Yesterday, 27 April, the WHO Director-General raised the influenza pandemic phase from 3 to 4. This decision was based primarily on epidemiological data demonstrating sustained human-to-human transmission and the ability of the virus to cause community-level outbreaks. Given the widespread presence of the virus, the WHO Director-General considered that global containment of the outbreak is no longer feasible. The current focus should be on mitigation measures.
As of 28 April, 10:00, two European countries have reported confirmed cases of novel influenza virus infection: one in Spain and two in the United Kingdom. Both countries have additional persons, nine and 17, respectively, who are still under investigation. All of these confirmed cases have a history of travel to Mexico.
In France, four, in Sweden, five, and in Germany, two, persons who were under investigation have now been confirmed to be negative.
A total of nine European countries (Czech Republic, Denmark, Germany, Greece, Ireland, Italy, Poland, Spain and the United Kingdom) currently have persons under investigation.
The number of countries reporting confirmed cases with novel influenza virus infection (human swine influenza H1N1) or persons with influenza-like illness being investigated for such infection is increasing rapidly.
Outside of the European Union, a total of 79 confirmed cases of novel influenza virus infection have been reported: 40 from the United States (California 7, Kansas 2, New York City 28, Ohio 1, Texas 2), 33 from Mexico and six from Canada. Most of these confirmed cases in the US and all of those in Canada have a history of travel to Mexico.
Thirteen non-EU countries are reporting persons being under investigation. Most of these persons, but not all, have a history of travel to Mexico or the US. In Mexico, more than 1600 persons are suspected of being infected.
Mexico is the only country so far reporting deaths (5) among confirmed cases. All cases diagnosed outside of Mexico show a mild form of the disease.
All EU Member States have implemented appropriate response measures in order to limit the spread of this infection to the continent. These include the provision of information to the general public and to travellers, and raising the alert on this situation among the healthcare workers. In addition, several Member States have implemented enhanced surveillance and/or activated their national pandemic preparedness plan. On a European level, the implementation of these measures is coordinated by the European Commission.
ECDC is providing technical support to the Member States and the European Commission with regards to the surveillance of cases reported in the EU and abroad. Technical guidance regarding the management of infected persons and their contacts has also been prepared and existing guidance documents on personal protective measures and public health measures to be implemented in case of an influenza epidemic/pandemic are being updated.
ECDC, in collaboration with the Member States, the European Commission and the World Health Organization, is closely monitoring this rapidly evolving situation, and provides daily updates on its website.
The next situational update will be published at 10:00 CET 29 April 2009.
Read more about Influenza A(H1N1) on the Influenza A(H1N1) outbreak page