The pronouncement last week by WHO Director General Margaret Chan that the H1N1 pandemic is officially over apparently ignores the latest reports from India. Health officials in the world’s second most populous nation say that the number of new H1N1 cases for the week of August 2-8 reached a new peak for the current season with 942 cases resulting in 83 deaths. One of India’s leading health officials stated “Many would say the virus has now settled down to replace the seasonal influenza strain. But there is no doubt that H1N1 continues to infect Indians in large numbers. A majority of those who died were pregnant women and the elderly — the vulnerable group.” The state of Maharashtra saw the most victims, recording 400 confirmed cases and 51 deaths. Karnataka was second with 200 cases and 12 casualties, while Andhra Pradesh, with 105 cases and six deaths, was third. Overall, India has been one of the countries hit hardest by the H1N1 virus, with nearly 37,000 cases and 1,833 deaths since the outbreak began in May of last year. To put these numbers into perspective, seasonal flu historically has a death rate of 1 per 1,000. Worldwide the H1N1 virus has killed nearly 1 in 100. In India, H1N1 has killed about 1 in

50. WHO’s Chan has responded to criticism that her announcement was premature, saying “Based on experience with past pandemics, we expect the H1N1 virus to take on the behavior of a seasonal influenza virus and continue to circulate for some years to come.” She added that isolated outbreaks are likely to occur, given the extreme virulence of the virus. Others have pointed out that the H1N1 virus may not have finished mutating, and could become even more deadly over the next several years. As HTB reported earlier, millions of H1N1 vaccine doses have expired and already been destroyed, with millions more set to expire over the next few months. The reports from India should remind us that although the pandemic may have faded, the virus has not. The Centers for Disease Control indicates that the 2010-2011 seasonal flu vaccine scheduled for shipment next month will include immunization to the 2009 strain of the H1N1 virus. Anyone travelling overseas not previously immunized against H1N1 should avail themselves of the seasonal flu vaccine. Photo by ghinson.

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About The Author

Frank Gillingham, M.D. serves as Chief Medical Director for HTH Worldwide. Frank has led HTH Worldwide's international business development efforts in Europe and Canada and has been a guest speaker at international business conferences and has authored a series of articles on travel medicine, including pieces on travel information available on the Internet and the role of physicians working with travel insurers. Frank is a Board-Certified Internist and Emergency Medicine Specialist. He is also a private emergency physician in Southern California and a former emergency department director and member of the UCLA emergency department staff. Frank completed residency training at Los Angeles County/USC Medical Center, received his M.D. from Albert Einstein College of Medicine and his B.A. from the University of Pennsylvania .

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