What we know so far... from WHO, CDC, Rhiza lab flu tracker

1. 2009 H1N1 Info gathered by Mona Youssef

2. Study has shown virus to be different from the normally circulating North American pig virus. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia , avian genes and human genes. "quadruple reassortant" virus How is it then that it made its first appearance in Mexico and the US?

9. He says ice-cream made him feel better, and Thank God has now recovered full health. But the rest of the planet has a quick –paced pandemic marching on…. 'Patient Zero' in Swine Flu Outbreak Identified as 5-Year-Old Mexican Boy: Edgar Hernandez

10. Timeline

13. WHO Report 95 AFFECTED COUNTRIES Nothing’s holding this virus back…….!!!

14. keyword A pandemic means an epidemic of an infectious disease, that spreads throughout a large number of people and can spread worldwide. A pandemic begins when : there is person-to-person sustained transmission on multiple continents.

15. The World Health Organization uses a six stage phase for alerting the general public to an outbreak

16. Phase 1 – animal to animal transmission. Phase 2 – an animal influenza virus is capable of human infection. Phase 3 - small outbreaks among close populations but not through human to human contact. Phase 4 - Human to human transmission Phase 5 - spread across two countries or more in one of the WHO regions (continents). Phase 6 – spread across two countries or more in one of the WHO regions plus spread to another WHO region.

17. W.H.O. identifies the following six epidemiological sub-regions. - African Region - Eastern Mediterranean Region - European Region - Region of the Americas - South-East Asian Region - Western Pacific Region

19. Even an island in the middle of the ocean isn’t out of its reach….

27. In one week , the United Nations agency raised the alert level twice, from phase 3 to phase 5, in response to the sustained transmission of H1N1 in Mexico and the United States. Graveness of the situation

28. 19/6/2009 19/6/2009 Country Cumulative total Newly confirmed since the last reporting period Cases Deaths Cases Deaths Country Cumulative total Newly confirmed since the last reporting period Cases Deaths Cases Deaths Country Cumulative total Newly confirmed since the last reporting period Cases Deaths Cases Deaths Argentina 918 4 185 3 Australia 2199 0 87 0 Austria 8 0 1 0 Bahamas 2 0 0 0 Bahrain 12 0 0 0 Barbados 4 0 1 0 Belgium 19 0 0 0 Bermuda, UKOT 1 0 0 0 Bolivia 11 0 0 0 Brazil 96 0 17 0 British Virgin Islands, UKOT 1 0 0 0 Bulgaria 2 0 0 0 Canada 4905 12 856 5 Cayman Islands, UKOT 4 0 0 0 Chile 3125 2 790 0 China 519 0 137 0 Colombia 60 1 7 0 Costa Rica 149 1 0 0 Cuba 15 0 8 0 Cyprus 1 0 0 0 Czech Republic 5 0 1 0 Denmark 22 0 7 0 Dominica 1 0 0 0 Dominican Republic 93 1 0 0 Ecuador 86 0 0 0 Egypt 29 0 3 0 El Salvador 160 0 35 0 Estonia 5 0 1 0 Finland 13 0 1 0 France 131 0 13 0 French Polynesia, FOC 1 0 0 0 Martinique, FOC 1 0 0 0 Germany 238 0 43 0 Greece 31 0 8 0 Guatemala 153 1 25 0 Honduras 108 0 8 0 Hungary 7 0 3 0 Iceland 4 0 0 0 India 30 0 0 0 Ireland 16 0 4 0 Israel 219 0 67 0 Italy 88 0 16 0 Jamaica 14 0 2 0 Japan 690 0 24 0 Jordan 2 0 0 0 Korea, Republic of 84 0 19 0 Kuwait 18 0 0 0 Laos 1 0 1 0 Lebanon 12 0 1 0 Luxembourg 2 0 0 0 Malaysia 23 0 6 0 Mexico 7624 113 1383 5 Morocco 8 0 5 0 Netherlands 87 0 19 0 Netherlands Antilles, Curaçao * 3 0 2 0 Netherlands Antilles, Sint Maarten 1 0 1 0 New Zealand 216 0 89 0 Nicaragua 144 0 26 0 Norway 17 0 4 0 Oman 3 0 3 0 Panama 272 0 0 0 Papua New Guinea 1 0 1 0 Paraguay 27 0 2 0 Peru 141 0 29 0 Philippines 311 0 118 0 Poland 7 0 0 0 Portugal 5 0 2 0 Qatar 3 0 0 0 Romania 18 0 2 0 Russia 3 0 0 0 Samoa 1 0 0 0 Saudi Arabia 22 0 5 0 Singapore 77 0 28 0 Slovakia 3 0 0 0 South Africa 1 0 1 0 Spain 512 0 13 0 Sri Lanka 1 0 0 0 Suriname 11 0 11 0 Sweden 43 0 6 0 Switzerland 27 0 0 0 Thailand 518 0 208 0 Trinidad and Tobago 18 0 13 0 Turkey 20 0 4 0 Ukraine 1 0 0 0 United Arab Emirates 2 0 1 0 United Kingdom 1752 1 291 0 Isle of Man, Crown Dependency 1 0 0 0 Jersey, Crown Dependency 1 0 0 0 United States of America 17855 44 0 0 Uruguay 36 0 0 0 Venezuela 60 0 15 0 Viet Nam 27 0 0 0 West Bank and Gaza Strip 5 0 3 0 Yemen 4 0 3 0 Grand Total 44287 180 4667 13

29. Countries of origin. Mixing of NH1N1 with seasonal flu virus could result in a strain resistant to tamiflu(NH1N1 is already resistant to other antivirals Mixing with H5N1 could produce strains capable of human to human transmission(Death toll of H5N1 is app. 66%) Australia 2199 0 87 0 Chile 3125 2 790 0 Egypt 29 0 3 0 Mexico 7624 113 1383 5 United States of America 17855 44 0 0 Grand Total 44287 180 4667 13 Country (19/6/2009) Cumulative total Newly confirmed since the last reporting period (17/6) Cases Deaths Cases Deaths

32. Previous Global Pandemics

33. 1918 - Spanish Flu (originated in birds). First hit soldiers in Europe during World War I, as their immune systems were weakened by war. The mortality rate was highest between 20 to 50 year olds. There was never any vaccine developed, after about 18 months, the virus seemed to just disappear . The final death toll was written as 40 million people worldwide . Soldiers whose immunity was weakened by war. Many of the victims who have died in Mexico have been young and otherwise healthy. society's healthiest demographic

34. 1957 - Asian Flu This flu started in birds in Asia. In September schools and public places started closing in an effort to contain the virus. In December the virus started to subside , but reappeared in January. over two million people died Reappeared

35. 1968 - The Hong Kong Flu This is the mildest pandemic It was first found in the early months of 1968 in Hong Kong, and was declared a global pandemic by December. Children were out of school and were therefore not able to spread it as much. It made a mild reappearance in 1970 and 1972 . it claimed about a million lives Reappeared…!!! Seasonal influenza normally claims app. ¼ to ½ a million lives yearly.

37. Disease spectrum ranges from very mild self-limited disease to Death. Novel H1N1 virus tends to affect younger people just like the seasonal H1N1. Novel H1N1 spreads just as easily as regular winter flu .

40. Characteristics of reported cases of influenza A(H1N1) by country Of note , the prevailing clinical picture in other countries has been GIT related.

48. (iv) Manufacturers are urged to develop clinical trial batches and accelerate initiation of clinical trials of influenza A (H1N1) vaccines and to start preparing for a potential future recommendation to move to commercial‐scale production. (v) The above activities should not interfere with the present production of the Northern hemisphere seasonal vaccines (vi) The number of needed doses of A (H1N1) vaccine will depend on the spread of influenza A (H1N1) virus in the next few weeks and on a better definition of the groups to be targeted (vii) An evidence‐based recommendation for the groups to be targeted for vaccination still requires more data

49. Influenza is unpredictable.

50. Human infection with 2009 H1N1virus: clinical observations from Mexico and other affected countries, May 2009

56. WHO Guidance

60. Roooooar! …… . Nobody’s scared of me nomore! Round and round she goes, where it stops , nobody knows…

61. Hey, who said that?

62. swine flu in humans can vary in severity from mild to severe. Severe disease with pneumonia, respiratory failure and even death

64. People with swine flu who are cared for at home should: I wish everyone could have a home like this

67. When to Seek Emergency Medical Care Emergency Warning Signs

69. Medications to Help Lessen Symptoms of the Flu

72. Steps to Lessen the Spread of Flu in the Home

76. Placement of the sick person

78. Protect other persons in the home

80. If you are the caregiver

84. Using Facemasks or Respirators

86. Household Cleaning, Laundry, and Waste Disposal

89. Pandemic Flu Planning Checklist for Individuals and Families

92. Looks to me like he’s conquered his matador , and has every right to fly……….