On October 27, 2009, the 32nd meeting held by the Central Epidemic Command Center (CECC) was convened by the commander-in-chief of CECC, the Vice Premier of the Executive Yuan, Li-Luan Chu.In light of recent increase in the number of pandemic influenza A (H1N1) cases, the commander-in-chief Chu instructed further reinforcing implementation of the relevant disease control measures on campuses and the national standards for implementing school closure at the meeting.Further, the immunization of pandemic influenza A (H1N1) vaccine and the distribution of masks to low-income families will be conducted according to plan.

CECC pointed out that the increase in number of pandemic influenza A (H1N1) cases is noted mostly in countries in the Northern Hemisphere, including Taiwan.In Taiwan, the influenza-like illness consultation rate at emergency departments and outpatient services and the number of hospitalized patients with influenza-like illness have been increasing, especially among students in northern Taiwan.Nevertheless, the pneumonia-related mortality rate seems to be decreasing.

Since October, 2009, the number of schools shutting down has been increasing for four consecutive weeks. CECC urged schools to fully comply with the national standards for implementing school closure and to seek advice and assistance from competent authorities such as the Ministry of Education and the Taiwan Centers for Disease Control (Taiwan CDC) when schools have any concerns regarding school closure.On the other hand, CECC also urged parents to comply with relevant disease control policies and keep a sick child at home in order to lower the risk of virus transmission.

Immunization of pandemic influenza A (H1N1) vaccine will be conducted according to schedule. People who are affected by Typhoon Morakot and currently stay in emergency shelter will receive immunization first beginning on Sunday, November 1, 2009. Next, front-line health care personnel will receive immunization beginning on November 2, 2009.The first 370 thousand Novartis pandemic influenza A (H1N) vaccine would be distributed to local health bureaus beginning on October 27, 2009.On the other hand, the first batch of 5 million pandemic influenza A (H1N1) vaccine produced by Adimmune will be available on October 30, 2009.

CECC announced the discovery of the second Oseltamivir-resistant pandemic influenza A (H1N) virus strain in Taiwan. The Oseltamivir-resistant pandemic influenza A (H1N) virus strain was isolated from a 44-year-old male who lives in northern Taiwan.The case developed antiviral resistance after treatment using Oseltamivir. After further epidemiological investigation, Taiwan CDC determined the case is an individual case that has not resulted in community transmission and is not related to the first case of Oseltamivir-resistant pandemic influenza A (H1N1). According to the latest statistics announced by WHO, a total of 39 strains of antiviral-reisistant pandemic influenza A (H1N1) virus have been detected in ten countries.Countries that have detected two and more strains of antiviral-resistant pandemic influenza A (H1N1) include the United States, the United Kingdom, Japan and Hong Kong. Since the occurrence of Oseltamivir-resistant viruses could still happen, besides continuing to reinforce the surveillance of pandemic influenza A (H1N1) antiviral resistance, Taiwan CDC has stockpiled 960 thousand treatment courses of Relenza that could be provided to hospitals when necessary.