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WHO Confirms SEVERE H1N1
Situation In Ukraine

From Patricia Doyle, PhD
Hello Jeff - I think this flu is going to get really bad very soon. I find it a travesty that the WHO, in essence, has strong-armed countries like the US, UK, etc to give up 10%, probably more, of our tamiflu supplies.  Also, I am sure we are giving some of our vaccine stockpile as well, to developing countries. I would bet the farm that a good deal of the tamiflu ends up on the black market.
Meanwhile, as far as the US is concerned, we already have a shortage of tamiflu...even before the 10% had been taken out of the stockpile. Now, the US situation is even worse.
It is a good thing that Dr. Niman will be on tonight keeping us informed and updated. We are surely not hearing about it on the mainstream news reports.  
Date: Mon 2 Nov 2009 Source: World Health Organization (WHO), CSR, Disease Outbreak News
On 28 Oct 2009, the Ministry of Health of Ukraine informed WHO, through its Country Office in Ukraine, about an unusually high level of activity of acute respiratory illness in the western part of the country, associated with an increased number of hospital admissions and fatalities.
On 30 Oct 2009, the Ministry of Health of Ukraine announced the confirmation of pandemic (H1N1) 2009 virus infection by RT-PCR in 11 out of 30 samples obtained from patients presenting with acute respiratory illness in 2 of the most affected regions. Tests were performed in 2 laboratories in Kyiv, including the National Influenza Centre. Confirmatory tests will be performed at one of the WHO Collaborating Centres for Influenza.
The situation is quickly changing with increasingly high levels of acute respiratory illness (ARI)/influenza-like-illness (ILI) activity being observed in Ternopil, Lviv, Ivano-Frankivsk, and Chernivtsi regions. The higher levels of transmission in these regions corresponds to an increased number of hospital admissions and fatalities associated with severe manifestations of acute respiratory illness.
As of 30 Oct 2009, over 2300 individuals have been admitted to hospital, including over 1100 children. 131 cases have required intensive care, including 32 children. As of 31 Oct 2009, a total of 38 fatalities associated with severe manifestations of ARI have been registered. Preliminary epidemiological data analysis indicates that severe cases and deaths primarily occur among previously healthy young adults aged 20-50 years. Fatal and severe cases are reported to have sought medical attention 5 to 7 days after onset of symptoms.
International experience of the (H1N1) 2009 pandemic to date, especially from the Southern Hemisphere, has shown that poor clinical outcomes are associated with delays in seeking health care and limited access to supportive care. In addition, this virus has also shown its ability to cause rapidly progressive overwhelming lung disease, which is very difficult to treat.
Public health measures recommended by the Ministry of Health of Ukraine across the entire country include: social distancing (school closures and cancellation of mass gatherings); enhancement of surveillance activities; increased respiratory hygiene; and continuation of the vaccination campaign against seasonal influenza targeting at-risk groups.
The Government of Ukraine has activated coordination mechanisms to respond to the rapidly evolving situation, including the harmonization of response plans across all administrative levels. In response to the request from the minister of health of Ukraine, WHO is deploying a multidisciplinary team of experts to assist national authorities in mitigating the impact of the pandemic. The team comprises the following expertise: health emergencies coordination, case management, epidemiology, laboratory diagnostics, logistics, and media/risk communications.
As per WHO's communication in May 2009, there is no rationale for travel restrictions, because such measures will not prevent the spread of the disease. Travellers can protect themselves and others by following simple recommendations aimed at preventing the spread of infection such as attention to respiratory hygiene. 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 and not only the pandemic (H1N1) 2009 virus.
-- communicated by ProMED-mail rapporteur Marianne Hopp
This is confirmation by WHO that the outbreak of acute respiratory illness throughout Ukraine is an extension of the global influenza (H1N1) 2009 pandemic. So far in Ukraine, 11 of 30 patient samples have tested positive for influenza pandemic (H1N1) 2009 virus. Confirmatory tests are in progress in another WHO Collaborating Centre. As of 30 Oct 2009, a total of 2300 people (including 1100 children) have been hospitalised, and as of 31 Oct 2009, there have been 38 fatalities. The Ukrainian authorities seem to have been unprepared for an outbreak on this scale, and WHO involvement in the control of the outbreak will be considerable. No travel restrictions are envisaged.
The locations of the most affected regions can be found using the interactive map of the regions (oblasts) of Ukraine at: http://www.infoukes.com/ukremb/mappuzzle.html. The HealthMap/ProMED-mail interactive map of Ukraine can be accessed at: http://healthmap.org/admin/prolink.php. - Mod.CP]
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