An outbreak of 2009 H1N1 seasonal flu underway in North Korea since early December has led to 126,574 suspected cases, the country's health ministry informed the World Health Organization (WHO) on Jan 19, according to a Jan 26 bulletin from the International Federation of Red Cross and Red Crescent Societies (IFRC).

Of the suspected cases, 81,640 have been confirmed as 2009 H1N1. Four deaths have been reported, three of them in children. Nearly half of the illnesses have been in children age 17 and younger, and the outbreak is affecting the whole country, with 28.7% of the illnesses from the capital city of Pyongyang.

The government is seeking support for flu vaccination to target those high-risk groups and has asked for 30,000 oseltamivir (Tamiflu) to be tabled for healthcare workers. The WHO has so far sent 5,000 tablets for frontline health workers and vulnerable groups.

The North Korean Red Cross is meeting daily with the health ministry to coordinate activities, and the WHO and other nongovernmental agencies were briefed on Jan 24 on the developing situation. The country's Red Cross said it may heed help getting the health ministry more supplies, such as rapid test kits, and assistance with social mobilization and surveillance activities.

The report on flu activity in North Korea is notable, because little is known about the disease activity there. The WHO said in its recent global flu update that flu activity in South Korea is on the rise, mainly involving H3N2 and influenza B. And in China—North Korea's neighbor to the north—high flu activity in underway, mainly led by influenza B, but with H3N2 circulating, as well.