New Cases in Japan, China, South Korea

Japan
WHO reported today that Japan has a total of 210 H1N1 cases, 51 of which were newly confirmed since yesterday. There was also report of the first two cases in Japan's denseley populated capital city, Tokyo. These two cases were high-school aged girls recently returned from New York City. The newly confirmed cases prompted officials to close even more Japanese schools (more below).

China & South Korea
There were also reports of a new quarantined H1N1 case in South Korea, a new case in Beijing (for a total of 2 in the capital city), and one in Taiwan (an Australian cruise ship doctor).

Quarantine & School Closings:
"About 4,500 schools, mostly in the western prefectures of Osaka and Hyogo about 400 km (250 miles) from Tokyo, have closed their doors until the end of the week. The local government in neighbouring Shiga prefecture, which also confirmed its first case on Wednesday, was also urging its schools to follow suit. A university campus in Shiga was also closed, affecting 18,000 students, after one of them was infected with the virus.

A hospital in the port city of Kobe, where a member of staff had been infected, was to ban visits to flu patients, Kyodo news agency said."

Shifts in Preparedness and Response (from H5N1 to H1N1)
"The (Japenese) government is considering drawing up a new plan by Friday to deal with the virus, which is not as deadly as the avian influenza for which existing plans had been created. It is also considering winding down strict health checks at international airports at the end of the week, which had been imposed to try to buy time before an outbreak in Japan."

http://www.who.int/csr/don/2009_05_20/en/index.html
http://www.alertnet.org/thenews/newsdesk/SP441009.htm
http://crofsblogs.typepad.com/h5n1/

Pandemic Alert Phase Change???

**It seems that the sharp increase of Japanese cases reflects the presence of community-level transmission of the A/H1N1 virus. Unless WHO changes their definitions of pandemic phases, this would certainly prompt an uptick in the Pandemic Alert from Phase 5 to Phase 6 (Pandemic). This change has not occurred, however, and there are no reports that WHO has convened the advisory council to discuss such a change. They have been considering development of a pandemic severity scale along with possible revisions of the pandemic phase definitions. More to come**