The information contained within this update is obtained from data provided by Ministries of Health of Member States and National Influenza Centers through reports sent to Pan American Health Organization (PAHO) or updates on their web pages.

Weekly Summary

- Respiratory illness activity remained above what is expected for this time of year in Canada, Mexico, and the United States; in the United States, the proportion of deaths attributed to pneumonia and influenza remained above the epidemic threshold

- The United States is investigating a possible cluster of four oseltamivir-resistant cases in a hospital setting

- Caribbean countries reported mostly decreasing trends and low to moderate intensity of acute respiratory disease

- Central America continues to report overall decreasing trends in acute respiratory disease

- Most of South America had stable or decreasing trends of acute respiratory disease, with the exception of Ecuador and Venezuela, which reported an increasing trend

- A median of 99.9% of subtyped influenza A viruses were pandemic (H1N1) 2009

- The United States reported a total of 21 osteltamivir-resistant pandemic (H1N1) 2009 cases since April 2009

- 554 new confirmed deaths in eight countries were reported; in total there have been 5,360 cumulative confirmed deaths