several states to assist with the investigation of the impact of the novel H1N1 influenza, including the assessment of the severity of illness, how easily the virus spreads, and the amount of time people may be infectious. In states where EpiAid teams have been deployed, many epidemiological activities are taking place or planned including:

* Active surveillance in the counties where infections in humans have been identified;
* Studies of health care workers who were exposed to patients infected with the virus to see if they became infected;
* Studies of households and other contacts of people who were confirmed to have been infected to see if they became infected; and
* Study to see how long a person with the virus infection sheds the virus.

Who is in charge of medicine in the Strategic National Stockpile (SNS) once it is deployed?
Local health officials have full control of SNS medicine once supplies are deployed to a city, state, or territory. Federal, state, and local community planners are working together to ensure that SNS medicines will be delivered to the affected area as soon as possible. Many cities, states, and territories have already received SNS supplies. After CDC sends medicine to a state or city, control and distribution of the supply is at the discretion of that state or local health department. Most states and cities also have their own medicines that they can access to treat infected persons.

*Note: Much of the information in this document is based on studies and past experience with seasonal (human) influenza. CDC believes the information applies to novel H1N1 (swine) viruses as well, but studies on this virus are ongoing to learn more about its characteristics. This document will be updated as new information becomes available.

For general information about influenza in pigs (not novel H1N1 flu) see Background Information on Influenza in Pigs.
http://www.cdc.gov/h1n1flu/qa.htm
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