MANILA, 8 June 2009, 1600 hrs—Laboratory-confirmed cases of influenza A(H1N1) in the Western Pacific Region increased to 1721 after six Member States reported new infections. No deaths from influenza A(H1N1) have yet been reported in the Western Pacific Region.
The Western Pacific Region has reported a total 1721 laboratory-confirmed cases of influenza A(H1N1):
- 1051 in Australia
- 134 in China
- 410 in Japan
- 5 in Malaysia
- 17 in New Zealand
- 33 in the Philippines
- 47 in the Republic of Korea
- 15 in Singapore
- 9 in Viet Nam.
Australia now has 1051 confirmed cases of the virus, the highest in the Western Pacific Region, after reporting 45 extra cases over 6–8 June. The state of Victoria has most of Australia's cases with 874, while New South Wales has the next highest number of infections with 82. On June 3, Victoria lifted its alert status from "contain" to "modified sustain" which allows efforts to be intensively focused on those at highest risk of complications. The remainder of the country remains on "contain" phase.
China reported 21 new cases over 6–8 June, taking its total to 134. They included five new cases detected in Hong Kong (China), all of which were related to recent travel to affected countries. The Republic of Korea reported six new infections over the same period, while Viet Nam reported four new cases. New Zealand and Singapore each reported one additional case.
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 A(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 Viet Nam 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 8 June 2009, 69 countries have officially reported 22 172 cases of influenza A(H1N1) infection, with 125 deaths. Mexico has reported 5563 laboratory-confirmed human cases of infection, including 103 deaths. The United States of America has reported 11 054 laboratory-confirmed human cases, including 17 deaths. Canada has reported 1795 laboratory confirmed human cases, including three deaths. Costa Rica has reported 68 laboratory-confirmed human cases, including one death.
The following countries have reported laboratory confirmed cases with no deaths: Argentina (147), Australia (1051), Austria (2), Bahamas (1), Bahrain (1), Barbados (1), Belgium (13), Bolivia (3), Brazil (28), Bulgaria (1), Chile (369), China (134), Colombia (24), Cuba (4), Cyprus (1), Czech Republic (2), Denmark (4), Dominican Republic (33), Ecuador (43), Egypt (1), El Salvador (49), Estonia (3), Finland (4), France (47), Germany (43), Greece (5), Guatemala (23), Honduras (34), Hungary (3), Iceland (1), India (4), Ireland (8), Israel (39), Italy (38), Jamaica (2), Japan (410), Kuwait (18), Lebanon (3), Luxembourg (1), Malaysia (5), Netherlands (4), New Zealand (17), Nicaragua (5), Norway (9), Panama (173), Paraguay (5), Peru (47), Philippines (33), Poland (4), Portugal (2), Republic of Korea (47), Romania (8), Russia (3), Saudi Arabia (1), Singapore (15), Slovakia (3), Spain (218), Sweden (13), Switzerland (10), Thailand (8), Turkey (8), the United Kingdom (428), Uruguay (15), Venezuela (4), and Vietnam (9).
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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