Monday, January 29, 2018

An IFRC H1N1 Flu Report From North Korea


Although we rarely get reports out of North Korea, with multiple influenza subtypes (H3N2, H1N1, Influenza B) raging across the Northern Hemisphere this winter, it shouldn't come as a surprise that the DPRK is being battered as well. 
What is a bit surprising is that they are apparently being hit by H1N1, while the rest of Asia has been reporting primarily Influenza B this winter. 
According to the Latest report from the South Korean CDC, H1N1 has only made up about 5% of their flu cases this winter.  Influenza B leads with 54%, followed by H3N2 with 39%.  This last report (issued Jan 19th) indicated flu was beginning to decline across the country.

We get details about the North Korean outbreak from the following bulletin issued by the International Foundation of Red Cross and Red Crescent Societies.

Information bulletin

DPR Korea: Influenza A Outbreak

This bulletin is being issued for information only and reflects the current situation and details available at this time. The Democratic People’s Republic of Korea Red Cross Society (DPRK RCS), with the support of the International Federation of Red Cross and Red Crescent Societies (IFRC), has determined that available information points toward significant humanitarian needs that may require support from the IFRC Disaster Relief Emergency Fund.

The situation

On 19 January 2018 the Vice Minister of Public Health (MoPH) officially informed the World Health Organization (WHO) Country Office in Pyongyang of an outbreak of Influenza A (H1N1) stating that between 1 December 2017 and 16 January 2018 there was a total of 126,574 suspected influenza cases – individuals presenting with influenza-like illness.
Of these, 81,640 cases were confirmed as Influenza A (H1N1) and as per the Ministry communication there had been four deaths – three children and one adult. 

According to the Ministry, 24.5 per cent of suspected influenza cases (numbering 31,010) were among children aged 0-7 years, 22.8 per cent (n= 28,858) were among children 8-16 years and the rest 52.7 per cent (n= 66,706), were among those who were above 17 years. The outbreak has become generalized throughout the country with 28.7 per cent of cases in the capital city – Pyongyang. 

The government has requested support for influenza vaccination targeting high-risk individuals with the MoPH specifically requesting 30,000 Oseltamivir tablets for healthcare workers. WHO has so far dispatched 5,000 tablets with 30,000 in the pipeline to distribute to frontline healthcare workers and vulnerable groups.
There is a request to strengthen the non-pharmaceutical aspect of the operation with an emphasis on public health including surveillance and preventive activities with all agencies (WHO, UNICEF) requested to support with conducting an effective communication programme. 

So far, the outbreak has not been graded as WHO is awaiting further epidemiological information from the MoPH including the age break down of suspected and confirmed cases, number of pregnant women affected and confirmation of the type of influenza.
(Continue . . . )

While there is no indication that there is anything unusual about this (presumably) seasonal H1N1 outbreak - with North Korean athletes now set to compete in the Winter Olympics in two weeks time - this is something we'll definitely want to keep an eye on.
I was led to this IFRC report by an amazing bit of reportage this morning from VOA news, (see North and South Korea Hit by Bird Flu Outbreaks Ahead of Olympics) which initially claimed that H1N1 was `avian or bird flu'.

Someone must have clued them in, as an hour later they changed the headline to North, South Korea Hit by Flu Outbreaks Ahead of Olympics and `corrected' their story to read:
North Korea’s Ministry of Public Health reported over 80,000 confirmed cases of the influenza strain H1N1 that is endemic in pigs, known as swine flu, between December 1, 2017 and January 16, 2018, according to a bulletin issued by the International Foundation of Red Cross and Red Crescent Societies.
Closer, but still no cigar. The H1N1 virus that is endemic in pigs is not the same virus as seasonal H1N1. Still, it is an improvement.  Of sorts.