MANILA, 1 June 2009, 1600 hrs—Viet Nam reported its first laboratory-confirmed case of influenza A(H1N1) as the Western Pacific's count rose to 806 cases. Australia recorded a further 43 cases and China, Japan, the Philippines and Singapore also announced new infections. So far no deaths from influenza A(H1N1) have been reported in the Western Pacific Region.
The Western Pacific Region has reported a total 806 laboratory-confirmed cases of influenza A(H1N1):
- 297 in Australia
- 64 in China
- 379 in Japan
- 2 in Malaysia
- 9 in New Zealand
- 16 in the Philippines
- 33 in the Republic of Korea
- 5 in Singapore
- 1 in Viet Nam
Viet Nam's first case was a 23-year-old man who returned to Ho Chi Minh City on 26 May from his studies in the United States of America, via Hong Kong. Health authorities in Viet Nam are conducting surveillance of passengers who travelled on the same flight as the man, and are working closely with WHO on disease control protocols.
Australia's new cases of influenza A(H1N1) took its count to 297. Most cases were detected in the more populous states of Victoria and New South Wales which have 173 and 54 cases respectively. On 1 June, passengers aboard the cruise liner Pacific Dawn were allowed to disembark after testing showed no additional cases on board the vessel. Earlier, three crew members had tested positive to the virus. As of 31 May, 46 passengers from the ship had been infected.
China's total rose to 64 cases after seven new infections were announced on 31 May. They included China's second case of local transmission, in a 22-year-old Chinese woman in Guangzhou. There is no evidence of sustained community-level transmission in China.
The Philippines announced that 10 people had tested positive over 28-30 May, bringing its total to 16. All cases are Filipinos except for one 13-year-old male Australian. Four cases have a history of travel to the United States of America. The rest were contacts of confirmed cases detected in Taiwan (China).
Singapore reported its fifth case, a 22-year-old Singaporean female. She had returned to Singapore on 29 May from New York in the United States of America, via Tokyo.
Japan announced nine new cases since its last reporting on 30 May. Most of Japan's cases were detected in Hyogo Prefecture, where 195 cases have been confirmed, and Osaka Prefecture which now has 157 cases. Chiba has reported nine cases, while Tokyo and Shiga each have three. Kanagawa, Kyoto, Saitama, and Shizuoka have two apiece. Yamanashi, Wakayama, Niigata and Fukuoka have one case each. The cases in Japan are mainly associated with schools and, at this stage, there is no clear sign of the virus transmitting into local communities.
Dengue fever threatens again in Western Pacific Region
As the number of influenza A(H1N1) cases climbs in the Western Pacific Region, another virus is having a serious but under-recognized impact. There are outbreaks of dengue fever in many parts of the world, including the Western Pacific Region, and early symptoms can be similar to seasonal influenza and the new influenza A(H1N1) virus.
Last year 213 248 cases of dengue were reported in the Western Pacific Region. As the Southern Hemisphere enters its influenza season, with the new influenza (H1N1) virus infecting more people, it is important that communities be aware that a range of febrile illnesses including dengue can be accompanied by symptoms in their initial stages which could be mistaken for influenza.
Nearly half the world's population, or 2.5 billion people, are at risk from dengue. WHO estimates there may be 50 million cases worldwide every year. In the Western Pacific Region, the current dengue season seems to have started early and has the potential to be the most serious in recent years, unless Member States strengthen outbreak preparedness.
Dengue has killed 14 people across 35 provinces in Vietnam since early this year from 16,635 cases reported since January. This is a significantly higher infection rate than 2008, when 11 447 people contracted the illness over the entire year.
From January to April this year dengue outbreaks were reported in Malaysia, Australia, Viet Nam, Fiji, Tonga and New Caledonia. Some countries and areas in the Region reported very high incidence rates: 2983 cases per 100 000 inhabitants in New Caledonia, 797 per 100 000 inhabitants in Cook Islands, and 249 in 100 000 inhabitants for Tonga. Compared to the same period in last year, dengue has risen significantly, particularly in New Caledonia, Australia, Vietnam and Malaysia.
Dengue is characterized by a sudden onset of headaches, severe muscle and joint pains and often also a rash. Nausea and vomiting may also ensue. In its initial phases, dengue as well as other febrile illnesses such as typhus and leptospirosis can be confused with influenza.
The ability to pick dengue from influenza is crucial, as dengue can progress into a more serious illness called Dengue Haemorrhagic Fever (DHF). Communities should be on the alert for possible complications from dengue, such as fainting, a rash, lingering acute fever, less frequent urination, nose and gum-bleeding, and severe pain behind the eyes. Care-givers and health-workers should be particularly vigilant with children, who are vulnerable to complications from dengue and are more likely to die from them.
Globally, complicated cases of dengue hospitalise an estimated 500 000 people each year, mostly children, though this number could be higher due to under-reporting. Without proper treatment, fatality rates can increase significantly. But with early recognition and treatment, death rates can be cut to less than 1%.
Dengue treatments include bed rest and proper management of fluids and aggressive emergency treatment in severe cases. On a community level, the response focuses on the eradication of breeding sites of mosquitoes whose bite causes the illness. Communities are their own first-lines of defence against dengue, as controlling mosquito numbers at the local level is crucial in reducing infections.
Influenza, on the other hand, can be treated with antiviral drugs in combination with isolation and quarantine protocols. Community messaging about hand-washing and social distancing is also very effective.
Global influenza A(H1N1) case count
As of 06:00 GMT, 1 June 2009, 56 countries have officially reported 15 738 cases of influenza A(H1N1) infection, with 99 deaths. Mexico has reported 4 910 laboratory-confirmed human cases of infection, including 85 deaths. The United States of America has reported 7 927 laboratory-confirmed human cases, including 11 deaths. Canada has reported 1 118 laboratory confirmed human cases, including 2 deaths. Costa Rica has reported 33 laboratory-confirmed human cases, including one death.
The following countries have reported laboratory confirmed cases with no deaths: Argentina (37), Australia (297), Austria (1), Belgium (10), Brazil (10), Chile (165), China (64), Colombia (17), Cuba (4), Czech Republic (1), Denmark (1), Dominican Republic (2), Ecuador (32), El Salvador (11), Estonia (1), Finland (3), France (24), Germany (20), Greece (4), Guatemala (5), Iceland (1), India (1), Ireland (3), Israel (14), Italy (26), Japan (379), Kuwait (18), Malaysia (2), Netherlands (3), New Zealand (9), Norway (4), Panama (107), Paraguay (5), Peru (31), Philippines (16), Poland (4), Portugal (1), Republic of Korea (33), Russia (3), Singapore (5), Slovakia (2), Spain (143), Sweden (4), Switzerland (6), Thailand (2), Turkey (2), the United Kingdom (215), and Uruguay (2).
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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