1. (CAREC) PAHO/WHO Serving 21 Member Countries in the English and Dutch Speaking Caribbean 2009 Pandemic Influenza in CAREC Member Countries: Summary and Lessons Learnt Dr. Eldonna Boisson Caribbean Epidemiology Centre (CAREC/PAHO/WHO)

2. Caribbean Epidemiology Centre (CAREC) PAHO/WHO Outline l Summary of 2009 influenza pandemic in CMCs l Respiratory illnesses in CMCs post pandemic l Lessons learnt from the influenza pandemic

3. Caribbean Epidemiology Centre (CAREC) PAHO/WHO Summary of the influenza pandemic in CAREC Member Countries

4. Caribbean Epidemiology Centre (CAREC) PAHO/WHO Influenza Pandemic in CAREC Member Countries l All 21 CAREC member countries reported laboratory confirmed cases of pandemic influenza A (H1N1) l Co-circulation of seasonal influenza A (H3N2 and H1N1) and influenza B

5. Caribbean Epidemiology Centre (CAREC) PAHO/WHO

7. Influenza Pandemic in CAREC Member Countries l Over 300 hospitalizations and 22 deaths l Region experienced two waves of pandemic l Second wave declined at the end of 2009 l No resistance to oseltamivir identified

8. Caribbean Epidemiology Centre (CAREC) PAHO/WHO Respiratory illnesses post pandemic

9. Caribbean Epidemiology Centre (CAREC) PAHO/WHO During 2010: l Co-circulation of pandemic influenza (H1N1), seasonal influenza A (H3N2) and influenza B at times l Influenza A(H3N2) was predominant type l Some RSV also circulating

10. Caribbean Epidemiology Centre (CAREC) PAHO/WHO

12. Lessons Learnt from the pandemic

13. Caribbean Epidemiology Centre (CAREC) PAHO/WHO Pandemic Plans l Need to be prepared always, no comfort zone l Adequate intersectorial plan and planning is critical for each country l Plans require continuous evaluation and adaptation to meet the changing needs of the disease situation l Must include a vaccination strategy

14. Caribbean Epidemiology Centre (CAREC) PAHO/WHO Surveillance and response l Has to be efficient and timely l Requires clinical, epidemiological and laboratory input in a collaborative manner l Surge capacity to support surveillance and response is essential l Surveillance for respiratory illnesses (NOT just pandemic influenza) needs to be strengthened

15. Caribbean Epidemiology Centre (CAREC) PAHO/WHO Laboratory needs l Surge capacity for laboratory testing is essential l Reserves of laboratory supplies should be available prior to the influenza season. l A regional laboratory network is needed to support the detection of influenza and other respiratory illnesses.

16. Caribbean Epidemiology Centre (CAREC) PAHO/WHO Communication l Public education and reassurance have to be continuous and at all levels of society l Sharing of experiences and technical information needs to be ongoing and is essential within and between countries

17. Caribbean Epidemiology Centre (CAREC) PAHO/WHO Conclusion Caribbean Community responded well to a rapidly changing status of pandemic influenza Countries must be adequately prepared to identify and respond to other public health emergencies of international concern in the future with strong surveillance systems

18. Caribbean Epidemiology Centre (CAREC) PAHO/WHO Thank you for your kind attention