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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/%20h1n1_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 32 (EW 32), August 9 to August 15, 20 countries reported updated information to the Pan American Health Organization (PAHO) regarding the qualitative indicators to monitor pandemic (H1N1) 2009 (Table 1).

Based on the most recent information provided by 34 countries on the geographical spread of pandemic (H1N1), 23 countries report widespread distribution. Belize is the only country reporting an increase in the spread from localized to regional. Information from Trinidad and Tobago was previously not available, but it is now reporting widespread distribution. Saint Kitts and Nevis and Dominica continue to report no activity (Map 1).

The trends in respiratory diseases were available for 30 countries. Argentina, Canada, Costa Rica, Dominican Republic, El Salvador, Jamaica, Mexico, Panama, Paraguay, Saint Lucia, United States, Uruguay, and Venezuela report decreasing trends, while Haiti, Honduras, and Bolivia reported increasing trends. Belize and Peru which reported increasing trends for EW 31 informed an unchanged trend, while Saint Lucia informed a decreasing trend for EW 32 (Map 2).

Regarding the intensity indicator, information has been provided by 29 countries. Low or moderate intensity was reported by 23. Five countries (Argentina, Costa Rica, El Salvador, Guatemala, and Paraguay) reported high intensity. Mexico reported very high intensity for the second consecutive week (Map 3).

Impact on health care services indicator is available for 28 countries. Eleven countries informed a moderate impact on health care services, three more in comparison with EW 31 (Belize, Costa Rica, and Peru). Among these countries, Peru reported a low impact to present and Belize and Costa Rica did not have information available up to date. No country reported a severe impact (Map 4).