Countries in the tropical zone

Very little influenza activity has been reported since the last update in tropical areas, though some localized transmission has been noted. Transmission has continued to occur in the Dominican Republic, all influenza A(H1N1)2009, and Jamaica, primarily influenza type B with smaller numbers of H1N1 (2009), but the numbers of cases are low and decreasing in both countries. An unconfirmed media account has reported that new cases of H1N1 (2009) were detected in Bolivia in late May along with an increase in severe respiratory infections. Many countries of the northern, tropical areas of South America report large numbers of respiratory disease in children, including hospital admissions for pneumonia, related to respiratory syncytial virus. Transmission in the tropical areas of sub-Saharan Africa has largely subsided to very low levels, including previously noted active transmission in Kenya and Ghana. Madagascar has continued to report small numbers of influenza type B, influenza A(H3N2), and influenza A(H1N1) 2009. Only sporadic detections of influenza viruses have been reported in the tropical countries of Asia.