WHO official says world edging towards pandemic
June 3, 2009 by fluoutbreak · Leave a Comment
(ChinaPost.com.tw) – The spread of H1N1 flu in Australia, Britain, Chile, Japan and Spain has nudged the world closer to a pandemic, the World Health Organisation said on Tuesday.
The newly-discovered strain had caused more infections than seasonal influenza at the start of Chile’s flu season, raising concern about how it would spread in the southern hemisphere, according to Keiji Fukuda, the WHO’s acting assistant director-general.
The virus has mainly affected people aged below 60 and caused 117 deaths worldwide, including some otherwise healthy people, he said. For now, the WHO’s pandemic scale remained at the second-highest level but the threshold may soon be crossed.
“Globally we believe that we are at Phase 5 but we are getting closer to Phase 6,” Fukuda told journalists. “The future impact of this infection has yet to unfold.”
It’s a Pandemic, Experts Say;
June 3, 2009 by fluoutbreak · Leave a Comment
June 3 (Bloomberg) — Swine flu, becoming entrenched in Australia and Chile, will prompt the World Health Organization to declare the first influenza pandemic in 41 years, said three people familiar with the agency’s plans.
Margaret Chan, the WHO’s director-general, will make the announcement sometime in the next 10 days, said the people, who spoke on condition of anonymity because the deliberations are private. The agency, having spent the past five years alerting the world to the dangers of a pandemic, is now looking for a way to declare one without causing panic.
Chan has to navigate a delicate path between raising alarm about a virus that in most cases causes little more than a fever and a cough, and underestimating a bug that could kill millions. Moving to the top of WHO’s six-step pandemic scale may spur some countries to restrict travel, ban public events and adopt other measures that aren’t needed for mild flu, worsening the deepest economic slump since the Great Depression.
“The formalization of an influenza pandemic does have cascading consequences,” said Michael Leavitt, former U.S. health and human services secretary. “The decision ought not to be taken lightly,” Leavitt said in an interview. “The system of evaluating and triggering different levels of alert is still being refined at the WHO.”
Chan and colleagues spent 7 hours on June 1 consulting experts and public health officials from 23 countries on how to explain that swine flu is global, but not severe.
Severity Scale
Following the discussion, the WHO is considering a three- point scale to denote different levels of severity once phase 6 has been declared, Keiji Fukuda, the agency’s assistant director-general of health security and environment, said on a conference call with reporters yesterday.
Pandemic Definition Continues to Mystify
May 26, 2009 by fluoutbreak · Leave a Comment
As cases of swine flu continue to increase in several countries, the World Health Organization (WHO) maintains that the outbreak does not merit the label “pandemic.” And in the United States, which accounts for just over half of the 12,954 confirmed cases of the disease reported to WHO from 46 countries, signs indicate the outbreak may have peaked.
Case counts in part reflect the intensity of a country’s surveillance efforts, but it’s clear that the novel H1N1 virus causing the disease has made solid headway in Japan, which has 350 confirmed cases, the most outside of the Americas. Cases over the past few days have also nearly doubled in Chile to 74, the highest number yet seen in the Southern Hemisphere. Still, WHO’s Keiji Fukuda, the assistant director-general, explained at a press conference today that the spread does not merit moving from a phase 5 alert to phase 6, which would indicate a full-scale pandemic. “It’s quite possible that it will continue to spread and it will establish itself in many other countries in multiple regions, at which time it would be fair to call it a pandemic,” said Fukuda. “Right now, we’re really still in the early parts of the evolution of the spread of this virus, and we’ll see where it goes.”
WHO earlier had defined phase 6 as sustained community spread of the virus in two regions of the world but last week put that definition on ice, following pressure from member countries that criticized the phasing system for not taking into account disease severity. Fukuda said in the next few weeks that WHO hopes to hold a videoconference with prominent scientists and public health specialists who have “a wide range of opinions” about how to define phases in influenza outbreaks. “We’re trying to see what kind of adjustments might be made to make sure that the definitions really meet the situation,” said Fukuda.
WHO Considers Revising Definition of “Pandemic”
May 23, 2009 by fluoutbreak · Leave a Comment
Responding to mounting confusion, the World Health Organization (WHO) has sent the definition of a full-scale, phase 6 influenza “pandemic” to the rewrite desk. But no formal revisions have been made yet, leaving the old definition in place, and that says a phase 6 alert should be triggered if two regions of the world have sustained community spread in humans of an animal or animal-human hybrid of a flu virus.
On 29 April, WHO raised the pandemic threat level from 4 to 5, citing sustained community transmission in the U.S. and Mexico. At the same time, WHO said phase 6 was “imminent” and would be declared if the same type of spread appeared in a second region of the world. But at a press conference today, Keiji Fukuda, WHO’s assistant director-general, said that representatives from several countries who attended the World Health Assembly in Geneva this week criticized the current phasing system, which relies solely on geographic spread without regard to severity of disease.
Fukuda said WHO agreed with the countries that the phase system needs to more accurately reflect the impact the virus is having on populations. Fukuda also said WHO might bump up the alert to phase 6 if the virus started to spread significantly in the Southern Hemisphere, including South America and Africa, even without causing severe disease.
When is a pandemic not a pandemic?
May 22, 2009 by fluoutbreak · Leave a Comment
Is it a pandemic or is it not a pandemic? Since the world has never had a chance to make a call like this at the outset of a pandemic, nobody is quite sure how to handle it. The usual definition — an epidemic (an increase in cases beyond what is expected) of global dimension — has a lot of wiggle room and WHO and everyone else is busy wiggling. One reason is not whether this meets the definition or not but what the consequences might be of calling this “a pandemic”
AP news story points us to 1946 H1N1 (maybe) pandemic as immunity guide
May 22, 2009 by fluoutbreak · Leave a Comment
Earlier today, I pointed out with some thumping of the ol’ chest that the CDC has indirectly confirmed my theory of late April regarding swine flu; namely, that we could compare this event with the 1946-47 pandemic/epidemic of H1N1 and the 1951 H1N1 severe epidemic to see if there was a correlation.
The New York Times article was the first confirmation of that. Now, the AP has also written on the topic. But their story is more precise in the age group (persons ages 60 and above) that seem to have natural antibodies against 2009′s swine H1N1.
A simple subtraction of the number 60 from the number 2009 (or 2008 if you prefer, since the virus apparently first manifested itself in September 2008 in Mexico) yields the number 1948. This is so close to the 1946-47 severe epidemic that it cannot be considered coincidence.
As I have mentioned many times previously, the 1946-47 epidemic may have, in fact, been a pandemic of influenza. It was certainly an epidemic, and was by accounts as severe, illness-wise, as the 1957 H2N2 “Asian flu” pandemic, with roughly the same mortality, which was serious but not apocalyptic.
Textbook research shows that flu seasons had been relatively mild from 1930 until 1946, when all viral Hell broke loose. A serious antigenic event — a huge drift, or perhaps a more likely antigenic shift due to reassortment of human flus — took place. It rendered vaccines useless (sound familiar?) and started a new chain of H1N1 flu that culminated in yet another antigenic seismic event in 1951. That virus caused more epidemics until it was deposed by H2N2 in 1957.
It is highly unlikely that antibodies to pre-1946 influenza are helping seniors today. In my own opinion, it must have been the 1946-47 strain of H1N1. And that would seem to indicate a swine background for that mutation, but I will leave that for the researchers.
At any rate, the roadmap is opened up and flattened out for viral researchers. Good luck to them.
Countries Clamor For New ‘Pandemic’ Definition
May 22, 2009 by fluoutbreak · Leave a Comment
With its rapid spread through North America and Japan, many experts say swine flu has reached pandemic proportions. So why is the World Health Organization stalling on its declaration?
In the 21 days since the World Health Organization declared that the first flu pandemic of the century is “imminent,” it’s become unclear just what “imminent” means. It’s also unclear what would tip the world into what the WHO calls Phase 6 — i.e., an actual pandemic.
This isn’t a question of semantics or science; it’s mainly a question of politics within the WHO.
The WHO is a creature of its 193 member-states. And some heavy hitters — China, Britain, Japan — are saying “whoa!” to the idea of declaring a pandemic. Instead, they want to redefine “pandemic.”
WHO Director-General Margaret Chan is struggling to respond to the situation, even as evidence mounts that the world has indeed entered a flu pandemic — by the WHO’s current definition.
Differing Patterns
At a meeting in Geneva on Thursday, Chan put forward a new reason for hesitating to declare a pandemic. “One of the things we’re not seeing is the same spread in the Southern Hemisphere that we’ve seen in the first three countries,” she said, according to Agence France-Press.
So far, 10 countries in Central and South America have reported a total of 125 cases of swine flu — not the explosive spread seen in Mexico, the United States and Canada.
Up to now, the WHO has said it was uncertainty about what was happening in Japan that prevented it from crossing the pandemic threshold.
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