14 countries report high pandemic (H1N1) 2009 activity
During the period 5 to 12 November 2009, high or very high pandemic activity has been reported in countries in Scandinavia, eastern Europe and south-eastern Europe. Very high pandemic activity was reported in Norway, Sweden, Bulgaria and the Republic of Moldova for the first time. Continuing very high pandemic activity was also reported in Iceland, Ireland and the Russian Federation (Urals and far eastern regions). High pandemic activity was reported in Belarus, Finland, Kazakhstan, Poland, the Russian Federation (Siberian, Volga, north-western and central regions), Turkey, Ukraine, and the United Kingdom (Northern Ireland only).
In addition, 145 deaths in 18 countries were associated with laboratory-confirmed pandemic (H1N1) 2009 virus infection. This raises the total number of deaths reported in the WHO European Region since April 2009 to 471.
Pandemic vaccine
As of 12 November,16 countries in the Region had started pandemic vaccination campaigns. Eight countries in the Region are eligible to receive vaccine donated to WHO, and these vaccination campaigns will start in late November or early December.
Situation in Ukraine
There have been 174 reported deaths from acute respiratory infection. Currently, 344 patients are in intensive care. After visiting several cities to the west of the capital, Kyiv, the WHO team of experts continues its investigations into the outbreak. The team has taken part in activities to share clinical experience throughout the country, and concluded that Ukraine’s health facilities are well prepared and medical staff highly motivated to deal with the influx of cases.
Clinical management of human infection
WHO has released revised guidance on the clinical management of human infection with pandemic (H1N1) 2009. Primarily information for health care providers managing patients with suspected or confirmed pandemic (H1N1) 2009, the guidance includes advice on diagnosis, treatment and management in resource-poor settings, based on knowledge gained through international consultations.
Key points include the following.
All patients should be advised to return to their health care provider for follow-up if they develop signs or symptoms of progressive illness.
Signs of progressive illness can include:
- persistent high fever for more than three days
- shortness of breath or difficulty in breathing, or turning blue
- bloody or coloured sputum, chest pain or low blood pressure
- in children, fast or laboured breathing
- drowsiness, confusion or severe weakness
- dehydration, which can cause dizziness, decreased urine output or lethargy.
In general, antiviral treatment recommendations are as follows.
- Patients with severe or progressive illness should be treated with antiviral medication as soon as possible.
- People with mild symptoms but who are at higher risk of severe illness (such as pregnant women, infants and young children, and those with chronic lung problems) should start antiviral treatment as soon as possible.
- Antiviral treatment is not necessary for people who have uncomplicated, or mild, illness and are not in a high-risk group for severe illness.
