The most frequent zoonosis

The most frequent zoonosis

• The most frequent zoonosis

• Reservoir

• Multiple hosts

• Species barrier

• Epizootics and epidemics

• Impossible to erradicate

• Individually avoidable

Expected phenomenon

• Expected phenomenon

• Fast global ignition process

• Phase 4  Phase 5  Phase 6  Portugal

• No pandemics are alike:

• 1889, 1900, 1918, 1957, 1968, 2009

• Different issue from seasonal influenza

• Emergence of the A(H1N1)2009 virus

• H1 generations

Worldwide impact

• Worldwide impact

• Ongoing spread of infection over both hemispheres
• Common trends in each hemisphere

• National impact

• Variable patterns according to location
• Flu activity with up & down pattern over the weeks

Southern hemisphere

• Southern hemisphere

• General widespread infection, though decreasing as Winter ends

• Northern hemisphere

• General flu activity during all Summer
• Japan reporting a significant increase of ILI cases

Some aspects differ from seasonal flu:

• Some aspects differ from seasonal flu:

• High activity during Summer, in the northern hemisphere
• Severe and fatal cases mainly in younger age groups
• Death mainly associated with a rapid respiratory failure

• Very fast worldwide spreading

• All world regions in just 9 weeks

Wide spectrum of severity (no symptoms  death)

• Wide spectrum of severity (no symptoms  death)

• Proportion of cases with no symptoms not yet established

• Majority of patients develops self-limited clinical cases

• Risk groups:

• Pregnancy, chronic respiratory disease, cardiovascular diseases, diabetes, obesity, immunodepression.

Most patients recover without hospitalization

• Most patients recover without hospitalization

• Care-providers must pay attention to signs of aggravation:

• Risk groups
• Severe respiratory failure can develop very quickly

• Guidelines issued on care provision and use of antivirals

Viruses remain unchanged

• Viruses remain unchanged

• Will evolve and diverge over time
• Sensitive to oseltamivir and zanamivir
• Resistant to amantadine and rimantadine
• 12 cases of oseltamivir resistance reported

• Increased incidence of the pandemic virus

Containment phase - April 24 – August 21

• Containment phase - April 24 – August 21

• First reported case - April 29
• First secondary case - July 4
• First cluster - July 5
• 100 cumulative cases - July 14
• 1000 cumulative cases – August 14
• 2000 cumulative cases – August 21

• Mitigation phase - August 21

Minister of Health

• Minister of Health

• DGS, INSA,INFARMED, INEM

• Emergency Coordination Committee

• Articulation with all sectors involved

• Involvement of citizens, families and enterprises