On June 11, 2009, the World Health Organization (WHO) raised the worldwide pandemic alert level to Phase 6 in response to the ongoing global spread of the novel influenza A (H1N1) virus. A Phase 6 designation indicates that a global pandemic is underway.

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The inevitable has become official. Today, the World Health Organization chief Margaret Chan announced that she had raised the pandemic alert scale to 6, the highest level, to indicate that a pandemic caused by the A (H1N1) swine flu virus is now underway. “The scientific criteria have been met,” Chan told journalists gathered at WHO’s main meeting hall in Geneva, Switzerland, just after 6 p.m. local time. “The world is now at the start of the 2009 influenza pandemic.”

Agency officials all but acknowledged at a press briefing on Tuesday that the declaration was imminent, as they had in early May as well. WHO’s official tally stood at 28,774 cases in 74 countries today, including 144 deaths.

Chan stressed that phase 6 indicates only geographical spread and does not denote an increase in severity. WHO characterizes the pandemic’s severity as “moderate,” but Chan warned that the virus “can change the rules, without rhyme or reason, anytime.”

Yesterday, Chan spoke by teleconference with several WHO member countries about the spread of the A (H1N1) virus in their locales. Their input led her to seek advice from an Emergency Committee, as specified in International Health Regulations. “All member countries as well as the experts on the emergency committee reviewed the evidence and there was consensus, a unanimous decision, that we have indisputable evidence that we are at the beginning days of a global pandemic caused by a new H1N1 virus,” said Chan.

A major concern to WHO is that developing nations, already burdened with more disease and weaker health systems, might be disproportionately hit by the pandemic. Chan urged international solidarity to prevent this from happening. “This is a time when the world’s countries …must come together,” she said. “No country’s people should be left behind without help.” But she didn’t provide specifics when asked later how supplies of a vaccine against the novel H1N1 virus, which will be very limited initially, can be distributed fairly.

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The Government of Canada today reassured Canadians that it will continue to implement the Canadian Pandemic Influenza Plan in close coordination with domestic and international partners in order to address H1N1 flu virus.

The announcement was made in response to today’s decision by the World Health Organization to raise the H1N1 flu virus pandemic alert level from Phase Five to Phase Six.  In doing so the WHO underscored:

• The decision is based on the spread of the virus and not the severity of illness it causes. The virus has caused sustained community level outbreaks in more than three countries across two WHO regions;
• In general, the H1N1 flu virus continues to cause moderate illness globally with most people affected recovering at home without medical treatment. For instance in Canada most infections to date have been mild; and,
• That borders should remain open.

“Since the beginning, Canada has taken decisive action to address the H1N1 Flu Virus and protect Canadians,” said Minister of Health, Leona Aglukkaq. “Today’s decision by the WHO does not change our approach. Entering Phase Six means we will build on the surveillance and management measures that are already in place under the Canadian Pandemic Influenza Plan.”

The Government of Canada will continue to advance the following activities as a result of the WHO’s Phase Six pandemic alert level:

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By NICK CUMMING-BRUCE and ANDREW JACOBS, The New York Times

GENEVA — The World Health Organization raised its alert on swine flu to the highest level on Thursday, in its first designation of a global pandemic in 41 years.

Calling further spread of the virus “inevitable,” the organization’s director general, Margaret Chan, said, “We are at the earliest days of a global pandemic.” The new H1N1 strain, she said, is “spreading easily from one person to another, and from one country to another” in more than one region of the world.

But the pandemic is “moderate” in severity, she noted, with the overwhelming majority of patients experiencing only mild symptoms and a full recovery, often in the absence of any medical treatment. And scientists are painstakingly tracking its every movement.

“The virus is spreading under a close and careful watch,” Dr. Chan said. “No previous pandemic has been detected so early or watched so closely.”

The heightened alert came after an emergency meeting with flu experts here that was convened after a sharp rise in cases in Australia, which reported 1,263 cases on Thursday, and rising numbers in Britain, Japan, Chile and elsewhere. The declaration will trigger drug makers to speed up production of a swine flu vaccine — expected to take a minimum of 4 to 6 months — and prompt governments to devote more money to containing the virus.

As the disease moves into the developing world, where rates of chronic disease are high and health systems typically poor, Dr. Chan said, “it is prudent to anticipate a bleaker picture.”

The virus itself can also change quickly, she said, and even those nations that have already experienced a rash of cases “should prepare for a second wave.”

“The virus writes the rules, and this one, like all influenza viruses, can change the rules without any rhyme or reason,” Dr. Chan said.

Unlike seasonal flus, which have taken their highest toll on the very young and the very old, Dr. Chan said, most severe cases of the new H1N1 virus have involved people between the ages of 30 and 50, while overall, the majority of all infections have occurred in people under 25.

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By Thomas H. Maugh II, Los Angeles Times

The World Health Organization this morning acknowledged what many health experts have been saying for weeks: The outbreak of novel H1N1 virus is now a pandemic.

In a letter sent to its member countries, the WHO said it is officially raising its infectious diseases alert to Phase 6, its highest level, in recognition of the fact that the virus is now undergoing communitywide transmission in Australia as well as in North America. Such spread in two distinct regions of the world is the primary criterion for raising the alert level.

FOR THE RECORD:An earlier version of this article said emergency rooms in Chile had been overrun by people fearful that they had contracted the swine flu virus. Actually, emergency rooms in Argentina, not Chile, reported this trend.

But the agency said that the pandemic is only “moderate in severity” and cautioned against overreactions to the increased alert level.

The announcement marks the advent of the first global influenza epidemic in 41 years. The last one was the Hong Kong flu epidemic of 1968, which killed an estimated 1 million people worldwide.

So far, the H1N1 or swine flu pandemic this year has accounted for 27,737 laboratory-confirmed cases and 141 deaths, although health officials believe many times that number have been infected but have not been tested because their disease was mild.

A normal seasonal flu outbreak kills about 250,000 to 500,000 people worldwide.

In most industrialized countries, the rise in the alert level will have little practical effect because health authorities were already behaving as though a pandemic had been declared. In the United States, where there have been more than 13,000 cases and at least 27 deaths, “Our actions in the past month have been as if there was a pandemic in this country,” said Glen Nowak, a spokesman for the Centers for Disease Control and Prevention.

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The Honourable Leona Aglukkaq, federal Minister of Health, along with Dr. David Butler-Jones, Chief Public Health Officer of Canada, Dr. Frank Plummer, Scientific Director General of the National Microbiology Laboratory, and Dr. Danielle Grondin, Assistant Deputy Minister, Infectious Disease and Emergency Preparedness in the Public Health Agency of Canada will provide an update on the topic of H1N1 flu virus.

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As of 14:00 GMT, 11 June 2009, 74 countries have officially reported 28,774 cases of influenza A(H1N1) infection, including 144 deaths.

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Jun 11, 12:00 PM Webcast

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The Public Health Agency of Canada has posted today’s updated national case numbers of H1N1 flu virus infections in Canada, as reported by the provincial and territorial health authorities.

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Changing your travel plans if you’re sick with flu-like symptoms.

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