Increased extent of and risk factors for pandemic (H1N1) 2009 and seasonal influenza among children, Israel.

During the pandemic (H1N1) 2009 outbreak in Israel, incidence rates among children were 2× higher than that of the previous 4 influenza seasons; hospitalization rates were 5× higher. Children hospitalized for pandemic (H1N1) 2009 were older and had more underlying chronic diseases than those hospitalized for seasonal influenza.

[Influenza A/H1N1 in Israel--clinical and epidemiological characteristics].

BACKGROUND: In March 2009, a novel A/H1N1 influenza virus began its inexorable spread around the world. Information regarding disease characteristics, groups at risk and prognosis remain partial. The Epidemiology Division of the Israeli Ministry of Health performs ongoing influenza surveillance and tracking of patients in Israel. The authors set out to characterize the disease and its spread in Israel. METHODS: Surveillance and investigation procedures were modified in accordance with changing Ministry of Health policy. From the outset of the outbreak and until June 30, 2009, all suspected cases of influenza A/H1N1 were investigated and laboratory verified. Starting July 1, 2009, lab confirmation was reserved for severely ill patients or those at high risk of complications. All hospitalized cases were monitored and tracked daily. RESULTS: By June 30, 2009, 596 patients had laboratory confirmed Influenza A/H1N1: 58% of these were aged 10-30 years, and only 5% were above 50 years of age; 58% were male. In addition to fever (83%), patients reported cough (74%), rhinorrhea (59%), and headache and sore throat (53% each). Thirty three patients were considered at high risk for complications, four of which required hospitalization in an intensive care unit; 64% of infections were acquired in Israel and 22% in the United States. By July 29, 2009, 952 additional cases had been verified. Overall, 13 of the cases had been hospitalized in intensive care, 3 of whom died. DISCUSSION: Early data indicate spread particularly to younger populations, expressing non-specific respiratory symptoms. Ongoing investment in real-time data collection and analysis will enable epidemiologists to supply the information necessary to deal with the influenza epidemic.

[The reemergence of malaria in Israel?].

Worldwide, malaria is the most prevalent vector-borne disease, endemic or hyperendemic in more than 100 countries. The disease is transmitted to humans by the bite of an infected female Anopheles mosquito, a protozoan of the genus Plasmodium with a life cycle split between man (the vertebrate host) and the mosquito vector. Since the 1960s, Israel has been considered a malaria free country, despite a substantial number of imported cases each year (mainly P. falciparum originating in Africa and P. vivax). Between 60-100 imported malaria cases are registered annually due to young people traveling to endemic countries and immigration from sub-Saharan Africa. However, since successful malaria control was achieved without the elimination of local Anopheles populations, concern about the possibility of renewed malaria transmission in Israel is increasing. Among travelers to malaria endemic countries, the disease can usually be prevented with prophylactic use of antimalarial drugs and strict measures to prevent mosquito bites. If, on their return, travelers become ill, they should seek prompt medical attention and inform their physician which countries they have visited. For their part, physicians should not fail to elicit travel history as part of the routine fever workup. Finally, intensive surveillance and control of the mosquito populations is also imperative to diminish the risk of reestablishment of malaria transmission.