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Pandemic (H1N1) 2009
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Health requirements and recommendations for entry visas for Saudi Arabia for Hajj and Umra, 1430 H (2009)
 The
Ministry of Health of Saudi Arabia has recently issued a set of
health requirements and recommendations for entry visas for
Saudi Arabia for the Hajj and Umra season, 1430 H (2009), with
special focus on reducing the transmission of pandemic (H1N1)
2009 influenza among pilgrims. These health requirements and
recommendations call for those population groups who are
considered to be at high risk for complications from influenza
to refrain voluntarily from this year’s Hajj. The requirements
issued by the Kingdom also request the health authorities in
pilgrims’ countries of origin to educate and advise pilgrims on
basic public health measures (personal hygiene measures, cough
etiquette, use of antiseptic hand gel, etc.) to be followed
during Hajj and Umra to prevent the spread of pandemic (H1N1)
2009 during the upcoming Hajj season.
  Read the related issue of
Weekly Epidemiological Monitor,
volume 2, issue 46, 15 November 2009
Further reading
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Pandemic (H1N1) 2009
virus infection in Afghanistan
 In recent weeks, Afghanistan reported a surge in cases from
pandemic (H1N1) 2009 virus infection. The outbreak first started
in Afghanistan on 3 July 2009 when the first
laboratory-confirmed case was reported in the multi-national
forces.
However, the first case amongst the civilian population
was reported on 28 October 2009 and till 07 November 2009, the
outbreak spread to 7 out of 34 provinces in the country with 772
laboratory-confirmed cases and 11 deaths. Of these, 69 cases
have been reported in the civilian population, 313 cases in the
foreign military personnel and 390 cases were reported in the
Afghan national armed forces personnel. Of the 11 deaths
reported so far, 3 deaths were reported in the Afghan military
personnel and the remaining 8 deaths were reported in the
civilian population.
Read the related issue of
Weekly
Epidemiological Monitor, volume 2, issue 45, 8 November 2009
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SAGE’s advise on pandemic influenza
vaccines
 The Strategic Advisory Group of Experts (SAGE) on Immunization,
which advises WHO on policies and strategies for vaccines and
immunization, devoted a session of its 27–29 October meeting to
pandemic influenza vaccines. The experts reviewed the current
epidemiological situation of the pandemic worldwide and considered
issues and options from a public health perspective.
Following the conclusion of the meeting, SAGE’s recommendations on
pandemic influenza vaccines have been released. The experts advised
WHO on the number of doses of vaccine needed to confer protection in
different age groups, the co-administration of seasonal and pandemic
vaccines, and vaccines for use in pregnant women. Recommendations on
the formulation of seasonal influenza vaccines for the southern
hemisphere in 2010 were also provided.
Read more on pandemic influenza vaccines
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Oman becomes the first country in the Region to launch vaccination
against pandemic (H1N1) 2009 virus infection
 On 26 October, the Sultanate of Oman launched its vaccination
campaign against pandemic (H1N1) 2009 virus infection. The first
120,000 doses of adjuvanted vaccines received by the country will be
used to vaccinate the Hajj Pilgrims, frontline health care workers
and the pregnant women who are considered to be at risk from
pandemic influenza.
In phases, the Sultanate is expected to receive 2.6 million doses of
pandemic vaccines until April 2010 to cover its entire population
including all foreigner residents living in the country.
A massive public awareness campaign has also started in the
Sultanate in connection with the vaccination campaign.
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First report of oseltamivir-resistant pandemic (H1N1) 2009 influenza
virus from the Region
 The Republic of Yemen reported its first oseltamivir resistant
pandemic (H1N1) 2009 virus last week. 2009. This is also the first
case of oseltamivir resistance virus reported from the Eastern
Mediterranean Region.
The specimen was taken from a 3 year old female child who was
admitted to the hospital on 07 October with high grade of fever,
cough, sore throat, body ache and difficulty in breathing. The child
was also a known case of congenital heart disease with pulmonary
hypertension. The child was put on antiviral medicine and was tested
positive for H1N1 by RT-PCR on 9 October at the National Public
Health Laboratory of Yemen. The clinical condition of the child did
not improve even 10 days after she was put on treatment. At this
stage, her second nasal swab was tested positive for H1N1 at the
same laboratory. The isolate was sent to NAMRU-3, a WHO
Collaborating Center) for routine antiviral resistance test and
found to be resistant to oseltamivir. The patient has now clinically
improved with no fever and difficulty in breathing.
Since the beginning of current influenza pandemic, a total of 40
cases of oseltamivir-resistant pandemic (H1N1) 2009 virus, including
the one from Yemen, have been reported globally to WHO till the end
of October 2009. Globally all resistant cases reported so far are
geographically dispersed and not epidemiologically linked to one
another. Extensive susceptibility testing of clinical samples and
virus isolates also suggests that such resistant viruses are not
circulating at a community level.
Read the related issue of
Weekly Epidemiological Monitor,
volume 2, issue 44, 01 November 2009
Further reading:
Weekly Epidemiological Record, 30 October 2009;
Volume-84, 44 (PP-453-468)
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