The H1N1 virus is linked to nine deaths in Canada in the last week, federal health officials say.

The Public Health Agency of Canada said the deaths were reported between Dec. 23 and Dec. 30 as follows:

  • 1 in British Columbia.
  • 4 in Alberta.
  • 3 in Ontario.
  • 1 in New Brunswick.

For the week ending Dec. 19, for which there is more information available, low levels of flu activity were reported across the country, and all flu indicators have declined for at least five consecutive weeks, the agency's FluWatch report said.

Likewise in the U.S., swine flu was widespread in four states last week compared with a peak in late October when 48 states reported high levels of illness.

The four states were Delaware, Maine, New Jersey and Virginia, the U.S. Centers for Disease Control and Prevention said Thursday.

European and Asian flu activity

Since April 12, a total of 379 laboratory-confirmed deaths related to H1N1 have been reported in Canada.

In North America, influenza transmission remains widespread but has declined substantially in all countries, the World Health Organization said Wednesday.

The most active areas of flu transmission currently are in central and eastern Europe, with a high intensity of respiratory disease in Greece, Poland, Bulgaria, Serbia, Ukraine and the Urals Region of the Russian Federation, WHO said in its weekly pandemic update.

Limited data suggests flu continues to circulate in Central Asia and East Asia but appears to be declining.

In southern Asia, influenza activity continues to be intense, particularly in northern India, Nepal and Sri Lanka, WHO said.

Worldwide as of Dec. 27, at least 12,220 swine flu deaths have been reported, the UN health agency said. Many deaths are never tested or recognized as influenza related. Experts say it could take two years to determine the death toll from H1N1.

Most people infected with H1N1 recover without medical treatment, but cases are occurring among people under age 65 who are typically not at such risk during regular flu seasons.

It's estimated that between 250,000 and 500,000 people worldwide die from regular flu each year, including 4,000 to 8,000 in Canada, according to WHO and the Public Health Agency of Canada.