Public Health: A (H1N1) spreading like wildfire?

The news from Australia today is particularly bleak: yesterday, Victoria - where the capital Melbourne seems to be the centre of the outbreak - announced yet more cases. Across Australia, there were 200 more confirmed yesterday, bringing the total number in the country to 900. As a percentage of the population of just 25 million, that is disturbing.

But the picture in the USA is no less worrying. There is far less publicity surrounding confirmed cases - but the USA appears to be exporting it: in the past two weeks, Malaysian Airlines flights from New York have carried non-symptomatic patients resulting in the cost and confusion of tracing hundreds of passengers and aircrew.

Yesterday, the number of confirmed cases in Singapore rose to 11 as a passenger who flew with Singapore Airlines from Frankfurt, landing on Monday morning, complained of feeling unwell on Wednesday - again, non-symptomatic as she passed through the departure airport, during the flight and even as she passed through Changhi's passenger checking system. Last month, Singapore reduced its warning level but since then a number of new cases have come to light. Even so, the number remains low in percentage terms.

In California, an 11 year old girl died after contracting the virus. So did a 55 year old woman in Philadelphia.

Where it all started, Mexico, the situation is dire: it's several weeks since they stopped counting suspected cases. At that time, they had reached about 2500. Now, confirmed cases have topped the 5,600 mark. The disease there has a disturbing pattern: more than half the dead are women between 20 and 54 years. They are supposed to be the most robust and healthy section of the population. In fact, more than 70% of the deaths are within that age group, the Mexican authorities say.

The World Health Organisation has succumbed to information overload: now updating its figures every two days instead of daily, it says that the infection has spread to 66 countries with more than 19,000 confirmed cases.

Cambodia - where our picture was taken - has reported no cases of A (H1N1)

Canada, again a country with a small population, has reported 1530 resulting in 2 deaths.

So why is the USA escaping so lightly? The answer is that it's not: but their cases are not hitting the news. In fact, the USA has reported more than 10,000 cases, more than a thousand in the three days to 3 June.

There is a full table at http://www.who.int/csr/don/2009_06_03/en/index.html. One thing is immediately apparent: countries with the largest pork consumption - Spain, China, Philippines have remarkably low incidences relative to populations compared to most other countries.

As if that's not bad enough, Egypt is in the grip of sudden outbreak of Avian flu that started in mid April and is rapidly spreading.Of 78 cases reported in Egypt in the past six weeks, 27 have proved fatal.