About Pandemic

H1N1インフルエンザの警戒レベルは、いまだにレベル６のようだ・・・

おそらく、経過観察中・・・

H1N1は、まだ、世界的な大流行を引き起こす可能性があるということではないの？

一時的に流行はおさまっているが、警戒レベルは６である・・・

ということですか？


長妻さん？

厚生労働省はこのような情報を的確に国民に伝えるべきである。


何やってんの？


国民はどのように対処すれば良いの？


厚生労働省のサイトには、意味不明な情報ばかりの報告が出ていた・・・



肝心かなめのパンデミック・レベル６に関する情報が出ていない・・・

About the Flu

Flu refers to illnesses caused by a number of different influenza viruses. Flu can cause a range of symptoms and effects, from mild to lethal.

Two strains of flu, seasonal flu and the H1N1 (Swine) flu, are currently circulating in the United States. A third, highly lethal H5N1 (Bird) flu is being closely tracked overseas.

Most healthy people recover from the flu without problems, but certain people are at high risk for serious complications.

In the U.S., epidemiologists at the Centers for Disease Control (CDC)  work with states to collect, compile and analyze reports of flu outbreaks. More on the current situation.

Flu symptoms may include fever, coughing, sore throat, runny or stuffy nose, headaches, body aches, chills and fatigue. In H1N1 flu infection, vomiting and diarrhea may also occur.

Annual outbreaks of the seasonal flu usually occur during the late fall through early spring. Most people have natural immunity, and a seasonal flu vaccine is available. In a typical year, approximately 5 to 20 percent of the population gets the seasonal flu and approximately 36,000 flu-related deaths are reported.

For the 2009-2010 flu season, the H1N1 flu virus caused more illness in young people and pregnant women than is usual for prior flu seasons. Like seasonal flu, illness in people with H1N1 can vary from mild to severe.

Interactive Timeline on H1N1: The Year in Review
Follow the month-by-month development of the 2009 H1N1 flu pandemic.

2009 H1N1 Pandemic: Summary Highlights, April 2009-April 2010
Centers for Disease Control and Prevention document that summarizes key events of the 2009 H1N1 pandemic and CDC’s response activities.

A flu pandemic occurs when a new influenza A virus emerges for which there is little or no immunity in the human population; the virus causes serious illness and spreads easily from person-to-person worldwide. On June 11, 2009, the World Health Organization  (WHO) declared that a global pandemic of H1N1 flu is underway.

H5N1 (Bird) flu is an influenza A virus subtype that is highly contagious among birds. Rare human infections with the H5N1 (Bird) flu virus have occurred. The majority of confirmed cases have occurred in Asia, Africa, the Pacific, Europe and the Near East. Currently, the United States has no confirmed human H5N1 (Bird) flu infections, but H5N1 (Bird) flu remains a serious concern with the potential to cause a deadly pandemic.

The Current Flu Situation

• Monitoring and response activities continue regarding H1N1 flu virus.  More…
• A pandemic has been declared. The World Health Organization has declared that a global pandemic level of H1N1 influenza is underway. More…
• Vaccines are the best tool we have to prevent influenza. The CDC encourages people to get vaccinated against seasonal influenza and the H1N1 flu. More…
• Learn more about the H1N1 flu, Seasonal flu and Prescription Medications. More…

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The Domestic Impact

On April 26, 2009 the Department of Health and Human Services issued a nationwide public health emergency declaration in response to the number of confirmed cases of H1N1 flu in the United States. On July 23, 2009, October 1, 2009, December 29, 2009, and March 26, 2010,  Secretary Sebelius signed renewals of the determination. The public health emergency declaration expired on June 23, 2010.

On October 24, 2009, President Obama signed a national emergency declaration for H1N1 flu.

H1N1 FluView (CDC):

Flu activity is tracked through CDC’s routine influenza surveillance systems and reported weekly in FluView. Flu View (CDC): View the Weekly Flu Surveillance Report View the Weekly Flu Activity Estimates

H1N1: The Year in Review - an interactive timeline
Follow the month-by-month development of the 2009 H1N1 flu pandemic.

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The Global Impact

• On June 11, 2009, the World Health Organization  (WHO) declared that a global pandemic of H1N1 flu was underway by raising the worldwide pandemic alert level toPhase 6. Note: This action was a reflection of the spread of the new H1N1 flu virus, not the severity of illness caused by the virus.
• More than 200 countries have reported cases of H1N1 flu infection.
• The United States reported the largest number of H1N1 flu cases of any country worldwide, however, most people who became ill have recovered without requiring medical treatment.
• Continuous global surveillance, rapid detection and isolation of influenza are ongoing, coordinated efforts. More information on the global response

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The Facts about Vaccination

For the 2010-2011 flu season, the flu vaccine vaccine will protect against the 2009 H1N1 pandemic virus and 2 other flu viruses. 

• Flu can still cause illness this summer. Individuals are encouraged to get their seasonal and H1N1 flu shots.
• Seasonal flu and H1N1 flu vaccines may be administered on the same day.
• The 2010-2011 seasonal vaccine will include protection against the H1N1 flu and seasonal flu.
• Our Flu Shot Locator widget will once again be available in the fall for finding where to get vaccinated where you live.

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Learn More

More on H1N1 Flu

More on Seasonal Flu

Ask the Flu Experts

Information on Prescription Medications

Current WHO phase of pandemic alert

CURRENT PHASE OF ALERT IN THE WHO GLOBAL INFLUENZA PREPAREDNESS PLAN

Pandemic preparedness

In the 2009 revision of the phase descriptions, WHO has retained the use of a six-phased approach for easy incorporation of new recommendations and approaches into existing national preparedness and response plans. The grouping and description of pandemic phases have been revised to make them easier to understand, more precise, and based upon observable phenomena. Phases 1–3 correlate with preparedness, including capacity development and response planning activities, while Phases 4–6 clearly signal the need for response and mitigation efforts. Furthermore, periods after the first pandemic wave are elaborated to facilitate post pandemic recovery activities.

The current WHO phase of pandemic alert is 6.

In nature, influenza viruses circulate continuously among animals, especially birds. Even though such viruses might theoretically develop into pandemic viruses, in Phase 1 no viruses circulating among animals have been reported to cause infections in humans.

In Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans, and is therefore considered a potential pandemic threat.

In Phase 3, an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks. Limited human-to-human transmission may occur under some circumstances, for example, when there is close contact between an infected person and an unprotected caregiver. However, limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemic.

Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion.

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.

During the post-peak period, pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels. The post-peak period signifies that pandemic activity appears to be decreasing; however, it is uncertain if additional waves will occur and countries will need to be prepared for a second wave.

Previous pandemics have been characterized by waves of activity spread over months. Once the level of disease activity drops, a critical communications task will be to balance this information with the possibility of another wave. Pandemic waves can be separated by months and an immediate “at-ease” signal may be premature.

In the post-pandemic period, influenza disease activity will have returned to levels normally seen for seasonal influenza. It is expected that the pandemic virus will behave as a seasonal influenza A virus. At this stage, it is important to maintain surveillance and update pandemic preparedness and response plans accordingly. An intensive phase of recovery and evaluation may be required.

WHO Guidelines for Pharmacological Management of Pandemic (H1N1) 2009 Influenza and other Influenza Viruses

Publication date: February 2010

The purpose of this document is to provide a basis for advice to clinicians on the use of the currently available antivirals for patients presenting with illness due to influenza virus infection as well the potential use of the medicines for chemoprophylaxis. The document addresses specifically the two neuraminidase inhibitors oseltamivir and zanamivir, and the two M2 inhibitors amantadine and rimantadine. It includes recommendations on the use of some other potential pharmacological treatments. While the focus of the document is on management of patients with pandemic influenza (H1N1) 2009 virus infection, the document includes guidance on the use of the antivirals for other seasonal influenza virus strains, and for infections due to novel influenza A virus strains. WHO recommends that country and local public health authorities issue local guidance for clinicians from time to time that places these recommendations in the context of epidemiological and antiviral susceptibility data on the locally circulating influenza strains.

This guidance updates and replaces the recommendations published in August 2009. This document will again be reviewed in September 2010 and, if necessary, updated.

Key changes to the guidelines are:

• Simplification of recommendations as pandemic influenza virus has become the predominant influenza virus worldwide.
• Specific guidance for the treatment of young children from birth, including guidance on dose and formulation.
• Additional guidance for treatment or chemoprophylaxis of patients with severe immunosuppression.
• Consideration of a wider range of investigational, regional or adjunctive treatments.
• Specific contraindications for some medicines.

(updated from May 2009 and August 2009 versions)

フォトレポート

2009年6月12日
国会議事堂内閣議室前

WHOがインフルエンザパンデミック警戒レベルをフェーズ５からフェーズ６に引き上げたことに伴い会見を行う舛添厚生労働大臣

６月１２日、舛添厚生労働大臣は、WHOがインフルエンザパンデミック警戒レベルをフェーズ５からフェーズ６に引き上げたことに伴い、会見を行いました。

大臣はまず、フェーズ６とは、複数の地域において、地域（コミュニティ）レベルでの継続的な感染拡大が見られる状況を指すものであり、ウイルスによる健康被害の深刻度が増したということではないということを断った上で、我が国における今後の感染拡大の可能性について触れ、「地方自治体や医療関係者などと十分な協力･連携をとって、万全の備えに努めてまいります」と表明しました。「警戒を怠ることなく、正しい情報に基づき冷静に対応していただきたい」舛添大臣は国民のみなさまにこのように呼びかけております。

（健康局結核感染症課）

The EUAs allowed for use of the products in a manner different from what they were FDA-approved for. This included allowing for off-label use of:

• oseltamivir to treat children younger than 1 year of age and to help prevent influenza in children 3 months to 1 year of age, and;
• oseltamivir and zanamivir to treat patients who are symptomatic for more than two days before initiation of treatment, or who had complicated illness requiring hospitalization.

On April 27, the WHO Director-General raised the level of influenza pandemic alert from phase 3 to phase 4, based primarily on epidemiological data demonstrating human-to-human transmission and the ability of the virus to cause community-level outbreaks. Based on reports of widespread influenza-like-illness and many severe illnesses and deaths in Mexico, CDC issued a travel health warning recommending that United States travelers postpone all non-essential travel to Mexico until further notice. As in past influenza seasons, CDC urged the public and especially those people at highest risk of influenza-related complications, to protect themselves by taking antiviral drugs early in their illness when recommended by their doctor; CDC also advised that everyone take every day preventive actions like covering coughs and sneezes and staying home from work and school when ill to help reduce the spread of illness.

On April 29, 2009 WHO raised the influenza pandemic alert from phase 4 to phase 5, signaling that a pandemic was imminent, and requested that all countries immediately activate their pandemic preparedness plans and be on high alert for unusual outbreaks of influenza-like illness and severe pneumonia. The U.S. Government was already implementing its pandemic response plan. CDC continued to post and update guidance for states, clinicians, laboratories, schools, partners and the public on topics ranging from the non-pharmaceutical measures communities could take to limit spread of disease, to how to evaluate a patient for possible infection with 2009 H1N1 influenza, to how to care for children who might be sick with 2009 H1N1 influenza.

A Pandemic is Declared

On June 11, 2009, WHO signaled that a global pandemic of 2009 H1N1 influenza was underwayby further raising the worldwide pandemic alert level to Phase 6. That day, CDC held its first press conference with the new CDC Director Thomas Frieden, MD, MPH. The press conference had a total of 2,355 participants. At the time, more than 70 countries had reported cases of 2009 H1N1 infection, and community level outbreaks of 2009 H1N1 were ongoing in multiple parts of the world. The WHO decision to raise the pandemic alert level to Phase 6 was a reflection of spread of the virus in other parts of the world and not a reflection of any change in the 2009 H1N1 influenza virus or associated illness. To date, most people in the United States who had become ill with 2009 H1N1 influenza had not become seriously ill and had recovered without hospitalization.

After the WHO declaration of a pandemic on June 11, the 2009 H1N1 virus continued to spread and the number of countries reporting cases of 2009 H1N1 nearly doubled from mid-June 2009 to early July 2009. Significant levels of 2009 H1N1 illness continued, with localized and in some cases intense outbreaks occurring. By June 19, 2009, all 50 states in the United States, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands had reported cases of 2009 H1N1 infection. The United States continued to report the largest number of 2009 H1N1 cases of any country worldwide, although most people who became ill recovered without requiring medical treatment. By late June more than 30 summer camps in the U.S. had reported outbreaks of 2009 H1N1 influenza illness, and CDC released guidance for day and residential camps to reduce the spread of influenza. At the June 25, 2009 Advisory Committee on Immunization Practices Meeting , CDC estimated that at least 1 million cases of 2009 H1N1 influenza had occurred in the United States.

In early July, 2009, three 2009 H1N1 influenza viruses that were resistant to the antiviral drug oseltamivir were detected in three countries. (Antiviral resistance is when a virus changes in such a way that the antiviral drug is less effective in treating or preventing illnesses caused by the virus.) CDC and WHO partners continued to conduct surveillance for antiviral resistance, although instances of antiviral resistance continued to be detected very rarely.

Also in July 2009, CDC reported findings in the MMWR that indicated a striking prevalence of obesity in intensive care patients who were confirmed to have 2009 H1N1 influenza. Throughout the pandemic, CDC would continue to examine the relationship between 2009 H1N1 influenza, obesity, severe disease and other underlying risk factors.

CDC continued to work with the Council of State and Territorial Epidemiologists (CSTE) to enhance surveillance for 2009 H1N1 influenza. As 2009 H1N1 cases continued to occur through the spring and summer, the task of counting cases became increasingly difficult. On May 12, 2009, CDC transitioned from reporting individual confirmed and probable cases of 2009 H1N1 influenza to reporting aggregate counts of 2009 H1N1 lab confirmed and probable cases, hospitalizations and deaths with the launch of an aggregate reporting web site. Once the numbers of cases increased beyond the point where counting of individual cases was practical, on July 23, 2009, CDC reported the number of 2009 cases for the last time. Reporting of 2009 H1N1 hospitalizations and deaths continued. In addition, CDC continued using its traditional surveillance systems to track the progress of the 2009 H1N1 influenza outbreak. Traditional surveillance systems do not count individual cases, but instead monitor activity levels and virus characteristics through a nationwide surveillance system.

CDC worked closely with countries in the Southern Hemisphere to monitor and enhance surveillance for influenza viruses throughout the summer months. The Southern Hemisphere’sinfluenza season began in May 2009 and countries there reported that 2009 H1N1 virus was spreading and causing illness along with regular seasonal influenza viruses. After mid-July, disease activity in most countries decreased, and by November, temperate regions of the Southern Hemisphere were reporting very little 2009 H1N1 disease activity. In general, the experience of the Southern Hemisphere with the 2009 H1N1 virus was similar to what is usually seen during a regular influenza season and did not seem to excessively impact the health care systems in the Southern Hemisphere. Also, surveillance systems did not find significant changes in the 2009 H1N1 influenza viruses circulating in the Southern Hemisphere as compared to viruses isolated from people in the Northern Hemisphere. These findings provided the U.S. with valuable clues related to what the 2009-2010 influenza season in the United States might be like. Importantly, the lack of significant changes in the virus indicated that the 2009 H1N1 vaccine being manufactured would closely match the currently circulating 2009 H1N1 viruses and likely provide people with good protection against 2009 H1N1 influenza.