1. Cluster: Health Information, Epidemiology, Evaluation & Research
PANDEMIC INFLUENZA A, H1N1 UPDATE SOUTH AFRICA, 12 JUNE TO
29 SEPTEMBER 2009
1. DISTRIBUTION OF CASES:
On overall 11 729 H1N1 cases were recorded in South Africa 29 September 2009.
Gauteng Province recorded greatest number of H1N1 cases (n=5 318) accounting for 45%
of all the cases reported, followed by KwaZulu Natal and Western Cape Provinces with 17
% (n=2 008 and 1 963 respectively), Figure 1. The national case fatality rate (CFR) was
0.7, with a provincial range of 0 to 3.1; Northern Cape Province recorded the greatest CFR
of 3.1% (Table 1).
Table 1: Number of pandemic H1N1 2009 by province (31 August Update)
Province of
residence*
Laboratory Confirmed
Cases
Percentage of
Laboratory
Confirmed Cases
Deaths CFR (%)
Eastern Cape 682 6 10 1.5
Free State 300 3 2 0.7
Gauteng 5 318 45 12 0.2
KwaZulu Natal 2 008 17 16 0.8
Limpopo 429 4 0 0
Mpumalanga 437 4 1 0.2
Northern Cape 98 1 3 3.1
Northwest 449 4 2 0.4
Western Cape 1 963 17 38 1.9
Unknown 45 0
South Africa 11 729 100 84 0.7
Epidemiology and Surveillance Directorate
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OUTBREAKS REPORT IN SOUTH AFRICA

2. Figure 1: Distribution of H1N1 Cases in South Africa
DISTRIBUTION OF CASES BY VARIOUS VARIABLES
Cases mainly peaked in the age group 10-14 years with 19% (Figure 2). The age group
5-19 years accounted for 54% of the cases. On the other hand, deaths peaked
in the age group 25-29 years with 7 cases (Table 2).
Epidemiology and Surveillance Directorate
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3. Table 2: Demonstrate distribution of Cases and Deaths by Age Group
Age Group Number of cases % Number of
Death
<1 216 2 1
1-4 933 8 1
5-9 1,957 17 2
10-14 2,272 19 3
15-19 2,094 18 8
20-24 1,172 10 7
25-29 700 6 12
30-34 503 4 9
35-39 536 5 9
40-44 402 3 8
45-49 330 3 6
50-54 276 2 10
55-59 119 1 2
60-64 53 0 2
65+ 57 0 3
Ukn 109 1 1
SA 11 729 100 84
H1N1 weekly update (29 September)
0
500
1000
1500
2000
2500
<1
1-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65+U
nknow
n
Date
NumberofCases
Figure 2: Distribution of Cases by Age Category
Epidemiology and Surveillance Directorate
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4. The distribution of H1N1 cases by reporting date shows that cases peaked on the 12
August 2009 with 531 cases, however it should be noted that number of cases on
this day differed from report to report thought the peak day remained consistent
from the previous reports, this maybe as a result of data validation process. Cases
substantially declined from 10 September to the 29 September 2009.
Table 3: Recording Date
Collection date
15-Jun-09 1
24-Jun-09 6
25-Jun-09 1
26-Jun-09 1
28-Jun-09 1
01-Jul-09 2
03-Jul-09 6
04-Jul-09 14
05-Jul-09 3
06-Jul-09 9
07-Jul-09 11
08-Jul-09 9
10-Jul-09 14
11-Jul-09 4
12-Jul-09 9
13-Jul-09 20
14-Jul-09 15
15-Jul-09 8
16-Jul-09 19
17-Jul-09 9
18-Jul-09 3
19-Jul-09 11
20-Jul-09 25
21-Jul-09 30
22-Jul-09 24
23-Jul-09 47
24-Jul-09 55
25-Jul-09 30
26-Jul-09 27
27-Jul-09 110
28-Jul-09 119
29-Jul-09 133
30-Jul-09 203
31-Jul-09 214
01-Aug-09 129
02-Aug-09 76
03-Aug-09 243
04-Aug-09 447
05-Aug-09 345
06-Aug-09 434
07-Aug-09 366
Epidemiology and Surveillance Directorate
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5. 08-Aug-09 216
09-Aug-09 161
10-Aug-09 158
11-Aug-09 522
12-Aug-09 531
13-Aug-09 324
14-Aug-09 277
15-Aug-09 172
16-Aug-09 194
17-Aug-09 480
18-Aug-09 303
19-Aug-09 309
20-Aug-09 323
21-Aug-09 360
22-Aug-09 235
23-Aug-09 128
24-Aug-09 485
25-Aug-09 404
26-Aug-09 372
27-Aug-09 262
28-Aug-09 259
29-Aug-09 132
30-Aug-09 122
31-Aug-09 309
01-Sep-09 190
02-Sep-09 207
03-Sep-09 169
04-Sep-09 105
05-Sep-09 30
06-Sep-09 37
07-Sep-09 116
08-Sep-09 76
10-Sep-09 51
11-Sep-09 35
12-Sep-09 16
13-Sep-09 13
14-Sep-09 29
15-Sep-09 40
16-Sep-09 37
17-Sep-09 27
18-Sep-09 23
19-Sep-09 7
20-Sep-09 8
21-Sep-09 16
22-Sep-09 9
23-Sep-09 4
25-Sep-09 4
26-Sep-09 5
Unknown 139
Total 11,729
Epidemiology and Surveillance Directorate
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6. 0
100
200
300
400
500
600
15-Jun-09
22-Jun-09
29-Jun-09
6-Jul-09
13-Jul-09
20-Jul-09
27-Jul-09
3-Aug-09
10-Aug-09
17-Aug-09
24-Aug-09
31-Aug-09
7-Sep-09
14-Sep-09
21-Sep-09
Figure 3: Distribution of H1N1 Cases by Day
Cases showed a relatively equal distribution in both males and females, though males
were mainly affected with 50%, Table 4.
Table 4: Distribution of Cases by Gender
Gender Number of cases Percent cases
Female 5,840 49.8
Male 5,826 49.7
Unknown 63 0.5
Total 11,729 100
Large number of cases were reported during week 32, 33 and 34, with 1 983, 1 713 and
1 181 respectively, compared to other weeks (Table 5).
Epidemiology and Surveillance Directorate
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7. Table 5: Distribution of Cases by Week
Week Number of cases Percent
24 1 0
25 1 0
26 10 0.1
27 46 0.4
28 79 0.7
29 73 0.6
30 273 2.3
31 1,010 8.6
32 2,210 18.8
33 2,193 18.7
34 2,145 18.3
35 2,036 17.4
36 1,057 9.0
37 361 3.1
38 171 1.5
39 38 0.3
Unknown 25 0.2
Total 11,729 100.0
0
500
1000
1500
2000
2500
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39
Week
Numberofcases
Figure 4: Distribution of Cases by Week
Epidemiology and Surveillance Directorate
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8. Distribution of Cases by Week and Province
Cases peaked in week 32 in nearly all the Provinces, and then started to decrease slightly
with a significant mark during week 36.
0
200
400
600
800
1000
1200
1400
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39
Week
NumberofCases
EC
LP
MP
NW
WC
NC
KZN
GP
FS
Figure 5: Trend Showing Distribution of Cases by Week
0
2000
4000
6000
8000
10000
12000
14000
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
TotalCases
Week
NumberofCases
FS
GP
KZN
NC
WC
NW
MP
LP
EC
Figure 6: Graph Showing Distribution of Cases by Week
2. Deaths cases review
Epidemiology and Surveillance Directorate
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9. Death Cases were recorded in approximately 42 hospitals. Tygerberg hospital recorded
greatest cases of 9 followed by Kalafong Hospital with 6 death cases. As a result review of
case management is recommended in this particular hospital.
Table 6: Deaths by facility
Facility_Name Freq.
2 Military Hospital 1
2 Military Hospital / Tygerberg 1
3 Military Hospital 1
AMPATH-KZN 4
Addington Hospital 1
Albert Luthuli 1
Barberton Hospital 1
Beaufort West Hospital 1
Cecilia Makiwane Hospital 1
Chis Hani Baragwanath Hospital 1
City Hospital - Joint Medical Holdings 1
De Aar Municipal Clinic 1
Dietrich Voigt Mia Inc. 5
Dora Nginza hospital 3
Durbanville Medi-Clinic 1
Eben Donges Hospital 6
Eerste River Hospital 1
Elizabeth Hospital 1
GP Polokwane 1
George Hospital 2
Helderberg Hospital 1
Inkosi Albert Luthuli Central Hosp 1
Kalafong hospital 4
Karl Bremer Hospital 6
Kimberly Hospital 1
Kokstad, Egum 1
Life Empangeni Garden Clinic 1
Life Glynwood Hospital 1
Life Robinson Hospital 1
Livingstone Hospital 2
Lower Umfolozi War Memorial Hospital 1
Mafikeng General Hospital 1
Mahatma Gandhi 1
Mount Edgecombe Medical Centre 1
Paed PE 1
Paed Springs 1
Pelonomi Hospital 1
Phys Uitenhage 1
Pretoria West / Kalafong Hospital 1
Sunninghill Hospital 1
Tygerberg Hospital 9
Vergelegen Mediclinic 1
WYN 1
Epidemiology and Surveillance Directorate
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10. Worcester Hospital 2
Wormest Hospital 1
Unknown 6
Total 84
Forty eight cases were recorded in females accounting for 57% compared to 43% in
males.
Table 7: Number of Deaths by Gender
Gender Number of deaths Percent
Female 48 57
Male 36 43
Total 84 100
48
36
Female
Male
Figure 8: Percentage of Deaths Cases by Gender
Epidemiology and Surveillance Directorate
ACKNOWLEDGEMENT
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11.  National Institute for Communicable Diseases
 Communicable Disease control directorate
 Epidemiology and Surveillance Directorate
 Provinces
 World Health Organisation
 Stakeholders
Epidemiology and Surveillance Directorate
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12. Epidemiology and Surveillance Directorate
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13. Epidemiology and Surveillance Directorate
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