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NMCPHC MEDICAL INFO TIME PERIOD 27 Jun – 3 Jul 09 TO THE SURGEON GENERAL NORTHCOM • Pandemic (H1N1) 2009 Influenza: As of 2 July there were 33,902 confirmed and probable human cases (170 deaths) of pandemic (H1N1) 2009 influenza (new WHO nomenclature) reported to the CDC. During week 25 (21-27 Jun 09), influenza activity decreased in the U.S. but remains higher than is normal for this time of year. CENTCOM • H5N1-Human: Egypt’s Ministry of Health has reported 3 new confirmed human case of avian influenza A(H5N1), raising the country’s case total to 81. All three cases were children who had close contact with dead or sick poultry. EUCOM • Pandemic (H1N1) 2009: As of 3 July countries have reported 89,921 pandemic (H1N1) 2009 cases (382 deaths) to the WHO. Geographic distribution of the cases is displayed here. The WHO reports underestimate the true case total since some countries no longer track cases and others lack the laboratory capability to detect pandemic (H1N1) 2009. Analysis of the WHO case reports and other available data suggests that a relatively low case fatality rate (0.06% to 0.0004%) will result from pandemic (H1N1) 2009 infection. CFR estimates for previous pandemics range from 0.1% to 2.5% (in 1918). • Q Fever: The Netherlands National Institute for Public Health and the Environment has reported an outbreak of Q fever that has generated 1,133 human case reports in 2009. This is the Netherlands’ third Q fever outbreak in the past three years. Most of the Q fever cases have been reported from Noord (North) Brabant Province. Q fever, an acute febrile zoonotic disease caused by infection with Coxiella burnetii, is on the CDC’s Category B bioterrorism agents list due to its highly infectious nature and persistence in the environment. The typical mode of transmission is by airborne spread of Coxiella in dust contaminated by parturition products and excreta of infected animals. SOUTHCOM • Pandemic (H1N1) 2009: With the winter influenza season just beginning, Argentina’s confirmed pandemic (H1N1) 2009 influenza case total now stands at 2,800 (44 deaths). Only Mexico and the U.S. have reported more pandemic (H1N1) 2009 deaths. The U.S. has donated 420,000 treatment courses of oseltamavir (Tamiflu) to help countries in the Pan American Health Organization (PAHO) region address the public health challenges posed by pandemic (H1N1) 2009 influenza. Note: No information to report on other COCOMs.
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