This report was prepared based on the indicators in the document Human infection with pandemic (H1N1)2009 virus: updated interim WHO guidance on global surveillance available at http://www.who.int/csr/disease/swineflu/notes/h1n1_surveillance_20090710/en/index.html
The qualitative indicators for surveillance of the Pandemic (H1N1) 2009 are described in Table 3 of this report. The information presented herein has been obtained through the official sites of the Ministries of Health of the countries in the Region as well as official reports submitted by the International Health Regulation (IHR) National Focal Points.
Update on the Qualitative Indicators
For Epidemiological Week 37 (EW 37), from 13 September to 19 September, 18 countries reported updated information to the Pan American Health Organization (PAHO) regarding the qualitative indicators to monitor pandemic (H1N1) 2009 (Table 1)1. Only those 18 countries were included in this analysis.
Presently, 14 countries in the Region reported having widespread geographical distribution of influenza virus.
Brazil and Cuba reported regional activity and Dominica and Saint Kitts and Nevis reported no activity (Map 1).
Barbados, Canada, Cuba, Honduras, Jamaica, Mexico, and the United States reported an increasing trend of respiratory disease. Brazil, Costa Rica, El Salvador, Paraguay, Saint Kitts and Nevis, and Venezuela reported a decreasing trend. The other five countries reported an unchanged trend (Map 2).
Regarding the intensity of acute respiratory disease, El Salvador, Mexico, and Paraguay reported high intensity of acute respiratory disease. The remaining 15 countries reported low or moderate intensity (Map 3).
Nine countries (Barbados, Brazil, Costa Rica, Ecuador, El Salvador, Mexico, Paraguay, United States, and Venezuela) reported moderate impact on health care services, while eight countries reported low impact (Map 4).
In North America and the Caribbean islands, trends in respiratory disease are increasing
The World Health Organization (WHO) does not recommend any travel restrictions or border closures due to pandemic (H1N1) 2009.