MANILA, 21 May 2009, 1600 hrs—On May 21, Japan reported that it had 276 laboratory-confirmed cases of influenza A(H1N1), an increase of 67 cases from the previous day. Australia reported four new cases and China announced its fifth case of the virus. No deaths have been reported in the Western Pacific Region
The new cases in Japan are mainly associated with schools and, at this stage, there is no clear sign of the virus transmitting into local communities. Cases continue to be reported from Hyogo Prefecture and Osaka. In addition three new cases were detected in Tokyo, Shiga and Kanagawa.
There are now 303 laboratory-confirmed cases of influenza A(H1N1) in the Western Pacific Region:
- 5 in Australia
- 5 in China
- 3 in Hong Kong (China)
- 276 in Japan
- 2 in Malaysia
- 9 in New Zealand
- 3 in the Republic of Korea
China's fifth laboratory-confirmed case was a 21-year-old Canadian-Chinese person who arrived in Beijing from Toronto on 16 May. He experienced flu-like symptoms on 19 May and reported to hospital on the same day. All four of the new cases in Australia are reported as having recently returned from an affected area overseas.
The new case in Shiga Prefecture in Japan is a 23-year-old university student who had spent time in Kobe. The two cases in Tokyo and Kanagawa are students of the same high school who had recently returned from the United States of America. Although the majority of cases in Japan are related to the initial school outbreaks around Kobe and Osaka but there are a small number of cases where public health authorities are finding it difficult to make a clear link to an affected school. Further information on those cases is expected in the near future as investigations continue.
National authorities in Japan have warned all prefectures that the virus could spread to other regions and have asked local public health authorities to be vigilant. WHO is collaborating closely with Japan's public health authorities to monitor this evolving situation. The government of Japan is providing regular updates throughout each day on the situation both to WHO and to the public.
School closures
Closing schools is a way of reducing contact between children and can help reduce the spread of the virus. Closing schools in Mexico, along with other measures to stop large numbers of people gathering together, appears to have reduced the rate of transmission in Mexico. The United States of America, the United Kingdom and Japan have also temporarily closed schools to minimize the risk of school outbreaks crossing into the wider community.
Closures are an important part of Japan's response to the recent sharp increase in confirmed cases of influenza A(H1N1). Authorities in Japan have closed thousands of schools, colleges and kindergartens around the country in parallel with the rising count of confirmed cases. So far 4,466 schools in six prefectures have been closed, according to the Ministry of Education, Culture, Sports, Science and Technology. Most of the closures have been primary schools, followed by kindergartens, junior high schools and finally high schools.
School closures offer no guarantee against virus spread. But if a high proportion of the cases are children, as is the case in Japan, reducing the spread in this group can help slow transmission and diminish spreading among older people in the community.
Global case count
As of 06:00 GMT, 21 May 2009, 41 countries have officially reported 10 587 cases of influenza A(H1N1) infection, with 84 deaths. Mexico has reported 3 734 laboratory-confirmed human cases of infection, including 74 deaths. The United States of America has reported 5 710 laboratory-confirmed human cases, including eight deaths. Canada has reported 496 laboratory confirmed human cases, including one death. Costa Rica has reported nine laboratory-confirmed human cases, including one death.
The following countries have reported laboratory confirmed cases with no deaths: Argentina (1), Australia (3), Austria (1), Belgium (5), Brazil (8), Chile (5), China (5), Hong Kong (China) (3), Colombia (12), Cuba (3), Denmark (1), Ecuador (1), El Salvador (6), Finland (2), France (16), Germany (14), Greece (1), Guatemala (3), India (1), Ireland (1), Israel (7), Italy (10), Japan (276), Malaysia (2), Netherlands (3), New Zealand (9), Norway (3), Panama (65), Peru (3), Poland (2), Portugal (1), Republic of Korea (3), Spain (111), Sweden (3), Switzerland (1), Thailand (2), Turkey (2), and the United Kingdom (109).
WHO is not recommending travel restrictions related to the outbreak of the influenza A(H1N1) virus. Individuals who are ill should delay travel plans and returning travellers who fall ill should seek appropriate medical care. These recommendations are prudent measures which can limit the spread of many communicable diseases, including influenza.
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