Pan American Health Organization, PAHO A focus of Tamiflu resistance on the American - Mexican border has been reported in the press, but not confirmed by PAHO.
World The E-CDC list covers countries outside Europe and provide country by country data. Australia report more than 25,000 cases with 85 deaths, China 2664 cases and no deaths, Hong Kong 5407 cases with 3 deaths, Japan 5022 cases with no deaths, reaching a cumulative total of 175 368 cases worldwide.
A study from the University of Wisconsin indicate that the H1N1 swine flu multiplies in greater numbers across the respiratory system, penetrates deeper into the respiratory tissues - making it more likely to cause pneumonia and causes more damage. Source: BBC U.S.A. The CDC has stopped reporting individual cases the 24 July when 43,771 cases were confirmed. Reports will now focus on hospital admissions and deaths. The 7 August 6,506 people has been admitted to hospital with H1N1 and 436 have died. The latest data clearly show that influenza activity in the U.S. has been declining over the past weeks. More information from the CDC here: H1N1 Flu Situation Update, and a graph over cases week by week.
Europe 32,690 cases have been reported and 43 deaths has been reported to date. The three worst affected countries are the United Kingdom (12,470 cases with 30 deaths), Germany (9,213 cases and no deaths) and Spain (1,538 cases with 8 deaths). The list of cases in each country can be found here: E-CDC
Comment The W.H.O. still recommend no restrictions to international travel.
Resistance Resistance will become a problem as the epidemic evolve. The manufacturer of Tamiflu, Roche, estimate from the clinical trials of tamiflu that 0.5% of isolates will be resistant and these strains will be selected by use of Tamiflu. Seasonal H1N1 influenza, but not seasonal H3N2 influenza, has shown a high degree of resistance to tamiflu even in countries with very little use of the drug, a study published in Eurosurveillance in February 2009 showed. The pandemic H1N1 has not so far showed same predilection for development of resistance to Tamiflu. Tamiflu resistant influenza virus will in most cases be suceptible to Relenza, another drug active against H1N1, manufactured by GlaxoSmithKline.
Travellers Tamiflu or Relenza are not recommended to healthy travellers not belonging to a risk group visiting countries with reported H1N1 influenza. If you belong to a risk group and receive influenza vaccines every winter, or if you are pregnant, you should consider bringing Tamiflu or Relenza with you, if visiting an area with a high number of reported cases.