Australia in top five countries worse hit by swine flu

The latest update from the World Health Organization, #43, says as of 3rd June, 66 countries have officially reported 19,273 cases of influenza A H1N1 infection (swine flu), including 117 deaths.

In order of those worse hit Australia is now in fourth position with 878 cases - the U.S. is top with 10,053 cases including 17 deaths, Mexico with 5,029 including 97 deaths, Canada with 1,530 cases including 2 deaths, Japan with 385 cases and the UK with 339 cases.

Health officials in the U.S. say the outbreak of the H1N1 flu virus appears to be on the wane with the start of summer in North America but they are preparing for its return in the autumn.

According to the U.S. Centers and Disease Control and Prevention (CDC) it is likely that there are in fact 11,468 probable and confirmed cases.

The CDC's Dr. Anne Schuchat says that 2.5% of cases (770 people) have been hospitalized with the virus and the death toll has reached 21, and though the viral activity appears to be declining in the nation as a whole she warns that the outbreak is not over as the virus is active in many parts of the country and is now increasing in many parts of the Southern Hemisphere.

According to Dr. Schuchat the current lull will be used to take stock of the nation's response to the new H1N1 flu and attempt to patch any gaps in the public health safety net before flu season starts in the autumn.

A recent report by the non-profit group Trust for America's Health has revealed that while investment in pandemic planning and stockpiling of antiviral medications has been a success, cuts in public health departments has left a lack of adequate resources to carry out the flu plans.

The report also found problems in plans for school closings and limiting mass gatherings, and that hospital emergency departments and other parts of the healthcare delivery system were overwhelmed, even with a mild outbreak.

According to the group the WHO's pandemic alert phases caused confusion because they did not account for severity of infection, only its spread - the WHO has put the H1N1 outbreak at level 5 on its 6 point scale despite most cases being relatively mild and Trust for America's Health says international cooperation had proved to be more difficult than previously thought.

In future outbreaks the group says stockpiles of antiviral medications and other supplies must be increased and vaccine development capabilities improved, along with plans for the rapid vaccination of all American citizens.

The group also urged government health officials to improve coordination at all levels of government and with other countries, and develop better strategies for school closings, sick-leave policies and other ways to limit public gatherings during periods of rapid infection - the group specifically called for a halt to planned layoffs at state and local health departments, and recommended hospitals improve strategies for handling a large influx of patients.

Dr. Schuchat has praised the report and says the CDC had already begun planning for how it will handle a second flu vaccination program on top of administering a seasonal flu vaccine.

Trust for America's Health report recommendations have been seconded by the U.S. Government Accountability Office this week which also called for more to be done to close gaps in the U.S. flu preparedness plan, including improving coordination between federal, state and local governments and the private sector.

Countries Affected by H1N1 with Largest Amount of Cases