Allergy Seasons in Hawaii

Hawaii could be a perfect place to live for people with allergies to continental trees and grasses. Yet, it has myriads of flowers and tropical trees blooming all year around. The State of Hawaii has the second highest childhood asthma rate in the nation, with 10.8% percent of children ages 0-17 diagnosed with asthma. This is mostly caused by Hawaii’s topical climate which makes for abundant vegetation, pollen, high humidity, dust mites, dust, cockroaches, and outdoor living.

One of the largest issues is outdoor mold. While in cold climates mold usually send their spores airborne from May through October, in warm and humid Hawaiian climate molds could persist throughout the year. Inhalation of mold spores could lead to sneezing, asthma, itchy and watery eyes. The symptoms may become worse for people eating cheese, mushrooms, soy sauce, dried fruits or vinegar. 

Other issues could be dust and pesticides from the cane fields. The worst months in Maui are May to November, especially mid-May to August because of the wind pattern.  Residents could also suffer from smoke coming from burning crops or garbage (combined with high winds) and polluted air due to high car traffic. Big island and Maui, to some extent Oahu, are also exposed to sulfurous odor coming from active volcanoes. Kauai is the best place for those who can't tolerate volcanic air. Yet Kauai and Hilo side of the Big Island could be the worst place for other types of pollen allergies as they have the wettest climate.  Oahu has very high mold levels too, although it could vary from place to place and depend on the exposure to indoor mold. You can check current pollen, dust and dander levels here.

See what people are saying about their experiences:  

2. erik in honolulu

   May 12, 2010 at 10:57 am

   I moved to Hawaii four months ago and my allergies have been the worst in my life since moving here. With so many flowers and fruits blooming year round, there is no relief from the pollen. Beware the rainbow state – bring allergy meds.

   
   

   Carrie B

   July 29, 2007 at 1:28 pm

   I lived on Oahu for 13 years. It might just be that you were allergic to mold- that the place you were staying in had mold. Another place to stay might be fine. 

   AllergyNurse

   . 

   Feb 3rd, 2007

   My husband and I lived in Kihei on Maui for a year. I got what I thought was bronchitis every few months. Apparently, it was allergies. My husband was fine most of the year but mid May to mid August he was severly ill from his allergies and asthma.

   It was so bad we had to move. We would love to go back to Hawaii but do not know which areas of Hawaii are better for people with severe allergies/asthma. I have heard that Kauai and Hilo side of the Big Island are bad. Any insights into specific good or bad areas of each island would be very appreciated. — Donna, formerly in Hawaii

   1. Al Choholic

      March 25, 2007 at 11:27 pm

      ha , so you moved here hoping to catch a break with allergies ?  Kihei has : 1.) basically two crowded roads , always glutted with cars ; 2.) cane growers , in tandem with Monsanto , waging chemical warfare against everyone on this island by burning their crops , which are contaminated by Monsanto ‘ s ” Franken – pesticides ” ….. not to mention the plastic piping , and various other ” miscellaneous ” items that they burn at these times ; 3.) much less than 100 miles away ( from Kihei , about 35 miles from Maui ) an active volcano . Hmmmmmm……
      I wouldn ‘ t so much call it ” allergies ” as I would call it ” polluted air ” . I ‘ m sure big cities are worse , the ones I ‘ ve been in are anyways , but Kihei is not the place to come for fresh air . If you had to be on Maui , I’ d suggest something Hana way , I ‘d LOVE to be there myself , but we ( gf and myself ) are not bohemian millionaires , nor are we locals , so nix that idea . If you have the money it ‘s the place to be …..
      unless if you have problems with mold . In which case , Kaua ‘ i , and Hilo area would be bad for you …. they both have a very wet climate , as I ‘ m sure you know Hana area has as well ( although not nearly as wet ) .
      My ” best ” suggestion for you two , I ‘ d guess something on Oahu , away from the city for sure , maybe towards North Shore , although somewhere thats not tooo wet . Oahu doesnt seem to get the vog as badly ( although they did get a spell of it around the time of the World Series last year ) as islands that are closer to Big Island …..
      by the way , your husband prob got sick between May and August because of the wind pattern at that time of the year …. pulling vog from Big Island .
      Lastly , I am a runner , moved from Minnesota , and the amount of stamina I ‘ ve lost in the year and a half that I ‘ ve been here ………wow .( And I run at night mostly. ) They burned here on Friday and now several people at work ( today is Sunday ) are sick …… I guess my points are 1.) money always tries to blame people for their ” allergies ” as they are sickening people ; 2.) there are better places out here than Kihei.

   1. Leilani Dune

      June 9, 2008 at 5:31 pm

      Hi:

      Kona is beautiful, but is not the place to be for asthma suffers. The State of Hawaii has failed its’ residents, as it failed to report the detrimental effects of asthma for fear of losing tourist or real estate business. As a result, our people have suffered greatly both economically and and physically.

      As a runner, and unaware of the detrimental effects of vog like conditions, I have developed a severe respiratory condition. I have never smoked, have been running since a teenager. We need to unite to make the State accountable to its’ people. Why sacrafice profit for health? ALoha, Leilani
   2. Alice Mastello

      December 9, 2010 at 2:10 pm

      We went to Hawaii in 1997 and I became horribly ill. I am very allergic to mold, systemically, and am afraid to go back there. Can not find out anything on mold there, but am reading the blogs and think I should continue to stay far away. Does anyone know how to find out what the mold counts are?

      
      

      Oct 14th, 2006 
      

      by AllergyNurse

      
      I’m on Maui now. Different grasses but the Waddle trees here leave enough pollen to coat a house! Shorter season than grass though, and not quite as bad. Cost of living here is killing me instead!
      
      
      
      

      Keith

      February 16, 2008 at 10:23 am

      I lived in the big Island and Oahu in the 90′s. Allergy Nurse, if you can handle the prices you might consider as a temporary fix moving to Oahu. It’s much more crowded than Maui, but I found it to be pretty good for me allergy-wise. We moved there as the mold in Hilo and the Vog in various places on the Big Island were too much for me. On Oahu I did fine. There were occasional days where I’d need to take an inhalor, but only a handful of times in a few years. You might also consider finding an environmental allergist who can help you build your immunity to allergies. These doctors are specially trained and more thorough than regular allergists. A good source for learning about this type of treatment would be to read some of Dr. Sherry Rogers’ books or google Dr. William Rea. He has a clinic in Texas and is big in the field. Not suggesting you go to Texas, but you can get the info on their site or from Rogers’ books like “Detox or Die” about how to find someone credible. Keep in mind you could have mold issues too, or even vog. You might think too of moving to the dryer part of Maui or Oahu where mold and pollen would be less. You’d still have access to the beaches, etc. Casey, the environmental allergy treatments migt help you too. I do have a friend who’s lived in Oregon for many years, he swears by the fact that no matter where in Oregon, it is very moldy and that could be what is affecting you more than the pollen. You need to be tested to see what the underlying causes are. If either of you had problems with mold or chemical sensitivities or there was something else depressing your immune system, it can manifest in greater sensitivity to allergies. Some other underlying immune issues could be: suppressed adrenals (read James Wilson’s book “Adrenal Fatigue”, underlying infections from dental cavitations or tooth, gum infections, sinus infections, use of steroids for asthma, arthritis also suppress immune function. Also having a plugged toxic liver is known as a great cause of allergies. Google “liver cleanses” and start reading about them. People have been known to get totally over allergies by doing them. Ideally you would do them under a practitioners supervision but you can do it on your own. You just need to prepare carefully and thoroughly. If any of you can find reputable alternative care that would be a big leg up to resolving some of these issues and Summer, you might some day be able to return to your beautiful home in the Hawaiian Islands. As per Arizona, I have heard very good things about it as far as being away from molds, that may be Summer what might have been aggravating your system. I hope this helps and I wish you all Aloha.

Mold Allergy

According to a recent Quest Diagnostics Study, allergies are on the rise. Especially in regards to two environmental allergens: ragweed and mold. Over the four year period, sensitization to common ragweed grew 15% nationally while mold grew 12%. By comparison, sensitization to the 11 allergens combined (including two house dust mites, cats and dogs, and five foods) increased 5.8%. 
Allergic responses to mold are quite common, the symptoms are hay fever-type: sneezing, runny nose, red eyes and skin rush. 

In US, mold allergies can appear any time. Mold is a precipitation-affected aeroallergen, it may increase in prevalence with a warmer climate. The southern part of United states faces the longest mold allergy season as warmer weather last for a longer time. Mold allergy season here normally begins in the month of June and continues up to the month of August, but it can start earlier and last longer. Mold allergy is especially bad in the coastal area due to the presence of humidity which results in wet summers. In the North, The map shows a snapshot of mold allergies in continental USA. Hawaii is not shown, but its climate is very favorable to mold growth. Midwest and Great Plains, mold allergy fluctuates throughout the year and can appear any time. 

Mold spores usually land on wet surfaces and need water or moisture to grow. There are many types of mold. Cladosporium is one of the most common indoor and outdoor varieties. This fungi appear olive-green, brown and black and are usually found on living and dead plant material. In May, it was observed in Washington, DC, Delaware, Florida, Idaho and many other states. 


Basidiosporus is another cosmopolitan mold. It can cause brown rot, grow and destroy the structural wood in buildings. It can cause type I allergies (hay fever-like, asthma) and type III hypersensitivity pneumonitis. 


Smuts can be found on cereal crops, grasses and other flowering plants. They usually do not grow indoors and cause type I allergy symptoms. In May they were identified in Idaho and other states. 


Ascospores are among the most variable fungi in appearance ranging from transparent and colorless to opaque black. They are very abundant in outdoor air on rainy days, often appearing when the first warm rains occur after winter.
Although generally considered "outdoor" spores, some Ascomycetes producing ascospores grow well indoors on wet materials. In May this type of fungi were identified in Florida and other states.


Alternaria - known as major plant pathogens - stimulates sensitization in the lower airways, grow on skin and mucous membranes, including on the eyeballs, not only within the respiratory tract. Many human health disorders  - related to alternariosis and alternariatoxicosis - can be caused by these fungi, although serious infections are rare.

All fungi can produce some kind of allergens, but the most common ones are less likely to cause symptoms. Cladosporium, Alternaria, Bipolaris, Curvularia, Pithomyces and Stachybotrys contain allergens reacting to the IgE, but Epicoccum, Fusarium, and Spegazzinia apparently do not. Besides, personal exposure to airborne fungi could significantly vary even in exactly the same conditions. Thus personal spore traps may be a better measure of exposure than stationary air sampling equipment. 

Foodborne outbreaks update

E.coli outbreak is spreading through Europe. As of June 1, more than 1,500 people are infected in Germany, source of E.coli cases remains unknown. The death toll rose to 16 with the first death outside of Germany, in Sweden.

Why is this strain of E. coli 0104:H4, 93% similar to EAEC 55989 with several antibiotic-resistant genes, so virulent? Was there something wrong with lettuce, tomatoes or cucumbers? Is it safe to eat vegetables? 

These questions remain unanswered. 

All we know is that women account for most of the cases, while young and middle-aged adults are most severely affected.  Kidney failure appears to be a signature of this E.coli.

Meanwhile all is quiet on the foodborne outbreak front in the US.

There were 8 E.coli cases (serotype O157:H7) reported in April (1 in Michigan, 3 in Minnesota and 4 in Wisconsin). 75% of infected were males. These cases were associated with in-shell hazelnuts. 

14 more E.coli cases  (serotype O157:H7) reported in April (3 in Maryland, 2 in New Jersey, 1 in North Carolina, 2 in Ohio and 6 in Pennsylvania) were associated with Lebanon Bologna. 

There were more outbreaks of Salmonella Typhimurium infections associated with African dwarf frogs and clinical/teaching microbiology laboratories. 

Persons infected with the outbreak strain of Salmonella Typhimurium from frogs

As of May 9, 2011, a total of 222 individuals infected with the outbreak strain of Salmonella Typhimurium have been reported from 41 states (statistics since April 1, 2009). The number of ill person identified in each state is as follows: Alaska (5), Alabama (2), Arizona (10), California (18), Colorado (12), Connecticut (3), Florida (1), Georgia (4), Idaho (4), Illinois (8), Indiana (1), Kansas (3), Kentucky (4), Louisiana (2), Massachusetts (6), Maryland (5), Michigan (6), Minnesota (1), Missouri (5), Mississippi (1), Montana (2), North Carolina (1), Nebraska (2), New Hampshire (3), New Jersey (3), New Mexico (2), Nevada (4), New York (7), Ohio (7), Oklahoma (1), Oregon (5), Pennsylvania (15), South Dakota (3), Tennessee (4), Texas (4), Utah (18), Virginia (11), Vermont (1), Washington (23), Wisconsin (4), and West Virginia (1).

Persons infected with the outbreak strain of Salmonella Typhimurium from microbiology labs

As of April 20, 2011, a total of 73 individuals infected with the outbreak strain of Salmonella Typhimurium have been reported from 35 US states: AK (1), AL (3), AZ (2), CA (1), GA (5), IA (1), ID (2), IL (3), IN (1), KS (1), KY (3), MA (2), MD (2), MI (2), MN (4), MO (2), NC (1), ND (1), NE (2), NJ (2), NM (3), NV (1), NY (1), OH (1), OK (1), OR (1), PA (6), SC (2), SD (1), TN (2), TX (1), UT (3), WA (5), WI (3), WY (1).

Fewer people were infected with another type of Salmonella, Salmonella Panama from Cantaloupe:  Oregon (5 cases), Washington (4 cases), California (2 cases), Colorado (1 case) and Maryland (1 case). Dates of illness onset ranged from February 5, 2011 to March 4, 2011. 62% were male. 

US foodborne outbreaks: 2011 stories

• Microbiology Laboratories - Salmonella Typhimurium
• African Dwarf Frogs - Salmonella Typhimurium
• Turkey Burgers - Salmonella Hadar
• Lebanon Bologna - Escherichia coli O157:H7
• Del Monte Cantaloupe - Salmonella Panama
• Hazelnuts - Escherichia coli O157:H7

Flu update: mostly in Southern Hemisphere

No more (well, almost no more) flu in Northern Hemisphere, but the Southern Hemisphere is cooling down. 
Flu activity is low throughout  the US and Canada. The only country in Europe reporting moderate flu levels is Armenia. Google trends shows slightly increased activity in Norway, but this may be an artifact of searches. 


According to the Pan American Health Organization (PAHO)/WHO, respiratory illness activity in Chile and Argentina was increasing between Week 12 (March 21-27) and Week 18 (May 2-8). However, almost all of this activity was attributed to non-influenza viruses. Google trends predicts increased activity in Brazil.

Influenza activity was low in tropical regions, Australia and New Zealand. According to the Australia Department of Health and Ageing, the number of laboratory-confirmed influenza cases decreased in recent weeks, although it remains higher than during the same period in 2010.



South Africa National Institute for Communicable Diseases reported low influenza activity as of May 1. According to Google flu trends, however, flu levels increased in the end of May. 

How cold is cold enough? How humid is really humid?

How cold is too cold? How windy is really windy? It depends on where you live. If you are from the South you will need a blanket if it's below 50 degrees Fahrenheit (10 °C). If you are accustomed to cold weather, 70 (20+ C) is too hot.  For residents of Oymyakon in Eastern Siberia with average winter temperature of -49°F (−45°C) and record low -90°F (-67.7°C), -30°F (−34.4°C)  is pretty pleasant. If you live in Cold Bay, Alaska, 15 miles per hour is not really windy, while in Oak Ridge, Tennessee average wind blows at only 4 miles per hour.

In general,

110 Fahrenheit is considered dangerously hot

100° F may be hazardous

90° F is uncomfortably hot

80-40 is considered a relatively comfortable range - the average surface temperature of the Earth is 59° F

30° F is uncomfortably cold
15° F is very cold (although for avid runners cold is below 10 F with winds over 15 mph)
0° F is bitter cold with significant risk of frostbite

But let's take a closer look at the world's climate, mostly defined by long-term (30 years) patterns in temperature and precipitation:


Purple regions (A) in this map are hot and rainy year around. Orange areas (B) are dry with little rain and a large range of daily temperatures. Green areas are two-season climates with warm, dry summers and cool, wet winters. Blue regions (C) have continental climates with distinct four seasons and moderate precipitation. E denote cold areas with permanent ice and tundra. Only about four out of twelve months temperature in these areas raises above freezing.

3 most windy cities in US (seasonal wind averages are given in miles per hour):

City                JAN    FEB    MAR    APR    MAY    JUN    JUL    AUG    SEP    OCT    NOV    DEC    ANN

MT. WASHINGTON, NH  46.1   44.3   41.4   35.8   29.7   27.3   25.3   24.7   28.8   33.8   39.5   44.5   35.1

ST. PAUL ISLAND, AK 19.9   20.0   18.8   17.4   14.9   13.6   12.1   13.7   15.4   17.4   20.0   20.1   16.9

COLD BAY,AK         17.5   17.9   17.4   17.5   16.2   15.8   15.6   16.2   16.2   16.6   17.5   17.5   16.8

10 most humid cities in US:
No. 10: Olympia, WA
Average relative humidity: 78%
Average annual precipitation days: 163
Highest precipitation month: November
No. 9: Houston, TX
Average relative humidity: 78%
Average annual precipitation days: 105
Highest precipitation month: June
No. 8: Brownsville, TX
Average relative humidity: 78%
Average annual precipitation days: 73
Highest precipitation month: September
No. 7: Victoria, TX
Average relative humidity: 78.5%
Average annual precipitation days: 91
Highest precipitation month: May

No. 6: Corpus Christi, TX

Average relative humidity: 78.5%
Average annual precipitation days: 77
Highest precipitation month: September

No. 5: Lake Charles, LA

Average relative humidity: 79.5%
Average annual precipitation days: 104
Highest precipitation month: June

No. 4: Port Arthur, TX

Average relative humidity: 78.5%
Average annual precipitation days: 77
Highest precipitation month: September

No. 3: Astoria, OR

Average relative humidity: 81%
Average annual precipitation days: 193
Highest precipitation month: November

No. 2: Mount Washington, NH

Average relative humidity: 83%
Average annual precipitation days: 209
Highest precipitation month: November

No. 1: Quillayute, WA
Average relative humidity: 83.5%
Average annual precipitation days: 209
Highest precipitation month: November 

Highest Average Annual Precipitation Extremes in the World
	Continent	Highest Avg. (Inches)	Place	Elevation (Feet)	Years of Record
	South America	523.6 *	Lloro, Colombia	520	29
	Asia	467.4 *	Mawsynram, India	4597	38
	Oceania	460.0 *	Mt. Waialeale, Kauai, HI	5148	30
	Africa	405.0	Debundscha, Cameroon	30	32
	South America	354.0	Quibdo, Colombia	120	16
	Australia	340.0	Bellenden Ker, Queensland	5102	9
	North America	256.0	Henderson Lake, British Colombia	12	14
	Europe	183.0	Crkvica, Bosnia-Hercegovina	3337	22
* The value given is continent's highest and possibly the world's depending on measurement practices, procedures and period of record variations.

Allergy Seasons in Alaska

Internet  offers many allergy resources for US States. Examples are pollen.com providing allergy forecasts for US zip codes and American Academy of Allergy sources of allergy levels reported by certified counting stations. Weather.com features pollen maps too.  Neither of these sites, however, tells anything about Alaska and Hawaii.

Actually Alaska's Aerobiology is similar to Northern Europe, with some tree patterns resembling northern states of US. Pollination of poplar  - food for honey bees - starts in April - as in Michigan. Birch is very high in May - as in Russia and Scandinavia. Grass is active in June and July. A core pollen season of prophylactic and clinical urgency in Fairbanks and Anchorage is defined from May 10 to June 5.

You may want to visit Anchorage Daily news site  and Anchorage Pollen and Mold Reporting or Fairbanks area report to find today' allergy information for Alaska, or check Dr. Anderson's calendar below.  It is based on the observations made for six seasons: 1982-1987, from three sample locations in Fairbanks area, but represents a good prototype for other parts of Alaska.

 

This pollen calendar shows the range of possible atmospheric pollen concentrations for late April through July, assuming the weather is relatively warm, dry, and breezy.

Reference: James H. Anderson, MLIS, PhD, Institute of Arctic Biology and BioSciences Library, University of Alaska Fairbanks

Do you have a runny nose?

Most likely this is not flu. Flu season is over in the Western Hemisphere and almost over on the East.

Google trends (on the right) show low activity in line with actual epidemiological data. As of March 20 (end of week # 11, 2011), flu activity in Europe and Russia is decreasing, and the peak is over in 38 countries of the region. Flu levels remain moderate in Armenia, Georgia, Serbia, some areas of Russia, and Ukraine where the percentage testing positive for influenza is 58%. The UK analyzed most of the viruses screened and identified 3% viruses resistant to oseltamivir but still sensitive to zanamivir.
Idaho was the last US state to get over flu in March, right after Nevada told it good bye.
Flu is almost over, but  allergies are on the rise. High pollen levels, mostly from trees, are bad news for seasonal allergy sufferers.

Tree Pollen in US in March

Knowing what is going on in your area, including flu and pollen levels, will help you to determine the reason for your scratchy throat or headaches. Additional clues include if you feel it in your nose (cold) or behind the nose (allergy), if you have itchiness (allergy) or fever (cold).

Also, flu attacks you gradually while with allergies you get all the symptoms at once. 

The EuroFlu bulletin describes and comments on influenza activity in the 53 countries in the WHO European Region. 

See WHO/Europe web site and  ECDC Weekly Influenza Surveillance Overview. 

	A = Dominant virus A H1N1 = Dominant virus A(H1N1) H3N2 = Dominant virus A(H3N2) H1N2 = Dominant virus A(H1N2) B = Dominant virus B A & B = Dominant virus A & B = : stable clinical activity + : increasing clinical activity - : decreasing clinical activity Low = no influenza activity or influenza at baseline levels Medium = usual levels of influenza activity High = higher than usual levels of influenza activity Very high = particularly severe levels of influenza activity No activity = no evidence of influenza virus activity (clinical activity remains at baseline levels) Sporadic = isolated cases of laboratory confirmed influenza infection Local outbreak = increased influenza activity in local areas (e.g. a city) within a region, or outbreaks in two or more institutions (e.g. schools) within a region. Laboratory confirmed. Regional activity = influenza activity above baseline levels in one or more regions with a population comprising less than 50% of the country's total population. Laboratory confirmed. Widespread = influenza activity above baseline levels in one or more regions with a population comprising 50% or more of the country's population. Laboratory confirmed.

	Intensity Geographic Spread Impact Sentinel swabs Percentage positive Dominant type ILI per 100,000 ARI per 100,000 Sentinel SARI Virology graph and pie chart Armenia Medium Local Low 2 0% None 0.0 (graphs) 106.8 (graphs) sari Click here Austria Low Sporadic Low 27 51.9% Type A, Subtype pH1N1 17.9 (graphs) 3.0 (graphs) Click here Azerbaijan Low Sporadic Low 19 0% Type A and B 352.8 (graphs) Click here Belarus Low Sporadic Low 39 15.4% Type A, Subtype pH1 1211.0 (graphs) Click here Belgium Low Sporadic 56.9 (graphs) 1486.9 (graphs) Click here Bosnia and Herzegovina Type A, Subtype pH1 (graphs) Click here Bulgaria Low Local 2 0% None 0.0 (graphs) 886.1 (graphs) Click here Croatia Medium Widespread Low Type A, Subtype pH1 33.8 (graphs) Click here Cyprus Low Sporadic Low 1.9 * (graphs) 4.7 * (graphs) Click here Czech Republic 26 57.7% Type B (graphs) Click here Denmark Low Sporadic 2 0% None 66.8 (graphs) 0.0 (graphs) Click here England Low Sporadic 25 16.0% None 7.4 (graphs) 408.8 (graphs) Click here Estonia Medium Local 28 25.0% None 12.5 (graphs) 333.6 (graphs) Click here France Low Sporadic Low 25 0% None 0.0 (graphs) 1213.3 (graphs) Click here Georgia Medium Widespread Moderate 32 87.5% Type B and Type A, Subtype pH1 428.1 (graphs) sari Click here Germany Low Regional 122 58.2% Type B 0.0 (graphs) 1085.4 (graphs) Click here Greece Low Local 13 30.8% Type A, Subtype pH1N1 96.6 (graphs) 0.0 (graphs) Click here Hungary Low Sporadic Low 19 26.3% Type B and Type A, Subtype pH1 102.9 (graphs) 0.0 (graphs) Click here Iceland Medium Regional Moderate 0 0% 56.6 (graphs) 0.0 (graphs) Click here Ireland Low Sporadic Low 9 11.1% None 5.9 (graphs) 0.0 (graphs) Click here Israel Low Sporadic Low 21 14.3% Type A and B 8.8 (graphs) Click here Italy Low Regional Low 19 26.3% Type A 197.9 (graphs) 0.0 (graphs) Click here Kazakhstan Medium Local Low 5 100.0% None 1.4 (graphs) 179.5 (graphs) sari Click here Kyrgyzstan 7 0% None (graphs) sari Click here Latvia Low Regional 0 0% Type B (graphs) Click here Lithuania Medium Widespread Low 10 0% None 75.5 (graphs) 777.4 (graphs) Click here Luxembourg Low Sporadic 14 21.4% Type B and Type A, Subtype pH1 1.0 * (graphs) 20.8 * (graphs) Click here The former Yugoslav Republic of Macedonia None (graphs) Click here Malta Medium Sporadic Low 0 0% 10.0 * (graphs) 0 * (graphs) sari Click here Montenegro 21.2 (graphs) Click here Netherlands 17 29.4% None (graphs) Click here Northern Ireland Low Sporadic 0 0% None 14.4 (graphs) 328.7 (graphs) Click here Norway Low Sporadic 1 100.0% Type B and Type A, Subtype pH1N1 51.1 (graphs) 0.0 (graphs) Click here Poland Medium Regional 36 27.8% Type B and Type A, Subtype pH1 99.7 (graphs) 0.0 (graphs) Click here Portugal Low None 4 0% None 6.7 (graphs) 0.0 (graphs) Click here Republic of Moldova Medium Sporadic Moderate 22 40.9% Type B and Type A, Subtype pH1N1 8.1 (graphs) 229.3 (graphs) sari Click here Romania Medium Local Moderate 24 41.7% Type B 22.8 (graphs) 1078.2 (graphs) sari Click here Russian Federation Medium Sporadic Low 45 31.1% Type A, Subtype pH1 5.5 (graphs) 695.3 (graphs) sari Click here Scotland Low Sporadic Low 25 16.0% Type B 2.3 (graphs) 242.7 (graphs) Click here Serbia Medium Regional Low 1 100.0% None 117.3 (graphs) sari Click here Slovakia Medium Sporadic Low 5 40.0% Type A, Subtype pH1 257.8 (graphs) 1830.7 (graphs) Click here Slovenia Medium Local 8 50.0% Type B and Type A, Subtype pH1 8.5 (graphs) 1008.7 (graphs) Click here Spain Low Sporadic 108 16.7% Type B 31.0 (graphs) 0.0 (graphs) Click here Sweden Medium Widespread Low 16 0% Type B 5.7 (graphs) 0.0 (graphs) Click here Switzerland Low Local 11 63.6% Type B and Type A, Subtype pH1 102.4 (graphs) Click here Turkey Low Sporadic Low 112 37.5% None 6.0 (graphs) Click here Ukraine Medium Local Low 11 0% Type A, Subtype pH1 5.2 * (graphs) 624.6 (graphs) sari Click here Uzbekistan Low Sporadic Low None (graphs) Click here Europe 912 32.7% Click here