18 May 2009

Monday 8pm

Will the= new Influenza A (H1N1) virus continue to spread this summer in the Northern Hemisphere? Cases total 8,829 with 74 deaths in 40 nations, cases in Japan jump from 7 to 125, and still no confirmed cases in Afric= a.

The Canadian Press carried an article online from Sunday, May 17, titled “Swine Flu spre= ad in North America may extend into summer, experts say” and the same possibility was acknowledged today (May 18) during the US CDC press confere= nce.

Dr. Allison McGee= r, a respiratory disease expert renowned for helping to coordinate Toronto’= ;s response to SARS in 2003 was cited in The Canadian Press article as follows: “McGeer says abnormal flu activity levels for this time of year are making her question “the delusion that this was actually going to qui= et down and we weren’t going to have a first wave” over the late spring and summer.”

McGeer was also quoted as stating that the amount of infection with the novel H1N1 virus is “very clearly starting to increase. I suppose it could shut itself of= f at any given time. But the last couple of days look like we’re going to = see a (flu) season…In Toronto, at least, I think we’re gone”.=

Similarly, Dr. Ar= nold Monto from the University= of Michigan was quo= ted in the same article as commenting he also is concerned about transmission continuing into the summer: “We are seeing a fair amount of circulati= on of the swine flu virus. And I’m not yet convinced that it’s goi= ng to go away completely. It may dampen down a bit as schools close. But I thi= nk we’re still seeing increasing transmission in the U.S.= 221;

Dr. Anne Schuchat, from the U.S. CDC, responded to a question from Richard Knox at today’= ;s press conference by stating: “We wonder whether this strain will cont= inue during the summer, and give us more of a summer influenza pattern. This is certainly a possibility. It is not something I can predict. Most years, the seasonal influenza strains have very reduced amounts here in the northern hemisphere. Unfortunately, we don’t know whether we’ll get a br= eak this summer with this virus. We’ll be looking there and also in the southern hemisphere whe= re we expect there may be an important increase of this virus.”

Over the weekend there were 118 new lab-confirmed cases in <= st1:place w:st=3D"on">Japan, mostly in young people, including non-travelers. Thus, many schools were closed in the areas of Osaka and Kobe. The WHO was continuing to monitor = for community-level transmission in Japan as well as Spain (103 = cases) and the UK (101 confirmed cases). Such transmission in either the western Pacific or European WHO regions, in conjunction with the proven community-level spread= in North America, would meet current criteria for changing from WHO Phase 5 (“imminent pandemic”) to Phase 6 (actual pandemic). =

Today marked the opening of the annual World Health Assembly. The threat of pandemic influen= za, sharing of viral isolates and future novel influenza vaccine(s) are topics likely to be discussed at length.

Daniel R. Lucey, MD, MPH

EROne Institutes, Department of Emergency Medicine<= /o:p>

Washingt= on Hospital Center

Georgeto= wn University = Medical Center

Department of Microbiology and Immunology, Washington, DC

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DRL23@Georgetown.edu