# 4089
Although the numbers reported to, and by the WHO (World Health Organization) are - by their own admission - incomplete and represent a significant undercount of cases, this week the WHO is reporting an increase of more than 1000 deaths from the H1N1 virus.
This makes the largest single-week uptick thus far in the pandemic and has garnered a good deal of press attention this morning.
Here is how the BBC is reporting the story, including a quote from the WHO’s Keiji Fukuda on the `Norwegian’ mutations.
Jump in number of global swine flu deaths
The global number of swine flu deaths has jumped by more than 1,000 in a week, latest figures from the World Health Organization (WHO) show.
At least 7,826 people are now known to have died following infection with the H1N1 virus since it first emerged in Mexico in April.
Europe saw an 85% increase in the week, with the total number of deaths rising from at least 350 to at least 650.
<SNIP>
Keiji Fukuda, WHO's special adviser on pandemic influenza, said: "The question is whether these mutations suggest that there is a fundamental change going on in viruses out there - whether there's a turn for the worse in terms of severity.
"The answer right now is that we are not sure."
Some excerpts from WHO today’s update, including the latest on the mutations in their virological update.
Pandemic (H1N1) 2009 - update 76
Weekly update
27 November 2009 -- As of 22 November 2009, worldwide more than 207 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including over 7820 deaths.
As many countries have stopped counting individual cases, particularly of milder illness, the case count is likely to be significantly lower than the actual number of cases that have occurred.
<SNIP>
Situation update:
In temperate regions* of the northern hemisphere, the early arriving winter influenza season continues to be intense across parts of North America and much of Europe. In North America, the Caribbean islands and a limited number of European countries there are signs that disease activity peaked.
In the United States and Canada, influenza transmission remains very active and geographically widespread. In the United States, disease activity appears to have peaked in all areas of the country. In Canada, influenza activity remains similar but number of hospitalisations and deaths is increasing. Most countries in the Caribbean have ILI and SARI levels coming down.
In Europe, widespread and increasing transmission of pandemic influenza virus was observed across much of the continent and most countries that were not yet experiencing elevated ILI activity in the last few weeks, have seen a rapid increase in ILI. Very high activity is seen in Sweden, Norway, Moldova and Italy. Over 99% of subtyped influenza A viruses in Europe were pandemic H1N1 2009. Impact on health care services is severe in Albania and Moldova. Some countries seem to have peaked already: Belgium, Bulgaria, Belarus, Ireland, Luxemburg, Norway, Serbia, Ukraine and Iceland.
Pandemic (H1N1) 2009 - update 76
Weekly update (more data on virological surveillance)
27 November 2009 -- The Global Influenza Surveillance Network (GISN) continues monitoring the global circulation of influenza viruses, including pandemic, seasonal and other influenza viruses infecting, or with the potential to infect, humans including seasonal influenza.
<SNIP>
A virus mutation at position 222 of the amino acid sequence of the haemagglutinin protein of the pandemic virus was recently reported in a few viruses from Norway. The mutation is D222G (aspartic acid to glycine), which, according to a public accessible gene sequence database "GenBank", has also been detected sporadically in viruses from several other countries since April 2009.
This change in the virus has been found in mild as well as severe cases. WHO, through its Global Influenza Surveillance Network (GISN) is monitoring virus mutations that are of potential public health importance.
Systematic surveillance conducted by the Global Influenza Surveillance Network (GISN) including WHO Collaborating Centres (WHOCCs) for reference and research on influenza, continues to detect sporadic incidents of H1N1 pandemic viruses that show resistance to the antiviral oseltamivir. To date, 75 oseltamivir resistant pandemic H1N1 influenza viruses have been detected and characterized worldwide. All of these viruses show the same H275Y mutation. All these viruses remain sensitive to zanamivir. Worldwide, more than 10,000 clinical specimens (samples and isolates) of the pandemic H1N1 virus have been tested and found to be sensitive to oseltamivir.
All pandemic H1N1 2009 influenza viruses analysed to date were antigenically and genetically closely related to the vaccine virus A/California/7/2009.
Virology data update
