Swine flu
In the temperate region of the southern hemisphere (represented by countries such as Chile, Argentina, Australia, New Zealand, and South Africa), influenza activity continues to decrease or return to normal activity. Active transmission persists in tropical regions of the Americas and Asia. Many countries in Central America and the Caribbean continue to report declining activity for the second week in a row.
However, countries in the tropical region of South America (represented by countries such as Bolivia, Ecuador, and Venezuela) are reporting increasing levels of respiratory disease. In the tropical regions of Asia, respiratory disease activity remains geographically regional or widespread but the trend is generally increasing as noted in India, Bangladesh, and Cambodia.
Most of Europe is reporting low or moderate respiratory diseases activity, but parts of Eastern Europe are beginning to report increases in activity.
Although WHO Collaborating Centres and other laboratories continue to report sporadic isolates of oseltamivir (Tamiflu) resistant influenza virus these were not resistant to the antiviral zanamivir (Relenza). The resistance have been associated with post-exposure prophylaxis, four with long term oseltamivir treatment in patients with immunosuppression. WHO is not changing its guidelines for use of antiviral drugs at this time.
Of note, the U.S.Centers for Disease Control and Prevention this week reported on an analysis of 36 fatal pandemic influenza cases in children under the age of 18 years. Sixty-seven percent of the children had one or more high-risk medical conditions, most commonly neurodevelopmental disorders. In addition, ten of 23 children for whom data were available were found to have strong evidence of secondary bacterial co-infections.
Measures in school settings
Experience to date has demonstrated the role of schools in amplifying transmission of the pandemic virus, both within schools and into the wider community. While outbreaks in schools are clearly an important dimension of the current pandemic, no single measure can stop or limit transmission in schools, which provide multiple opportunities for spread of the virus.
WHO recommends the use of a range of measures that can be adapted to the local epidemiological situation, available resources, and the social role played by many schools. National and local authorities are in the best position to make decisions about these measures and how they should be adapted and implemented.
WHO continues to recommend that:
- Students, teachers, and other staff who feel unwell should stay home.
- Plans should be in place, and space made available, to isolate students and staff who become ill while at school.
- Schools should promote hand hygiene and respiratory etiquette and be stocked with appropriate supplies.
- Proper cleaning and ventilation and measures to reduce crowding are also advised.
