شعر اندر احوالات دامپزشکی

به گزارش روابط عمومي و امور بين الملل سازمان نظام دامپزشكي جمهوري اسلامي ايران در سفري كه رئيس اين سازمان و سخنراني كه درجمع دانشجويان دانشكده دامپزشكي دانشگاه آزاد اسلامي واحد كرج داشت، يكي از دانشجويان ترم آخر رشته دامپزشكي دانشگاه آزاداسلامي واحد كرج كه داراي طبع شعر هم است براي هم شغلي هايش و درباب دامپزشكي شعري سروده وتقديم به همه آنها كرده است كه در پي مي آيد.

و اما شعر گویم از طبیبی که دام ها را جز او نبود حبیبی

در عشق‌ورزی نه مانندپزشک است تو خود دانی که نامش دامپزشک است

بباشد شغل او بس مشکل و سخت چه بسیاران ز رنجش بسته اند رخت

بود مصداق شاهی با سخاوت همی راند به ر عیت ها شفاعت

بگویم رعیت و شاهی کدام است ! که انسان اشرف و رعیت دام است

برد رنج و تعب از دار دنیا به علم و حلم خود چون ابن سینا

بباشد کار او سخت هر زمانی که حیوان الکن است در هم زبانی

اگر انسان رود از بهر درمان بگوید درد خود را با دل و جان

شود آگه طبیب از درد آنان کند درمان دردش را چه آسان

اگر بیطار رود بر پیش دامی کجا داند زبان بی زبانی ؟

اگر داند زبان بی زبانان بدارد او نشانی از سلیمان

بگیرد جان خود را بر کف دست رود بر پیش مخلوقات سر مست

کند بازدید همی لحم و لبن را که یابد اندر آن جنس خفن را

میان این همه بیماری روز نباشد مشکلی همچون زئونوز

بود علم پزشکی سهل بسیار عجب سخت است و مشکل کار بیطار

اگر خواهی بدانی حال رفیقان بیا بنگر تو افعال طبیبان

اگر داری بسی دینار و درهم پزشکان می کنند درد تو مرهم

اگر در کیسه ات پولی نداری بگردد دکترت از تو فراری

اگر باشد تو را سیم و زر خوب در آن وقت می شوی بیمار مطلوب

چه بسیار دیده ایم بیمار و مریضی که پول می باشدش شیرین تر از جان

چو که دارند فراوان پول و ثروت که پول حتی ندارد به پشیزی

نبنماید قبول او را هاسپیتالی بیافتد جان دهد بر روی قالی

جونین باشد همی وضع پزشکان که پول می باشدش شیرین تر از جان

چو که دارند فراوان پول و ثروت همی دارند میان خلق عزت

ولی نانش نباشد حاصل کار کجا نان پزشک و نان بیطار

میان دو طبیب دام و انسان تفاوت سرحد و گشتیم حیران

یکی بی پول همی قلبش شکسته دگر جون غم ندارد دل خجسته

یکی اندر رفاه هر ماه فرانسه یکی هم می زند در خواب پرسه

بود قانع به گردش در خود شهر یکی هم می رود کشور به کشور

بیارد در دمی صدها بهانه که باشد ساعتی در پارک لاله

طبیبان می برند طفلان به هاروارد کند بیچاره بیطار ناله داد

نگارد جیره ای با آرد و سویا ندارد بهره ای از مال دنیا

پس اندازی ندارد بهر فردا کند آه دلش با ناله سودا

تو که دانی همی درد دل من بیا بشنو حدیث آخر من

در این عالم کنند در بوق و شیپور که بستانندحقوق آدمی را از پس گور

بنازم حسن خلق احمدی را بفرمود این کلام ایزدی را

که انسان ها نمایید بر دگر رحم فرو گیرد ز حیوان هم یکی زخم

نهادند ارج حدیث را هر دو انسان پدید آمد گروه دامپزشکان و پزشکان

ولی اندر میان این دو قشر علم آموز تفاوت باشدش مثل شب و روز

اگر باشد چونین اوضاع ایشان نه تقصیر تو باشد نه پزشکان

چرا که نیک نمی دارد نظارت بباشد این گنه در دست دولت

و اما اولیاء امر خدا را بگیرد از پس دریا صدا را

نباشد این چونین عدلی و انصاف نباشد دامپزشکی جزء اصناف

بریم رنج و بکاهیم رنج حیوان خد ا را خوش نیاید باشیم حیران

خلاصه گفتم از حال دو دسته یکی آسوده خاطر یک چه خسته

و اما در آخر اینکه:

اگر مردم ز سختی ها نگیرم من بهانه بگشتم سنگ زیرین زمانه

ز درد و رنج و حسرت سینه ام تنگ بگشته عقل و جان همچون یکی سنگ

بگردید قلبمان چون سنگ خارا مسلمانان مسلمانان خدا را !

علیرضا خلج زاده (ماهیچ)

Influenza A-H1N1

23 May 2009 -- As of 06:00 GMT, 23 May 2009, 43 countries have officially reported 12 022 cases of influenza A(H1N1) infection, including 86 deaths.

The breakdown of the number of laboratory-confirmed cases by country is given in the following table and map.

Map of the spread of Influenza A(H1N1): number of laboratory confirmed cases and deaths [jpg 492kb]
As of 08:00 GMT, 23 May 2009

Laboratory-confirmed cases of new influenza A(H1N1) as officially reported to WHO by States Parties to the International Health Regulations (2005)

Country	Cumulative total		Newly confirmed since the last reporting period
	Cases	Deaths	Cases	Deaths
Argentina	1	0	0	0
Australia	12	0	5	0
Austria	1	0	0	0
Belgium	7	0	2	0
Brazil	8	0	0	0
Canada	719	1	0	0
Chile	24	0	0	0
China	11	0	0	0
Colombia	12	0	0	0
Costa Rica	20	1	0	0
Cuba	4	0	0	0
Denmark	1	0	0	0
Ecuador	8	0	0	0
El Salvador	6	0	0	0
Finland	2	0	0	0
France	16	0	0	0
Germany	17	0	3	0
Greece	1	0	0	0
Guatemala	4	0	0	0
India	1	0	0	0
Ireland	1	0	0	0
Israel	7	0	0	0
Italy	14	0	4	0
Japan	321	0	27	0
Korea, Republic of	3	0	0	0
Malaysia	2	0	0	0
Mexico	3892	75	0	0
Netherlands	3	0	0	0
New Zealand	9	0	0	0
Norway	4	0	1	0
Panama	76	0	3	0
Peru	5	0	0	0
Philippines	1	0	0	0
Poland	2	0	0	0
Portugal	1	0	0	0
Russia	1	0	1	0
Spain	126	0	13	0
Sweden	3	0	0	0
Switzerland	2	0	1	0
Thailand	2	0	0	0
Turkey	2	0	0	0
United Kingdom	117	0	5	0
United States of America	6552	9	788	0
Grand Total	12022	86	854	0

Chinese Taipei has reported 1 confirmed case of influenza A (H1N1) with 0 deaths. Cases from Chinese Taipei are included in the cumulative totals provided in the table above.

Cumulative and new figures are subject to revision

Weekly Disease Information

Vol. 22 - No. 22, 28 May, 2009

• 22/05/2009: Rift Valley fever, Madagascar, (Follow-up report No. 3)
• 22/05/2009: Peste des petits ruminants, Congo (Rep. of the), (Follow-up report No. 1)
• 22/05/2009: Foot and mouth disease, China (People's Rep. of), (Immediate notification)
• 22/05/2009: Foot and mouth disease, China (People's Rep. of), (Immediate notification)

Feline Heartworm’s a Different Animal

Clients and veterinarians need to learn more about how it behaves in cats.

Gary D. Norsworthy, DVM

Click to Enlarge

Click to Enlarge

Severe interstitial disease can occur when immature adult heartworms die and are carried into the lungs by blood flow as seen in the lungs of this 8-year-old cat. This cat requires continual medication using corticosteroids and a bronchodilator to relieve dyspnea.

A recent study at Auburn University has shown us a new side of feline heartworms.

Dillon and Blagburn, with the financial backing of Pfizer Animal Health of New York, performed an amazing study¹. They infected three groups of cats with heartworm larvae.

The first group was untreated to see what would happen from natural exposure.

The second group was given ivermectin at the time in the life cycle that would kill the immature adults but not the adults. This group showed the pathology that occurs when the 2-inch-long immature adults die; the pathology that occurred was only due to immature adults, not to 6-inch-long adult worms.

The third group was infected while receiving selamectin. This group was to demonstrate the efficacy of this drug in preventing heartworm infections; its high efficacy was clearly demonstrated.

The following is a synopsis of what we now know about heartworm disease in cats.

Life Cycle
When a mosquito bites a cat, third-stage larvae (L3) are deposited on the cat’s skin. Within minutes they enter the subcutaneous tissue through the bite wound. The L3 molt within a couple of days to fourth-stage larvae (L4).

L4 migrate subcutaneously in fat and muscle for two months, then molt to become a juvenile or immature adult worm. (Immature adult worms have incorrectly been called L5 larvae.) Immature adult worms enter circulation via a peripheral vein. This occurs about 60 days after infection. An antibody response begins about this time; some cats test antibody positive.

Within the next 15 to 30 days -- 75 to 90 days post-infection -- the immature adult worms arrive in the pulmonary arteries. The vast majority of the juvenile worms die, are carried by blood flow into the lungs and cause an intense inflammatory response affecting the pulmonary arterioles, bronchi and alveoli.

It is estimated that about 3 to 4 percent of the immature adults become 6-inch-long adult heartworms and live for two to four years before dying spontaneously.

HARD
Heartworm associated respiratory disease, or HARD, is unique to the cat. You will not find it by studying heartworm disease in dogs. It is defined as vascular, airway and interstitial lung lesions caused by the death of immature adult worms, and the inflammation may last up to eight months.

If we administer 100 infective larvae to a dog, 75 will mature to adults. If we administer 100 infective larvae to a cat, many will become immature adult heartworms; however, only three to four will mature to adults. A very large number of immature adult worms develop but never make it to adulthood due to the effects of the cat’s immune system. Severe lung lesions are present but:

• No adult worms will be present on necropsy.
• The immature adult worms disintegrate within the lung tissue and are very difficult to find on necropsy.
• Antibodies disappear very quickly.
• Antigen tests will be negative because there have been no adults.

Radiographically, these cats may look similar to cats with allergic bronchitis. Interstitial or bronchial patterns may be present, and the caudal pulmonary arteries may be enlarged and blunted. In some cats, apparent enlargement may be due to periarterial inflammation. Repeated exposure to immature adult heartworms results in severe interstitial and bronchial disease. (See Figures 1,2)

It is no wonder that this disease has eluded detection until the Dillon and Blagburn study.

Incidence

3 Important Points By about three months post-infection, 2-inch-long immature adult heartworms are in the pulmonary arteries. . Most of these are killed by the immune system, never becoming adult heartworms. They are carried by blood flow into the lungs. . About 3 percent to 4 percent of the immature adults become 6-inch-long adult heartworms.

A large necropsy study in Gainesville, Fla., found that 5 percent of cats had adult heartworms², virtually the same incidence as FeLV and FIV infections. In the same group of cats, 15 percent were antibody positive. Interestingly, many that did not have adult heartworms present had signs of severe lung disease. In retrospect, what was observed was HARD, but at the time HARD was not understood.

In the 1997 Heska Heartworm Survey³, 15.9 percent of tested cats were heartworm-antibody positive. In the 1998 Miller, et. al. study⁴, 12 percent of tested cats, many from non-endemic areas, were antibody positive. Because many cats with HARD test antibody negative, the 12 to 16 percent incidence is probably much lower than the true incidence.

For every 10 heartworm-infected dogs in a given locale, one cat has adult heartworms. However, it is likely that only about 10 percent of heartworm-infected cats have an adult worm. That makes the exposure and infection rates of dogs and cats about the same.

Heartworm Testing

Antibody Tests

Antibodies are produced by the presence of immature adults, and they begin to wane as the immature adult worms die. If the immature adult worms mature to adults, the adult worms suppress the immune system, causing antibodies to dissipate. Most antibody tests turn negative about four months later as long as new infections do not occur.

A positive antibody test means one or more of these possibilities:

• A current infection with late L4.
• A current infection with immature adult heartworms.
• A current infection with adult heartworms.
• A previous heartworm infection. Antibody persists about four months.

Many cats with HARD are antibody positive and antigen negative. However, many test negative on both antigen and antibody tests, making differentiation from cats with allergic bronchitis virtually impossible.

Antigen Tests

A positive antigen test means (one or both):

• One or more adult female heartworms.
• One or more dying adult female heartworms.

Heartworm tests are inclusionary, not exclusionary. If they are positive, they are meaningful. If they are negative, they are not meaningful.

Antigen or antibody testing is not necessary to begin heartworm prevention because there is not a reaction between current heartworm prevention products and any stage of the heartworm.

Microfilaria Testing

In contrast to dogs, very few microfilaria circulate in cats. This test has very poor sensitivity in cats. This also explains why cats are very poor reservoirs for heartworm infections to other cats or to dogs.

Summary

• Positive antibody test: This cat is or has been infected with heartworms that progressed at least to the immature adult stage. It is clearly at risk of future infections
• Positive antigen test: This cat is infected with adult heartworms. It is clearly at risk of future infections.
• Microfilaria testing: This test has a very poor diagnostic yield.

Treatment of HARD
Most cats with HARD have mild coughing, but a severe respiratory crisis can occur when a large number of immature adult heartworms die at once. The treatment for the crisis cat is corticosteroids at shock doses: dexamethasone sodium phosphate (1-2 mg/kg IM or IV) or prednisolone sodium succinate (50-100 mg/kg IV) and a bronchodilator such as terbutaline. Oral prednisolone (1-2 mg/kg) or corticosteroid inhalers can be used prophylactically for inflammation.

These cats should be placed on a heartworm preventive product to prevent new infections.

Misnamed?
If we knew nothing about Dirofilaria immitis before the Dillon and Blagburn study, what common name would we have put on this parasite?

I seriously doubt we would call it a “heartworm.” Its normal locations in the cat are the pulmonary trunk and the left and right pulmonary arteries. Immature adults and adults are found in the heart only when the pulmonary arteries are filled with worms.

I was at a meeting of heartworm researchers and interested practitioners a few months ago. I suggested that we rename this parasite to better reflect its location in the cat and to make a break with the misunderstandings of the past. Not surprisingly, my idea was not well received. And I am not now on a campaign to change its name. However, it is important that we realize that this parasite does not follow the pattern of heartworms in dogs.

We all know that “cats are not small dogs.” We need to also appreciate that “cat parasites are not small dog parasites!”

What should we do now?
First, we need to appreciate what Dillon and Blagburn, with Pfizer’s financial backing, have done. Their study was one of the blockbusters in feline medicine.

Accolades also need to go to the “KNOW Heartworms” campaign of the American Assn. of Feline Practitioners. However, we must go past singing praises and move into action. This information needs to be shared with our clients, who must be motivated to act on it.

Create a handout for your clients endorsing heartworm prevention for all cats. Use the “KNOW Heartworms” materials in your exam rooms, and proactively use your annual examinations and other opportunities to talk to clients about this very important subject.

Clients need to know:

• Heartworm disease is much more common in cats than we thought. We have missed it because of a lack of understanding that we now have.
• Even with our new knowledge, heartworms are difficult to diagnose. Blood tests have severe limits on sensitivity.
• There is no good way to rid the cat of this parasite. It must die on its own.
• All cats should be on heartworm prevention using the same schedule as for dogs in that locale.
• Even indoor cats need to be included because about 25 percent of diagnosed cats are indoors only⁴.

Dr. Norsworthy, DVM, Dipl. ABVP (feline), owns and practices at Alamo Feline Health Center in San Antonio, Texas. He frequently speaks about cat health at veterinary conferences and seminars.

FOOTNOTES:

1. Dillon AR, Blagburn BL, Tillson DM, et. al. “Immature heartworm infection produces pulmonary parenchyma, airway, and vascular disease in cats” (abstract #133). J Vet Intern Med 2007;21(3):608-609.
   .
2. Levy JK, Snyder PS, Taveres LM, et. al. “Prevalence and risk factors for heartworm infection in cats from Northern Florida.” JAAHA 2003;39:533-537.
   .
3. Piché CA, Cavanaugh MT, Donoghue AR, Radecki SV. “Results of antibody and antigen testing for feline heartworm infection at Heska Veterinary Diagnostic Laboratories.” In: Seward RL, ed. Recent Advances in Heartworm Disease: Symposium ’98. Batavia, Ill: American Heartworm Society; 1998:139-143.
   .
4. Miller MW, Adkins CE, Stemme K, et. al. “Prevalence of exposure to Dirofilaria immitis in multiple areas of the United States.” In: Seward RL, ed. Recent Advances in Heartworm Disease: Symposium ’98. Batavia, Ill.: American Heartworm Society; 1998:161-166.

Weekly Disease Information

• 19/05/2009: African swine fever, Russia, (Follow-up report No. 16)
• 18/05/2009: Rabies, France, (Follow-up report No. 1)
• 18/05/2009: Equine infectious anaemia, France, (Follow-up report No. 1)
• 17/05/2009: Highly pathogenic avian influenza, China (People's Rep. of), (Immediate notification)

Influenza A-H1N1

19 May 2009 -- As of 06:00 GMT, 19 May 2009, 40 countries have officially reported 9830 cases of influenza A(H1N1) infection, including 79 deaths.

The breakdown of the number of laboratory-confirmed cases by country is given in the following table and map.

As of 06:00 GMT, 19 May 2009

Laboratory-confirmed cases of new influenza A(H1N1) as officially reported to WHO by States Parties to the International Health Regulations (2005)

Country	Cumulative total		Newly confirmed since the last reporting period
	Cases	Deaths	Cases	Deaths
Argentina	1	0	0	0
Australia	1	0	0	0
Austria	1	0	0	0
Belgium	5	0	0	0
Brazil	8	0	0	0
Canada	496	1	0	0
Chile	4	0	3	0
China	7	0	1	0
Colombia	11	0	0	0
Costa Rica	9	1	0	0
Cuba	3	0	0	0
Denmark	1	0	0	0
Ecuador	1	0	0	0
El Salvador	6	0	2	0
Finland	2	0	0	0
France	14	0	0	0
Germany	14	0	0	0
Guatemala	3	0	0	0
India	1	0	0	0
Ireland	1	0	0	0
Israel	7	0	0	0
Italy	9	0	0	0
Japan	159	0	34	0
Korea, Republic of	3	0	0	0
Malaysia	2	0	0	0
Mexico	3648	72	545	4
Netherlands	3	0	0	0
New Zealand	9	0	0	0
Norway	2	0	0	0
Panama	59	0	5	0
Peru	2	0	1	0
Poland	1	0	0	0
Portugal	1	0	0	0
Spain	103	0	0	0
Sweden	3	0	0	0
Switzerland	1	0	0	0
Thailand	2	0	0	0
Turkey	2	0	0	0
UK	102	0	1	0
United States of America	5123	5	409	1
Total	9830	79	1001	5

Cumulative and new figures are subject to revision

First case of swine flu confirmed in Turkey

ISTANBUL - A first case of swine flu has been detected in Turkey in an American who arrived at Istanbul’s international airport, Health Minister Recep Akdag said Saturday. The U.S. citizen, flying from the United States via Amsterdam was found to be suffering from the H1N1 virus after arriving at Istanbul's Ataturk Airport en route to Iraq late on Friday, Akdag told a news conference in Istanbul. He said the virus HIN1 had been confirmed in blood tests carried out after thermal cameras picked up the fact that the man was running a high fever. "The man’s condition, in general, is good, and he has been placed in isolation along with his family," Akdag said. The victim is a 27-year-old Iraqi-born man, the Turkish health minister added. Most of the passengers on the KLM flight to Istanbul had been contacted and given anti-viral medicines, Akdag told another press conference later in the day. He also urged those who authorities had not been able to reach to call a hot line established to assist them. "Everything is under our control," Prime Minister Tayyip Erdogan told reporters before departing for a trip to Russia. "Everything is being monitored closely." Turkey has installed 27 thermal cameras at its borders and in airports to monitors passengers for symptoms of swine flu. More than 1,000 new cases of the flu were reported worldwide in 24 hours, with 7,520 people known to have been infected with the disease, according to the latest figures issued by the World Health Organization in Geneva on Friday. With new cases reported by local authorities in Malaysia, Ecuador, Peru and now Turkey, the virus has now spread to 36 countries from its epicenter, Mexico. From: hurriyet.com

Influenza A-H1N1

16 May 2009 -- As of 07:00 GMT, 16 May 2009, 36 countries have officially reported 8451 cases of influenza A(H1N1) infection.

Mexico has reported 2895 laboratory confirmed human cases of infection, including 66 deaths.

The United States has reported 4714 laboratory confirmed human cases, including four deaths.

Canada has reported 496 laboratory confirmed human cases, including one death.

Costa Rica has reported nine laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Argentina (1), Australia (1), Austria (1), Belgium (2), Brazil (8), China (4), Colombia (11), Cuba (3), Denmark (1), Ecuador (1), El Salvador (4), Finland (2), France (14), Germany (14), Guatemala (3), Ireland (1), Israel (7), Italy (9), Japan (4), Netherlands (3), New Zealand (9), Norway (2), Panama (43), Peru (1), Poland (1), Portugal (1), Republic of Korea (3), Spain (100), Sweden (2), Switzerland (1), Thailand (2), and the United Kingdom (78).

WHO is not recommending travel restrictions related to the outbreak of the influenza A(H1N1) virus.

Individuals who are ill should delay travel plans and returning travelers who fall ill should seek appropriate medical care. These recommendations are prudent measures which can limit the spread of many communicable diseases, including influenza.

Further information on the situation will be available on the WHO web site on a regular basis.

Weekly Disease Information

• 14/05/2009: Newcastle disease, Bulgaria, (Immediate notification)
• 13/05/2009: Rift Valley fever, Madagascar, (Follow-up report No. 2)
• 12/05/2009: Foot and mouth disease, Bahrain, (Immediate notification)
• 11/05/2009: Brucellosis (Brucella melitensis), Croatia, (Follow-up report No. 3)
• 11/05/2009: Bluetongue, Austria, (Follow-up report No. 1)
• 11/05/2009: Classical swine fever, Croatia, (Follow-up report No. 1)
• 11/05/2009: Newcastle disease, Croatia, (Immediate notification)
• 10/05/2009: African swine fever, Namibia, (Follow-up report No. 1)
• 08/05/2009: Bluetongue, United Kingdom, (Follow-up report No. 23)
• 08/05/2009: Rabies, Italy, (Follow-up report No. 9)
• 08/05/2009: Infectious salmon anaemia, United Kingdom, (Follow-up report No. 5

From: OIE

Influenza A-H1N1

14 May 2009 -- As of 06:00 GMT, 14 May 2009, 33 countries have officially reported 6497 cases of influenza A(H1N1) infection.

Mexico has reported 2446 laboratory confirmed human cases of infection, including 60 deaths.

The United States has reported 3352 laboratory confirmed human cases, including three deaths.

Canada has reported 389 laboratory confirmed human cases, including one death.

Costa Rica has reported eight laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Argentina (1), Australia (1), Austria (1), Brazil (8), China (4), Colombia (7), Cuba (1), Denmark (1), El Salvador (4), Finland (2), France (14), Germany (12), Guatemala (3), Ireland (1), Israel (7), Italy (9), Japan (4), Netherlands (3), New Zealand (7), Norway (2), Panama (29), Poland (1), Portugal (1), Republic of Korea (3), Spain (100), Sweden (2), Switzerland (1), Thailand (2), and the United Kingdom (71).

WHO is not recommending travel restrictions related to the outbreak of the influenza A(H1N1) virus.

Individuals who are ill should delay travel plans and returning travelers who fall ill should seek appropriate medical care. These recommendations are prudent measures which can limit the spread of many communicable diseases, including influenza.

Further information on the situation will be available on the WHO web site on a regular basis.

Influenza A-H1N1

13 May 2009 -- As of 06:00 GMT, 13 May 2009, 33 countries have officially reported 5728 cases of influenza A(H1N1) infection.

Mexico has reported 2059 laboratory confirmed human cases of infection, including 56 deaths.

The United States has reported 3009 laboratory confirmed human cases, including three deaths.

Canada has reported 358 laboratory confirmed human cases, including one death.

Costa Rica has reported eight laboratory confirmed human cases, including one death.

with no deaths - Argentina (1), Australia (1), Austria (1), Brazil (8), China (3, comprising 1 in China, Hong Kong Special Administrative Region, and 2 in mainland China), Colombia (6), Cuba (1), Denmark (1), El Salvador (4), Finland (2), France (13), Germany (12), Guatemala (3), Ireland (1), Israel (7), Italy (9), Japan (4), Netherlands (3), New Zealand (7), Norway (2), Panama (29), Poland (1), Portugal (1), Republic of Korea (3), Spain (98), Sweden (2), Switzerland (1), Thailand (2), and the United Kingdom (68).

WHO is not recommending travel restrictions related to the outbreak of the influenza A(H1N1) virus.

Individuals who are ill should delay travel plans and returning travelers who fall ill should seek appropriate medical care. These recommendations are prudent measures which can limit the spread of many communicable diseases, including influenza.

Further information on the situation will be available on the WHO web site on a regular basis.