FIGURE 1. Number of confirmed (N = 822) and suspected (N = 11,356) cases of novel influenza A (H1N1) virus infection, by date of illness onset — Mexico, March 11–May 3, 2009
07/05/2009
México, 6 may (EFE).- La ONU afirmó hoy en México que actualmente no existen problemas de propiedad intelectual para elaborar la nueva vacuna contra la gripe A, cuya producción aún no ha sido puesta en marcha entre las empresas farmacéuticas que pueden elaborarla.
La ONU afirma que no hay un problema de protección intelectual para fabricar la vacuna Ampliar fotografía
“Los temas de propiedad intelectual están al parecer bien resueltos con la industria farmacéutica”, dijo en una rueda de prensa el coordinador residente de Naciones Unidas en México, Magdy Martínez Solimán.
El funcionario consideró que ello era “una muy buena noticia” para los 23 países en los que se han detectado hasta hoy 1.700 casos de gripe causada por el virus AH1N1, de baja letalidad.
Un grupo de expertos se reunirá el próximo 14 de mayo en Ginebra para decidir si se puede dar ya luz verde a la producción de la vacuna, lo que entraña el problema de que habría que parar o reducir la producción de vacunas contra la gripe estacional.
Martínez Solimán indicó que además de cuatro grandes multinacionales farmacéuticas “se han citado a laboratorios en países del Este de Europa” y “asiáticos”, entre ellos de China, “que también están en condiciones de producir la vacuna”.
Sin precisar fecha, dijo que próximamente la OMS convocará a donantes y representantes del sector privado a Ginebra para ver cuál va a ser el mecanismo mediante el que los países que no puedan comprar la vacuna en cantidades suficientes “puedan recibirla gratuitamente”.
Martínez Solimán anticipó que en las próximas semanas el secretario general de la ONU, Ban Ki Moon, instará a los miembros de la ONU a “que contribuyan de manera más decidida” y “práctica” a acciones de solidaridad global frente a la gripe A.
Entre las peticiones se hará una para contar con “mecanismos de financiación para asegurar que los países más necesitados (…) dispongan de medios para luchar contra riesgos sanitarios globales”.
Ban también pedirá un “intercambio transparente de información” y de “conocimientos y medicinas” sobre la epidemia, así como garantías para que la OMS cuente con los medios suficientes para enfrentar la epidemia.
Además, hará un llamado a una mayor aportación “del sector privado, en particular de la industria farmacéutica internacional”.
El funcionario internacional aprovechó su comparecencia para felicitar a México por la “presteza”, “decisión e “integridad moral” con que está luchando contra el virus, que hasta el momento ha dejado 42 víctimas mortales.
Fuente: La ONU afirma que no hay un problema de protección intelectual para fabricar la vacuna – Yahoo! Noticias. Disponible en: http://es.noticias.yahoo.com/9/20090506/tsc-la-onu-afirma-que-no-hay-un-problema-539a483.html [Accedido Mayo 7, 2009]
Publicado: may 7th, 2009. 
7 de mayo, AP -
La amenaza de gripe porcina en Africa empalidece en comparación con otras enfermedades que matan a millares de personas en el continente cada día, dijo el jueves Luis Sambo, director para el Africa de la Organización Mundial de la Salud.
Sambo dijo que cada país africano tiene unas 1.000 dosis de antibióticos para tratar la gripe porcina. Añadió que apenas una docena de casos sospechosos han sido descubiertos, y pidió a los gobiernos africanos que compartan la información.
La gripe porcina ha matado a 42 personas en México y a dos en Estados Unidos, y ha infectado a unas 2.000 personas en más de 20 países.
Unas 22 millones de personas están infectadas con el virus del sida en el Africa sub-sahariana.
Fuente: La OMS resta importancia a gripe porcina en Africa – Yahoo! Noticias. Available at: http://es.noticias.yahoo.com/11/20090507/twl-afr-med-gripe-porcina-africa-1be00ca.html [Accedido Mayo 7, 2009]
Publicado: may 7th, 2009.
7 May 2009 — A las 06:00 GMT, del 7 de mayo de 2009 se habían notificado oficialmente 2099 casos de infección humana por virus gripal A(H1N1) en 23 países.
México había notificado 1112 casos humanos confirmados mediante pruebas de laboratorio, 42 de ellos mortales, y los Estados Unidos de América otros 642, 2 de ellos mortales.
También se habían notificado casos confirmados mediante pruebas de laboratorio, ninguno de ellos mortal, en los países siguientes: Alemania (9), Austria (1), Canadá (201), Región Administrativa Especial de Hong Kong (China) (1), Colombia (1), Costa Rica (1), Dinamarca (1), El Salvador (2), España (73), Francia (5), Guatemala (1), Irlanda (1), Israel (4), Italia (5), Nueva Zelandia (5), Países Bajos (1), Portugal (1), República de Corea (2), Reino Unido (28), Suecia (1) y Suiza (1).
La OMS no recomienda ninguna restricción de los viajes ni el cierre de fronteras en relación con el brote de gripe por A(H1N1).
Las personas enfermas deberían aplazar sus planes de viaje, y los viajeros de regreso que se encuentren enfermos deben buscar atención médica. Estas recomendaciones son medidas de precaución que pueden limitar la propagación de muchas enfermedades transmisibles, entre ellas la gripe.
La OMS seguirá informando periódicamente de la situación en su sitio web.
Fuente: WHO | Influenza A(H1N1) – update 19. Available at: http://www.who.int/csr/don/2009_05_07/es/index.html [Accedido Mayo 7, 2009]
Publicado: may 7th, 2009.
El organismo dijo que aumentó el número de infectados en Canadá, que llegaron a 201 desde la anterior cifra de 165, pero no se notificaron muertes.
Reuters
Ginebra. Más de 2 mil personas en 23 países han sido infectadas con la cepa H1N1 de influenza informó este jueves la Organización Mundial de la Salud (OMS).
En su último conteo, que tiende a ser menor que los reportes nacionales pero es considerado más seguro, la agencia de Naciones Unidas indicó que 42 personas han muerto en México debido a la nueva cepa que genéticamente es una mezcla de virus porcino aviario y humano.
La anterior cifra de muertos que entregó incluía 29 muertes en México.
El gobierno mexicano dice que lo peor ha pasado y suavizó las restricciones a la actividad comercial y pública en el país que ha estado en el epicentro del brote.
La última cifra de influenza de la OMS -2 mil 099 casos en todo el mundo- no cambia el número de infecciones confirmadas o muertes en Estados Unidos, que se mantienen en 642 y 2 respectivamente.
Sin embargo, aumentó el número de infectados en Canadá, que llegaron a 201 desde la anterior cifra de 165, pero no se reportaron muertes.
Los países europeos con casos confirmados en laboratorios de la OMS incluyen a España (73), Gran Bretaña (28), Alemania (9), Italia (5), Francia (5), Portugal (1), Irlanda (1), Holanda (1), Austria (1), Dinamarca (1), Suecia (1) y Suiza (1).
Polonia, país en donde las autoridades confirmaron un caso durante las últimas horas del miércoles aún no forma parte del recuento oficial de la OMS.
La agencia también confirmó casos de infecciones en Nueva Zelanda (5), Israel (4), Corea del Sur (2), El Salvador (2), Hong Kong, China (1), Guatemala (1), Colombia (1) y Costa Rica (1).
La evidencia de que la enfermedad, conocida popularmente como gripe porcina, se haya extendido masivamente en comunidades fuera de América del Norte llevaría a la directora general de la OMS, Margaret Chan, a declarar una pandemia global.
Chan aumentó la semana pasada el nivel global de alerta a nivel 5 en respuesta a la propagación del virus H1N1. La fase 5 significa que la pandemia es inminente.
La OMS repitió el jueves su consejo de que los viajes internacionales no sean restringidos a causa del brote.
“Los individuos que estén enfermos deberían retrasar sus planes de viaje y los viajeros que vuelven y caen enfermos deberían buscar atención médica adecuada. Estas recomendaciones son medidas prudentes que pueden limitar la propagación de varias enfermedades contagiosas, incluyendo la influenza”, explicó.
Fuente: Se elevan a dos mil 99 los contagios en 23 naciones validados por la OMS — La Jornada. Available at: http://www.jornada.unam.mx/ultimas/2009/05/07/reporta-oms-mas-de-2-mil-casos-confirmados-en-23-paises-de-influenza-ah1n1 [Accedido Mayo 7, 2009]
Publicado: may 7th, 2009.
Acualización: Nuevas infecciónes por virus de Influenza A (H1N1) — para todo el Mundo, May 6, 2009
Since mid-April 2009, CDC, state and local health authorities in the United States, the World Health Organization (WHO), and health ministries in several countries have been responding to an outbreak of influenza caused by a novel influenza A (H1N1) virus (1). In March and early April 2009, Mexico experienced outbreaks of respiratory illness subsequently confirmed by CDC and Canada to be caused by the novel virus. The influenza strain identified in U.S. patients was genetically similar to viruses isolated from patients in Mexico (2). Since recognition of the novel influenza A (H1N1) virus in Mexico and the United States, as of May 6, a total of 21 additional countries had reported cases, with a total of 1,882 confirmed cases worldwide. Several WHO member states are conducting ongoing investigations of this worldwide outbreak, and WHO is monitoring and compiling surveillance data and case reports. On April 29, WHO raised the level of pandemic alert from phase 4 to phase 5, indicating that human-to-human spread of the virus had occurred in at least two countries in one WHO region. This report provides an update of the initial investigations and spread of novel influenza A (H1N1) virus worldwide.
Mexico
Since implementing enhanced surveillance on April 17, the number of suspected cases has increased rapidly, along with hospitalizations for severe acute respiratory illness (Figure 1). As of May 5, using an updated case definition of fever plus cough or sore throat for a suspected case and real-time reverse transcription–polymerase chain reaction (rRT-PCR) or viral culture for a laboratory-confirmed case, Mexico had identified 11,932 suspected cases and 949* cases of laboratory-confirmed novel influenza A (H1N1) virus infection, including 42 patients who died. Cases with laboratory-confirmed infection have been identified in 27 of 31 Mexican states and the Federal District. Confirmed cases in Mexico and in the United States have a similar age distribution (Table). Information is available on the clinical course of illness for 22 patients with laboratory-confirmed illness who were hospitalized, including seven patients who died. Five of the 15 surviving patients and one of the seven patients who died had underlying chronic medical conditions. Additional details on the clinical signs and symptoms of these and other patients are being collected. Among patients with confirmed cases for whom information was available, 56 (98%) of 57 reported fever, 49 (94%) of 52 reported cough, 23 (79%) of 29 reported dyspnea, 35 (80%) of 44 reported headache, and 34 of (83%) 41 reported rhinorrhea. The government of Mexico has instituted several measures to slow disease transmission and reduce mortality, including closure of all schools and avoidance of large public gatherings, distribution of oseltamivir to all health-care units, publication of specific clinical guidelines, and establishment of a call center to educate members of the public who are seeking health-care information.
United States
After recognition of the first cases of infection with the novel influenza A (H1N1) virus, CDC and state health departments initiated enhanced surveillance measures to identify additional cases. As of May 6, a total of 1,487 confirmed† and probable cases had been reported from 43 states, including 642 confirmed cases (reported from 41 states) and 845 probable cases (reported from 42 states). Current experience with laboratory testing results indicates that the probability of laboratory confirmation for probable cases is >99%. States with the most confirmed cases are Illinois (122 cases), New York (97), California (67), Texas (61), and Arizona (48). Dates of illness onset for patients with confirmed or probable illness range from March 28 to May 4 (Figure 2), although the most recent case counts do not account for testing and reporting delays. Among persons with laboratory-confirmed illness, 35 hospitalized patients have been reported from 16 states, including two patients from Texas who died, both with underlying medical conditions. The age distribution of persons with laboratory-confirmed disease ranged from 3 months to 81 years (Table). A total of 18 patients were aged <2 years, and 31 were aged 2–4 years.
The age distribution of the 35 laboratory-confirmed hospitalized patients ranged from 6 months to 53 years (median: 15 years). Among patients with confirmed disease for whom data were available, 262 (90%) of 292 reported fever, 249 (84%) of 296 reported cough, 176 (61%) of 290 reported sore throat, 65 (26%) of 249 reported diarrhea, and 54 (24%) of 221 reported vomiting.
Other Countries
On April 26, the first cases of novel influenza A (H1N1) virus infection outside of the United States and Mexico were reported in Canada. As of May 6, WHO had reported that 309 persons with laboratory-confirmed disease had been identified in 21 countries other than Mexico and the United States. Confirmed cases have been reported from Asia (Hong Kong S.A.R. and Korea), the Pacific region (New Zealand), the Middle East (Israel), Europe, and Central and South America (El Salvador, Costa Rica, Colombia, and Guatemala) (Figure 3).
Of 178 patients for whom travel history was available, 145 (82%) reported recent travel to Mexico, and four (2%) reported travel to the United States. Among those who had not traveled to Mexico, 17 (52%) reported contact with a returning traveler from Mexico. Canada, Germany, Spain, and the United Kingdom all have reported evidence of in-country, second-generation, human-to-human transmission (e.g., a health-care worker in Germany who had cared for a patient with a confirmed infection). No reports have been made of sustained, community-wide transmission in affected countries. Consistent with cases in North America, most of the cases reported from other countries have been among young adults, with a median age of 27.1 years (range: 2–62 years, N = 45). The majority of cases in other countries have been uncomplicated, and no deaths have been reported; four patients have been hospitalized.§
Reported by: General Directorate of Epidemiology, Ministry of Health, Mexico; Pan American Health Organization; World Health Organization; Public Health Agency of Canada; Influenza Div, National Center for Immunization and Respiratory Diseases, CDC Influenza Emergency Response Team, CDC.
Editorial Note:
Early surveillance data from this outbreak suggest that the novel influenza A (H1N1) virus has the potential for efficient, rapid spread among countries. Although the illness associated with infection generally seems self-limited and uncomplicated, a substantial number of cases of severe disease and death has been reported in previously healthy young adults and children. Several characteristics of this outbreak appear unusual compared with a typical influenza seasonal outbreak. First, the percentage of patients requiring hospitalization appears to be higher than would be expected during a typical influenza season (3). Second, the age distribution of hospitalizations for novel influenza A (H1N1) virus infection is different than that of hospitalizations for seasonal influenza, which typically occur among children aged <2 years, adults aged ≥65 years, and persons with chronic health conditions (3). In Mexico and the United States, the percentage of patients requiring hospitalization has been particularly high among persons aged 30–44 years.
Two deaths have been reported in the United States, resulting in a preliminary case-fatality rate of 0.2% among patients with laboratory-confirmed disease. However, such case-fatality rates should be viewed with caution. The actual case-fatality rate is difficult to ascertain in a rapidly evolving outbreak because an unknown proportion of currently infected patients might die, denominators might be uncertain because of unreported cases, and groups at high risk for death from seasonal influenza (e.g., older adults and patients with chronic disease) might not yet have been exposed to the novel influenza A (H1N1) virus.
Summertime influenza outbreaks in temperate climates have been reported in closed communities such as prisons, nursing homes, cruise ships, and other settings with close contact (4–8). Such outbreaks typically do not result in community-wide transmission, but they can be important indicators of viruses likely to circulate in the upcoming influenza season (8). The novel influenza A (H1N1) virus has been circulating in North America largely after the peak influenza transmission season. For that reason, the epidemiology and severity of the upcoming influenza season in the southern hemisphere or in the northern hemisphere cannot be predicted. The imminent onset of the season for influenza virus transmission in the southern hemisphere, coupled with detection of confirmed cases in several countries in the southern zone, raise concern that spread of novel influenza A (H1N1) virus might result in large-scale outbreaks during upcoming months. Countries in the southern hemisphere that are entering the influenza season should anticipate outbreaks and enhance surveillance accordingly. Influenza virus can circulate year round in tropical regions; therefore, these countries should maintain enhanced surveillance for novel influenza A (H1N1) virus.
Studies in countries affected by the novel influenza A (H1N1) virus should help guide surveillance, case management, and prevention strategies in countries not yet affected. Key concerns that should be addressed in these studies include assessment of the potential impact on public health; clinical progression of disease, including rates and types of complications for different age and risk groups; and information on virus transmissibility. Assessment of potential disease severity associated with this novel virus will help inform decisions on prevention strategies to slow the spread of infection. Effective control measures will depend on the ability of national governments to quickly gather and share virologic, epidemiologic, and clinical information from multiple sources as new cases appear.
References
- CDC. Swine influenza A (H1N1) infection in two children—southern California, March–April 2009. MMWR 2009;58:400–2.
- CDC. Outbreak of swine-origin influenza A (H1N1) virus infection—Mexico, March–April 2009. MMWR 2009;58:463–6.
- Thompson WW, Shay DK, Weintraub E, Brammer L. Influenza-associated hospitalizations in the United States. JAMA 2004;292:1333–40.
- Uyeki, TM, Zane SB, Bodnar UR, et al. Large summertime influenza A outbreak among tourists in Alaska and the Yukon Territory. Clin Infect Dis 2003;36:1095–102.
- Miller JM, Tam TW, Maloney S, et al. Cruise ships: high risk passengers and the global spread of new influenza viruses. Clin Infect Dis 2000;31:433–8
- Kohn MA, Farley TA, Sundin D, Tapia R, McFarland LM, Arden NH. Three summertime outbreaks of influenza type A. J Infect Dis 1995;172:246–9.
- Gaillat J, Dennetière G, Raffin-Bru E, Valette M, Blanc MC. Summer influenza outbreak in a home for the elderly: application of preventive measures. J Hosp Infect 2008;70:272–7.
- Young LC, Dwyer DE, Harris M, Guse Z, Noel V, Levy MH; Prison Influenza Outbreak Investigation Team. Summer outbreak of respiratory disease in an Australian prison due to an influenza A/Fujian/411/2002(H3N2)-like virus. Epidemiol Infect 2005;133:107–12.
* As of May 6, 2009, the number of laboratory-confirmed cases had increased to 1,112.
† Case definition available at http://www.cdc.gov/h1n1flu/casedef.htm.
§ Additional information is available at http://www.who.int/csr/don/2009_05_06.
Alternative Text: The figure above shows the 822 confirmed and 11,356 suspected cases of novel influenza A (H1N1) virus infection in Mexico with dates of onset from March 11 through May 3, 2009. Both confirmed and suspected cases rose sharply from April 19 to April 26, then decreased sharply.
FIGURE 2. Number of confirmed (N = 394)* and probable (N = 414)† cases of novel influenza A (H1N1) virus infection with known dates of illness onset — United States, March 28–May 4, 2009§
* Onset dates available for 394 of 642 confirmed cases.
† Onset dates available for 414 of 845 probable cases.
§ Data reported by CDC as of May 6, 2009.
¶ Case definition available at http://www.cdc.gov/h1n1flu/casedef.htm.
Alternative Text: The figure above shows the 394 confirmed and 414 probable cases of novel influenza A (H1N1) virus infection in the United States with known dates of onset from March 28 through May 4, 2009. Both confirmed and probable cases rose sharply from April 21 to April 27, then decreased sharply
FIGURE 3. Number of confirmed cases (N = 1,882) of novel influenza A (H1N1) virus infection — worldwide, May 6, 2009*
* Data reported by the World Health Organization as of May 6, 2009.
Alternative Text: The figure is a map of the world showing the 1,882 confirmed cases of novel influenza A (H1N1) virus infection in the United States, by country, as of May 6, 2009.
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Date last reviewed: 5/7/2009
Fuente: Update: Novel Influenza A (H1N1) Virus Infections — Worldwide, May 6, 2009. MMWR, May 8, 2009 / 58(17);453-458 Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5817a1.htm [Accedido Mayo 7, 2009].
Publicado: may 7th, 2009.
