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in Argentina Pandemic H1N1 Fatalities
The Ministry of Health in the province of Santa Fe reported tonight, through the Situation Room that operates under the Contingency Plan prepared in connection with the pandemic influenza A (H1N1), the total number of reported cases with Epidemiological fact sheets exceeds 2000, with 400 confirmed and 18 deaths, 15 of which belong to Node Rosario, one of the Venado Tuerto and two of Santa Fe
This record corresponds to the information available to date Sunday July 5 to 20 hours.
The above translation describes 18 confirmed fatalities in Santa Fe Province, including 15 deaths in Rosario, as of Sunday night (see updated map). A national report which reported no deaths in Santa Fe last week has an updated number of 9 for Santa Fe, and 60 for the entire country, most of which is from cases in adjacent Buenos Aires Province. The 60 confirmed cases is a marked increase from the 26 reported last week However, the 60 reported cases do not include other recent fatalities cited in media reports which included 11 deaths in Corrientes, 5 deaths in Neuquen, and at least one death in Tierra del Fuego, Jujuy, Cordoba, San Juan, Salta, La Pampa, Rio Negros, Entre Rios, and Santiago del Estero. The national totals do not include any fatalities in the above provinces, raising concerns of a rapid rise in cases that has not been reported beyond the local media reports.
These data indicate the death tally has tripled in the past week and is among the highest in the world (behind the United States and Mexico). However, the cases in Argentina developed very recently, raising concerns that the virus has changed.
To date, there is only one partial pandemic H1N1 MP sequence at Genbank or GISAID. It was collected in April and is identical to a large number of public sequences. However, there are no sequences representing the recent fatalities or June precursors to H1N1 associated with the recent fatalities.
The rapid rise in cases and the failure to provide timely sequence data continues to increase pandemic concerns of an evolving H1N1 that is largely missed by current surveillance approaches.
Recent reports out of Hong Kong described oseltamivir resistance in a traveler from San Francisco who had not taken Tamiflu, raising concerns of resistance in the US. Although no such case has been identified to date, the Hong Kong case was mile and recent (detected June 11) and US efforts have been directed away from mild cases. Moreover, none of the sequences from resistant cases in Denmark, Japan, and Hong Kong have been made public, even though sequences were generated weeks ago.
The failure to promptly disclose these sequences is also cause for concern. In Japan, notification was reportedly delayed while a manuscript was being submitted to the Journal of Infectious Diseases, although release of sequence data would not prevent publication.
The delays in release of important sequence data from pandemic H1N1 are hazardous to the world's health.