5What Has HappenedCase of unusual pneumonia and Influenza like illness have occurred rapidly in Mexico since mid March, 2009.Few cases of Swine Flu reported in Southern CaliforniaMore Death were reported in Mexico, unusual high fatalityYoung people and people of working class were victim.It should be the end of seasonal Flu
6What do we know, (and don’t) เจอ ไวรัสไข้หวัดใหญ่สายพันธ์ใหม่ New (novel) virus has been identified, a new virus contain genetic material of both human flu virus and swine flu virus.“We know it is a novel (new) virus, completely new - not regularly found”“We know it has happened (a new virus), but we do not know how it happened.” - (how the virus genetic material combined to make a new strain). Perhaps, the Mother Nature may know!
7What do we know, (and don’t) จำนวนผู้ป่วย เพิ่มขึ้น เป็น 100, 1000, 1500,2000+ ใน Mexico ภายในระยะเวลาเพียง 5-6 weeks.จำนวนผู้เสียชีวิตพุ่งสูงขึ้นรวดเร็วในระยะแรก – case fatality rate %Several clusters, multi – area, and across societyHuman-to-Human transmission patternNo related pigs sick!, it is all human.
8What do we know, (and don’t) Wave of human-to-human transmission in MexicoImported cases in 21countries, air travel (เกือบทั้งหมด)Subsequence 2nd outbreak, contact – US, Canada, Spain, Germany, S. KoreaCNN – Sweden reported confirmed case travel from the US.
9What we don’t know yetUncertainty about – viral behavior, characterization, infectivity?Virulence, true Case Fatality (ประมาณ 2-6%)Host range – Human, Swine, Poultry and other animalsNeed to know more and quickly -Biology – Interaction, Immunity, pathologyEpidemiology pattern, speed,Clinical picture (?) –แบบสมบูรณ์ หรือรู้ชัดเจนพอ??????? Second Wave ( -imminent)
10Influenza A (H1N1): Morbidity & Mortality ประเทศcasedeath1.United States40312.Mexico822293.Canada1404.Spain575.United Kingdom276.Israel47.New Zealand68.Austria9.Germany910.Netherlands11.Switzerland12.Denmark13.China14.France15.Korea, Republic of216.Costa Rica17.Ireland18.Italy519.Colombia20.El Salvador21.PortugalUp to 5 May 20091.Affected countries(21 countries)2.Total confirmed(1490 Cases)3.Total dead(30 Cases)4.CFR(2.01%)
12Imported case/Last case Limited Indigenous/Last case Wide spread Indigenous/Last caseAustria/ Apr 29New Zealand/ May 4United Kingdom/ AddSwitzerland/ Apr 30Israel/ May 4United States/ AddNY TX CA AZ FL AL CO DE ILNetherlands/ Apr 30Korea, Republic of/ AddCanada/ AddBC AB ON NS NBChina, Hong Kong SAR/ May 1? France/ May 4Spain/ AddDenmark/ May 1? Italy/ AddMexico AddCosta Rica/ May 2Germany/ Add- BavariaIreland/ May 3Colombia/ May 4El Salvador/ May 4Portugal / May 4
13SEOUL, May 5 (Xinhua)-- South Korean Health Ministry on Tuesday confirmed a 44-year-old woman as the country's second patient affected by the Influenza A/H1N1.
14German gives nurse virus Bangkok Post – May 2nd, 2009German gives nurse virusBerlin: Germany confirmed yesterday the second case of swine flu contract in Europe by someone who had not traveled to Mexico, in a nurse who treated the patient with virus.Question ?? – Hospital Infection,Infectivity of new virus.