Penumbra Pandemia

"Absenteeism at record levels in Australia due to flu
By Kate Sikora
The Daily Telegraph
July 10, 2009 12:01am
http://www.news.com.au/business/story/0,27753,25759149-462,00.html
HEALTH authorities have lost the battle against swine flu, conceding it now makes up about 60 per cent of all influenza cases.
And it is only going to get worse as businesses already feeling the impact brace for bigger numbers in staff absenteeism.
Just this week 1000 people have already been diagnosed with the flu in NSW, The Daily Telegraph reports.
It is expected to be the worst flu season on record with numbers expected to skyrocket in coming weeks.
Health experts yesterday warned workplaces will be hard hit with every worker off at least twice this winter with flu symptoms.
Currently 100 out of every 1000 workers are off sick - an increase of 20 per cent from last year with predictions the number could spike to as much as 60 per cent.
Swine flu is now the dominant virus, accounting for two thirds of all flu cases in NSW. However, it is feared the state could follow Victoria, where 90 per cent of all flu cases are swine flu.
swine flu," NSW Chief Health Officer Kerry Chant said.
"This year's flu is swine flu.
"If you had asked me a few months ago if swine flu would become the dominant strain compared to normal season influenza I would have said 'no'."
The usual seasonal viruses such as influenza A and influenza B have disappeared as the ferociousness of swine flu spreads through the community.
NSW Health figures show that in the past week there has been a 17-fold increase in influenza patients at hospitals compared with the same period last year.
From July 1, about 175 people a day began arriving at hospital emergency departments with the flu. In May, it was just 25 a day.
Businesses are bracing for record absenteeism, with some workers given influenza kits containing hand sanitisers, masks and tissues to control the spread of the disease.
The Daily Telegraph yesterday reported the virus is expected to infect companies with a $1 billion sick bill.
Direct Health Solutions director Paul Dundon manages an absenteeism call-in service for companies such as NAB.
He said projections showed absenteeism could reach more than 40 per cent.
"Even people who aren't sick but have been exposed to swine flu are being ordered to stay away," he said.
"Workers are taking three days off rather than just one. Absenteeism is already sitting at levels 20 per cent higher than last year."

"Ainakin 19 uutta sikainfluenssatapausta Suomessa
YLE Uutiset
July 2009 klo 07:08, päivitetty July 2009 klo 07:55
Viikonloppuna Suomessa varmistui ainakin 19 uutta H1N1-tartuntaa. Kaikkien suomalaisten sikainfluenssatapausten määrä nousi maanantaiaamuna siis jo 62:een, kerrotaan Terveyden ja hyvinvoinnin laitokselta.
Kyseessä on tähän mennessä suurin hyppäys tartuntojen määrässä. Yliopistojen infektiolääkärit on tänään kutsuttu koolle päivittämään Suomen pandemiastrategiaa.
Suomessa Terveyden ja hyvinvoinnin laitos lisäsi viime viikolla suosituksessaan Ison-Britannian niihin maihin, joissa vierailleiden on syytä tarkkailla terveyttään matkan jälkeen. Euroopan maista Isossa-Britanniassa on hoidettu selvästi eniten viruksen saaneita potilaita, lähes 7 500:aa. Britanniassa uhriluku nousi jo seitsemään, kun kolme ihmistä kuoli maanantaina sikainfluenssaan. Kaikilla kuolleilla oli muita vakavia terveydellisiä ongelmia sikainfluenssan lisäksi.
WHO:n mukaan maailmanlaajuisesti sikainfluenssatartunnan on saanut noin 95 000 ihmistä. Tautiin on kuollut jo yli 400 ihmistä, kertoi WHO maanantaina.
Huhtikuussa Meksikossa puhjenneen epidemian ensimmäinen suomalaistartunta varmistui toukokuun puolessavälissä. Kesäkuun alussa Suomessa oli havaittu H1N1-virusta vasta neljällä."

"Explosion in Argentina Pandemic H1N1 Fatalities
Recombinomics Commentary 17:17
July 6, 2009
http://www.recombinomics.com/News/07060901/H1N1_Argentina_Explosion.html
According to data provided by the Situation Room, there are more than 2,000 cases reported, of which 400 were confirmed as positive.Of the 15 deaths corresponding to node Rosario, Santa Fe to two and the rest of the Venado Tuerto.
The Ministry of Health in the province of Santa Fe reported tonight, through the Situation Room that operates under the Contingency Plan prepared in connection with the pandemic influenza A (H1N1), the total number of reported cases with Epidemiological fact sheets exceeds 2000, with 400 confirmed and 18 deaths, 15 of which belong to Node Rosario, one of the Venado Tuerto and two of Santa Fe
This record corresponds to the information available to date Sunday July 5 to 20 hours.

The above translation describes 18 confirmed fatalities in Santa Fe Province, including 15 deaths in Rosario, as of Sunday night (see updated map). A national report which reported no deaths in Santa Fe last week has an updated number of 9 for Santa Fe, and 60 for the entire country, most of which is from cases in adjacent Buenos Aires Province. The 60 confirmed cases is a marked increase from the 26 reported last week However, the 60 reported cases do not include other recent fatalities cited in media reports which included 11 deaths in Corrientes, 5 deaths in Neuquen, and at least one death in Tierra del Fuego, Jujuy, Cordoba, San Juan, Salta, La Pampa, Rio Negros, Entre Rios, and Santiago del Estero. The national totals do not include any fatalities in the above provinces, raising concerns of a rapid rise in cases that has not been reported beyond the local media reports.
These data indicate the death tally has tripled in the past week and is among the highest in the world (behind the United States and Mexico). However, the cases in Argentina developed very recently, raising concerns that the virus has changed.
To date, there is only one partial pandemic H1N1 MP sequence at Genbank or GISAID. It was collected in April and is identical to a large number of public sequences. However, there are no sequences representing the recent fatalities or June precursors to H1N1 associated with the recent fatalities.
The rapid rise in cases and the failure to provide timely sequence data continues to increase pandemic concerns of an evolving H1N1 that is largely missed by current surveillance approaches.
Recent reports out of Hong Kong described oseltamivir resistance in a traveler from San Francisco who had not taken Tamiflu, raising concerns of resistance in the US. Although no such case has been identified to date, the Hong Kong case was mile and recent (detected June 11) and US efforts have been directed away from mild cases. Moreover, none of the sequences from resistant cases in Denmark, Japan, and Hong Kong have been made public, even though sequences were generated weeks ago.
The failure to promptly disclose these sequences is also cause for concern. In Japan, notification was reportedly delayed while a manuscript was being submitted to the Journal of Infectious Diseases, although release of sequence data would not prevent publication.
The delays in release of important sequence data from pandemic H1N1 are hazardous to the world's health."

"Sikainfluenssa leviää Suomessa: Jo yli 60 tartuntaa
IL
Maanantai July 2009 klo 09.04 (päivitetty klo 10.39)
http://www.iltalehti.fi/uutiset/200907069883814_uu.shtml
Suomessa on ilmennyt viikonloppuna paljon uusia sikainfluenssatartuntoja.
Terveyden ja hyvinvoinnin laitoksen mukaan varmistettuja tartuntoja on jo yli 60. Vielä perjantaina H1N1-tapauksia kerrottiin olevan 43.
Tartuntoja saattaa olla enemmänkin, sillä viikonloppuna on tullut ilmi paljon uusia tapauksia, kertoo tartuntatautilääkäri Antti Alitalo THL:stä STT:lle.

Leviämisnopeus yllätti Suomessa
YLE:n mukaan sikainfluenssan aggressiivinen leviäminen on yllättänyt asiantuntijat. Auroran sairaalan infektiosairauksien klinikan ylilääkärin Ville Valtosen mukaan virus on edennyt poikkeuksellisen nopeasti.
- On hieman yllättänyt, että tämä uusi virus pystyy leviämään kesäaikana pohjoisella pallonpuoliskolla näinkin tehokkaasti. Esimerkiksi Isossa-Britanniassa on jo täysi epidemia päällä ja se on hyvin harvinaista, että pohjoisella pallonpuoliskolla influenssa etenee näin vauhdikkaasti kesäaikaan, Valtonen sanoo YLE:n verkkosivuilla."
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Editor's note: Yllättävää on, että leiämisnopeus on yllättänyt infektiolääkärit. Luulisi tuon olevan maalaisjärjelläkin selvää, että jos tauti leviää elpommin kuin tavallinen kausi-influenssa,, se leviää hyvin nopeasti. Ekä viranomaiset eivät ottaneet huomioon sitä, että jos he eivät suostu testaamaan laboratoriossa lieviä epäiltyjä tautitapauksia, tauti leviää nopeammin kuin jos lievätkin tapaukset testattaisiin ja löydetyt lievää tautia sairastavat potilaat saataisiin eristykseen. Nyt tauti on reissannut lievänä jo pitkin poikin Suomea junalla, bussilla, lentokoneella ja muilla kulkuvälineillä päiväkoteihin, kouluihin, vanhainkoteihin ja moniin muihinkin paikkoihin.

"Tamiflu Resistant Swine H1N1 in Hong Kong and San Francisco
Recombinomics Commentary 13:36
July 3, 2009
http://www.recombinomics.com/News/07030901/H274Y_HK_SF.html
The virus was identified during PHLSB's routine sensitivity test of HSI virus to oseltamivir and zanamivir, the spokesman said.
"This is the first time Tamiflu resistance in HSI virus found in Hong Kong," he said, adding that similar cases were also reported in Denmark and possibly Japan.
"Tests showed that this strain is sensitive to zanamivir (Relenza)," he said.
The virus was isolated from the specimen taken from a 16-year-old girl coming from San Francisco. She was intercepted by Port Health Office at the Hong Kong International Airport on June 11 upon arrival. The girl was then admitted to Queen Mary Hospital for isolation. She was tested positive to HSI but opted not to take tamiflu. She had mild symptoms and was eventually discharged upon recovery on June 18.
The spokesman noted that PHLSB conducted routine sensitivity tests on specimens taken from confirmed HSI patients.

The above comments from the Hong Kong Department of Health press release describe Tamiflu resistance (presumably H274Y, aka H275Y) in a patient arriving from San Francisco. The resistance was discovered during routine surveillance and there is no indication the patient was taking oseltamivir, indicating the pandemic H1N1 was evolutionarily fit.
The two other cases described this were (in Denmark and Japan) were in patients under prophylactic treat of Tamiflu. In both cases the resistance was due to H274Y (and discovered because of the prophylactic treatment).
Evolutionarily fit swine flu with H274Y is cause for concern. Last year seasonal H1N1 with H274Y spread worldwide. It had previous spread from one genetic background to another via genetic hitchhiking and recombination.
It is likely that H274Y in pandemic H1N1 will now follow a similar, but accelerated, pathway due to widespread use of oseltamivir to control the spread of pandemic H1N1.
The export of H274Y from San Francisco, and failure to identify the polymorphism in the United States, raises serious surveillance concerns."
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Editor's comment: Just wondering, did the Tamiflu stock market price reach it's highest value, and has the big money sold the shares now and bought Relenza in turn.

"Japan Reports Tamiflu-Resistant H1N1 Influenza Case
Kyodo
July 02, 2009 11:09 ET 15:09 GMT
DOW JONES NEWSWIRES
The health ministry said Thursday it has detected a genetic mutation of the new H1N1 strain of influenza A that is resistant to the anti-flu drug Tamiflu, the first such virus in Japan, the Kyodo News service reported. The Health, Labor and Welfare Ministry said the Tamiflu-resistant virus was detected in a man infected with the new influenza in Osaka Prefecture, Kyodo reported."

"Vical H1 Influenza Vaccine Delivers Robust Preclinical Results With 100% Response
http://www.newspress.com/Top/Article/article.jsp?Section=BUSINESS&ID=565605450364616717
SAN DIEGO,
30 June 2009
GLOBE NEWSWIRE
Vical Incorporated (Nasdaq:VICL) announced today that the company's vaccine against A/H1N1 pandemic influenza (swine flu) produced robust immune responses well above the accepted protection threshold in 100% of vaccinated mice and rabbits after a standard two-dose vaccine regimen. In addition, at least 75% of vaccinated animals achieved or exceeded the protection threshold after a single dose of vaccine. The company is ready to advance directly to large-scale cGMP manufacturing of the vaccine for human clinical trials, subject to securing external funding for this program. ---"
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Editor's note: Sounds too good to be true. But what may be the side effects and adverse effects? Does the law require the corporation to tell them?

"Indonesia: all aircraft passengers to get masks
The mask for pendatang
BBC
By editorial staff of 29/06/2009 @ 22:57
The Indonesian government will distribute the mask to all the aircraft passenger from the country that it was known was collided with H1N1 or pig flu. The government also obliged each aircraft passenger and the ship from overseas to fill up the health card. These efforts were carried out to stem spread him the virus H1N1 in Indonesia, after the influenza patient H1N1 that came from overseas to improve to eight people.
One of the important decisions of results of the interdepartmental co-ordination of the meeting related today was, more increased the supervision procedure in all the international airports. The government stressed this, because eight patients who were known were infected by the virus H1N1, was ascertained tertular overseas. Health Minister Siti Fadilah Supari said, one of the steps in his prevention was to distribute the mask to aircraft passengers from the country that was collided with by the virus of pig flu. Was not explained when the mask will be distributed in each international airport. The official of the Department of the Health said, technical the implementation of these efforts will be discussed in the other opportunity. Apart from distributing the mask, the government according to Transport Minister Menteri Perhubungan Jusman Sjafii Djamal, also will tighten the supervision in the airport and the international port.
Each passenger from overseas his plan will be obliged to fill up the health card. The official in all the international airports also will tighten the use of the implement pemindai hot. Up until last Sunday, the number of influenza patients of A H1N1 or pig flu in Indonesia that has been it was confirmed positive totalling eight people, four among them the foreign citizen and Indonesian citizen who just came from the country to be collided with by this virus."

toggletext translated
orginal article

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"Masker buat para pendatang
oleh Redaksi 29/06/2009 @ 22:57
BBC
http://www.infeksi.com/newsdetail.php?lng=in&doc=3571
Pemerintah Indonesia akan membagikan masker kepada seluruh penumpang pesawat dari negara yang diketahui terdampak H1N1 atau flu babi.
Pemerintah juga mewajibkan setiap penumpang pesawat dan kapal laut dari luar negeri untuk mengisi kartu kesehatan.
Upaya ini dilakukan untuk membendung merebaknya virus H1N1 di Indonesia, setelah pasien influenza H1N1 yang datang dari luar negeri bertambah menjadi delapan orang.
Salah-satu keputusan penting hasil rapat koordinasi antar departemen terkait hari ini adalah, lebih meningkatkan prosedur pengawasan di semua bandar udara internasional.
Pemerintah menekankan hal ini, karena delapan orang pasien yang diketahui terinfeksi virus H1N1, dipastikan tertular di luar negeri.
Menteri Kesehatan Siti Fadilah Supari mengatakan, salah-satu langkah pencegahannya adalah membagikan masker kepada penumpang pesawat dari negara yang terdampak virus flu babi.
Tidak dijelaskan kapan masker itu akan dibagikan di setiap bandar udara internasional.
Pejabat Departemen Kesehatan mengatakan, teknis pelaksanaan upaya ini akan dibahas pada kesempatan lain.
Selain membagikan masker, pemerintah menurut Menteri Perhubungan Menteri Perhubungan Jusman Sjafii Djamal, juga akan memperketat pengawasan di bandar udara dan pelabuhan internasional.
Setiap penumpang dari luar negeri rencananya akan diwajibkan mengisi kartu kesehatan.
Petugas di semua bandar udara internasional juga akan memperketat penggunaan alat pemindai panas.
Sampai hari Minggu kemarin, jumlah pasien influenza A H1N1 atau flu babi di Indonesia yang sudah dikonfirmasi positif sebanyak delapan orang, empat diantaranya warga negara asing dan sisanya warga negara Indonesia yang baru datang dari negara terdampak virus tersebut."

"Air Traffic Patterns To Predict Infectious Disease Spread: Researchers
Bernama
Ottawa
30 June 2009
http://www.bernama.com/bernama/v5/newsindex.php?id=421769
Canadian researchers have designed a system using air travel patterns to predict how infectious diseases will spread around the world, and by taking preventive measures as soon as an outbreak occurs, local media reported Monday.
The system known as BIO.DOASPORA system, is developed by a physician Dr. Kamran Khan of St. Michael's Hospital in Toronto and his colleagues, accurately to predict how the A/H1N1 flu virus would circulate worldwide after arising in Mexico earlier this year, reports China's Xinhua news agency.
Using their BIO.DIASPORA system, the team analyzed the flight itineraries of more than 2.3 million passengers who departed Mexico on commercial flights during March and April 2008 to predict the spread of the A/H1N1 flu.
The findings show the international destinations of air travellers leaving Mexico were strongly associated with confirmed importations of the virus around the world.
"We know that infectious diseases don't respect national boundaries, but if there is one thing they have to respect as they're spreading around the globe, it's the architecture of the airline transportation system," said Khan.
"This is their mechanism for spreading around the globe."
Khan said he came up with the idea of using the air traffic grid to better understand the global transmission of infectious disease after the 2003 SARS crisis. That outbreak killed more than 770 people, including 44 Canadians.
"It just became so obvious how the airline transportation network was a major conduit of the spread of infectious diseases," he said.
Days before Khan and his team were to deliver a report on BIO. DIASPORA to the Public Health Agency of Canada, news began trickling out about a new flu virus in Mexico. Their system allowed them to track its spread as it quickly infiltrated populations in one country after another.
"The movement of passengers out of Mexico aligned very nicely with the observed spread of H1N1," said Khan, principal author of a paper on the initiative published this week in the New England Journal of Medicine.
"I see this publication as being an important point now where we can say: OK, this is proof of principle that where people move, infectious disease of people will follow, that that principle now is validated in this A/H1N1 outbreak."
Co-author Dr. Michael Gardam, director of infectious diseases prevention and control for the Ontario Agency for Health Protection and Promotion, said the system provides for the first time an accurate picture of not only where diseases will travel, but how often and when.
"This work provides the world with a potent early-warning system for emerging infectious diseases," he said."

"Silent Spread of Tamiflu Resistant Pandemic H1N1
Recombinomics Commentary 13:05
June 30, 2009
http://www.recombinomics.com/News/06300901/H274Y_Swine_Silent.html
He had to start with no ill. That was in the preventive treatment with Tamiflu, because he had been in close contact with a swine influenza hit abroad. Since there had been five days of Tamiflu, the person suddenly ill with H1N1, but it not appear that the medicine worked. It appeared as through the samples here and in England that the person had been resistance, "says Nils Strandberg.

The above translation provides additional information on the patient who developed a pandemic H1N1 infection while taking a prophylactic dose of oseltamivir (Tamiflu). The five days suggests the patient was infected after her contact, who was infected overseas, returned. The patient was given Tamiflu because of her infected contact and developed flu-like symptoms while taking Tamiflu, which led to the isolation of the virus and sequence data (generated in Denmark and England) showing resistance (which was almost certainly H274Y).
The above description made no mention of an isolate from the patient who traveled overseas and no indication that an isolate was collected. Therefore, it is highly unlikely that a wild type sequence from the overseas traveler or the patient with resistant H1N1 exist. This absence was also signaled by statements from Roche and other agencies who used the qualifiers of "appears" and "probably" when describing the develop of resistance, because there is no evidence that resistance developed in the patient in Denmark.
A more likely scenario involves the silent spread of oseltamivir resistant H1N1. Denmark, like most countries in Europe, has focused on detection of H1N1 in travelers and contacts. Consequently, the number of H1N1 positive cases has been low. Although countries have been making sequences public shortly have collection of isolates, the number of public pandemic H1N1 sequences from Denmark at Genbank or GISAID remains at one. The NA sequence has been released and it is wild type. However, the isolate was collected from a patient in April, so there are no recent public sequences from Denmark.
Similarly, sequences from other countries are also limited and in many cases the public sequences do not include NA, so even if H274Y was in the isolate, it would not be in the database. The publicity associated with the Danish case will likely lead to more isolates and more sequences, and the explosion of cases in England, may lead to a more serious approach toward testing for community spread in European countries like Denmark, which are focused on airport travelers and contacts.
Airport screening will only detect a small subset of infected patients, because those infected shortly prior to travel will not yet have symptoms and about 30% of infected patients don't develop a high fever. Moreover, others take medication for flu-like symptoms, which lowers fevers. Thus, infected patients have been flying into these countries undetected for months, and community spread is significant, but not reported because of a lack of testing.
The detection of H274Y in pandemic H1N1 has parallels with H274Y in seasonal H1N1. The resistance was widely reported in early 2008 in Norway, but subsequent testing demonstrated that the resistance was widespread in the fall of 2007 and had silently circulated for months prior to detection. The limited number of NA sequence for most countries outside of North America allows for a repeat of silent spread of Tamiflu resistantant pandemic H1N1 at this time.
More detail on the current case and contact who was infected overseas would be useful, as would serious testing and for community spread in countries reporting low levels of infections, which includes most countries in Europe, and rapid release of associated sequences."

"Roche Comments on Tamiflu Resistant H1N1 Raise Concerns
Recombinomics Commentary 16:11
June 29, 2009
http://www.recombinomics.com/News/06290903/H274Y_Swine_Roche.html
While receiving the drug, the patient appeared to develop resistance to it," David Reddy, Roche's pandemic taskforce leader, told reporters on a conference call on the Danish case. "This is the first report we have of it in H1N1."
The Danish patient, who has since recovered, was taking the drug as a prevention to avoid the contraction of swine flu, Reddy said. He was probably already infected with the virus, and resistance to the drug emerged because he was given the lower prevention dose

The above comments in media reports following the Roche conference call raise serious doubts about the claim that the osletamivir (Tamiflu) resistance arose in the Danish female patient because if prophylactic treatment. The patient had been exposed to an H1N1 positive contact outside of Denmark and was given a prophylactic dose of Tamiflu as a precaution. She subsequently developed symptoms and recovered when treated with Relenza.
However, there has been no data presented to show that wild type H1N1 infected the Danish patient or the patient who infected the Danish patient. Moreover, the use of the qualifiers "appear" and "probably" suggests that no such data exists.
Patients have been know to develop resistance in response to treatment. In Vietnam, a contact (sister) of a patient developed resistance at two NA positions (H274Y and N294S), which are two changes known to confer resistance and which were not detected in H5N1 from her brother, supporting development of resistance in response to treatment of his sister.
However, in the Danish case, no such evidence was presented. If resistance was present in the contact that infected the Danish case, the result would have been as described, The prophylactic treatment would have had little effect, and the resistant H1N1 would still have been sensitive to Relenza.
Therefore, the report of Tamiflu resistance (which was probably H274Y) raises concerns that resistance will spread via recombination, as happened fro H274Y in seasonal flu. Initially, the polymorphism was rare. It was first in clade 2C in China, followed by clade 1 in the US and UK, followed by clade 2B. In each sub-clade the polymorphism appeared on multiple genetic backgrounds in the absence of Tamiflu treatment.
The hitch hiking led to an expansion of H274Y, and when it paired up with HA A193T, the subclade expanded and both acquistions became fixed.
The large reservoir of H274Y in seasonal flu provides donor sequences for H274Y acquisition in swine H1N1. The report of resistance in the Danish patient raises concerns that the resistance can rapidly spread under the section pressure of Tamiflu treatment.
Information on the contact location for the Danish patient, as well as sequence data on samples collected before and after treatment would be useful. However, since some media reports suggest she was on prophylactic Tamiflu for five days prior to symptoms, there probably is no isolate collected prior to treatment. However, H1N1 from her contact would be useful, although the existence of such material is doubtful, based on the qualifiers in the Roche statements, as well as the failure to provide any hard data supporting the contention that the resistance developed in response to treatment in Denmark.
Absent such evidence, the resistance is likely to have developed prior to treatment, and represents an evolutionarily fit H1N1.
Sequence data from the patient will help trace this sub-clade to provide additional evidence on the likelihood that the resistance emerged in Denmark, which, at this point, appears to be doubtful."

"Cruise ship with A/H1N1 outbreak onboard arrives in Russia
RIA Novosti
Moscow
29 June 2009
http://en.rian.ru/russia/20090629/155385779.html
A cruise ship with 14 A/H1N1-infected people onboard arrived in Russia's second city of St. Petersburg on Monday, Russia's chief sanitary official Gennady Onishchenko said.
Swine flu was confirmed in 13 crew members and one passenger of the Emerald Princess cruise liner, which sailed from the Finnish capital, Helsinki. The infected have been quarantined in their cabins and are being treated with the anti-viral drug Tamiflu.
"A/H1N1 flu has been confirmed in all quarantined people," Onishchenko said. "Their condition does not require hospitalization."
Other passengers and crew passed medical checks. The ship had 3,243 passengers and 1,201 crew members onboard.
The first case of the highly pathogenic virus, which infected at least 70,893 people worldwide, was confirmed in several crew members on June 18. When the vessel arrived to St. Petersburg, 16 people had already recovered and tested negative for the virus."
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Editor's note: How come the cruise ship came from Finland, there's no confirmed epidemic in Finland (say the officials,...)

"Dane resistant to Tamiflu
Indland
29 une 2009 15.20
http://www.dr.dk/Nyheder/Indland/2009/06/29/151411.htm?rss=true
Det første tilfælde i verden af resistens over for influenzamedicinen Tamiflu hos folk med influenza H1N1 er fundet i Danmark.
Personen er nu rask, og der er ikke påvist yderligere smitte med det resistente virus, oplyser Statens Serum Institut.
Den smittede havde været i tæt kontakt med en anden smittet person, og var derfor i forebyggede behandling med Tamiflu. Alligevel fik personen influenzasymptomer og er i stedet behandlet med en anden type influenzamedicin, Relenza.

Muteret virus i Danmark
Verdens sundhedsorganisationen WHO opfordrer efter det danske tilfælde til mere opmærksomhed på mulighed for udvikling af resistens hos viruset.
Det er ikke usædvanligt, at en influenzavirus muterer spontant, og i en pressemeddelelse kalder Statens Serum Institut det "Velkendt og forventeligt."
De understreger desuden, at det ikke udgør en trussel mod folkesundheden."
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Briefly in English: The first case in the world of resistance to influenza drug Tamiflu (oseltamivir) in people with influenza H1N1 has been found in Denmark. The person had been in close contact with another infected person and was for that reason on prophylactic Tamiflu medication. Despite this the person got influenza symptoms an is on influenza medication of another type, Relenza (zanamivir).
The person is now healthy, and there is no further evidence of infection with resistant virus, according to Statens Serum Institut.

"STM ja THL tiedottavat: Suomessa ensimmäinen maan sisäinen influenssa A(H1N1)-tartunta
STM ja THL
29.6.2009
http://www.thl.fi/fi_FI/web/fi/tiedote?id=14473
Suomessa varmistui viikonlopun aikana yhdeksän uutta influenssa A(H1N1)-tartuntaa. Lähes kaikki tartunnan saaneet olivat Yhdysvalloista palanneita matkailijoita. Lisäksi yksi henkilö on Suomessa saanut tartunnan Yhdysvalloista palanneelta sairastuneelta lähiomaiseltaan. Tartunnan saaneet voivat hyvin ja ovat kotihoidossa.
Suomessa nyt varmistettu maan sisäinen tartunta ei ole yllättävä, koska kyseessä on lähikontakti epidemia-alueelta palanneeseen oireiseen potilaaseen. Pidempiä tartuntaketjuja tai yhteisötartuntoja ei ole Suomessa todettu. Niiden estämiseksi jatketaan entisenkaltaisia torjuntatoimia tunnistamalla ulkomailta tuodut influenssatapaukset sekä paikalliset hengitystieinfektioiden ryppäät.
Maan sisäinen tartunta todettiin Helsingin ja Uudenmaan sairaanhoitopiirissä HUS:ssa. Sairaanhoitopiirissä todettiin kaiken kaikkiaan kahdeksan uutta influenssa A(H1N1)-tapausta viikonlopun aikana.
Oulussa tartunta varmistui yhdeltä puolisonsa kanssa niinikään USA:ssa käyneeltä matkailijalta. Matkakumppani saattoi sairastaa taudin jo matkan aikana. Terveyden ja hyvinvoinnin laitos (THL) ottaa tartunnan saaneiden kanssa samoilla lennoilla olleisiin entiseen tapaan yhteyttä. Oulun pariskunta matkusti 27.6. myös junalla (Pendolino 845, Vaunu 4, paikat 67 ja 68, lähtö klo 16).
Suomessa on nyt influenssa A(H1N1)-tartunnan saaneita varmistettu kaikkiaan 36.
Meksikosta, Yhdysvalloista, Kanadasta, Etelä- ja Väli-Amerikasta (erityisesti Argentiina ja Chile), Australiasta, Uudesta-Seelannista sekä Hongkongista, Thaimaasta ja Filippiineiltä palaavia matkustajia kehotetaan edelleen tarkkailemaan terveyttään matkan jälkeen noin viikon ajan ja tarvittaessa ottamaan yhteyttä puhelimitse terveyskeskukseen."
*******************
Briefly in English: First confirmed human-to-human H1N1 infection found in Finland

"US passes million swine flu cases
BBC News
Page last updated at 11:15 GMT, Saturday, 27 June 2009 12:15 UK
http://news.bbc.co.uk/2/hi/americas/8122262.stm
US health officials estimate that at least one million Americans have been infected with swine flu since the H1N1 virus emerged nearly three months ago.
The number is far higher than cases actually reported to the authorities.
The Centers for Disease Control and Prevention (CDC) said many cases were mild, although 127 people had died.
The CDC based its figures on surveys, rather than laboratory evidence, but the numbers suggest the death rate from swine flu is lower than thought.
'We're saying that there have been at least a million cases of the new H1N1 virus so far this year in the United States,' said Anne Schuchat of the CDC.
'Reported cases are really just the tip of the iceberg.'
The CDC has based its estimate on mathematical modelling, based on surveys by health officials.
If the figures are correct, it is reassuring news, because it indicates that the fatality rate from swine flu is even lower than thought, says BBC medical correspondent Fergus Walsh.
However, Dr Schuchat warned that swine flu might exhibit higher infection rates than seasonal flu and could return in a more virulent form in the autumn.

Argentina election
According to the CDC, there have been 27,717 confirmed or probable cases; some 3,000 people have needed hospital treatment and there have been 127 deaths.
Swine flu continues to affect mainly people under 50 years of age, with many of those worst affected having underlying health problems such as asthma or diabetes. The average age of those who died in the US is 37.
Officials from the CDC and the World Health Organization are watching outbreaks in the southern hemisphere, in particular in Argentina, Chile and Australia, to see how the H1N1 virus has been spreading during the winter months and whether it is likely to become more virulent.
Argentina's health ministry has registered 26 deaths attributed to swine flu, and 1,587 cases. Officials are advising people to try to leave space between each other as they line up to vote in legislative elections on Sunday.
Chilean health authorities say there have been 6,211 cases and 12 deaths.
In Australia, there have been five swine-flu related deaths, all of patients with existing medical conditions, and 3,677 cases, according to official figures.
The H1N1 virus first emerged in April in Mexico, which has recorded 116 deaths and 8,279 cases, according to the WHO.
On 11 June, the WHO declared a global flu pandemic, meaning that swine flu virus was spreading in at least two regions of the world.
Officials stressed that this did not mean the virus was causing more severe illness or more deaths.
According to the latest figures from the WHO, there have been 263 deaths and nearly 60,000 cases in some 100 countries and territories. "
***************
Editor's note: If the mathematical modelling of CDC is accurate, in Finland there should be well over 800 swine flu cases.

"Soaring Death Rate in Buenos Aires Raises Pandemic Concerns
Recombinomics Commentary 18:03
June 27, 2009
http://www.recombinomics.com/News/06270901/H1N1_Buenos_Aires.html
"We're seeing the placement of young patients, between 15 and 50 years with pneumonia, some rapidly evolving towards a gravity which for many is unusual, in which the lung is' fire 'in a matter of hours," said Dr. Jorge San Juan, head of the Department of Intensive Care Hospital Muñiz.
This has led to patients with these characteristics begin to be treated in an increasingly aggressive. THE NATION As reported yesterday, doctors from the Ministry of Health received the directive to take, from now on, all cases of influenza and potential influenza A (H1N1), with the recommendation to perform chest radiographs for patients with symptoms of fever and fatigue and internal quickly to all suffering from pneumonia.
"The bodies were viscera, meninges and brain swollen, a little common factor in death from influenza. Additionally, the lungs were in bad shape, with some spots we could not identify. The studies sent pathology, "said the coroner who asked not to publicize his name until the health authorities take note of it found.

The above translation describes patients in and around Buenos Aires (see updated map). In the past few days 26 confirmed fatalities have been reported as well as 15 additional probable fatalities. H1N1 infections of swine on a nearby farm (see map) has also been described in an OIE report.
The targeted population, as well as the description of the rapid deterioration sounds remarkable like reports on the 1918 pandemic.
Sequence data on these patients and swine would be useful. It is the beginning of flu season in Argentina, and the potential for the evolution of a more virulent Pandemic H1N1 looms large."

"Medical Emergency in Buenos Aires Raises Pandemic Concerns
Recombinomics Commentary 23:43
June 27, 2009
http://www.recombinomics.com/News/06270902/H1N1_Buenos_Aires_Emergency.html
Some hospitals began to strengthen measures, including the case of Posadas Hospital, one of the largest hospitals in the province of Buenos Aires that concentrates a large number of internees from the flu. Through a press release, the hospital reported that it declared a state of emergency by the Institution that "all staff will be available to the agency needs to be addressed" after the epidemic of influenza A.
In addition, the Posadas created through Resolution No. 640/09 an Internal Crisis Committee itself, with the aim of ensuring compliance and monitoring of the actions that the hospital must develop to deal with the situation posed by an outbreak of Influenza A .
Meanwhile, health authorities in Buenos Aires and Buenos Aires have some alternatives to strengthen the system, including the use of military hospital in Campo de Mayo, the release of bed in the hospital's intensive care Malvinas Argentinas, the installation of sanitary units in campaign Buenos Aires and mobile primary care close to railway stations and Eleven Constitution.

The above translation describes the declaration of a medical emergency in Buenos Aires. The Ministry of Health website lists 15 confirmed fatalities, 180 confirmed cases, and 559 suspect cases as of Friday (see Buenos Aires map), but media reports suggest the actual number of cases is higher. Recent reports out of Argentina also described the rapid decline of relative young patients (15-50), with descriptions similar to those used to describe dying patients in 1918. In addition, there has been an outbreak of H1N1 at a pig farm northwest of Buenos Aires (see map).
The sudden jump in cases and fatalities are cause for concern. In the country the number of confirmed fatal cases rose to 27, but there are reports of 15 more fatalities that are suspect. There have also been reports of travelers from Argentina testing positive at airport checks in multiple countries. These travelers should provide multiple samples for sequencing studies to determine if there have been changes in the virus.
Recently PB2 E627K was reported in a traveler from the United States. However, the sequence suggested the change was acquired in China. Although the E627K was present in the original samples and confirmed in the initial clone, and subsequent sub-clone had reverted back to the wild type sequence, raising concerns that some key changes may not be stable under certain culture conditions, and important changes could be lost especially if the virus is cultured in chicken eggs, which could select against important changes associated with adaptation to human hosts.
Therefore, analysis by multiple labs of these sequences would be useful. The flu season is just beginning in the southern hemisphere, providing a favorable environment for rapid adaptive changes. The movement of a swine H1N1 into a human host parallels the 1918 pandemic, which also was associated with mild infections in the later spring, followed by a much more virulent and lethal H1N1 in the fall.
The rapid developments in Buenos Aires bear close scrutiny and active sequence analysis as H1N1 increases its gene pool transmitting through human hosts. Many countries worldwide, including those in the southern hemisphere are experiencing explosive growth, and the developments in Buenos Aires may signal a new wave of Pandemic H1N1."

"WHO: Sikainfluenssavirus ei näytä muuntuvan
25.6.2009 22:50
STT–REUTERS
Moskova. Sikainfluenssavirus on vakaa, eikä se näytä risteytyvän lintuinfluenssan tai muiden influenssavirusten kanssa, kertoi maailman terveysjärjestö WHO torstaina.
WHO:n johtaja Margaret Chan sanoi torstaina Moskovassa, että H1N1-virus on yhä erittäin vakaa.
Chan kuitenkin korosti, että influenssavirukset ovat luonteeltaan hyvin arvaamattomia ja mutaatioalttiita. Sikainfluenssan on pelätty risteytyvän erityisesti lintuinfluenssan kanssa nykyistä vaarallisemmaksi.
Chanin mukaan tutkijat ovat seuranneet viruksen käytöstä ympäri maailmaa. Tällä hetkellä WHO keskittyy varmistamaan, ettei H1N1 muutu eteläisen pallonpuoliskon maissa, joissa kiertää tavallinen kausi-influenssa.
Maailman terveysjärjestö WHO on julistanut sikainfluenssan pandemiaksi eli maailmanlaajuiseksi kulkutaudiksi. Tartunnan on saanut järjestön tilastojen mukaan lähes 56 000 ihmistä, joista 238 on kuollut."
************
Editor's note: Jos sikainfluenssavirus on vakaa eikä muunnu, miten se ylipäänsä ilmaantui? Kolmen eri lajin virusten rekombinantti.

"Sikainfluenssatartunnat levinneet potilaista lääkäreihin ja hoitajiin
Mari Heikkilä
MediUutiset
klo 10:57 Wednesday 24 June 2009
http://www.mediuutiset.fi/uutisarkisto/article303172.ece?s=u&wtm=medi-24062009
Yhdysvaltain tartuntatautiviranomaisjärjestö CDC on huolissaan sikainfluenssan leviämisestä terveydenhuoltohenkilöstön parissa. Osa laiminlyö oman suojautumisensa.
Järjestö patistaa potilaiden kanssa työskenteleviä käyttämään hengitystieinfektioiden rutiinisuojautumiskeinojen lisäksi hyvin sopivia N95-hengityssuojaimia ja silmäsuojaimia sekä tekemään aerosoleja synnyttävät tutkimukset alipaineistetussa eristyshuoneessa.
Sikainfluenssa siirtyi Yhdysvalloissa toukokuun 12. päivään mennessä 48 terveydenhuoltohenkilöstöön kuuluvalle. Näistä kaksi sai sairaalahoitoa, mutta kukaan ei kuollut.
Tarkemmin analysoiduissa 26 tapauksen joukossa oli 4 lääkäriä, 9 hoitohenkilökuntaan kuuluvaa ja 12 muuta terveydenhuollossa toimivaa. Näistä puolet (13) oli hyvin todennäköisesti saanut tartunnan työpaikallaan sikainfluenssapotilaalta. Yksi tartunta lienee siirtynyt terveydenhuoltohenkilöltä toiselle. Sairastuneista kuusi kertoi olleensa sairastuneen läheisensä kanssa tekemisessä ja neljä matkustaneensa Meksikoon.
Suojautuminen jää puolitiehen
Työpaikallaan todennäköiseseti tartunnan saaneet eivät olleet suojautuneet aina sikainfluenssapotilaiden kanssa työskennellessään viranomaissuositusten mukaisesti.
Vain kolme kertoi käyttäneensä hengityssuojainta. Viisi kertoi käyttäneensä hanskoja. Silmäsuojaimia ei käyttänyt kukaan. Hanskoja, pukua ja hengityssuojaimia ei kukaan käyttänyt aina.
Yksi lääkäreistä, joka oli luultavasti saanut tartunnan potilaalta, kertoi aina käyttäneensä N95-hengityssuojainta. Hengityssuojaimen sopivuutta ei kuitenkaan oltu koskaan testattu eikä ole tiedossa, käyttikö kyseinen lääkäri myös pukua ja silmäsuojaimia.
Viime talven kausi-influenssarokotus ei estänyt tartuntoja. Rokotuksen viime syyskuun jälkeen oli saanut kahdeksan kuudestatoista sairastuneesta.
Tartunnat leviävät avohoidossa
Toukokuun loppuun mennessä vain 653 (6 prosenttia) 10 053 Yhdysvaltain sikainfluenssapotilaasta oli saanut sairaalahoitoa. CDC muistuttaakin, että terveydenhuollon henkilökunta on suuressa vaarassa saada tartunnan avohoidossa olevilta potilailta. Myös avohoidossa työskentelevien tulee noudattaa suojautumisohjeita.
Raportissa puolet mahdollisesti potilaalta tartunnan saaneista kertoi työskennelleensä avohoidossa ennen oireiden ilmenemistä."

"Pandemic H1N1 Cluster in Buffalo New York Raises Concerns
Recombinomics Commentary 12:44
June 22, 2009
Davis was an eighth grader at Harvey Austin School 97 on Sycamore Street.
News 4 talked to the 15-year-old's mother Lucretia Belton. Matthew attended Harvey Austin School 97.
His mother said complications from swine flu included pneumonia and MRSA.
She said his kidneys were failing, and he was being kept alive by machines.
A nine-year-old girl is also at Women and Children's Hospital with the H1N1 virus.
She's a fourth grader at Charles Drew Science Magnet School 59's museum campus.

The above comments describe two students of magnet schools in Buffalo, NY that are a mile apart (see updated map). Both students were on life support yesterday, and the middle school student (15) died after life support was withdrawn. The elementary school student (9F) remains on life support. The clustering of two critically ill students raises concerns about the emergence of a more lethal strain of Pandemic H1N1.
The two serious cases may simply reflect the high level of H1N1 infections in the area. 37 Buffalo area zip codes have registered at least one confirmed H1N1 case (see map and list below). Moreover adjacent Niagara County announced clusters of cases in two elementary schools, and clusters were also described for Hamilton Ontario, just across the border from Buffalo and Niagara county (see map). Moreover, H1N1 has been widespread in the Halton area, where infections have been confirmed in more than 30 schools in Oakville.
However, the state agency and media reports do not describe any pre-existing conditions for either student and these two cases follow two announcements by the city of New York of 14 deaths in May. Seven were announced on Tuesday, and seven more were announce on Friday, but these announcements lacked detail. All had died in May and all were between the ages of 25-64. However, there was no additional information and no mention of pre-existing conditions.
The significance of the failure to mention pre-existing remains unclear. Many of the prior death were said to have pre-existing conditions, but there was little evidence pointing to a strong role of these conditions in the deaths. In Mexico, most of the fatalities were in young adults who did not have pre-existing conditions. Although reports of US cases have stated that 70% of fatalities had pre-existing conditions, it remains unclear if such figures include the 14 cases announced by NYC or other cases that have been confirmed but not announced.
Recent comments in press conferences by WHO and the CDC have added to the uncertainty. At the WHO press release introductory remarks by Kieji Fukuda cited 249 deaths worldwide, which raised questions, since the official tally at the time was only 140 deaths. Last week at the CDC press conference, opening remarks by Dan Jerrnigan indicated that 40% of the fatal cases had pre-existing conditions, which was much lower than the 70% cited for the released cases. In both instances the press conference transcript was edited to reflect the numbers for the released cases. However, the delay in the acknowledgement of the cases in New York raises concerns that the higher number of fatal cases and the lower percentage of cases with pre-existing condition reflects the current number of confirmed cases, which includes a high percentage of fatal cases without pre-existing conditions.
The clustering of the critical cases in Buffalo raises concerns of a Pandemic strain that is evolving and becoming more lethal. The 2009 Pandemic is tracking with the 1918 Pandemic, which produce mild disease in the spring, and was more lethal in the fall when previously healthy young adults.
One such change that could increase lethality is PB2 E627K. This polymorphism is present in seasonal influenza A, including the 1918 pandemic strain. It allows for optimal replication at lower temperatures, which may lead to a more transmissible and lethal Pandemic strain. This change has been reported for an isolate from Shanghai from a patient (22F) who recovered. The collection date, location, age and gender, suggests that the isolate came from a Chinese national who was a student in the US and flew to Shanghai on a flight that originated in New York with a lay-over in Hong Kong. Thus, the virus could have originated in New York, Hong Kong, or Shanghai, since the student developed symptoms shortly after arriving in Shanghai. The sequencers in China promptly released full sequences on all eight gene segments, and sequenced a clone to confirm that the E627K was not a sequencing error. The sequence of the clone exactly matched the original sequence.
However, this change may not offer much advantage at this time of the year in the northern hemisphere, but the change could appear in the southern hemisphere or could signal a change that is more widespread and circulating in the Hong Kong area. In any event, the presence of E627K in pandemic H1N1 strongly suggests that it will emerge in the fall, which is cause for concern.
The Buffalo cluster however raises concerns of additional changes, so sequencing of the isolate from the fatally infected middle school student would be useful.

Buffalo Area Zip Codes with at least 1 confirmed H1N1 case
14031; 14032; 14043; 14051; 14059; 14068; 14072; 14075; 14086; 14127; 14150; 14201; 14203; 14204; 14206; 14207; 14208; 14209; 14210; 14211; 14212; 14213; 14214; 14215; 14216; 14217; 14218; 14219; 14220; 14221; 14222; 14223; 14224; 14225; 14226; 14227; 14228"

H1N1 flu (Swine flu) linked to French fries sold in fast food restaurants
examiner.com
21 June 2009, 7:38 AM
http://www.examiner.com/x-672-Disease-Prevention-Examiner~y2009m6d21-H1N1-flu-linked-to-French-fries-sold-in-fast-food-restaurants
Russian researchers have made a link between the H1N1 flu and the French fries that are sold in our fast food restaurants. The link sounds a bit far-fetched, but worth investigating. The world of gentically modified foods is extremely secretive and evil in many ways because it undermines our health.
The Russian report states, "Scientists from Russia’s Ministry of Health are warning in a secret report to Prime Minister Putin that they have discovered a ‘critical link’ between the H1N1 influenza (Swine Flu) virus and genetically modified amylopectin potatoes that are consumed in massive quantities nearly exclusively by Westerners and sold in fast food restaurants as French Fries."
According to the report, the protease enzyme (the enzyme that begins the digestion of proteins) of the potatoes in question has been altered to make them more hardy and less vulnerable to the Potato virus X, a dangerous plant disease that can cause devastating losses of potato crops. This genetic change causes an “explosive” replication of the H1N1 influenza virus."
This proposed link between the H1N1virus and French fries would explain why a vast number of cases of H1N1 are common to the young. A US News and World Report states that "Of the 5,000 confirmed and more than 100,000 probable cases of swine flu, the average age of infected people is 15; two thirds are younger than 18." The youngest are, by far, the largest consumers of fast food.
In addition, the countries that are reporting large numbers of H1N1 cases are those countries that grow these genetically modified potatoes: the US, Australia, Canada, United Kingdom, and Chile, a country that grows large quantities of potatoes for the US. Large countries that do not allow planting of genetically modified potatoes, such as Russia, China, and India, report few H1N1 case, 3, 318, and 16, respectively."
**************
Editor's note: Quite a thought!

"H1N1-virus leviää rivakammin kuin kausi-influenssa
Etelä-Suomen Sanomat / STT
http://www.ess.fi/?article=236179
11 May 2009 klo 21:43 (Päivitetty klo 22:04)
Meksikosta maailmalle kulkenut sikainfluenssa näyttää tarttuvan helpommin kuin kausi-influenssa, arvioi Maailman terveysjärjestön WHO:n tutkijaryhmä.
Meksikon tartuntoja selvittänyt ryhmä laski, että ärhäkimmillään virus tarttuu ihmisestä toiseen 73 kertaa. Tarttuvuus on siten paljon korkeampi kuin kausi-influenssalla, ryhmä raportoi Science-lehdessä tänään. Kausi-influenssaan menehtyy vuosittain 250 000-500 000 potilasta.
Ryhmä arvioi jopa 23 000 meksikolaiseen sairastuneen H1N1-viruksen aiheuttamaan infektioon helmikuun puolivälin jälkeen. Tutkimus vahvisti otaksumaa siitä, että tartunnan lähde olisi pieni La Glorian kylä Veracruzissa Etelä-Meksikossa. Kylän lähistöllä on miljoonan elikon jättisikala.
Uusi H1N1-virus saattaisi aiheuttaa WHO:n ryhmän arvion mukaan osapuilleen yhtä ankaran infektion kuin vuonna 1957 kaksi miljoonaa ihmistä tappanut influenssa. Uusi influenssa ei ole yhtä ankara kuin ensimmäinen tiedetty H1N1-viruksen aiheuttama influenssa, vuonna 1918 puhjennut tuhoisa espanjantauti."

"25:s sikainfluenssatapaus varmistui
YLE Uutiset
julkaistu tänään klo 17:30, päivitetty tänään klo 17:35
http://yle.fi/uutiset/kotimaa/2009/06/25s_sikainfluenssatapaus_varmistui_817089.html
Suomessa on varmistunut 25:s sikainfluenssatapaus. Uusin tautiin sairastunut on nuori, Oulusta kotoisin olevan mies. Myös hän oli tullut vastikään Yhdysvalloista.
Kaikki Suomessa tähän mennessä sikainfluenssaan eli H1N1-tautiin sairastuneista ovat olleet matkailijoita. Uusia tapauksia on todettu erityisesti Yhdysvalloissa matkanneiden piiristä.
Tartuntojen määrä on viime päivinä vastannut jo likipitäen sitä, että keskimäärin jokaisella Yhdysvaltain-lennolla tulee yksi taudin saanut Suomeen.
Terveyden ja hyvinvoinnin laitoksen tutkimusprofessori Ilkka Julkusen mukaan tartuntariski Yhdysvalloissa vaikuttaakin olevan nyt melkoisen korkea.
- Suomessa tauti ei ole tarttunut ihmisestä toiseen, tutkimusprofessori Ilkka Juntunen kertoo.
Kaikkiaan Suomessa on nyt tutkittu noin parisataa sikainfluenssaepäilyä, joista siis noin kymmenesosa on osoittautunut positiiviseksi.
THL kehottaa Meksikosta, Yhdysvalloista, Kanadasta, Australiasta ja Etelä-Amerikasta palaavia matkailijoita tarkkailemaan terveyttään viikon ajan matkan jälkeen ja tarvittaessa soittamaan terveyskeskukseen.
Lisääntyneistä tautitapauksista huolimatta Suomen lentokentillä ei ole päätetty lisätoimista taudin leviämisen estämiseksi.
Maailman terveysjärjestö WHO arvioi, että maailmalla varmistuneiden sikainfluenssatapausten määrä on jo yli 44 000."
********************
Miten ihmeessä Suomessa olisi voinut löytyä ihmisestä toiseen tapahtuneita tautitapauksia, kun Suomessa viranomaiset eivät suostu testaamaan muita kuin suoraan tietyistä endeemisen taudin maista tulleita ja niitä, jotka ovat olleet suorassa useiden tuntien kontaktissa sellaisten endeemisiltä alueilta palanneiden kanssa, jotka ovat sairastuneet laboratoriovarmennettuun tautiin? Tietenkään, tietenkään Suomessa ei ole löytynyt ihmisestä toiseen tarttunutta tautia.

"Authorities baffled how man from isolated community contracted swine flu
The West Australian
20th June 2009, 15:30 WST
http://www.thewest.com.au/default.aspx?MenuID=77&ContentID=149391
Health authorities are trying to establish how a 26-year-old WA man from the most remote Indigenous community in the world contracted swine flu to become the first person in Australia to die with the virus.
The man from the isolated community of Kiwirrkurra, in the Gibson Desert, died in the Royal Adelaide Hospital late yesterday.
He was just 26 and suffering existing health conditions.
Kiwirrkurra is home to around 300 people and lies 1200 km east of Port Hedland and 700km west of Alice Springs.
It is understood members of the community have been told not to leave the area because of the potential danger of spreading the virus.
It has yet to be established if the man actually died of swine flu but it has been confirmed that he had the virus.
The man had been sick for three weeks and had been in a critical condition since Monday after being transferred to Royal Adelaide Hospital from Alice Springs."

Canada(MB): Swine flu patients in ICU tough to manage, 'just really, really sick': doctors
Helen Branswell Medical Reporter
THE CANADIAN PRESS
18/06/2009 9:29 PM
http://www.winnipegfreepress.com/breakingnews/Swine-flu-patients-in-ICU-tough-to-manage_-_just-really_-really-sick__-doctors.html
In a typical flu season, the Winnipeg hospitals where Dr. Anand Kumar works might see one, maybe two life-threatening cases of viral pneumonia caused by influenza.
So seeing 10, 15 and more flu patients in those same hospitals' intensive care beds in June is still a shock, suggests Kumar, a critical care specialist who works at three different hospitals in the city.
"You just don't see this many of them," Anand says of the patients, struggling to survive swine flu infections.
"You don't see rows and rows of patients on ventilators because they have respiratory failure, a viral pneumonia kind of thing. It's unusual."
At last count, Manitoba hospitals had 30 respiratory distress patients in the ICU, some confirmed swine flu cases, others for whom tests are still pending---"
---"People who end up getting admitted to hospital are generally presenting with shortness of breath. And by the time they get to the ICU, swine flu patients - most much younger than your average hospitalized flu patient - are gravely ill from a viral assault on their lungs.
"They're getting very bad, bad respiratory failure," says Dr. Michael Gardam, head of infectious disease prevention and control for Ontario's public health agency---"
---"In addition to trying to keep these patients alive, clinicians like Anand and Dean are gathering data. The case studies they are writing, and which will shortly be competing for space in medical journals, will help doctors who haven't yet see severe swine flu cases know how to handle them when they do.
Likewise, autopsies that have been performed on a number of people who died of their infections will help scientists figure out what the virus does in the body, information physicians may be able to mine for clues on how to improve a severely ill person's chances of survival---"
---"He says the emerging evidence - confirmed by Anand's and Dean's observations - is that at least a portion of the sickest of the sick are suffering from an aggressive viral pneumonia---"
************
Editor's note:
Hospitals and clinics are not testing any mild cases so it is impossible to know how many are actually infected in the population as a whole. Only the worst cases are being tested and compiled in statistics.
What we can easily see is that there are many more serious cases period than in the 'regular' flu season.

"Vuorokauden sisällä varmistui viisi uutta H1N1-tartuntaa Suomessa
julkaistu 19 June 2009 klo 14:51, päivitetty 19 June 2009 klo 17:43
YLE Uutiset
http://yle.fi/uutiset/kotimaa/2009/06/vuorokauden_sisalla_varmistui_viisi_uutta_h1n1-tartuntaa_suomessa_816146.html
Suomessa on hoidettu nyt yhteensä 18:aa sikainfluenssapotilasta. Torstai-illasta alkaen on varmistettu viisi uutta tapausta Turussa, Kuopiossa, Pohjois-Karjalassa ja pääkaupunkiseudulla.
Kolme heistä oli vastikään palannut Yhdysvalloista, yksi Meksikosta ja yksi Hongkongista, kertoo THL:n tutkimusprofessori Ilkka Julkunen. Kaikki uudet potilaat ovat hyväkuntoisia, eivätkä he sairasta influenssan vakavaa muotoa.
Suomessa sikainfluenssaan sairastuneet ovat olleet matkailijoita. THL kehottaa Meksikosta, Yhdysvalloista, Kanadasta, Australiasta ja Chilestä palaavia matkailijoita tarkkailemaan terveyttään viikon ajan matkan jälkeen ja tarvittaessa soittamaan terveyskeskukseen."
*************
Editor's comment: It is a reat shame that the officials in Finland do not test for novel H1N1 unless the patient has ILI fever over 38 C AND a laboratory confirmed contact with novel H1N1 patient that stayed in endemic countries.

"Kuopiossa varmistui sikainfluenssatartunta
19.6.2009 14:27
STT
http://www.hs.fi/kotimaa/artikkeli/Kuopiossa+varmistui+sikainfluenssatartunta/1135247045963
Savon Sanomat kertoi perjantaina nettisivuillaan, että Kuopion yliopistollisessa sairaalassa on varmistunut sikainfluenssatartunta. Tartunnan saanut nuori mies hakeutui hoitoon keskiviikkona. Positiivinen testitulos varmistui torstai-iltana.
Mies matkusti Torontosta Lontoon kautta Helsinkiin ja edelleen Kuopioon alkuviikosta, Savon Sanomat kertoo. Tapaus on jo 14. sikainfluenssatartunta Suomessa, mutta ensimmäinen Pohjois-Savon sairaanhoitopiirissä. Kuopion yliopistollinen sairaala oli kuitenkin osannut varautua tartuntaan.
Savon Sanomien haastatteleman infektiolääkärin mukaan potilaan kanssa samalla lennolla olleet eivät ole tartuntavaarassa, sillä potilas oli lentojen aikana oireeton. Mies on tällä hetkellä kotikaranteenissa. Hänen oireensa ovat lievät, joten hän toipuu hyvää vauhtia.
Sairaalasta ei perjantaina haluttu vahvistaa tietoa STT:lle."

"Suomessa varmistui 13. influenssa A(H1N1) -tapaus
Thursday 18.6.2009
THL
http://www.thl.fi/fi_FI/web/fi/uutinen?id=14289
Suomen 13. influenssa A(H1N1) -tapaus varmistui keskiviikko-iltana 17.6. Etelä-Pohjanmaan sairaanhoitopiirissä.
Tartunnan saanut nainen oli palannut Helsinkiin maanantaina 15.6. lennolla AY 006 New Yorkista Yhdysvalloista. Potilas toipuu jo kotonaan ja voi hyvin. Perheenjäsenet ovat saaneet suojalääkityksen.
Kaikki Suomessa tähän saakka influenssa A(H1N1) -tartunnan saaneet ovat olleet matkailijoita. Viime viikon tartunnoista viisi oli saatu New Yorkin matkalla.
Meksikosta, Yhdysvalloista, Kanadasta, Australiasta ja Chilestä palaavia matkustajia kehotetaan edelleen tarkkailemaan terveyttään matkan jälkeen noin viikon ajan ja tarvittaessa ottamaan yhteyttä puhelimitse terveyskeskukseen.
Näytteitä mahdollisista epäilyistä on tutkittu yhteensä 180.
Lisätietoja:
Tutkimusprofessori Ilkka Julkunen, THL, puh. 020 610 8372 (virustutkimukset, immuunivaste ja rokotukset)
Tartuntatautilääkäri Antti Alitalo, THL, puh. 020 610 8557 (tapausten seuranta)"
*************

Briefly in English: 13th novel H1N1 case found in Finland. The case was a woman that came on flight AY 006 back to Finland from New York last Monday 15 May 2009. The patent is in home quarantine and her condition is getting better now. The family members have been receiving the protection medication.

"Suomen yhdestoista sikainfluenssa varmistui
16.06.2009 23:08
http://www.verkkouutiset.fi/index.php?option=com_content&view=article&id=6094:suomen-yhdestoista-sikainfluenssa-varmistui&catid=2:kotimaa&Itemid=4

Yhdysvalloista Chigagosta lauantaina palanneella keski-ikäisellä miehellä on varmistunut influenssa H1N1-influenssatartunta.
Mies sairastuit lentomatkan aikana ja hän on saanut influenssalääkityksen Suomeen palattuaan. Sairastuneen miehen oireet ovat olleet lieviä, ja hän on hyväkuntoisena kotihoidossa.
Miehen lähipiiri ja matkakumppanit ovat saaneet tartunnasta tiedon ja ennaltaehkäisevän lääkehoidon. Samalla lennolla olleita pyritään informoimaan tartunnan mahdollisuudesta.
Kyseessä on yhdestoista varmistettu uuden influenssan eli sikainfluenssan aiheuttama tartunta Suomessa.
Asiasta kertoi Helsingin ja Uudenmaan sairaanhoitopiiri HUS tiistaina."

"Finland confirms 11th A/H1N1 flu case
Xinhua
Helsinki
16 June 2009
http://news.xinhuanet.com/english/2009-06/16/content_11552328.htm
Finland has confirmed the eleventh case of A/H1N1 flu, local media reported Tuesday.
The patient, a middle-aged man, returned to Finland from Chicago, the United States on Sunday.
Typical A/H1N1 flu symptoms have showed up during his trip. The patient is now in good condition and quarantined at home."

"Sikainfluenssarokote valmistui
AP, DPA, Reuters
julkaistu 12 June 2009 klo 11:00, päivitetty 13 June 2009 klo 08:52
http://yle.fi/uutiset/ulkomaat/2009/06/sikainfluenssarokote_valmistui_800618.html
Sveitsiläinen lääkeyhtiö Novartis on ilmoittanut, että se on testannut onnistuneesti ensimmäisen erän rokotteita, jotka on tarkoitettu H1N1-influenssan hoitoon. Yhtiön mukaan ensimmäinen erä valmistui viikkoja aikaisemmin kuin ennakolta oletettiin.
Novartis antoi ilmoituksensa vain päivä sen jälkeen, kun kansainvälinen terveysjärjestö WHO oli julistanut sikainfluenssan pandemiaksi.
Novartiksen mukaan rokotteen ensimmäinen tuotantoerä siirtyy jatkotestaukseen ja arviointiin. Yhtiö aloittaa rokotteen kliiniset testaukset heinäkuussa.
Lääkeyhtiöt Novartis, Sanofi-Aventis, GlaxoSmithKline ja Solvay käyvät kovaa kisaa siitä, kuka onnistuu ensimmäinä tuomaan markkinoille toimivan rokotteen. Yhtiöt yrittävät saada rokotteet markkinoille ennen syksyä, jolloin flunssakausi alkaa pohjoisella pallonpuoliskolla.
WHO:n on arvioinut, että ensimmäiset rokotteet tullevat myyntiin vasta syksyllä. Maailman suurin flunssarokotteiden valmistaja Sanofi-Aventis on arvioinut, että ensimmäisen myyntierän valmistumiseen mennee ainakin neljä kuukautta.
Novartiksen mukaan yli 30 maan hallitukset ovat pyytäneet yhtiötä toimittamaan niille rokotteita. Esimerkiksi Yhdysvaltain terveysvirasto on tehnyt tilauksensa jo toukokuussa. Tilauksen arvo on noin 289 miljoonaa dollaria."

"Kaksi kouluikäistä sairastui sikainfluenssaan
YLE Uutiset
julkaistu 14 June 2009 klo 14:27, päivitetty 14 June 2009 klo 19:13
http://yle.fi/uutiset/ulkomaat/2009/06/sikainfluenssarokote_valmistui_800618.html
HUS:n tiedotuspäällikkö Riitta Lehtonen vahvistaa, että Suomessa on todettu kaksi uutta A(H1N1)-tapausta. Potilaat ovat kouluikäisiä lapsia, joiden oireet ovat lieviä. Perhe palasi Yhdysvalloista viime perjantaina.
Suomessa on nyt varmistettu seitsemän ns. sikainfluenssatapausta. Tiedotuspäällikkö Lehtonen korostaa, että kaikki tapaukset ovat lieviä. Uusimmatkin potilaat ohjattiin Jorvin sairaalasta nopeasti kotihoitoon."

Secretary of HHS Sebelius declaring the USA response to H1N1 pandemic.
June 11, 2009http://www.blogger.com/img/blank.gif
http://www.cdc.gov/h1n1flu/webcast061109.htm

"Current phase of alert in the WHO global influenza preparedness plan
11 June 2009
http://www.who.int/csr/disease/avian_influenza/phase/en/
In the 2009 revision of the phase descriptions, WHO has retained the use of a six-phased approach for easy incorporation of new recommendations and approaches into existing national preparedness and response plans. The grouping and description of pandemic phases have been revised to make them easier to understand, more precise, and based upon observable phenomena. Phases 1–3 correlate with preparedness, including capacity development and response planning activities, while Phases 4–6 clearly signal the need for response and mitigation efforts. Furthermore, periods after the first pandemic wave are elaborated to facilitate post pandemic recovery activities.
The current WHO phase of pandemic alert is 6. ---"
**********
Editor's note: One of the steps of history has been taken today, 11 June 2009.

"WHO declares swine flu pandemic
CNN
11 June 2009
http://edition.cnn.com/2009/HEALTH/06/11/swine.flu.who/index.html
The World Health Organization raised the swine flu alert Thursday to its highest level, saying H1N1 has spread to enough countries to be considered a global pandemic.
Increasing the alert to Level 6 does not mean that the disease is deadlier or more dangerous than before, just that it has spread to more countries, the WHO said.
As of Wednesday evening, the virus had spread to 72 countries, the health agency said. There were 25,288 confirmed cases and 139 deaths. The United States had 13,217 cases and 27 deaths, the Centers for Disease Control and Prevention said Friday.
Also Thursday, authorities in Hong Kong ordered the closure of all elementary schools, kindergartens and day care centers in the city after 12 students were found to be infected with the virus.
Authorities have not determined the source of the infection, said Hong Kong's Chief Executive Donald Tsang. This makes it the first cluster of swine flu cases in the city without a link to someone who had traveled overseas.
The number of cases continues to grow in Britain, Japan and Australia -- all of them outside the Americas, where the virus was first detected in April.
Thursday's declaration of a pandemic by the WHO made this the first flu pandemic in 41 years.
In Hong Kong, the schools and day care centers were told to close for 14 days as investigators tried to identify the source of the infection, said Tsang, the chief executive.
The health department will decide after two weeks whether or not to continue the shutdown.
A month ago, Hong Kong quarantined about 300 hotel guests for a week after the first case of the virus was confirmed there.
Hong Kong's abundance of caution stems from the government's unwillingness to see a repeat of the SARS epidemic in 2004, which killed nearly 300 people.
Also on Thursday, Israel's health ministry announced that the number of people diagnosed with swine flu there was 68.
Health officials have begun using the virus' clinical name -- H1N1 -- to reflect that it's actually a combination of several different types of flu and to reduce confusion about whether eating pork can spread the virus. It cannot."

"WHO julisti sikainfluenssan pandemiaksi
julkaistu tänään klo 17:02, päivitetty tänään klo 17:52
http://yle.fi/uutiset/ulkomaat/2009/06/who_julisti_sikainfluenssan_pandemiaksi_799273.html
Maailman terveysjärjestö WHO on julistanut sikainfluenssan pandemiaksi. WHO päätti torstaina nostaa influenssan varoitustason korkeimpaan eli 6. luokkaan.
WHO ilmoitti asiasta jäsenmailleen sen jälkeen, kun oli neuvotellut asiasta influenssa-asiantuntijoiden kanssa.
Pandemiajulistus tarkoittaa sitä, että uusi virus leviää nopeasti maailmalla. Taudin vakavuudesta se ei sinänsä kerro. WHO:n mukaan suurin osa A(H1N1)-influenssatartunnoista on ollut tähän mennessä lieviä.
Julistuksen odotetaan tehostavan sekä rokotteen kehittämistä että hallitusten toimia viruksen pitämiseksi aisoissa.
Ensimmäisenä Meksikossa pari kuukautta sitten todettu tauti leviää nyt Amerikan lisäksi Aasiassa ja Euroopassa. Myös Australiassa sikainfluenssa on levinnyt viime päivinä nopeasti.
Maailman terveysjärjestön WHO:n eilen julkaisemien tietojen mukaan kaikkiaan 74 maasta on löytynyt liki 28 000 sikainfluenssatartuntaa. Tautiin on kuollut 141 ihmistä.
Noin puolet kuolleista on ollut nuoria ja muutoin terveitä. Sikainfluenssa myös jatkaa leviämistään kesäkautena pohjoisella pallonpuoliskolla, kun tavallisesti influenssavirukset katoavat lämpimän sään myötä.
Edellisen kerran WHO julisti pandemian vuonna 1968 hongkongilaisen influenssan takia.
Sikainfluenssa leviää Saksan ja Hongkongin kouluissa
Saksassa ja Hongkongissa on puolestaan todettu tartuntoja koululaisilta.
Düsseldofin japanilaisessa koulussa sikainfluenssa on tarttunut 30 koululaiseen. Ensimmäinen saksalaiskoulun sairaustapaus paljastui jo maanantaina, kertovat viranomaiset. Loput lapsista diagnosoitiin keskiviikkona. Valtaosa tartunnan saaneista lapsista on japanilaisia.
Lapset ja heidän perheensä on määrätty karanteeniin. Koulu pysyy suljettuna ainakin tiistaihin asti. Tapaukset nostavat sikainfluenssatartuntojen määrän Saksassa 116:een.
Hongkong puolestaan vahvisti aamulla ensimmäiset sikainfluenssatapauksensa. Hongkongilaisesta koulusta löytyi 12 tartuntapausta. Alueen hallinto ilmoitti sulkevansa kaikki päiväkodit ja ala-asteen koulut kahdeksi viikoksi taudin leviämisen ehkäisemiseksi."

"Manitoba Ventilator Request Raises H1N1 Pandemic Concerns
Recombinomics Commentary 23:51
June 8, 2009
http://www.recombinomics.com/News/06080901/H1N1_MB_Vents.html
Manitoba has experienced an increased concentration of severe respiratory illness admitted to the intensive-care units, which is higher in number than previous influenza outbreaks. The majority of the cases are in people of Aboriginal descent.
The Public Health Agency of Canada has provided three epidemiologists to Manitoba to assist in assessing Manitoba's cases of influenza-like illness.
The Winnipeg Regional Health Authority (WRHA) is taking steps to provide enough support in intensive-care units (ICUs) and prioritizing patients for personal-care home beds. There are also 15 additional ventilators that have arrived and will be put to use as needed. The WRHA may also defer non-urgent surgical procedures that would normally require ICU care.

The above comment from a Manitoba press release today describes an increasing problem of severe disease in First Nation residents. The increase in number of cases began 1-2 weeks ago and is evident in multiple provinces (see updated map). Last week the medevacing of patients to Winnipeg was detailed this afternoon's press release strongly suggests the problem is growing.
Although it is unclear if these more severe cases are linked to poor health conditions and overcrowding, of if there is a genetic component in the target population or circulating swine H1N1 that is exacerbating the problem, but it is a growing problem and many expand as swine H1N1 spreeads through less developed areas of Asia and Africa.
The circulation of a swine H1N1 in a heterogeneous human population is likely to cause problems, which can grow as the virus adapts to its new host or the virus spreads through populations at greater risk.
Although many local agencies in the United States and Canada have limited testing of mild cases and have begun focusing on the more severe hospitalized cases, the number of frequency of positives continues to grow, even though the flu seasonal has ended in the northern hemisphere.
The spread of the swine H1N1 during the off season may be linked to an avan PB2, which optimizes viral replication at 41C, which may contribute to the rapid spread of the virus.
Most cases have been mild, and the spread of the virus has been largely silent. However, deaths are beginning to mount with five announced today (PA, OK, QB, OR, CA), in addition to three on Friday (TX, WA, NY), six on Thursday (AZ, PA, UT, IL, CA, WI) and seven on Wednesday (3 NY, MI, CT,VA).
These increase in fatalities among a population that is largely under 65, and the increasing admissions to hospitals and ICU's, continue to increase pandemic concerns."

"Pohjois-Suomessa asuvalla sikainfluenssatartunta
maanantaina 1.6.2009
Etelä-Suomen Sanomat
http://www.ess.fi/?article=238634
Yksi suomalainen on saanut sikainfluenssatartunnan (H1N1) New Yorkissa Yhdysvalloissa. Hän asuu Pohjois-Suomessa.
Kyseessä on nyt neljäs suomalainen, joka sairastunut influenssa A-infektioon.
Sairastuneen lähikontaktit on selvitetty, ja heille on annettu hoito-ohjeet.
Tartunta varmistui viime lauantaina. Terveyden ja hyvinvoinnin (THL) laitoksen mukaan sairastunutta hoitava sairaanhoitopiiri ei potilaan pyynnöstä tiedottanut julkisesti asiasta. Tämän takia tieto tartunnasta tuli julki vasta maanantaina.
THL kehottaa niitä matkailijoita, jotka palaavat Meksikosta, Yhdysvalloista tai Kanadasta, tarkkailemaan terveyttään viikon ajan matkan jälkeen. Jos matkalta palannut sairastuu kuumeiseen hengitystieinfektioon, hänen tulisi ottaa yhteyttä terveyskeskukseen.
Viruksen aiheuttamaan H1N1-influenssaan on maailmalla sairastunut yhteensä noin 17 000 ihmistä, joista suurin osa on Meksikossa ja Yhdysvalloissa.
Neljännestä varmistetusta tartunnasta kertoi ensimmäisenä Suomen Lääkärilehti."

"Australian swine flu infections over 300
Radio Australia News
Last Updated: 31 May 2009
http://www.radioaustralianews.net.au/stories/200905/2585653.htm?desktop
The number of Australians diagnosed with swine flu has risen to 303.
Cases have been diagnosed in every state and territory, with the majority 212 in Victoria and 57 in New South Wales.
Schools have been closed in several states, as a way of minimising the impact on communties where people have come down with swine flu.
Health Minister, Nicola Roxon, says work has to continue to reduce the spread of the disease.
She says, "The aim is to make sure that we delay that for as long as possible in order to be able to ensure that when the disease really does attack the broadest number in the community that we are closer to the date of having a vaccine produced."
She says "That way we can make sure that we can protect those that are most likely to be particularly vulnerable to the harder edge of this disease.""

"Suomessa kolmas sikainfluenssatapaus
YLE Uutiset
julkaistu 27 May 2009 klo 11:41, päivitetty 27 May 2009 klo 20:17
http://yle.fi/uutiset/kotimaa/2009/05/suomessa_kolmas_sikainfluenssatapaus_759877.html
Suomessa on varmistunut kolmas sikainfluenssatapaus. Sairastunut on Yhdysvalloista Suomeen palannut 30-vuotias mies. Hänellä todettiin influenssa A(H1N1)-infektio myöhään tiistai-iltana.
Mies on hyväkuntoinen ja kotihoidossa. Miehen lähikontaktit on selvitetty, ja he ovat saaneet estolääkityksen. Tartunta todettiin Helsingin ja Uudenmaan sairaanhoitopiirissä.
Potilaan kanssa samoilla lennoilla olleisiin matkustajiin otetaan yhteyttä ja heitä kehotetaan tarkkailemaan mahdollisia oireita sekä hakeutumaan hoitoon tarvittaessa.
Suomessa on otettu näytteitä yhteensä noin 80 ihmiseltä. Aiemmin on varmistettu kaksi tartuntaa Meksikosta palanneilta suomalaisilta.
Maailman terveysjärjestön WHO:n mukaan uuteen influenssaan on sairastunut tähän mennessä noin 13 400 ihmistä. Tautiin on kuollut noin sata ihmistä, joista lähes kaikki Meksikossa ja Yhdysvalloissa."
*****
Briefly in English:
Male, 30 years, in good and stable condition in home quarantine in Helsinki region in Finland. This is the third confirmed novel H1N1 case in Finland.

[Editor's note: In Finland they test only suspected patients that
1) have had contact with a confirmed novel H1N1 case AND
2) develop fever higher than 38,5 degrees Celsius with respiratory symptoms

"Sikainfluenssan kohtalonhetki on syksyllä
UTUonline.fi
TN
Julkaistu 14.05.2009 11:34, päivitetty 14.05.2009 19:11
http://www.utuonline.fi/sisalto/argumentti/PenttiHuovinen09.html
Uuden influenssaviruksen A(H1N1) aiheuttamia tapauksia on ilmennyt nyt myös Suomessa ja tauti leviää edelleen. Sen mahdollista muuntautumista entistä ärhäkämmäksi myös pelätään. Mitä siitä tiedetään, THL:n tutkimusprofessori ja Turun yliopiston bakteriologian dosentti Pentti Huovinen?
- Influenssan käyttäytymisen arviointi perustuu edellisten influenssapandemioiden yhteydessä saatuihin kokemuksiin. Jos uusi virus käyttäytyy odotetusti, kesän aikana uusia tautitapauksia kyllä ilmenee jonkin verran, mutta varsinaista taudin leviämistä odotetaan vasta syksyksi tai talveksi. Influenssavirus leviää parhaiten kylmässä ja kuivassa ilmanalassa. Suomi on jo tilannut rokotteen uutta influenssavirustyyppiä vastaan. Rokote saataneen 4-6 kuukauden kuluttua ja toivottavasti ennen oletettua viruksen leviämistä.
Miten uuden viruksen aiheuttamaan taudin leviämiseen suhtaudutaan, riippuu olennaisesti siitä, kuinka suuri on vakavien tautitapausten määrä. Toistaiseksi kuolleisuus on ollut onneksi normaalien kausi-influenssojen luokkaa. Hyvä uutinen on myös, että ainakin toistaiseksi viruslääkkeet tehoavat kyseiseen virukseen.

Käsihygienia on parasta pandemian torjuntaa
- Pandemiauhkan yhteydessä on kiinnitetty suurta huomiota käsihygieniaan, mikä on erinomainen asia. Tästä hyötyvät yksilöt ja koko yhteiskunta. Hyvällä käsihygienialla torjutaan kaikkia käsien välityksellä leviäviä mikrobeja. Maskien käytöstä on hyötyä vasta sitten kun yskiviä ihmisiä on ympärillä. Silloinkin yskivien ihmisten maskin käyttö on tärkeämpää kuin terveiden, jotteivät pisarat leviä ympäristöön. Maskien käyttö ilman hyvää käsihygieniaa antaa kuitenkin valheellisen turvallisuuden tunteen.
Influenssakohun keskellä kannattaa muistaa, että parin vuoden kuluttua nykyisestä uudesta influenssaviruksesta on tullut normaali kausi-influenssavirus, joka kiertänee maailmaa muiden influenssa A H3N2- ja H1N1-kausi-influenssavirusten kanssa. Samalla se on liitetty osaksi joka vuosi valmistettavaa kausi-influenssarokotusta.
Lintuinfluenssavirus H5N1 on edelleen yhtä suuri uhka kuin kuukausi sitten. Jos se muuntuu ihmisestä toiseen tarttuvaksi, on mahdollista, että saamme vielä toisen pandemiauhkan nykyisen päälle. Runsaat kymmenen vuotta kaikki ovat odottaneet H5N1-pandemiaa. Uusi virus tulikin yllättäen Meksikosta ja oli ennen näkemätöntä H1N1-alatyyppiä, kahden sikaviruksen, yhden lintuviruksen ja ihmisen viruksen kombinaatio. Tämä osoittaa influenssavirusten arvaamattomuutta. Mikrobit tanssittavat ihmistä!"

"Two more confirmed with swine flu
BBC News
Page last updated at 16:18 GMT, Saturday, 16 May 2009 17:18 UK
http://news.bbc.co.uk/2/hi/health/8053632.stm#map
Two new cases of swine flu have been confirmed in England, bringing the total number in the UK to 87, the Health Protection Agency has said.
Both are adults, one is a man from the Reading area and the other is from the east of England.
The news came as the Foreign Office lifted its advice against non-essential travel to Mexico.
The UK government has signed a deal to secure up to 90 million doses of a new H1N1 flu vaccine by December.
Health Secretary Alan Johnson said the vaccine - which would provide immunity from the virus - will be available regardless of whether a pandemic is officially declared.
Of the new cases, one affects a patient who has recently returned from overseas. The source of the second new infection is still being investigated.
The HPA said there were 172 possible cases of swine flu currently under laboratory investigation in the UK.
Around the world, more than 7,500 cases of swine flu - also known as H1N1 - have been confirmed and 66 people have died.
The Foreign Office said it was lifting its travel restrictions to Mexico because of a decline in the number of reported new cases.
However, it said British nationals should continue to follow local advice on precautions to avoid exposure to the virus.
A spokeswoman for the Department of Health said the localised cases of swine flu found in the UK have so far been mild, and anti-virals had been effective in reducing symptoms and preventing the spread of infection.
But she warned against complacency: "It is right to prepare for the possibility of a global pandemic. The UK's arrangements are continuing to ensure that we are well-placed to deal with this new infection."

"Jump in swine flu cases in Japan
BBC News
Page last updated at 08:52 GMT, Monday, 18 May 2009 09:52 UK
http://news.bbc.co.uk/2/hi/asia-pacific/8054881.stm
The number of swine flu cases in Japan has risen rapidly - with more than 120 cases now confirmed.
Nearly 2,000 schools and companies have closed, and the government has discouraged unnecessary travel to quell the spread of the disease.
Just four cases had been confirmed in Japan as of Friday - people who had returned from Canada.
The first case in someone who had not been abroad - a 17-year-old student in Kobe - was reported on Saturday.
Call for calm
Japanese media said the new wave in infections would make Japan the fourth-most infected country in the world, after Mexico, the United States and Canada.
None of those infected are thought to be in danger of their lives, officials say, but the government is taking no chances.
"We must be careful, but with quick treatment patients can recover," said Prime Minister Taro Aso. "We must respond calmly and appropriately."
Most of those infected are thought to be students in the Hyogo and Osaka prefectures in western Japan.
Experts believe the virus spread quickly between the two urban areas after high schools in Kobe and Osaka met for a volleyball tournament.
Kobe High School, along with nearly 1500 other schools in Hyogo, has now been closed, and several hundred more are closed in Osaka.
Japan has also established testing centres at airports, and is encouraging high risk groups to wash their hands frequently and wear masks.
Even in the sporting arena, steps have been taken to reduce the potential for infection.
At a national sumo wrestling competition in Tokyo on Sunday, officials sprayed disinfectant on the hands of every spectator as they arrived.
The outbreak has caused alarm in Japan, which with its aging population is exceptionally anxious about flu, the BBC's Roland Buerk in Tokyo says.
People routinely wear face masks on public transport to prevent the spread of coughs and colds."

"New York principal's death linked to flu virus, hospital says
CNN
NEW YORK
updated 18 May 2009
http://edition.cnn.com/2009/HEALTH/05/17/ny.flu.death/index.html
An assistant principal of a New York middle school who was hospitalized with the H1N1 virus, commonly known as swine flu, died Sunday from flu complications, hospital and state officials said.
It's the sixth death in the United States that health authorities have linked to the virus.
"It is with great sadness tonight that we learn that New York has lost one of its residents to an illness related to H1N1," New York Gov. David Paterson said.
Mitchell Wiener, 55, assistant principal at Intermediate School 238 in Queens, died at 6:17 p.m. Sunday, said Andrew Rubin, a spokesman at Flushing Hospital.
"We believe he had complications of the swine flu," Rubin told CNN Radio, adding that once Wiener was admitted to the hospital, he was listed in critical condition. However, he wouldn't say whether Rubin had any pre-existing medical conditions.
Last week, when city and state officials announced that four students were infected and that a school official in Queens was "critically ill" with the virus, Mayor Michael Bloomberg did not name the official but described the staffer as an assistant principal who "may have had other health problems."
"We're trying to identify that and ascertain whether those problems were exacerbated by the flu or whether it's totally unrelated," Bloomberg said at the time.
Since the H1N1 outbreak surfaced last month, the Centers for Disease Control and Prevention has linked four U.S. deaths to swine flu: a Mexican toddler who was visiting with her family in Texas; a pregnant Texas woman who had been on life support since April; a Washington state man with heart problems who died from flu complications; and an Arizona woman with lung disease.
The Texas Department of State Health Services said Friday that the death of a Nueces County man in his 30s was linked to swine flu. Wiener's case is the sixth U.S. death linked to H1N1.
All had pre-existing medical problems.
Wiener's school is one of eight temporarily closed in New York due to flu concerns.
"We are now seeing a rising tide of flu in many parts of New York City," Thomas R. Frieden, the city's health commissioner, said earlier Sunday. "With the virus spreading widely, closing these and other individual schools will make little difference in transmission throughout New York City, but we hope will help slow transmission within the individual school communities."
The flu strain, which originated in Mexico, killed dozens of people there, causing U.S. officials to worry that it could take a similar toll after spreading across the border. But it has thus far acted similar to typical seasonal influenza, which usually can be treated successfully but can be deadly among the very old, very young and people with pre-existing health problems."

"Transmission of Swine H1N1 In Japan Signals Phase 6
Recombinomics Commentary 14:46
May 18, 2009
http://www.recombinomics.com/News/05180901/Swine_H1N1_Japan_6.html
Japan's four earlier suspected swine flu cases came from travelers inbound from North America, but this new bout appears to be wholly domestic. Most of the cases involve teenagers - the first confirmed infected on Saturday were high-school students on a volleyball team - but those sick with the new strain of flu now range from as young as 5 years old to 60. "It circulated silently without anybody thinking of it," says Peter Cordingley, spokesman for the WHO in Manila. "The virus is highly transmittable and signs of it breaking out of a contained area into the greater community must be watched and taken very seriously."
The above comments on community transmission of H1N1 in Japan (see updated map) again indicate that the pandemic is at phase 6. Early definitions of pandemic phases used sustained transmission as the definition of phase 6. However, the new definition used sustained transmission as the definition of phase 4, while phase 5 represent transmission in a region, and phase 6 was transmission worldwide.
Swine H1N1 has been transmitting worldwide for over a month. Testing outside of North America was largely limited to travelers from North America, but H1N1 was seeding prior to the enhance surveillance at airports, and transmission would have been largely undetected.
The levels in the United States (see updated map) are approaching the reported levels in Mexico, and travel from the US would increase seeding. However, these increases would also be prior to enhanced surveillance at airports. However, such testing is destined to fail, because travelers infected within a day or two of travel would not be detected. Similarly, as many as 1/3 of cases have no fever.
Although the CDC estimated that the number of true cases in the US was 100,00, that estimate is likely to be 1-2 orders of magnitude too low. Surveillance in the US detects about 0.1% of true cases, so the 1500 cases in the CDC weekly report would represent 1.5 million cases in the US alone, and this estimate may be low because many cases are mild, and those in regions not reported to have high levels are not tested.
Nationwide, the number of confirmed cases of swine H1N1 (including cases that are influenza A positive and non-typable) is close to the level reported for H3N2 for the entire season. The number of swine H1N1 cases is rapidly increasing, and in week 18 was almost 3 times the level of influenza A (1097 vs 401).
Thus, the widespread transmission in North America (Mexico, US, and Canada) insures worldwide transmission. Community transmission has already been reported in Scotland, and now there is confirmed transmission in Japan, leaving no doubt that the spread in North America has been extended to Europe and Asia.
The raising of the pandemic level to 6 is long overdue."

Japan's total cases of new flu reach 129
www.chinaview.cn
Xinhua
TOKYO
18 May 2009 09:53:51
http://news.xinhuanet.com/english/2009-05/18/content_11393534.htm
The total number of cases of new flu infections, both domestic and those contracted aboard, reached 129 in Japan, Kyodo News reported.
The number, calculated by Kyodo, means 33 more infections were confirmed Monday. The latest tally from the government stood at 96.
Japanese government on Monday convened an emergency meeting to discuss countermeasures on the spread of the epidemic.
Prime Minister Taro Aso called for public calm, saying the Japanese government has no plans to ask citizens to refrain from holding meetings or scale down corporate activity.
************

Editor's note: This should definitely mark pandemic phase 6.

Arvostettu virologi: Sikainfluenssaan yhä suhtauduttava valppaasti
YLE Uutiset
julkaistu 17 May 2009 klo 17:31, päivitetty 17 May 2009 klo 19:12
http://yle.fi/uutiset/kotimaa/2009/05/arvostettu_virologi_sikainfluenssaan_yha_suhtauduttava_valppaasti_742019.html
Sikainfluenssaan on edelleen syytä suhtautua valppaasti, sanoo yksi maailman johtavista virustutkijoista, hollantilainen Albert Osterhaus. Osterhaus luennoi illansuussa sikainfluenssatilanteesta Helsingin Messukeskuksessa, jonne on kokoontunut noin 7 000 mikrobiologian ja tartuntatautien asiantuntijaa Euroopasta ja muualta maailmasta.
- Virus jatkaa leviämistään. Virusta ei ole enää ainoastaan Meksikossa, Yhdysvalloissa ja Kanadassa. Se on levinnyt myös esimerkiksi Kiinaan ja Japaniin. Eli virus jatkaa leviämistään, Osterhaus huomautti YLE Uutisten haastattelussa sunnuntaina.
H1N1-influenssan on vahvistettu tarttuneen yli 8 000 ihmiseen lähes 40 maassa. Siihen on kuollut yli 70 ihmistä, heistä suurin osa Meksikossa. Huhtikuussa Meksikossa epidemiaksi puhjennut tauti on osoittautunut toistaiseksi pelättyä vaarattomammaksi sairastuneille, mutta suunta voi vielä kääntyä, virologi uskoo.
- Tiedämme, että kausi-influenssaan kuolee vuosittain jopa puoli miljoonaa ihmistä. Se on paljon, ja kuolemien estämiseksi olisi tehtävä nykyistä enemmän. Mutta on kuitenkin olemassa melko suuri mahdollisuus, että uusi virus aiheuttaa influenssapandemian, jossa voi kuolla yksi tai kaksi miljoonaa ihmistä. Ja vielä vakavamman skenaarion mukaan virus voi muuntua sitäkin tappavammaksi.
Aihetta vakavaan suhtautumiseen antaa Osterhausin mukaan sekin, että kuolonuhreista monet ovat nuoria.
- Suurin osa sairastuneista tai kuolleista on ollut suhteellisen nuoria, 20 ikävuoden molemmin puolin. Sekin on huolestuttava piirre. Yleensä influessa iskee kohtalokkaasti iäkkäisiin ihmisiin.
Yksi selitys virustutkijan mukaan tälle voi olla, että nuoret eivät ole aiemmin altistuneet vastaaville viruksille, kuten vanhemmat ikäluokat mahdollisesti ovat.
”Ihmiset tarvitsevat tietoa taudista”
Tiedotusvälineitä on arvosteltu liiallisesta sikainfluenssan uutisoinnista. Osterhaus korostaa tasapainoista uutisointia. Hänen mukaansa median on oltava vastuullinen, sillä paisuttelu voi kostautua.
- Voi käydä niin, että ihmiset eivät lopulta ota uutisia vakavasti. Toisaalta, jos on pienikin mahdollisuus, että tautiin voi kuolla jopa miljoonia, ihmisten täytyy saada tietoa.
Osterhaus kauhistelee eurooppalaisen median vaikenemista sen jälkeen, kun yksi meksikolaisministeri sanoi vaaran olevan ohi.
- Meksikon terveysministeri sanoi, että nyt se on ohi. Se oli poliittinen lausunto, jolla ei ollut mitään tekemistä todellisuuden kanssa. Sitten monet eurooppalaiset tiedotusvälineet totesivat, että selvä, palataanpa muihin töihin, Osterhaus päivittelee.
Alan johtavia tutkijoita
Hollantilainen Albert Osterhaus johtaa Erasmus-sairaalan virologian osastoa Rotterdamissa sekä Alankomaiden kansallista influenssakeskusta. Hän on taustaltaan eläinlääkäri, ja hän on tutkimusryhmineen ollut tunnistamassa useita eläinperäisiä viruksia, kuten sarsia vuonna 2003.
Helsingin Messukeskuksessa Albert Osterhaus puhui ajankohtaisesta sikainfluenssatilanteesta, muun muassa pandemian todennäköisyydestä ja mahdollisuuksista estää taudin leviämistä."

"Sikainfluenssa leviää edelleen
YLE Uutiset / Reuters
julkaistu 16 May 2009 klo 17:50, päivitetty 16 May 2009 klo 17:51
http://yle.fi/uutiset/ulkomaat/2009/05/sikainfluenssa_leviaa_edelleen_741631.html
Maailman terveysjärjestö WHO ilmoittaa, että maailmassa on todettu yli 8000 sikainfluenssa tartuntaa. Kuolleiden määrä on noussut yli seitsemäänkymmeneen.
WHO:n tuorein selvitys kertoo, että H1N1-influenssatartunnan on saanut maailmassa 8.451 ihmistä. Heistä 72 on kuollut. Tautia on todettu kaikkiaan 36 maassa. Eniten tautia esiintyy Meksikossa ja Yhdysvalloissa. Yhdysvallat, kuten myös Suomen ulkoministeriö, on kuitenkin lieventänyt varoituksiaan Meksikoon matkustamisesta.
Tieto tartuntojen määrän kasvusta kertoo osittain siitä, että varmistukset tartunnoista valmistuvat yhdessä sumassa sekä osittain siitä, että tauti leviää edelleen.
Sikainfluenssan aiheuttama virus käyttäytyy kuten ns. normaalit influenssat. Tavallisiin influenssoihin kuolee maailmassa vuosittain noin puoli miljoonaa ihmistä, erityisesti vanhuksia ja heitä, joilla on hengitystiesairauksia.
WHO:n pääjohtajan Margaret Chanin mukaan sikainfluenssan muuntuneesta, uudesta kannasta vallitsee vielä epävarmuus. Se kuitenkin leviää ja saattaa olla erityisen uhkaava Kaakkois-Aasiassa."

"Hong Kong wants US to screen outgoing passengers at airports
By Channel NewsAsia's Leslie Tang
CNA/vm
14 May 2009 1957 hrs
HONG KONG
http://www.channelnewsasia.com/stories/southeastasia/view/429252/1/.html
Hong Kong wants the US to screen outgoing passengers at its airports to prevent the H1N1 flu from spreading to other countries.
Hong Kong's second confirmed case is a student who had flown in from San Francisco. This has put the city on high alert as the 24-year-old patient remains under quarantine in Princess Margaret Hospital.
The Hong Kong resident, travelling from San Francisco, boarded his Cathay Pacific flight, though he was feeling unwell.
Health officials have written a letter to their US counterparts, urging them to medically screen departing airport passengers to prevent spreading the virus to other countries.
Hong Kong Health Secretary, York Chow, said: "We have not received any response right now. But what we have informed the American government is, since they are a representative of the WHO and a signatory to the International Health Regulations, I think that everyone has the responsibility to ensure that they do not allow any infection to go outside their country or territory.
"I think that Hong Kong is fulfilling that duty and responsibility and I hope that other countries will do that too."
Just last week, more than 300 people were released from a week-long quarantine in response to the city's first case, which was also imported.
Hotel guests and staff were under lockdown after a Mexican traveller who checked into the Metropark Hotel tested positive for H1N1. The government was accused of going overboard in trying to contain the virus.
Health authorities met with headmasters of various schools today to discuss measures to deal with a possible pandemic.
They have said schools will only be closed if a local H1N1 case occurs, meaning it cannot be traced to a source outside of Hong Kong.
Health officials said the risk of an H1N1 outbreak in the community is higher during the summer. That's when many students studying overseas will return, possibly bringing back more imported cases."

”Mexico denies swine flu cover-up
BBC News
21:30 GMT, Tuesday, 12 May 2009 22:30 UK
http://news.bbc.co.uk/2/hi/americas/8047052.stm
Mexico's health minister has denied allegations by Fidel Castro that the country intentionally failed to reveal the existence of swine flu last month.
The former Cuban leader accused Mexico of covering up the outbreak in order to avoid missing out on a visit by US President Barack Obama.
The minister, Jose Angel Cordova, said Mexico had been extremely forthcoming and proactive over the outbreak.
It has been doing all it can to combat the H1N1 virus ever since, he added.
Mr Castro's comments came after Cuba reported its first confirmed case of swine flu on Monday. Correspondents say his remarks may contribute to a further worsening of relations between the two countries.
Cuba cancelled all flights to Mexico when news of the outbreak first emerged.
Mexico has confirmed the deaths of 58 people from swine flu and the spread of the virus caused a national crisis, with restrictions on public gatherings only relaxed last week.

'Not the CIA'
Mexican President Felipe Calderon said last week he might cancel a planned trip to Cuba "as one of the unforeseen consequences of decisions that have no technical basis" - a clear reference to Cuba's ban on flights.
Mr Castro responded late on Monday in an internet column in which he referred to President Obama's visit to Mexico in mid-April, which came days before a spreading flu outbreak in the country was officially diagnosed as swine flu.
"The Mexican authorities did not inform the world of [the outbreak], awaiting the visit of Obama," the former Cuban leader wrote.
"Now they threaten us with suspending Calderon's trip."
A Mexican was diagnosed with swine flu in Mexico on Monday. He had become ill after returning from a trip home in late April.
"The only thing that can be confirmed now is that [the flu] wasn't brought here by the CIA," Mr Castro added in his column.
"It came from Mexico."

"NHS flu absence 'may reach 85%'
BBC News
23:01 GMT, Wednesday, 13 May 2009 00:01 UK
http://news.bbc.co.uk/2/hi/health/8048554.stm
NHS may struggle to cope if there is a flu pandemic because of the number of staff who will fail to turn up for work, a report suggests.
Birmingham University researchers quizzed more than 1,000 health workers and found as many as 85% may be absent.
This is more than double the official predictions and the experts believe such a scenario could put too much strain on the health service.
But leading doctors said the NHS would cope because of the excellent planning.
Under contingency plans already drawn up, protocols are in place to allow the NHS to cancel non-emergency treatment such as elective operations.
NHS may struggle to cope if there is a flu pandemic because of the number of staff who will fail to turn up for work, a report suggests.
Birmingham University researchers quizzed more than 1,000 health workers and found as many as 85% may be absent.
This is more than double the official predictions and the experts believe such a scenario could put too much strain on the health service.
But leading doctors said the NHS would cope because of the excellent planning.
Under contingency plans already drawn up, protocols are in place to allow the NHS to cancel non-emergency treatment such as elective operations."

”Flu bans heighten trade tensions
BBC News
16:42 GMT, Tuesday, 5 May 2009 17:42 UK
http://news.bbc.co.uk/2/hi/americas/8034284.stm
Mexico says it has written to the World Trade Organization (WTO), demanding an explanation from countries which have restricted its imports over swine flu.
Economy Minister Gerardo Ruiz Mateos said such bans lacked a basis in science and would not be permitted.
Among others, Russia and China have banned pork products or pigs from Mexico and other affected countries.
Of 1,490 infections verified in 20 countries, 30 people have died - 29 in Mexico, and one in the US.
The World Health Organization (WHO) is urging nations to remain vigilant, saying a global pandemic still threatens.
It is shipping 2.4 million anti-flu treatments donated by Tamiflu manufacturer Roche to 72 countries "most in need" of them, including Mexico and countries finding it hard to pay to stockpile adequate supplies.
Normal life is beginning to resume in Mexico, with traffic returning to the streets of the capital and some bars reopening.
Schools and universities are set to reopen on Thursday.

In other developments:
* China extends its ban on pork products to 17 more US states, bringing the total number to 36, reports Reuters news agency
* Dozens of Mexicans are being flown home from China on a specially-chartered Mexican plane. They are among about 70 Mexicans confined despite just one confirmed case of the virus. The issue sparked a diplomatic row, with Mexico accusing China of targeting its citizens unfairly, and Beijing saying it was a "purely medical" issue
* The UK is delivering specially-produced leaflets offering advice on swine flu and advice on how to prevent its spread

'Unjustified barriers'
Mr Ruiz Mateos said a complaint had been sent to the WTO regarding eight countries which have imposed restrictions on Mexican exports, arguing the restrictions lack a scientific basis.
The trade restrictions are among tough measures imposed by some countries in an apparent bid to tackle the spread of swine flu, which the WHO currently rates as a level five threat - meaning a pandemic is "imminent".
The eight identified by Mr Ruiz Mateos are China, Russia, the UAE, Ukraine, Bolivia, Ecuador, Honduras and Azerbaijan.
"We won't permit unjustified barriers on Mexican exports," Mr Ruiz Mateos told a news conference.
He said the countries he had singled out were not big trading partners with Mexico, but the action sought to ward off similar measures by other countries.
Mexican Finance Minister Agustin Carstens said the government was set to offer measures such as temporary tax relief to companies hit by the crisis, and that this would likely cost the economy some 17.4bn pesos ($1.3bn; £873m) overall.
Several of the countries which have found their pork exports banned as a result of swine flu have argued there is no proof that the infection can be caught by eating pork - a stance backed by scientists, says BBC business reporter Rodney Smith.
The tough measures taken by some countries have already increased some tensions, particularly in the areas of trade and travel links.
But, speaking after imposing a ban on British pork, Nikolai Vlasov, Russia's chief veterinary inspector, defended the measures.
"We are constantly told that pork is not dangerous," Mr Vlasov said, according to Associated Press news agency.
"But at the same time, nobody has proved that it is safe."
As well as the UK, Russia has banned pork products from Spain, parts of Canada and the United States. It has banned all meat imports from Mexico, Central American and Caribbean countries.
China has banned imports of live pigs and pork products from 15 countries including several in central Asia, central America and Europe, as well as several US states and the Canadian province of Alberta.”

"Recommended composition of influenza virus vaccines for use in the 2009-2010 northern hemisphere influenza season
WHO
14 May 2009
http://www.who.int/csr/disease/influenza/recommendations2009_10north/en/index.html

It is recommended that vaccines for use in the 2009-2010 influenza season (northern hemisphere winter) contain the following:
— an A/Brisbane/59/2007 (H1N1)-like virus;*
— an A/Brisbane/10/2007 (H3N2)-like virus;**
— a B/Brisbane/60/2008-like virus.#

* A/Brisbane/59/2007 is a current vaccine virus; A/South Dakota/6/2007 (an A/Brisbane/59/2007-like virus) is a current vaccine virus used in live attenuated vaccines.
** A/Brisbane/10/2007 and A/Uruguay/716/2007 (an A/Brisbane/10/2007-like virus) are current vaccine viruses.
# B/Brisbane/33/2008 is a B/Brisbane/60/2008-like virus."

"WHO ei vielä päättänyt sikainfluenssan vastaisesta rokotteesta
AP, AFP, Reuters
julkaistu tänään klo 20:00
http://yle.fi/uutiset/ulkomaat/2009/05/who_ei_viela_paattanyt_sikainfluenssan_vastaisesta_rokotteesta_739023.html
Maailman terveysjärjestön WHO:n asiantuntijat eivät ole päässeet yksimielisyyteen siitä, pitääkö lääketehtaiden ryhtyä tuottamaan sikainfluenssarokotetta tavallisten kausi-influenssarokotteiden sijaan.
WHO:n varatoimitusjohtaja Keiji Fukuda sanoi, että WHO, lääketeollisuus ja terveysviranomaiset eivät saaneet päätöstä aikaan telekonferenssissaan. Influenssarokotteita valmistavia lääkeyhtiöitä on maailmassa runsaat 20.
Maailman terveysjärjestö aloittaa vuosikokouksensa maanantaina Genevessä Sveitsissä. Kymmenpäiväinen kokous muutettiin viisipäiväiseksi sikainfluenssan aiheuttaman pandemian uhan vuoksi. Näin kansalliset viranomaiset pääsevät nopeammin toteuttamaan sikainfluenssan vastaisia toimia kokouksen jälkeen.
Puoli miljoonaa kuolee kausi-influenssaan vuosittain
Tavalliseen kausi-influenssaan kuolee vuosittain maailmassa puoli miljoonaa ihmistä, joten sen vastaiset rokotuskampanjat ovat hyvin perusteltuja. Epävarmoja ollaan nyt siitä, onko syytä keskittyä kausi-influenssan sijaan sikainfluenssaa aiheuttavan H1N1-viruksen torjuntaan. Lääketehtailla ei ole voimavaroja satsata vahvasti molempiin yhtä aikaa.
Influenssarokotteiden kehittelyyn ja tuotantoon kuluu aikaa kuukausia, ja tehtyä päätöstä - keskittymistä sikainfluenssa- tai kausi-influenssarokotteisiin - eivät lääketehtaat voi muuttaa matkan varrella.
WHO arvioi, että H1N1-rokotetta voitaisiin valmistaa kaksi miljardia annosta vuosittain. Aikaa rokotteen valmistumiseen WHO ennustaa kuluvan neljästä kuuteen kuukauteen.
Asiantuntijat: "Rokotteen valmistus alkaa"
Lääketehtaiden työtä vaikeuttaa se, että virus muuttaa koko ajan muotoaan. Poliittisia linjauksia pitäisi tehdä siitä, kuinka paljon rokotetta valmistettaisiin, kuinka se jaeltaisiin ja ketkä rokotettaisiin.
Jotkut asiantuntijat arvelevat, että päätös on käytännössä jo tehty - sikainfluenssarokotetta ryhdytään heidän mielestään valmistamaan. Näin ajattelee yhdysvaltalainen rokoteasiantuntija ja entinen lääketieteen professori David Fedson Virginian yliopistosta.
- Jos sikainfluenssarokotteeseen ei satsata, meillä ei ole käsissämme mitään, jos tauti saa myöhemmin katastrofin mittasuhteet, hän sanoo. - Toisaalta sikainfluenssa voi ilmaantua uudelleen myös lievässä muodossa.
Sairastuneita yli 6600, kuolleita lähes 70
Sikainfluenssaan sairastuneiden määrä kasvaa maailmalla edelleen. Eri maiden terveysviranomaisten ilmoitusten perusteella sairastuneita on jo yli 6600, heistä Yhdysvalloissa 3352 ja Meksikossa 2656 henkilöä uutistoimisto AP:n mukaan. Kanadassa sairastuneita on 389.
Sairastuneita on löytynyt 34:stä maasta. Suomessa tautitapauksia on kaksi. Euroopassa H1N1-viruksen sairastuttamia on eniten Espanjassa, sata tapausta. Britanniassa sairastuneita on 78.
Sikainfluenssa on aiheuttanut maailmalla 69 kuolemaa. Meksikossa on kuollut 64 tautiin sairastunutta, Yhdysvalloissa menehtyneitä on kolme, Kanadassa ja Costa Ricassa kummassakin yksi."

INFLUENZA A (H1N1) - WORLDWIDE (27): CASE COUNTS
Archive Number 20090514.1800
Published Date 14-MAY-2009
Subject PRO/AH/EDR> Influenza A (H1N1) - worldwide (27): case counts
http://www.promedmail.org/pls/otn/f?p=2400:1001:676739511774982::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,77486
************************************************
A ProMED-mail post http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
[Please note that there may be discrepancies between the various sources of
information due to different times of "closure" of daily figures reported.
Times of daily report closures where known are listed in the table of
contents below. Newswires may mention a confirmed case in a location that
has not been on the official reporting entity list as the confirmation
arrived after closure of the day's report. - Mod.MPP]
In this update:
[1] WHO - global updates (06:00 GMT)
[2] PAHO - Americas regional update (17:00 GMT-4)
[3] CDC - USA update (11:00 GMT -4)
[4] Mexico - MOH update (08:40 GMT -5)
[5] Canada - Public Health Agency of Canada (15:00 GMT -4)
[6] News brief
******
[1] WHO - global updates (06:00 GMT)
Date: Wed 13 May 2009
Source: WHO Epidemic and Pandemic Alert and Response (EPR) [edited]

Influenza A (H1N1) - update 27 -- 13 May 2009
---------------------------------------------
As of 06:00 GMT, 13 May 2009, 33 countries have officially reported 5728
cases of influenza A (H1N1) infection.
Mexico has reported 2059 laboratory confirmed human cases of infection,
including 56 deaths. The United States has reported 3009 laboratory
confirmed human cases, including 3 deaths. Canada has reported 358
laboratory confirmed human cases, including one death. Costa Rica has
reported 8 laboratory confirmed human cases, including one death.
The following countries have reported laboratory confirmed cases with no
deaths - Argentina (1), Australia (1), Austria (1), Brazil (8), China (3,
comprising 1 in China, Hong Kong Special Administrative Region, and 2 in
mainland China), Colombia (6), Cuba (1), Denmark (1), El Salvador (4),
Finland (2), France (13), Germany (12), Guatemala (3), Ireland (1), Israel
(7), Italy (9), Japan (4), Netherlands (3), New Zealand (7), Norway (2),
Panama (29), Poland (1), Portugal (1), Republic of Korea (3), Spain (98),
Sweden (2), Switzerland (1), Thailand (2), and the United Kingdom (68).

Summary table of cases reported to WHO 30 Apr -- 13 May 2009
------------------------------------------------------------
Country: No. cases (deaths) Apr 30 / May 1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10 / 11 / 12 / 13
Argentina: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1
Australia: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1
Austria: 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Brazil: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 4 / 6 / 6 / 8 / 8 / 8
Canada: 19 / 34 / 51 / 85 / 101 / 140 / 165 / 201 / 214 / 242(1) / 280(1) / 284(1) / 330(1) / 358(1)
China, Hong Kong, SAR, mainland: 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 2 / 2 / 3
Colombia: 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 3 / 3 / 6
Costa Rica: 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 8(1) / 8(1) / 8(1) / 8(1)
Cuba: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1
Denmark: 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
El Salvador: 0 / 0 / 0 / 0 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 4 / 4 / 4
Finland: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 2
France: 0 / 0 / 2 / 2 / 4 / 4 / 5 / 5 / 12 / 12 / 12 / 13 / 13 / 13
Germany: 3 / 4 / 6 / 8 / 8 / 9 / 9 / 10 / 11 / 11 / 11 / 11 / 12 / 12
Guatemala: 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 3
Ireland: 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Israel: 2 / 2 / 3 / 3 / 4 / 4 / 4 / 6 / 7 / 7 / 7 / 7 / 7 / 7
Italy: 0 / 0 / 0 / 1 / 2 / 5 / 5 / 5 / 6 / 6 / 9 / 9 / 9 / 9
Japan: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 3 / 4 / 4 / 4
Mexico: 97(7) / 156(9) / 397(16) / 506(19) / 590(25) / 822(29) / 942(29) / 1112(42) / 1204(44) / 1364(45) / 1626(45) / 1626(48) / 2059(56) / 2059(56)
Netherlands: 1 / 1 / 1 / 1 / 1 / 1 / 1 / 2 / 3 / 3 / 3 / 3 / 3 / 3
New Zealand: 3 / 4 / 4 / 4 / 6 / 6 / 5 / 5 / 5 / 5 / 7 / 7 / 7 / 7
Norway: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 2 / 2 / 2
Panama: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 2 / 3 / 15 / 16 / 29
Poland: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Portugal: 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Republic of Korea: 0 / 0 / 1 / 1 / 1 / 2 / 2 / 3 / 3 / 3 / 3 / 2 / 3 / 3
Spain: 13 / 13 / 13 / 40 / 54 / 57 / 73 / 81 / 88 / 88 / 93 / 95 / 95 / 98
Sweden: 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1 / 2 / 2 / 2
Switzerland: 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Thailand: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 2
United Kingdom: 8 / 8 / 15 / 15 / 18 / 27 / 28 / 32 / 34 / 34 / 39 / 47 / 55 / 68
United States: 109(1) / 141(1) / 160(1) / 226(1) / 286(1) / 403(1) / 642(2) / 896(2) / 1639(2) / 2254(2) / 2532(3) / 2600(3) / 3009(3)
Total No. countries reporting cases: 11 / 13 / 16 / 18 / 21 / 21 / 23 / 24 / 25 / 29 / 30 / 30 / 33
Total cases reported: 257(8) / 367(10) / 658(17) / 898(20) / 1085(26) /
1490(30) / 1893(31) / 2371(44) / 2500(46) / 4379(49) / 4694(53) / 5251(56) / 5728(61)
--
communicated by:
ProMED-mail rapporteur Marianne Hopp"

"China's Shandong quarantines 23, declares health emergency over A/H1N1 flu
www.chinaview.cn 2009-05-14 12:21:35
JINAN, May 14 (Xinhua)
http://news.xinhuanet.com/english/2009-05/14/content_11372650.htm
Health authorities in east China's Shandong Province put 23 people under home or hospital quarantine Thursday morning to check for symptoms of A/H1N1 influenza, the provincial health department said.
The 23 had been in close contact in a Beijing-Jinan train with a male resident of Shandong who health officials said Wednesday had tested positive for the disease.
The provincial health authorities are seeking 20 other passengers who were in the same car of train D41, from Beijing to the provincial capital of Jinan, on Monday.
After the man was diagnosed, Shandong Province declared China's first swine-flu health emergency at about 6 p.m. Wednesday.
Wang Suilian, vice governor of the eastern province, said Shandong declared the second-level health emergency, which will involve many departments coordinating to contain the disease and keep the public informed.
Shandong's flu case, the second known case on the Chinese mainland, involved a 19-year-old student surnamed Lv who arrived in Beijing from Canada on May 8 and traveled to Jinan three days later.
Lv was hospitalized Monday. He was recovering with a normal body temperature on Wednesday, when he was taken off intravenous feeding.
"We only prescribed some anti-influenza medicine like Tamiflu for Lu," Dr. Ma Jiren, who is also deputy director of Jinan's Health Bureau, said Thursday.
Lv is in an isolation ward in the Jinan Hospital of Infectious Diseases.
Zong Lin, chief of the disease control and prevention section of the Shandong Provincial Health Bureau, said health officials were sending text messages and running notices on TV to find the remaining passengers.
A health official surnamed Zhang said that the second-degree emergency declaration was the highest-level response available to provincial governments. A first-degree emergency declaration would be up to the central government.
Beijing launched a second-degree emergency response against bird flu in January after a 19-year-old woman died of the disease in the capital. The city's poultry markets were closed and disinfected, and disease control staff went door-to-door in suspected infection areas to check flu patients.
"A second-degree emergency can be declared when an A-class infectious disease is confirmed. The A/H1N1 influenza is currently classified as B-class infectious disease in China.
"However, the health department proposed the emergency be declared immediately, because the scientific community is still unclear about how the virus spreads and there is a high risk of a mass outbreak," he said.
The mainland's first A/H1N1 flu patient, who has been at the Chengdu Infectious Diseases Hospital in southwest Sichuan Province for four days, was making a rapid recovery.
All 147 passengers who had been exposed to that patient on Northwest Airlines flight NW029 from Tokyo to Beijing, had been contacted by the Beijing Health Department, said the department on Wednesday."

WHO definition of phase 6 of pandemic alert as in 14 May 2009:
http://www.who.int/csr/disease/avian_influenza/phase/en/index.html
"Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way."

Transmission of Swine H1N1 In Scotland Signals Phase 6
Recombinomics Commentary 13:13
May 14, 2009
http://www.recombinomics.com/News/05140902/Swine_H1N1_Scotland_6l.html
A 16-YEAR-OLD girl is being classed as the latest "probable" case of swine flu in Greenock.
However, Deputy First Minister Nicola Sturgeon, who is also Scottish Health Secretary, said there was "no obvious connection" between the teenager and any other confirmed or probable cases in the town.
She said if no link emerges between the girl and any other cases, it could be the first evidence of "community transmission" in Scotland.
The news follows the closing of a nursery school and a primary for a week.
As reported in yesterday's Evening Times, Ladybird Nursery shut its doors to pupils less than 24 hours after Ravenscraig Primary became the first school in Scotland to close because of the swine flu outbreak.
A total of 80 youngsters at the nursery are being given the anti-viral drug Tamiflu as a precaution after a three-year-old was diagnosed as a "probable" case.
Ms Sturgeon said the three-year-old, and a five-year-old boy who attends Ravenscraig, are both linked to a 19-year-old man from Greenock who tested positive for swine flu.

The above comments describe a large cluster of confirmed and probable H1N1 swine flu cases in the Greencock region of Scotland (see updated map). In addition to the large cluster, there is an unlinked case, signaling community transmission in Scotland, Community transmission of swine H1N1 outside if North America paves the way for a phase 6 declaration.
Swine H1N1 is spread widely throughout North America (see updated map). In the United States, the incidence of swine flu outpaced the combined cases of H1N1 and H3N2 seasonal flu. The explosion in cases led to a significant backlog at the CDC, which was confirming swine flu cases. Recently, the confirmatory kits were distributed to state labs, but the shortage of kits has led to limited testing, which is primarily focused on severe cases.
However, although swine H1N1 was widespread in Mexico, the United States, and Canada, the WHO maintained the pandemic level at phase 5 because community transmission was not confirmed outside of North America.
This confirmation was largely dependent on testing. The virus has been sequenced worldwide, and the various isolates are closely related (well over 99% identity). Thus, the efficient human to human transmission in North America would be present worldwide, but many cases are mild are go unreported or tested.
The confirmed community transmission in Scotland, fulfills the WHO requirement of community transmission in two or more regions to rause the pandemic level from 5 to 6..
Therefore, a phase 6 designation should be announced in the near term."

"Sikainfluenssaan sairastuneiden kontaktit tiedossa
YLE Uutiset
julkaistu 13 May 2009 klo 17:38, päivitetty 13 May 2009 klo 21:24
Sikainfluenssaan sairastuneiden suomalaisten kanssa tekemisissä olleet suomalaiset ovat terveysviranomaisten tiedossa. Lähellä sairastuneita olleet henkilöt on selvitetty, jotta heidät voidaan tarvittaessa ohjata hoitoon.
Kaksi A (H1N1)-viruksen aiheuttaman influenssan saanutta suomalaista toipuu parhaillaan taudistaan. Kaikki heidän kanssaan lähikontaktissa olleet on selvitetty sairastuneiden kanssa käydyissä keskusteluissa. Lähikontaktilla tarkoitetaan esimerkiksi samassa taloudessa asuvia perheenjäseniä tai samoissa tiloissa yli neljä tuntia oleskelleita henkilöitä.
Toinen sairastuneista töissä Sanoma Newsissa
Suomessa on jäljitetty esimerkiksi ne henkilöt, jotka olivat tekemisissä toisen sairastuneen kanssa hänen käydessään Laurea-ammattikorkeakoulun Keravan toimipisteessä viime viikon torstaina ja perjantaina.
Keskiviikkona vahvistui, että tiistaina sairastuneista henkilöistä yksi on töissä mediakonserni Sanoma Newsissä. Toimitusjohtaja Mikael Pentikäinen kertoi YLE Uutisille, että sairastunut ei ole kuitenkaan ehtinyt käydä työpaikallaan lomamatkansa jälkeen, vaan hän on jäänyt kotiin työtoverin ja työterveyshuollon suosituksesta. Henkilö on kotihoidossa ja voi Pentikäisen mukaan hyvin. Sanoma-konserni ei ole myöskään ryhtynyt mihinkään erityisjärjestelyihin tapauksen takia, vaan on kehottanut työtekijöitä noudattamaan viranomaisten yleisiä hygieniaohjeita.
Tartunnan saaneista suomalaisista toinen sairastui viime viikon keskiviikkona KLM:n lennolla Meksikon pääkaupungista Mexicosta Amsterdamiin. Tieto on toimitettu myös Hollannin terveysviranomaisille, jotka jäljittävät samalla lennolla lähipenkkiriveissä istuneita matkustajia.
Sairastuneiden kanssa tekemisissä olleille on annettu ohjeet käsihygieniasta ja oireiden seurannasta. Oireita on kehotettu tarkkailemaan viikon ajan kontaktin jälkeen. Mikäli tänä aikana ilmenee kuumetta yli 38°C sekä hengitystieoireita, kuten yskää tai nuhaa tai kurkkukipua, tulee ottaa yhteyttä omaan terveyskeskukseen tai työterveyshuoltoon."
************
Briefly in English:
The two Finnish coonfirmed swinefluenza cases flew in KLM airplane from Mexico City to Amsterdam. KLM is now contacting only people who sat in the next rows in the airplane.

" WHO: Sikainfluenssa pysyvään seurantaan
julkaistu 4 May 2009 klo 22:53, päivitetty 5 May 2009 klo 11:01
AFP, AP, Reuters
http://yle.fi/uutiset/ulkomaat/2009/05/who_sikainfluenssa_pysyvaan_seurantaan_719991.html
Maailman terveysjärjestö WHO tahtoo sikainfluenssan pysyvään seurantaan. Tauti ei ole maailmanlaajuisessa eläintautiseurannassa samalla tavalla kuin esimerkiksi lintuinfluenssa. Tarkempi syyni tarvitaan, koska sikainfluenssa on muuntuneessa muodossaan mahdollisesti vaarallinen ihmisille.
WHO:n asiantuntija Peter Ben Embarek sanoo, että sikainfluenssaan ei ole suhtauduttu toistaiseksi vakavasti, koska sitä ei ole pidetty erityisenä vaarana. Se on hyvin yleinen sioilla, ja sitä on siksi hoidettu vain eläintautina.
Nyt epidemiana oleva uuden tyypin influenssa tarttuu ihmiseen ja ihmisestä ihmiseen. Siksi myös sikainfluenssalle tarvitaan tarkempi seuranta, arvioi WHO:n Embarek.
Tartunnan on WHO:n mukaan saanut tähän mennessä yli 1 100 ihmistä ja siihen on kuollut 26 ihmistä. Vahvistettuja tartuntoja on 21 maassa. WHO ei vielä tässä vaiheessa katso tarpeelliseksi nostaa hälytysvalmiuttaan korkeimmalle eli kuudennelle asteelle."

" Suomalainen H1N1-virustartunnan saaneen lennolla
julkaistu 11 May 2009 klo 07:33, päivitetty 12 May 2009 klo 11:29
YLE Uutiset, Reuters, DPA, AP
http://yle.fi/uutiset/ulkomaat/2009/05/suomalainen_h1n1-virustartunnan_saaneen_lennolla_731252.html
Suomalainen mies on matkustanut avovaimonsa kanssa samassa lentokoneessa kuin sikainfluenssaan sairastunut mies. Kiinalaisen virustartunta vahvistettiin maanantaina maan ensimmäiseksi tautitapaukseksi. Suomalaismies kuuli vasta maanantaina YLEn kirjeenvaihtajalta olleensa samalla perjantaisella lennolla sairastuneen kiinalaismiehen kanssa.
Suomen suurlähetystö on ollut yhteydessä suomalaismieheen. Mies odottaa nyt soittoa kiinalaisviranomaisilta.
Suomalaismies lensi perjantai-iltana Tokiosta Pekingiin samassa koneessa sikainfluenssaan sairastuneen kiinalaismiehen kanssa. Tokion lentokentällä matkustajat oli tarkastettu huolellisesti, mutta tautia ei ollut havaittu.
Jatkolennolla Pekingistä Sichuaniin mukana olleet matkustajat on eristetty, mutta Pekingiin jääneitä matkustajia ei.
Yli sata matkustajaa tavoittamatta
Kiinan terveysministeriö ilmoitti, että Sichuanin maakunnassa on varmistettu maan ensimmäinen sikainfluenssatartunta.
Tartunnan saanut 30-vuotias miespotilas palasi äskettäin Yhdysvalloista, missä hän on opiskellut Missourin yliopistossa. Hän on nyt sairaalahoidossa Chengdun kaupungissa lounaisessa Sichuanin maakunnassa, kertoi virallinen uutistoimisto Xinhua.
Miehen kanssa samalla lennolla Chengduun saapuneista 150 matkustajaa on paikannettu ja kymmenet heistä on eristetty, ja he ovat terveysviranomaisten seurannassa. Myös muut hänen kanssaan läheisessä kosketuksessa olleet on eristetty viranomaisten tarkkailuun. Viranomaiset jäljittävät vielä 150:tä muuta, jotka ovat matkustaneet tartunnan saaneen kanssa samassa koneessa.
Kiinan viranomaiset ovat pyrkineet estämään viruksen pääsyn maahan, koska sen arvioidaan leviävän nopeasti tiheästi asutussa maassa."

"Co-pilot suspected of carrying H1N1
The Jakarta Post , Jakarta
Tue, 05/12/2009 2:32 PM
National
http://www.thejakartapost.com/news/2009/05/12/copilot-suspected-carrying-h1n1.html
Hasan Sadikin Hospital in Bandung, West Java, is treating a co-pilot suspected of having contracted the H1N1 virus, a hospital spokesman said to state news agency Antara.
"We have received a patient sent from Husein Sastranegara airport. He arrived at the hospital at 5.26 pm on Monday. He is suspected to have been infected with the type A influenza virus [H1N1]," Dr Pirmal Soedjana, a member of the hospital's Special Infections Handling Team, said.
He said that the patient, before being admitted to the hospital, had made several overseas trips including to Singapore and Malaysia. (dre)"

"Lentokentällä lisätty ohjeistusta sikainfluenssan takia
julkaistu 12 May 2009 klo 13:59
YLE Uutiset
Helsinki-Vantaan lentokentällä on lisätty matkustajien terveysohjeistusta sikainfluenssan takia. Muuten lentokenttä toimii kuten ennenkin, eikä kentällä ole ryhdytty erityistoimiin.
Helsinki-Vantaan lentokentällä on tänään jaettu terveysviranomaisten ohjeita siitä, miten pitää toimia, jos epäilee mahdollista sikainfluenssaa tai -tartuntaa.
- Olemme laittaneet matkustajia varten esille Terveyden ja hyvinvoinnin laitoksen painattamia ohjeita tautiin liittyen, kertoo Finavian apulaisjohtaja Heini Noronen-Juhola.
Muuten lentokentän toiminnassa ei ole mitään tavallisesta poikkeavaa.
- Meillä ei esimerkiksi ole käytössä desinfiointialtaita tai lämpökameroita, Noronen-Juhola jatkaa.
Samalla hän kertoo, että kentällä seurataan tilannetta koko ajan ja ollaan jatkuvassa valmiudessa toimia viranomaisten ohjeiden mukaisesti.
- Meillä on useita eri suunnitelmia eri tilanteiden varalta. Jos viranomaisilta tulee ohje tai määräys tehdä jotain, niin me toimimme ohjeen mukaisesti, apulaisjohtaja Heini Noronen-Juhola jatkaa."

"Sikainfluenssaa nyt myös Suomessa
julkaistu 12 May 2009 klo 09:23, päivitetty 12 May 2009 klo 18:48
YLE Uutiset
http://yle.fi/uutiset/kotimaa/2009/05/sikainfluenssaa_nyt_myos_suomessa_733629.html
Suomessa on löytynyt kaksi vahvistettua sikainfluenssatapausta. Tartunta on löydetty kahdelta pääkaupunkiseudulla asuvalta nuorelta aikuiselta, jotka palasivat samalla lennolla Meksikosta Amsterdamin kautta 6. toukokuuta.
Potilaat ovat olleet kotihoidossa ja voivat hyvin, eikä heillä ole vakavaa vaaraa.
Sairastuneet olivat olleet kahden viikon lomamatkalla Méxicossa ja Cancúnissa. Toinen heistä sairastui lentopäivänä 6. toukokuuta ja toinen pari päivää myöhemmin, kerrottiin sosiaali- ja terveysministeriön tiedotustilaisuudessa.
Sairastuneiden lento Suomeen lähti Amsterdamista kello 18.15 ja saapui Helsinkiin 21.45. Toinen sairastuneista ehti olla koulussa kaksi päivää ennen kuin hänen sairautensa vahvistettiin. Hän opiskelee Laurea-ammattikorkeakoulun Keravan yksikössä. Opiskelija on nyt kotona, ja muille opiskelijoille on annettu ohjeet mahdollisia oireita ja käsihygieniaa varten.
Sairastuneet ovat läheistensä ruokahuollon varassa, kertoo Terveyden ja hyvinvoinnin laitoksen (THL) ylijohtaja Juhani Eskola.
- Ystävät tai sukulaiset voivat toimittaa sinne ruokaa. Ei se sen monimutkaisempaa ole, Eskola sanoo.
Eskolan mukaan sairastuneita on pyydetty rajoittamaan tiiviitä kontakteja muihin ihmisiin, ja heille on annettu hygienianhoito-ohjeet. Näin ollen tartuntavaaraa ei ole.
- Heille on käyty läpi käsihygieniaa ja yskimis- ja aivastushygieniaa, aivan tällaisia perusasioita. Se riittää tällaisessa tapauksessa, Eskola vakuuttaa.
Terveyskeskukset ja neuvontapuhelin auttavat
Keravan kaupungin terveydenhuollon johtaja Minna Helenius kertoo, että kaupunkilaisten kyselyt sikainfluenssasta on ohjattu pääkaupunkiseudun kuntien ja Helsingin ja Uudenmaan sairaanhoitopiirin HUSin yhteiseen terveysneuvonta-puhelinpalveluun. Suurin osa yhteydenotoista menee sinne ja loput omaan terveyskeskukseen, kertoo Helenius.
- Laurea-ammattikorkeakoulun Keravan yksikössä opiskelevia ulkopaikkakuntalaisia on kehotettu ottamaan yhteyttä omaan terveyskeskukseen, jos kysyttävää ilmenee.
Vahvistetut sikainfluenssatapaukset eivät kuitenkaan toistaiseksi ole ruuhkauttaneet terveysneuvonnan puhelinpalvelua. Sairaanhoitaja Merja Thölix arvelee kuitenkin, että illan aikana yhteydenottoja alkaa tulla enemmän.
- Aikaisemmin soittoja on tullut parisenkymmentä päivässä, Thölix kertoo.
Tyypillinen soittaja haluaa Thölixin mukaan tietää, voisivatko hänellä olevat flunssan oireet viitata sikainfluenssaan.
Amsterdamin-lennolla olleet ottaneet yhteyttä lääkäriin
Ministeriö kehotti tiistaiaamuna sairastuneiden suomalaisten kanssa samalla lennolla olleita ihmisiä ottamaan yhteyttä terveyskeskukseensa, jos heillä ilmenee kuumeisia hengitystieinfektion oireita. Ministeriön mukaan varoaika mahdolliselle tartunnalle on noin viikko. Jos samalla lennolla olleille ilmenee oireita 13. toukokuuta mennessä, pitää ottaa yhteyttä terveyskeskukseen.
Tiistaina kello 16:een mennessä samalla lennolla olleet ovat ottaneet yhteyttä lääkäriin ainakin Pohjois-Savossa, Keski-Suomessa ja Etelä-Pohjanmaalla. Työikäinen kuopiolainen tarkistutti yliopistollisessa sairaalassa lievät hengitystieinfektio- ja kuumeoireensa. Keskiviikkona selviää, oliko kyseessä sikainfluenssavirus.
Lennolla ollut keskisuomalainen perhe otti yhteyttä Keski-Suomen sairaanhoitopiiriin. Perheellä ei ollut oireita. Oireeton henkilö on ollut tarkkailtavana myös Etelä-Pohjanmaalla Seinäjoen keskussairaalassa. Keski-Pohjanmaan keskussairaalassa on puolestaan otettu näytteet New Yorkista tulleesta potilaasta. Potilas on kotihoidossa.
Viranomaiset luottavat matkustajien tavoittamisessa tiedotusvälineisiin
Suomen terveysviranomaisilla ei ole tietoa siitä, kuinka paljon Amsterdamin-lennolla oli suomalaisia ja mistä päin maata he ovat kotoisin. THL:n ylijohtajan Juhani Eskolan mukaan lennolla olleita ei yritetä tavoittaa, vaan viranomaiset luottavat tiedottamisessa tiedotusvälineisiin.
- Lennolla mukana olleiden jäljittämisessä joudumme nyt luottamaan aika paljon tietoon, joka on mennyt tiedotusvälineiden kautta tänä aamuna.
Aamulla tiedotusvälineiden välityksellä annetun ohjeen mukaan lennolla mukana olleiden pitää ottaa puhelimitse yhteyttä terveyskeskukseen, jos he sairastuvat kuumeeseen tai hengitystieinfektioon.
Lentoyhtiöltä ei ole yritetty saada tietoa matkustajista, koska matkustajaluetteloiden ja istumajärjestyksen saaminen olisi liian hidasta. Eskolan mukaan tiedonsaanti muilta lentoyhtiöiltä on vaikeampaa kuin Finnairilta.
- Meillä on varsin hyvät ja toimivat suhteet Finnairiin, mutta muiden lentoyhtiöiden kanssa yhteistyö on vähän kimuraisempaa. Kyllä mielestäni kaikki lentoyhtiöt ovat yhteistyöhaluisia, mutta tällaiset pikaisesti tehtävät jäljitystehtävät ovat varsin uusia haasteita.
Ministeriö rauhoittelee
Sosiaali- ja terveysministeriön mukaan H1N1-tapausten esiintyminen myös Suomessa oli odotettavissa, koska virus on levinnyt laajalti eri puolilla maailmaa. Suomessa tilanteeseen on kuitenkin varauduttu hyvin, eikä ihmisillä ole syytä huolestua.
Myös Thaimaa on ilmoittanut tänään ensimmäisestä sikainfluenssatapauksestaan. Thaimaa on ensimmäinen Kaakkois-Aasian maa, josta on löydetty sikainfluenssaa. Maailmalla sikainfluenssaan on sairastunut 5 000 ihmistä."
************
In English:
"Finland Confirms First Two Swine Flu Cases
published 12 May 2009 10:05 AM, updated 12 May 2009 01:02 PM
http://yle.fi/uutiset/news/2009/05/finland_confirms_first_two_swine_flu_cases_733734.html
On Tuesday morning health officials confirmed the country's first two cases of swine flu. The two infected Finns returned from a trip to Mexico City and Cancun via Amsterdam on May 6. Their flight arrived at Helsinki-Vantaa Airport at 9:45 p.m. Health officials urge people who were on the same flight to contact their health care provider if they begin to show symptoms of fever or respiratory illness.
The first of the patients became ill on May 6, and the second a couple of days later, according to officials speaking at a Ministry of Health and Social Affairs press conference on Tuesday.
The patients live in the capital region and are nursing flu-like symptoms at home, not in hospital, officials said.
The risk of infection to H1N1 lasts about a week from exposure to the virus, health authorities said.
Passengers on the Helsinki-bound flight from Amsterdam who develop flu-like symptoms by Wednesday, May 13 are asked to contact their health care providers if they develop flu-like symptoms.

Officials Urge Calm
The Ministry of Social Affairs and Health says the spread of the virus to Finland was expected and that authorities are well prepared to combat with the virus. The ministry added that people should not worry unnecessarily.
The spread of the flu to Finland follows the first confirmed Nordic cases being found this month in Denmark, Sweden and Norway.
The World Health Organisation has confirmed some 5,000 infections of H1N1 flu virus worldwide."
**************
Editor's note:
The other patient was let to go to school for two days before the illness was confirmed to be swinefluenza.

New York Confirms Swine H1N1 High School Spread
Recombinomics Commentary 14:39
May 10, 2009
http://www.recombinomics.com/News/05100902/Swine_H1N1_NY_HS.html
As I reported previously, on Monday Wadsworth Laboratories received a large batch of 102 specimens from the North Shore Long Island Jewish Health System (North Shore-LIJ) for laboratory confirmatory testing. These are specimens collected about 10 days ago when the outbreak in Queens connected to St. Francis Preparatory School was in the news. These older specimens underwent preliminary testing at North Shore-LIJ laboratories. The clinical needs of these patients were appropriately addressed.
Today I have the results of New York City specimens in that batch, which include 75 patient specimens from New York City now confirmed with H1N1. Fifty of these 75 cases, or over 65 percent, have a direct link to the St. Francis School outbreak, and represent students and faculty there.
The remaining 25 cases involve children under high-school age and could represent siblings of the St. Francis students, but that cannot be fully determined until the epidemiological investigations are completed.
Because these specimens are from the first days of the outbreak in New York State more than a week ago, they do not indicate active cases, and we believe these individuals have fully recovered. However, we felt it important to brief you on the results of the large batch of older specimens from North Shore-LIJ, as these numbers when added to our current map graphic on our web site will indicate a rather substantial jump in the overall New York City cases.
At this point in the outbreak, reporting daily numbers of new cases is not important because the illness continues to be mild to moderate, similar to seasonal influenza. The numbers are also not particularly significant because they only represent lab-tested specimens, and many individuals with mild symptoms do not go to a physician or hospital, but instead, recover at home - as has been our advice for some time.
As we go forward, the focus of our monitoring and reporting will be more on identifying new locations, trends, and patterns of the H1N1 virus, as well as watching for more severe disease. The test results from the North Shore-LIJ specimens will help us to better understand the early phase of H1N1 in New York and how it has spread geographically over time.
As I mentioned earlier, we are entering a new phase in our response to this outbreak, and Governor Paterson has asked that I only provide updates when there are important new developments.

The above comments from the State of New York swine flu website confirm the spread of H1N1 in the Queens high school last month. Although only 25 students vacationed in Mexico, on April 23 and 24 there were 150 students with flu-like symptoms. 28 were initially confirmed and 17 were suspect based on lab results. The number of cases created a backlog, and the results have now been released for the samples collected last month.
However, there is concern that the swine H1N1 is still silently spreading (see updated map), because the vast majority of cases are mild, and require enhanced surveillance for detection, although a simple influenza A test will be more predictive of swine flu as the seasonal flu season ends in the northern hemisphere.
The above announcement by the NY lab has been echoed across the country. The testing will be selective, and a complete picture of the H1N1 spread will be lacking. This focus on the more severe cases mimics confirmations in Mexico, where the lab confirmed cases significantly underestimates the level of infections.
The focus on severe cases increases the case fatality rate. In the US there have been three reported H1N1 deaths and there has also been a death in Alberta , Canada, raising concerns that the number of fatal infections will climb significantly over the near term.
The identity between H1N1 in Mexico and the US (as well as all other countries submitting sequence data - see list of isolates here), raises concerns that the silent spread will produce frequent co-infections between swine and seasonal H1N1. These co-infections can produce genetic exchanges between human and swine isolates via reassortment and recombination.
This type of rapid genetic evolution between human and swine H1N1 raises concerns that a more virulent H1N1 will emerge in the near term, and lead to a significant rise on severe cases in the fall, when the flu season begins in the northern hemisphere."