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2009 H1N1 Flu: International Situation Update

May 7, 2010, 6:00 PM ET

This report provides an update to the international flu situation using data collected through May 2, 2010, and reported by the World Health Organization (WHO) on May 7. WHO continues to report laboratory-confirmed 2009 H1N1 flu deaths on its Web page.  These fatal cases are an under representation of the actual numbers as many deaths are never tested or recognized as influenza related.

Currently, the most active areas of 2009 H1N1 transmission are in parts of West Africa, the Caribbean, and Southeast Asia.  2009 H1N1 transmission appears to be declining in Ghana after peaking in April.  Seasonal B viruses have become more prominent in Cameroon and the Democratic Republic of Congo.  In Guatemala, an increasing trend in respiratory disease has been reported in recent weeks. Cuba has noted increased detection of severe 2009 H1N1 cases since March, but overall activity may have peaked the first week of May.  Reports of school outbreaks due to 2009 H1N1 continue to occur in Malaysia. 

Respiratory disease activity has increased in Bangladesh since mid-April and appears to be due to both 2009 H1N1 and seasonal B viruses.  Respiratory disease activity remains low in East Asia, with influenza activity in some countries primarily attributable to seasonal B viruses.  Influenza activity in the southern hemisphere is sporadic, though the ILI levels in one region in Chile have been slightly above the epidemic threshold for four weeks.  Influenza virus circulation remains low in Europe.

Selected Highlights

  • According to WHO, the majority of 2009 H1N1 virus isolates tested worldwide remain sensitive to oseltamivir, an antiviral medicine used to treat flu. Among 2009 H1N1 isolates tested worldwide, 285 have been found to be resistant to oseltamivir – 65 of these isolates were detected in the United States. Approximately 1.1% of U.S. 2009 H1N1 viruses tested by CDC since September 1, 2009, have been resistant to oseltamivir.
  • Influenza B is the predominating influenza virus in certain countries, accounting for 83.3% of all influenza detections in the Russian Federation, 72.3% in China, 91.4% in the Republic of Korea, and 100% in Iran and Sweden.
  • Some seasonal A (H1N1) viruses were detected in the Russian Federation, and Cuba, Ghana, and the Russian Federation reported some A (H3N2) activity.
  • On February 18, 2010, WHO 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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