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2009 H1N1 Flu: International Situation Update

March 5, 2010, 4:30 PM ET

This report provides an update to the international situation using data collected through February 28, 2010, and reported by the World Health Organization (WHO) on March 5. WHO continues to report laboratory-confirmed 2009 H1N1 flu cases and deathson its Web page. These laboratory-confirmed cases represent a substantial underestimation of total cases in the world, as most countries focus surveillance and laboratory testing only on people with severe illness.

In nearly all countries of the world where influenza infection is reported, the 2009 H1N1 influenza virus continues to predominate among all subtyped influenza A viruses. Based on FluNet data collected by 28 countries from February 14 to February 20, 2010, 75% of all subtyped influenza A viruses were 2009 H1N1 positive.  40.6% of specimens testing positive for influenza were typed as influenza A and 59.4% as influenza B. 

The 2009 H1N1 influenza virus is currently most actively being transmitted in parts of Southeast Asia and East and South-eastern Europe.  In the temperate zone of the northern hemisphere, transmission is low in most areas.  Respiratory disease activity has increased slightly in Mexico and Peru, but it is unclear if this is related to 2009 H1N1.  Multiple countries in sub-Saharan Africa are reporting increasing 2009 H1N1 related cases based on limited surveillance data.

Selected Highlights

  • According to WHO, the majority of 2009 H1N1 influenza isolates tested worldwide remain sensitive to oseltamivir, an antiviral medicine used to treat influenza disease. Among 2009 H1N1 isolates tested worldwide, 264 have been found to be resistant to oseltamivir – 60 of these isolates were detected in the United States.
  • Influenza B activity continues to increase in China and Hong Kong SAR China. Hong Kong SAR China has reported increased influenza B activity accounting for 55.4% of all influenza detections, while in China it accounted for 88.4%.  In addition to the increasing proportion of influenza type B viruses detected in China, low levels of seasonal H3N2 and type B viruses are circulating in parts of Africa and Asia.
  • As of February 18, 2010, WHO has published recommendations for the following viruses to be used for influenza vaccines in the 2010-2011 influenza season of the Northern Hemisphere:
    • an A/California/7/2009 (H1N1)-like virus;
    • an A/Perth/16/2009 (H3N2)-like virus*;
    • a B/Brisbane/60/2008-like virus.

* A/Wisconsin/15/2009 is an A/Perth/16/2009 (H3N2)-like virus and is a 2010 Southern Hemisphere vaccine virus.

International Resources for 2009 H1N1 Information

Health Organizations

World Health Organization (WHO) Regional Offices

Travel and 2009 H1N1 Flu

Human cases of 2009 H1N1 flu virus infection have been identified in the United States and several countries around the world. For information on 2009 H1N1 flu and travel, see the CDC H1N1 Flu and Travel website.

Reports and Publications

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