The United States' number of pandemic flu cases climbed to 33,902, with 170 deaths, the US Centers for Disease Control and Prevention (CDC) reported today. The new totals reflect 6,185 more cases and 43 more deaths than last week. In its new surveillance report today for the week ending Jun 27, the CDC said flu activity decreased but is still higher than normal for this time of year. The New York/New Jersey area is still reporting elevated activity, as is the Pacific Northwest. [Current CDC numbers]

Authorities in Malta today confirmed the country's first two pandemic flu cases, two 26-year-old men who had recently traveled with a group to Spain, Deutsche Presse-Agentur reported. Others from the group also have flu symptoms. Before today's confirmation, Malta was the only European Union country that had not reported a novel flu case. Elsewhere, Uganda today reported its first case, a 40-year-old British man who had recently arrived from Kenya, Xinhua, China's state news agency, reported. [Jul 2 DPA article]

Paraguay's health ministry today reported the nation's first novel flu death, a man in his 60s, Agence France-Presse (AFP) reported. No details were available about any preexisting conditions. Meanwhile, China's state media said a woman who was hospitalized with a novel H1N1 infection was found dead yesterday in a hospital bathroom, according to the Associated Press. She was reportedly recovering and her death is under investigation. [Jul 2 AFP story]

The United Kingdom is moving from a novel flu containment strategy to focus more of its resources on more vulnerable patients, AFP reported yesterday. Prime Minister Gordon Brown announced the change yesterday, noting that case numbers spiked by 2,000 over the past week and that a "more flexible and local approach" will be used in hard-hit areas. Media reports say hot spots include London, the West Midlands, and Glasgow. [Jul 1 AFP story]

Some health officials in Argentina are criticizing the government for rejecting calls to postpone the nation's recent election, a move they say could have avoided the virus's spread at crowded polling places and focused the public's attention on pandemic issues, the New York Times reported yesterday. The officials said the health minister who just resigned was among those who recommended postponing the election. Increased flu cases prompted an emergency declaration in Buenos Aires. [Jul 1 New York Times article]

President Obama has called a "flu summit" on Jul 9 to discuss the nation's pandemic flu preparedness plans for the fall, CNN reported yesterday. The meeting will be held at the National Institutes of Health and be led by Department of Homeland Security Secretary Janet Napolitano and Department of Health and Human Services (HHS) Secretary Kathleen Sebelius. On Jul 30 Obama met with federal officials who helped manage the 1976 influenza outbreak to discuss lessons learned from their experience. [Jul 1 CNN story]

HHS Secretary Kathleen Sebelius announced today that the country will supply 420,000 treatment courses of oseltamavir (Tamiflu) to the Pan-American Health Organization to fight novel H1N1 flu in Latin America and Caribbean countries. She announced the effort while attending a series of meetings in Cancun, Mexico, for health ministers throughout the Americas. [Jul 2 HHS statement]

Japan's health ministry today confirmed the country's first instance of oseltamivir (Tamiflu) resistance in a novel flu virus, Reuters reported. The patient, from Osaka prefecture, was sick with the new H1N1 virus in mid May and has since recovered. A health ministry spokesman said the patient's sensitivity to the drug has not been tested yet. Danish officials reported the world's first oseltamivir-resistant novel flu case Jun 29 [Jul 2 Reuters article]

The world's number of pandemic flu cases rose to 77,201 today, including 332 deaths, the World Health Organization (WHO) reported. Today's numbers represent 6,308 more cases and 21 more deaths than the last report on Jun 29. Countries included for the first time are the French overseas territory of New Caledonia, Kenya, Mauritius, Myanmar, and Saint Lucia. About a third of the new cases are from the United Kingdom. South American countries and Thailand also reported large increases. [WHO update 56]

Health officials in Argentina's Buenos Aires city and province yesterday, amid quickly rising numbers of pandemic flu cases, declared a health emergency, extending school vacations and giving the mayor the power to suspend sports and other entertainment gatherings, the Associated Press reported today. Public places remain open. Buenos Aires is the fifth province to declare a health emergency. Argentina has South America's highest number of pandemic flu cases, with 1,587, including 26 deaths. [Jul 1 AP story]

Roche, the maker of Tamiflu (oseltamivir), today launched a program to help developing countries buy the drug at a discount for their national stockpiles. The company will produce and store the drug at a significantly reduced price, with the cost spread over the drug's shelf life. Roche will ship the supplies whenever the country requests them. The price will depend on the length of storage time that the country requests. An international health group will likely coordinate the orders. [Jul 1 Roche press release]

Bosnia's health ministry today announced the nation's first pandemic flu case, a 24-year-old woman who recently arrived from a South American country, the AP reported. She is recovering in isolation at the home of relatives. Meanwhile, the US territory of Guam confirmed its first pandemic flu case today, a woman in her 40s who just returned from Texas, KUAM, Guam's broadcast network, reported. [Jul 1 AP story]

NOTE: This item originally cited "San Francisco officials" as a source, but there has been no official confirmation of these cases nor any evidence they are related to each other.
A San Francisco doctor reported five cases of novel H1N1 infections in pregnant women in the city, according to KPIX, a northern California television station, in a story that referred to the cases as a "cluster." All five remain hospitalized, two of them in intensive care, all in their third trimester. [Jun 29 KPIX story]

Health officials in Spain and Uruguay today reported their first novel H1N1 deaths, Agence France-Presse (AFP) reported. The patient who died in Spain was a 20-year-old Moroccan woman who was 7 months pregnant and had asthma. Spain's health ministry said the baby was delivered by Caesarean section and, though premature, appears to be healthy. The Uruguayan was a 60-year-old woman who died of multiple organ failure before tests confirmed novel H1N1. [Jun 30 AFP article]

Indonesia's health minister said yesterday that visitors arriving at the country's airports from nations hit by novel flu will be asked to wear a mask for 3 days, according to a report today from AFP. The masks are a precautionary measure to reduce human-to-human transmission, she said. The masks will be handed out to international visitors as soon as funding for them comes through; however, those who don't wear them will not be penalized. [Jun 30 AFP article]

Argentina's health minister, Graciela Ocana, resigned yesterday, citing differences with the government on the handling of pandemic flu and a previous dengue fever outbreak, the New York Times reported yesterday. Meanwhile, a crisis committee will meet today to discuss raising the response level, according to a local media report, which could close schools and other public places and curb mass gatherings. Argentina has 1,488 confirmed novel flu cases, many of them around Buenos Aires. [Jun 29 New York Times article]

Saudi Arabian health officials who just concluded a 4-day meeting with international health experts to discuss pandemic flu risks related to the hajj today advised that children, pregnant women, elderly people, and those with chronic health conditions avoid the annual pilgrimage, the Associated Press reported. The 4-day hajj starts in late November this year and is expected to attract about 3 million pilgrims. The health ministry said the crowded setting could pose a flu transmission risk. [Jun 30 AP story]

San Diego researchers with close knowledge of the confirmation of the first US novel flu cases reported today in a letter to the New England Journal of Medicine that the sensitivity of rapid tests used during the outbreak was low, the same as for seasonal strains, and varied by subtype. When they compared rapid tests to polymerase chain reaction (PCR) tests, sensitivity for the QuickVue rapid test was 51% for novel H1N1, 63% for seasonal H1N1, and 31% for H3N2. [Jun 29 N Engl J Med letter]

Airline industry data show a high correlation between the start of the H1N1 flu pandemic in various countries and the number of passengers from Mexico that tend to arrive in those countries in March and April, according to Toronto researchers. Of the 20 countries that had the highest passenger volume from Mexico in 2007 and 2008, 16 experienced importations of H1N1 from Mexico in 2009; countries that had more than 1,400 such passengers had a "significantly elevated" risk of flu importation. [Jun 29 N Engl J Med letter]

The latest global number of new pandemic flu cases is 70,893 cases, including 311 deaths, the World Health Organization (WHO) reported today. The new total is an 11,079-case rise from the WHO's last update on Jun 26. The once-weekly update of US cases represents more than half of the new cases. The number of fatalities rose by 48 since the last report. The list includes four countries reporting their first cases: Iraq, Lithuania, Monaco, and Nepal. [WHO update 55]

A Danish patient confirmed as having novel H1N1 influenza exhibited resistance to the antiviral drug oseltamivir (Tamiflu), an official from Roche, the maker of the drug, said today. "While receiving the drug, the patient appeared to develop resistance to it," David Reddy, Roche's pandemic task force leader, said on a conference call, according to Reuters. "This is the first report we have of it in H1N1," he said. [Jun 29 Reuters report]

The pandemic vaccine now being produced will require two shots 3 weeks apart to provide full immunity, which could overwhelm state agencies, officials said at a meeting last week at the Centers for Disease Control and Prevention. And children younger than 9 years old will need four shots, the CDC said, according to a Bloomberg News report. "Public health departments are underfunded and will get fatigued," said flu expert William Schaffner, adding that one shot will give at most 20% protection. [Jun 26 Bloomberg News report]

Kenya's health ministry today announced the country's first novel flu case, a 20-year-old British man visiting as a student, Agence France-Presse (AFP) reported. The man got sick 2 days after arriving in Kenya and is recovering in isolation at a hotel. In other developments, Myanmar's government on Jun 27 reporting the country's first pandemic flu case, a 13-year-old girl who became ill after visiting Singapore with her family, according to Irrawaddy, a Thai-based news service. [Jun 29 AFP article]

Brazil has reported its first swine flu fatality, in an adult woman of unspecified age, according to a story in today's Hindustan Times. Brazil's health ministry said in a statement that the woman, who died Jun 28, was "from the state of Rio Grande do Sul who had spent 1 week in Argentina." The story said officials were investigating another suspected novel flu death in the same state. [Jun 29 Hindustan Times story]

Children with chronic medical conditions have fewer flu-related complications when they receive oseltamivir (Tamiflu) within a day of flu diagnosis, researchers reported today in an early online edition of Pediatrics. The study covered six flu seasons between 2000 and 2006 and was based on a Reuters Thomson database. Compared with those who didn't receive the drug, children who received oseltamivir had fewer complications and hospitalizations 14 and 30 days after flu diagnosis. [Jun 29 Pediatrics abstract]

The global number of novel H1N1 cases climbed to 59,814 cases, including 263 deaths, the World Health Organization (WHO) reported today. The total reflects a 3,947 increase from the last update on Jun 24. Jurisdictions appearing on the list for the first time are Indonesia, Iran, Serbia, and the UK crown dependency of Guernsey. Countries reporting the highest increases since the last report include Chile, the UK, Mexico, Australia, and Canada. [WHO update 54]

The nation's number of novel flu cases rose to 27,717 cases and 127 deaths, the US Centers for Disease Control and Prevention (CDC) reported today. The tally represents 6,268 more cases and 40 more deaths than the last update a week ago. States reporting the highest number of cases include Wisconsin, Illinois, Texas, New York, California, Pennsylvania, and Massachusetts. New York has the most fatalities, 35, followed by California with 16. [Current CDC numbers]

A surveillance expert from the CDC said yesterday at the agency's immunization group meeting in Atlanta that the true number of pandemic H1N1 cases in the United States could be as many as 1 million, the Associated Press (AP) reported today. Lyn Finelli said the projection was based on mathematical modeling and surveys from health officials. She told the Advisory Committee on Immunization Practices (ACIP) that 6% or more of the population from some urban areas could be infected with the virus. [Jun 26 AP story]

Robin Robinson, an official from the US Biomedical Advanced Research and Development Authority (BARDA) who addressed the ACIP group yesterday, projected that as many as 60 million doses of the pandemic H1N1 vaccine could be available by September, the AP reported today. However, others at the meeting said the estimate may be too optimistic. [Jun 26 AP story]

The pandemic H1N1 strain is dominating seasonal flu strains in Victoria, according to a report from the Victoria Infectious Diseases Reference Laboratory (VIDRL) that covered last week. Of 138 influenza A samples tested, 60 were novel H1N1, 3 were H3N2, and 2 were seasonal H1N1. Victoria is the state with the most confirmed novel flu cases, 1,560 of Australia's 3,519. Experts predicted that the new flu strain might push out seasonal strains as the southern hemisphere's flu season progresses. [VIDRL weekly flu surveillance report]

Health officials in England said pandemic flu response in two parts of the country will shift from a containment to a management strategy, the London Daily Mail reported today. The change, which affects London and West Midlands, means that schools will no longer close and that antiviral medication will no longer be given to close contacts of flu patients, only those who have illness symptoms. Also, most illnesses will be diagnosed clinically rather than through lab testing. [Jun 26 Daily Mail story]

Sanofi Pasteur, one of the five companies that are developing a novel H1N1 vaccine for the US market, said it began large-scale production on Jun 23, according to the company's Web site. The company will still need to conduct clinical trials, which it said in an earlier statement could take place as early as August. In late May the company received a $190 million order from the US Department of Health and Human Services to make bulk vaccine and conduct other activities. [Sanofi timeline of novel flu vaccine developments]

Animal health officials from Argentina said yesterday in a report to the World Organization for Animal Health (OIE) that two workers at a pig farm where the animals tested positive for novel H1N1 were sick between Jun 7 and 9, but did not seek medical care or undergo testing. The report said pigs started getting sick on Jun 15. The virus sickened 30% of the 5,586 pigs, but none have died. The facility has its own restocking system, and no pigs have entered from outside the farm since July 2008. [Jun 25 OIE report]

The health system in the Rochester, N.Y., area is under heavy strain from a "very high volume" of novel flu patients, according to Dr. Andrew Doniger, public health director for Monroe County, which includes Rochester. In a Jun 24 report posted by the news site MPNnow, Doniger said people with possible flu should not try to see a doctor unless they have severe symptoms, such as persistent fever or breathing difficulty. He said the area had relatively few flu cases until the second week of June. [Jun 24 MPNnow report]

A pig in Argentina has tested positive for novel H1N1 influenza, the director of the country's animal health and sanitation service, Jorge Amaya, said today, according to a Dow Jones News report. Because no animals have been moved into the area recently, animal health officials are exploring whether the animal contracted the virus from a human. Other hogs are being tested in areas in proximity to the pig, which has since recovered. [Jun 25 Dow Jones Newswire story]

Iraq has recorded its first cases of the novel H1N1 influenza, in five women's basketball players and their male coach, according to Agence France-Presse (AFP). The six returned from Chicago to Iraqi Kurdistan a week ago and have been hospitalized for monitoring since then, the Kurdish region's health minister said. On the trip back from Chicago, the team passed through Amman, Jordan, where another player was held after she tested positive for the virus, the story said. [Jun 25 AFP report]

Serbian leaders announced yesterday that athletes attending the World University Games in Belgrade next month will be required to show a certificate saying they don't have the new flu, the Associated Press (AP) reported yesterday. Athletes without a certificate will be quarantined. And today, the nation's health minister said a 29-year-old Belgrade man who visited Argentina last week has Serbia's first confirmed case of the illness, the Web site Balkan Insight reported. [Jun 24 AP report]

Egypt has confirmed its first novel H1N1 case in an Egyptian returning from a Muslim pilgrimage to Mecca, Saudi Arabia, according to Middle East Online, which cited a health ministry spokesman quoted by the state-owned newspaper Al-Akhbar. The man was hospitalized in stable condition. Health ministry officials had warned of the dangers posed by the flu to millions of Muslim pilgrims traveling to Saudi Arabia. [Middle East Online report]

Aboriginal leaders in Manitoba have declared an emergency in their communities over the novel flu, and they want the Canadian federal and provincial governments to do the same, the Canadian Press reported. The emergency declaration permits aboriginal groups to divert money from other programs, and a similar declaration at higher levels would lead to increased efforts to provide emergency supplies and healthcare workers to hard-hit communities, said the leader of the Assembly of Manitoba Chiefs. [Jun 25 Canadian Press report]

The global tally of novel H1N1 flu cases rose to 55,876, including 238 deaths, the World Health Organization (WHO) reported today. The total is an increase of 3,707 since the last WHO update 2 days ago. The list includes nine countries reporting their first novel flu cases: Antigua and Barbuda, Cambodia, Cape Verde, Cote d'Ivoire, Ethiopia, Latvia, Montenegro, Tunisia, and Vanuatu. Countries reporting more than 200 new cases are Argentina, Australia, Brazil, Canada, Mexico, and Britain. [WHO update 53]

Indonesia's health ministry reported the country's first novel flu cases today, Bloomberg news reported. The patients are a pilot who traveled to Australia and Hong Kong and a British woman from Australia who was hospitalized in Bali. Officials had said there were no local cases of novel flu, but 2 days ago Singapore's health ministry included Indonesia on a list of 15 countries that it said had exported the virus. Health experts worry that the new virus could reassort with H5N1 avian influenza. [Jun 24 Bloomberg News story]

Seven more people in Argentina have died of novel H1N1 influenza, raising the total to 17, the most in South America, the country's health ministry reported yesterday, according to the Associated Press (AP). All the deaths occurred in or near Buenos Aires, where a city health official said nonessential surgeries would be postponed to free up hospital beds. Argentina has 1,213 novel flu cases, the WHO said today, an increase of 203 from the last report. [Jun 23 AP story]

South Korean health officials have quarantined 25 members of a high school group from Hawaii after five members of the group tested positive for the novel flu virus, Agence France-Presse (AFP) reported today. The group has been quarantined at a hospital since Jun 22 and will be treated and observed for about a week. [Jun 24 AFP story]

US agriculture officials believe the novel H1N1 virus originated in Asia, not in North America, where it was first found, according to a New York Times report today. There is no evidence that the new virus has ever circulated in North American pigs, but a virus taken from a pig in Hong Kong in 2004 was found to be closely related to it, the story said. US officials thus speculate that a human carried the virus from Asia to North America--but they said there is no way to prove the idea. [Jun 24 New York Times report]

Scientists and public health officials from North America will meet at Arizona State University for 4 days starting tomorrow to discuss pandemic mitigation techniques that relate to mathematical and computer modeling. They will discuss issues such as the impact of mass transit on disease spread, vaccine and antiviral medication planning, and real-time disease surveillance. The conference will also include tabletop pandemic preparedness exercises. [Jun 23 ASU press release]

In a report yesterday on effects of the economic downturn, the World Bank said the severity and impact of the current pandemic seem to resemble the Hong Kong influenza pandemic of 1968-69, which could mean a drop in gross domestic product of 0.7%. The World Bank said developing countries are most vulnerable to pandemic effects because of high population density, weak healthcare systems, and high prevalence of chronic diseases. The pandemic will likely erode Mexico's output by 5.8% in 2009 [Jun 22 World Bank report]

Montenegro's health minister today confirmed the country's first novel flu case, in a student who was returning from New York to his home in Macedonia, the Balkan Insight Web site reported. The patient has been isolated, and his relatives and contacts he visited in Belgrade are being monitored in their homes. Meanwhile, Latvia also reported its first novel flu case, in a woman who got sick on a flight home after visiting the United States and Canada, Agence France-Presse reported. [Jun 23 Balkan Insight story]

Honduras and the Philippines reported their first novel flu fatalities yesterday, according to media reports. The Honduran patient was a 23-year-old pregnant woman who lived in a rural area and died in mid June, Reuters reported. The Filipino victim is a 49-year-old woman who also suffered a heart attack, news services said. She worked for the country's House of Representatives, which was shut down for 5 days so the building could be sanitized. [Jun 23 Reuters story]

A disease-control specialist in Australia's Northern Territory said today that the government's recent decision to restrict oseltamivir (Tamiflu) to "critical case criteria" should be relaxed for aboriginal patients who have suspected pandemic flu symptoms, the Australian Broadcasting Corporation reported. The expert said that 50% of people in the communities have chronic health conditions and that broader antiviral use could reduce the risk of disease transmission to vulnerable people. [Jun 23 ABC story]

A 15-year-old boy in Buffalo, N.Y., died Jun 19 of novel H1N1 flu that was complicated by a methicillin-resistant Staphylococcus aureus (MRSA) infection, the Buffalo News reported today. A few children die each year of seasonal flu with secondary MRSA infections, and the CDC has been watching to see if similar coinfections occur with the new virus. Meanwhile, a 9-year-old boy in Buffalo is currently in critical condition with H1N1 and MRSA infections, the story said. [Jun 23 Buffalo News story]

The World Health Organization's (WHO's) count of novel H1N1 influenza cases today reached 52,160, nearly 8,000 more than the last count on Jun 19. The WHO listed the death toll as 231, up from 180 as of 3 days ago. Five countries are new to the list today: Algeria, Bangladesh, Brunei Darussalam, Fiji, and Slovenia. Media reports said that Ethiopia and Iran also have reported their first cases, all in people who were recently in the United States. [WHO update 52]

The novel H1N1 influenza virus accounted for 98% of all influenza A viruses that were subtyped in the United States in the week of Jun 6-13, the Centers for Disease Control and Prevention (CDC) reported on Jun 19. Only 0.2% of isolates were influenza B. The CDC said overall flu activity declined but remained above normal for this time of year, with 11 states reporting widespread activity. The death of one child was linked to the novel virus. [CDC flu surveillance report]

The US State Department warned on Jun 19 that travelers to China may be quarantined for 7 days if they arrive with a fever or flu-like symptoms. Chinese authorities target travelers with even slightly elevated temperatures if they come from areas with novel H1N1 cases, plus people sitting near them, the statement said. It also said the US has received reports of children being separated from parents and travelers being held in unsuitable quarantine conditions with poor drinking water and food. [Jun 19 State Department warning]

The Muscular Dystrophy Association (MDA) has canceled its remaining summer camps after 11 children at camps in two states got sick with novel H1N1 infections, the group said in a Jun 19 statement. The MDA said children who attend the camps have weakened respiratory muscles, which puts them in a high-risk flu group. The CDC consulted on and agreed with the cancellation of the MDA's remaining 47 camps, which were set to host 2,500 children. [Jun 19 MDA press release]

As the Public Health Agency of Canada works on its priority list for the novel H1N1 vaccine, people aged 5 to 40 and those living in aboriginal communities may be at the top of the list, Canwest News Service (CNS) reported today. Officials said the pandemic strain, unlike seasonal flu, is striking mainly children and young adults. Though older people appear to have some immunity to the virus, immunizing their grandchildren may provide an extra measure of protection, an expert said. [Jun 22 CNS story]

AVI Biopharma, based in Portland, Ore., announced yesterday that it has received a contract of up to $5.1 million from the US Department of Defense to develop one or more RNA-based drugs to treat novel H1N1 flu. In addition to identifying potential drug targets and lead and backup drug candidates, the contract supports the production of testing material for animal studies. The company said its RNA-based drugs use proprietary technology that targets messenger and premessenger RNA. [Jun 21 AVI Biopharma press release]

The number of global novel influenza cases grew to 44,287 cases, including 180 deaths, the World Health Organization (WHO) reported today. The total is a 4,667 increase from the number it reported in its Jun 17 update. The list includes the first confirmed cases from Laos, Oman, St Maarten, Papua New Guinea, South Africa, and Suriname. Countries reporting large increases include Mexico, Canada, Argentina, Chile, and the United Kingdom. [WHO update 51]

The nation's number of novel H1N1 cases grew to 21,449, including 87 deaths, the US Centers for Disease Control and Prevention (CDC) reported today. The number reflects an increase of 3,594 cases and 43 fatalities from a week ago. States reporting the most cases include Wisconsin, Illinois, Texas, New York, Massachusetts, and California. New York confirmed the highest number of deaths, 24, followed by Texas with 10, and California, Utah, and Illinois with 8 each. [Current CDC numbers]

Australian health officials today reported the country's first novel flu death, a 26-year-old man from a remote Western Australia community, the Australian Broadcasting Corporation reported. The man, who reportedly had a number of other health conditions, died in an Adelaide hospital where he was flown earlier this week for pneumonia treatment. Tests yesterday revealed he also had novel H1N1 flu. Some experts warn that the pandemic's effects could be more severe in remote populations. [Jun 19 ABC story]

Officials in Papua New Guinea and Bangladesh reported the nations' first novel H1N1 cases, according to media reports today. Few details were available about the patient in Papua New Guinea, other than he or she had recently developed flulike symptoms after overseas travel. Meanwhile, a health official in Bangladesh said the country's first case was in a 17-year-old boy who had recently traveled with a student group to the United States. [Jun 19 AFP story]

New Zealand's health ministry announced today that the country was shifting from a "contain" to a "manage" pandemic response level. In a statement, the ministry said the change reflects increased transmission of the virus, particularly in Wellington, Christchurch, and Auckland, not the severity of the disease. The ministry said the change will enable community health services to manage large numbers of influenza patients and maintain service levels for other sick people. [Jun 19 New Zealand health ministry statement]

The world's number of novel H1N1 cases climbed to 39,620, including 167 deaths, the World Health Organization (WHO) reported yesterday. The total is a 3,692 increase from the number reported Jun 15. Yesterday's list includes the first cases reported by 12 jurisdictions, most of them European overseas territories in the Caribbean. Other areas reporting their first cases include UK crown dependencies Isle of Man and Jersey and the countries of Jordan, Qatar, Samoa, Sri Lanka, and Yemen. [WHO update 50]

In some US areas hit hardest by the novel flu virus, up to 7% of the population may have been infected, a Centers for Disease Control and Prevention (CDC) official said at a news briefing today. "In some areas where there's been a lot of transmission, such as New York City, they're finding that maybe around 7% of the community was infected or had influenza-like illness," said Dr. Daniel Jernigan of the CDC's flu division. But he said that percentage does not apply nationwide. [Transcripts of CDC H1N1 briefings]

South Africa's health ministry confirmed in a statement today the nation's first novel flu case, a 12-year-old boy from the United States who arrived in South Africa on Jun 14 and had flu-like symptoms. The patient was isolated in a hospital the next day and discharged a few days later. Elsewhere, the Chinese administrative region Macau reported its first case, a man who had arrived from the Philippines with a fever, Agence France-Presse reported today. [Jun 18 South Africa Department of Health statement]

Investigators from the European Union recently reported in the Jun 13 issue of Veterinary Record preliminary results of a study of novel H1N1 infection and spread in pigs. Lab testing confirmed that pigs are susceptible to the new virus and that sick ones can transmit the virus successively to uninfected animals. Disease severity varied, but none of the pigs died. Researchers said the virus can become established in pig populations, but illness patterns could vary in the field. [Jun 13 Veterinary Record issue]

Japan's health ministry will close special clinics for people with influenza infections in an effort to prevent people from overwhelming them in the fall if a more severe wave of the novel H1N1 virus strikes, the Asahi Shimbun reported today. Officials fear overcrowded clinics could delay treatment for those with severe illnesses. Sick patients will be treated at any medical clinic. The ministry also said it would scale back quarantine measures at entry ports to prepandemic levels. [Jun 18 Asahi Shimbun story]

Leaders from three of Manitoba's First Nations communities met with Canada's health minister yesterday and said their demand for a field hospital in the area was turned down, Canwest News reported today. They said federal officials say that a field hospital could slow novel flu outbreak response efforts. The chiefs said they raised concerns about the 20 hours it takes to transport severely ill patients to Winnipeg for treatment, but said they believe federal officials heard their issues. [Jun 18 Canwest News Service story]

Egypt's pig cull was billed as a way to reduce novel H1N1 risks, but now officials have shifted their rationale to improving public health, according to Egypt Today magazine. Many of the country's large pig farms are in "garbage cities" that segregate recyclable materials from organic matter, 30% of which is fed to the pigs. In a ProMed post on the article, a moderator asked why officials have not used a more defensible reason: preventing reassortment between H5N1 and novel H1N1 viruses. [Jun 17 ProMed-mail post]