The Progressive Expansion Of The Novel A (H1n1) V Epidemic In The Episouth Region (Mediterranean And Balkans)

Background: EpiSouth is a network covering 26 Mediterranean and Balkan countries. Since April 2009, all continents have been progressively affected by the A(H1N1)v influenza pandemic. Methods: In the scope of the project, EpiSouth countries shared, on a voluntary basis, information regarding their confirmed cases, case definitions and cases management strategies. Data concerning confirmed cases were analysed on a weekly basis. Results: The first confirmed case was reported on the 27th of April in Spain. As of 06 July 2009, 2,577 confirmed cases were reported by 24/26 countries. The most affected country was Spain (776 cases) followed by Israel (681) and France (330). The pandemic spread within the four EpiSouth sub-regions was slightly different: the number of cases started to increase markedly first among EpiSouth EU countries (week 19), followed by Middle-East (week 23), and finally North Africa and Balkans (Week 27). These different dynamics can be partly explained by the historical or socio-economical links existing between countries. The more rapidly affected EpiSouth countries (e.g. Spain, Israel or France) are those with close links (e.g. numerous direct daily flights with the Americas) while countries with less direct or frequent connections could delay longer the implementation of a local cycle of transmission. Later, population movements within EpiSouth countries also contributed to a further pandemic spread (e.g. cases exported from France to Algeria, Slovenia and Tunisia and from Spain to Lebanon and Serbia). The third phase was linked to relations with neighbouring areas e.g. Saudi Arabia exported cases to several EpiSouth countries. Conclusion: While all countries were faced with the same difficulties regarding implementation of control measures, the ongoing information exchange between countries has proven its importance. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive