As of 31 August 2009, 48 of the 53 Member States in the WHO European Region had reported laboratory-confirmed cases of pandemic (H1N1) 2009 virus infection.
As of 31 August 2009, 48 of the 53 Member States in the WHO European Region had reported laboratory-confirmed cases of pandemic (H1N1) 2009 virus infection. Kyrgyzstan reported its first two laboratory-confirmed cases on 25 August 2009.
Recommended use of antivirals
WHO has issued guidelines for the use of antiviral drugs in the management of patients infected with pandemic (H1N1) 2009 virus: WHO guidelines for pharmacological management of pandemic (H1N1) 2009 influenza and other influenza viruses.
The guidelines represent the consensus reached by an international panel of experts who reviewed all available studies on the safety and effectiveness of these drugs. They emphasize the use of oseltamivir and zanamivir to prevent severe illness and death, reduce the need for hospitalization and reduce the duration of hospital stays.
Severe illness
For patients who initially present with severe illness or whose condition begins to deteriorate, WHO recommends treatment with oseltamivir as soon as possible. Studies show that early treatment, preferably within 48 hours after symptom onset, is strongly associated with better clinical outcome. For patients with severe or deteriorating illness, treatment should be provided even if started later. Where oseltamivir is unavailable or cannot be used for any reason, zanamivir may be given.
This recommendation applies to all patient groups, including pregnant women, and all age groups, including young children and infants.
Children
WHO recommends prompt antiviral treatment for children with severe or deteriorating illness, and those at risk of more severe or complicated illness. This recommendation includes all children under the age of 5 years, as this age group is at increased risk of more severe illness. Otherwise healthy children older than 5 years need not be given antiviral treatment unless their illness persists or worsens.
Preparing for the second wave
WHO is advising countries in the northern hemisphere to prepare for a second wave of pandemic spread. The pandemic will persist in the coming months as the virus continues to move through susceptible populations. Close monitoring of viruses by a WHO network of laboratories shows that viruses from all outbreaks remain virtually identical.
The overwhelming majority of patients continue to experience mild illness. Although the virus can cause very severe and fatal illness, even in young and healthy people, the number of such cases remains small.
While these trends are encouraging, large numbers of people in all countries remain susceptible to infection. Even if the current pattern of usually mild illness continues, the impact of the pandemic during the second wave could worsen as larger numbers of people become infected.
Severely ill patients requiring intensive care are likely to be the most urgent burden on health services, creating pressures that could overwhelm intensive care units and disrupt the provision of care for other diseases.