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  • WHO Leaves Pandemic Alert Level Unchanged

    <TABLE border=0><TBODY><TR><TD width="100%">DJ WHO Says Bird Flu Pandemic Alert Level Unchanged </TD><TD align=right></TD></TR></TBODY></TABLE>
    GENEVA (AP)--A family of eight people infected with bird flu in Indonesia may have passed the disease among themselves rather than individually catching it from poultry, but the World Health Organization is leaving its pandemic alert level unchanged, the agency said Wednesday.
    "All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness," said a WHO statement. "Although human-to-human transmission cannot be ruled out, the search for a possible alternative source of exposure is continuing."
    The agency's alert level remained Wednesday at 3, where it has been for months. That means there is "no or very limited human-to-human transmission."
    WHO spokeswoman Maria Cheng said it was unlikely the agency would raise the alert level in the immediate future.
    "We haven't seen evidence from Indonesia that the disease is passing easily from human to human," Cheng told The Associated Press.
    She said WHO had considered convening a meeting of experts to debate whether to raise the alert level, but had decided that the current situation didn't merit that step.
    "We had discussed that," she said. "But that is not going to happen."
    The agency has suspected that in rare cases bird flu may have passed from one person to another, but it usually has been caught by people from chickens and other poultry.
    WHO said that testing indicated there had been no significant mutations in the virus. Experts have feared that a mutation of the virus into a strain that could easily pass among humans could set off a deadly flu pandemic.
    According to the WHO, 218 people have been confirmed to have been infected with bird flu since 2003, and 124 of them have died.
    The agency said the Indonesian Health Ministry had confirmed a man who died May 22 had been infected with the deadly H5N1 strain of bird flu.
    He was the seventh member of an extended family confirmed to have become infected. An eighth person in the family, who died of similar symptoms May 4, was buried before tissue samples could be taken, so the cause of death couldn't be determined, but she is assumed to be part of the cluster, WHO said.
    The family lives in the Kubu Sembelang village, Karo District, of North Sumatra.
    "The newly confirmed case is a brother of the initial case," WHO said. "Specimens were taken on 21 May and flown the same day to Jakarta. Tests run overnight confirmed his infection. His 10-year-old son died of H5N1 infection on 13 May. The father was closely involved in caring for his son, and this contact is considered a possible source of infection."
    It said the investigation is continuing, but that preliminary findings indicate that three of the confirmed cases spent the night of April 29 in a small room with the first woman infected and that she was coughing frequently.
    That group included the woman's two sons and a second brother, who is the sole surviving case among infected members of this family, WHO said. Other infected family members lived in adjacent homes.
    So far health workers have found no sign that the case has moved outside the family and there is also "no evidence that efficient human-to-human transmission has occurred."
    Laboratory testing has completed full genetic sequencing of two viruses isolated from cases in this cluster. That has found "no evidence of genetic reassortment with human or pig influenza viruses and no evidence of significant mutations," WHO said.
    Such a change could have been dangerous, because it might combine the bird flu virus with a strain that would make it easily pass among humans.
    </PRE>
    (END) Dow Jones Newswires 05-24-06 0902ET

  • #2
    Re: WHO Leaves Pandemic Alert Level Unchanged

    http://www.cdc.gov/flu/pandemic/phases.htm

    Phase 3: Human infection(s) with a new subtype but no human-to-human spread, or at most rare instances of spread to a close contact.
    Phase 4: Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.

    It is not comforting when people change the rules in the middle of the game.

    What is the world supposed to think of WHO?

    They have not released the sequences and now they are denying the facts that are as clear as day.
    "All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness," said a WHO statement. "Although human-to-human transmission cannot be ruled out, the search for a possible alternative source of exposure is continuing."


    Helen Branswell looked a little further into the issue and here is what she heard.
    Henderson, who wasn't so sure, suggested in this case it seems illness has spread beyond caregivers to others in the family. An 18-month-old girl and a 10-year-old boy are among the dead.


    "They all had contact, but it was not the kind of contact we've had described before, where the caregiver would be really heavily exposed," he noted.


    It should be remembered that Maria Cheng is just a spokesperson for WHO and she is not an infectious disease expert.

    "We haven't seen evidence from Indonesia that the disease is passing easily from human to human," Cheng told The Associated Press.

    Is this true?

    By their own admition we have seen human-to-human-to-human transmission of the virus.

    But the real issue is that they are changing the requirements once again by saying that the virus must pass 'easily from human to human'.

    Can anyone find a description of Phase 4 that says anything about the virus passing easily from human to human?

    If you can you deserve the Pulizter for fiction.

    In case anyone forgot let me mention again what the defintion of Phase 4 is:

    Phase 4: Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.

    Does anyone see the word 'easily' in that description?

    I didn't think so.

    Here comes the cue de gras.
    WHO spokeswoman Maria Cheng said it was unlikely the agency would raise the alert level in the immediate future.

    She said WHO had considered convening a meeting of experts to debate whether to raise the alert level, but had decided that the current situation didn't merit that step.

    "We had discussed that," she said. "But that is not going to happen."

    Why?

    What possible explanation could there be for not having a meeting of experts to debate whether to raise the alert level?

    Since WHO cannot seem to give a straight answer on what is going or provide justification for it's decisions it is incumbant upon the journalists and concerned citizens of this world to seek the truth.

    Comment


    • #3
      Re: WHO Leaves Pandemic Alert Level Unchanged

      DB-
      First off...you're right...they keep playing words games and changing the rules...reminds me of how a large corporation works...especially when something is going wrong.
      I'm going to step out on a limb here and say...if/when and after BF goes fullscale pandemic, the Pandemic Phase Chart will go through some major revisions and we'll see at least 12 levels with possible sub-levels (7a, 7b..etc)...just my two cents..I'm definitely not an expert but I know a spade when I see a spade.

      -Hawkeye

      Comment


      • #4
        Re: WHO Leaves Pandemic Alert Level Unchanged

        I honestly don't think that journalists are very interested. The story has been out there for several weeks - most of us have honestly guessed for several weeks that this is H2H, haven't we? You've only got to read back through the posts.
        The question is - why aren't people ( and journalists) interested? Is it because
        1) we are all seen as eccentrics, chasing a story that won't happen ?
        2) it's on the other side of the world where hygiene is backwards, so it won't happen here?
        3) it's too big a problem to get to grips with?
        4) we're all doom & gloom mongers

        I think that this is the way that it will evolve - BF stories will be ignored because they don't fit in the accepted version of the world, but meanwhile the stock-market will continue to fall. And one day we'll wake up with full-blown pandemic 5 or 6 and people will say - 'why didn't anyone tell us?'

        Comment


        • #5
          Re: WHO Leaves Pandemic Alert Level Unchanged

          It's all about being scared. No one wants to hear about BF...few can handle it...we've gone through the denial, acceptace etc. I really think people are scared to look at it seriously...they are hoping it will just go away...like SARS or biting pitbulls.

          -hawkeye

          Comment


          • #6
            Re: WHO Leaves Pandemic Alert Level Unchanged

            The member nations are the votes for the change in the Pandemic Phase level.

            I would like to remind everyone the pithy comments belong in the Discussion forum. Start a thread there if you do not see one that addresses this issue. This thread is for articles, content and analysis.

            Thank you.

            S.

            Comment


            • #7
              Re: WHO Leaves Pandemic Alert Level Unchanged

              JAKARTA, Indonesia (Reuters) -- Limited human-to-human transmission of bird flu might have occurred in an Indonesian family and health experts are tracing anyone who might have had contact with them, the World Health Organisation said.

              But a senior WHO official said in Jakarta this was not the first time the world was seeing a family cluster and said that fresh scientific evidence has shown the virus in Indonesia has not mutated to one that can spread easily among people.

              WHO said on Wednesday it had no immediate plans to call a meeting of experts to discuss raising its global bird flu alert.

              "Right now it does not look like the task force will need to meet immediately, but this is subject to change depending on what comes out of Indonesia," WHO spokeswoman Maria Cheng said, when asked to comment on press reports of an imminent meeting.

              Financial markets, however, were spooked on fears the Indonesia cluster could be the start of a pandemic. Currencies in Asia, where most bird flu cases have occurred, fell. U.S. commodity prices came under pressure while European markets slipped as investors turned jittery.

              Concern has been growing about the case in north Sumatra in which seven family members from Kubu Sembilang village died this month. The case is the largest family cluster known to date.

              WHO and Indonesian health officials are baffled over the source of the infection but genetic sequencing has shown the H5N1 bird flu virus has not mutated, the U.N. agency said on its Web site (http://www.who.int) on Tuesday.

              Nor was there sign of the virus spread among villagers.

              "To date, the investigation has found no evidence of spread within the general community and no evidence that efficient human-to-human transmission has occurred," the WHO said.

              Sick poultry have been the source of bird flu infection for most human cases worldwide. Pigs are susceptible to the virus.
              Clusters are looked on with far more suspicion than isolated infections because they raise the possibility the virus might have mutated to transmit efficiently among humans.

              That could spark a pandemic, killing millions of people.

              The WHO statement came after one of the family members, a 32-year-old father, died on Monday after caring for his ailing son, who had died earlier. The agency said such close contact was considered a possible source of infection.
              Closing in

              But Firdosi Mehta, acting representative of the WHO in Indonesia, urged against any over-reaction, saying this was not the first cluster that the world has known.

              Limited transmissions between people are caused by close and prolonged contact when the sick person is coughing and probably infectious. Experts in Kubu Sembilang were acting to contain any further spread.

              "We are going wide, contacting the various contacts, putting on (anti-viral) Tamiflu whoever has had close contact, basically putting family members who have not been affected on Tamiflu as a precaution," Mehta told Reuters in an interview in Jakarta.

              "There is active surveillance in the village, fever surveillance to look for any more cases that are occurring outside this immediate family cluster," he said.

              But another WHO spokesman said the agency was worried.

              "This is the most significant development so far in terms of public health," Peter Cordingley, spokesman for the West Pacific region of the WHO, said in the Philippine capital on Wednesday.

              "We have never had a cluster as large as this. We have not had in the past what we have here, which is no explanation as to how these people became infected."

              "We can't find sick animals in this community and that worries us," he added.

              Bird flu has killed 124 people in 10 nations since it re-emerged in Asia in 2003. It is essentially a disease in birds and has spread to dozens of countries in wild birds and poultry.

              In China, where the virus has been entrenched for the last 10 years, fresh trouble may be brewing as authorities confirmed an outbreak of the H5N1 among wild birds in its remote far-western Qinghai province and Tibet.

              About 400 wild birds had been found dead "recently", its state Xinhua news agency said, quoting the Agriculture Ministry.

              An outbreak of the H5N1 killed thousands of birds in Qinghai Lake this time last year and this strain of the virus has since turned up in parts of Europe, Africa and the Middle East.

              Markets are also nervous about a suspected cluster in Iran.

              An Iranian medical official told Reuters on Monday that a 41-year-old man and his 26-year-old sister from the northwestern city of Kermanshah had tested positive for bird flu.

              But Health Minister Kamran Lankarani denied this although international health officials are still investigating.

              The two siblings were among five members of a family who became sick and the other three remain in hospital.

              Comment


              • #8
                Re: WHO Leaves Pandemic Alert Level Unchanged

                This is rather interesting.

                We have three WHO representatives with three different messages.

                Maria Cheng is in Geneva.
                Right now it does not look like the task force will need to meet immediately, but this is subject to change depending on what comes out of Indonesia," WHO spokeswoman Maria Cheng said, when asked to comment on press reports of an imminent meeting.

                Firdosi Mehta is the acting representative of the WHO in Indonesia.
                urged against any over-reaction, saying this was not the first cluster that the world has known.

                Peter Cordingley, spokesman for the West Pacific region of the WHO is in the Philippine capital.
                "This is the most significant development so far in terms of public health,"

                "We have never had a cluster as large as this. We have not had in the past what we have here, which is no explanation as to how these people became infected."

                "We can't find sick animals in this community and that worries us," he added.


                So the representative in Indonesia says people shouldn't overreact because we have had human-to-human clusters before. At the same time the representative in the Philippines says we have never had a cluster this large with no explantion as to the source of infections and then you the representative in Geneva who says there is no need to have a meeting until more information comes in.

                Oy Veh.

                Comment


                • #9
                  Re: WHO Leaves Pandemic Alert Level Unchanged

                  http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20060523/flu_indonesia_tests_060524/20060524?hub=Health

                  UN officials 'stumped' by human bird flu deaths

                  Updated Wed. May. 24 2006 10:02 AM ET
                  Associated Press

                  JAKARTA, Indonesia <!-- /dateline -->-- The U.N. health agency described the deaths of six Indonesian family members from bird flu as the most important development in the spread of the virus since 2003, saying it is investigating whether the disease has spread from person to person.

                  "We have a team down there, they are examining what is going on and they can't find an animal source of this infection," said Peter Cordingley, spokesman for the Western Pacific region of the World Health Organization.

                  "This is the first time that we've been completely stumped" by a source for the infection, he said.

                  Six of the seven people in an extended family in northern Sumatra who caught the disease have died, the most recent on Monday.

                  WHO is investigating whether the H5N1 strain of bird flu was spread among family members, though it said Wednesday there was no evidence the virus had mutated to a form that will spread more easily between humans, possibly sparking a pandemic.

                  Steven Bjorge, the WHO team leader in the village of Kubu Sembelang, said none of the poultry in the area had tested positive for the H5N1 bird flu virus.

                  "We're not surprised that there is possible human-to-human transmission," Bjorge said.

                  "The thing we're looking for is whether it's sustained beyond the immediate cluster."

                  Isolated cases of very limited human-to-human transmission have been documented -- including one in Thailand involving a mother and child -- but such cases do not mean a pandemic flu strain has emerged.

                  There was no indication the Sumatra infections had spread to anyone outside the family.

                  Still, the scenario worries scientists.

                  "No matter what's going on at this stage, it's a limited transmission between members of the same family," Cordingley said from Manila, Philippines.

                  "What we are looking out for is any sign of this virus going outside of this family cluster into the general community, that would be very worrying. We haven't seen any signs of that yet."

                  Bird flu has killed 124 people worldwide, more than a quarter of them in Indonesia. So far, most human cases have been traced to contact with infected poultry.

                  Bjorge said the virus that infected the family members was genetically the same as the one found circulating in the area earlier. Tests are still being carried out on poultry in the village.

                  Peter Roeder, an animal health expert from the U.N. Food and Agriculture Organization in Rome, said tests so far had been negative for the virus, but antibodies were found in some specimens taken from chickens and ducks.

                  It's unclear, however, whether they were infected at the time the family members fell ill.

                  They could have been sickened much earlier or developed antibodies after vaccination, he said, adding that no immunization records were available.
                  Dead poultry was also found in an area outside the village, but test results for those birds have not yet come back, said Roeder, who has worked closely with Indonesia to strengthen poultry surveillance and response to bird flu outbreaks.

                  Bjorge said the woman first believed to be infected worked as a vegetable vendor in a market where live poultry was sold.

                  Experts are trying to determine if that's where she became infected. The woman, who died May 4, was never tested for the H5N1 virus, but WHO considers her part of the family cluster.

                  The woman's 25-year-old brother is the only family member still living after being infected.

                  "All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness," the WHO said in a statement on its Web site.

                  Bjorge said some samples have been taken from villagers, but that local authorities have resisted working with outside health experts.

                  WHO has enlisted local villagers to help monitor the village for anyone experiencing flu-like symptoms.

                  If anyone is found to have even mild symptoms, they will be quarantined and given the anti-bird flu drug Tamiflu, he said.

                  Comment


                  • #10
                    Re: WHO Leaves Pandemic Alert Level Unchanged
                    "No matter what's going on at this stage, it's a limited transmission between members of the same family," Cordingley said from Manila, Philippines.


                    For a reminder on what constitutes Phase 4:

                    Phase 4: Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.



                    Peter Cordingley is basically admitting that they are at Phase 4.

                    "What we are looking out for is any sign of this virus going outside of this family cluster into the general community, that would be very worrying. We haven't seen any signs of that yet."

                    Not only would it be worrying, that would be Phase 5 or Phase 6.

                    Right now they are looking for Phase 5 or Phase 6 type of transmission. They are looking for efficient and sustained transmission of the virus. They already have limited transmission which constiutes Phase 4, but now the real question is whether or not we are at Phase 5 or possibly Phase 6.

                    Comment


                    • #11
                      Re: WHO Leaves Pandemic Alert Level Unchanged

                      Originally posted by DB
                      "No matter what's going on at this stage, it's a limited transmission between members of the same family," Cordingley said from Manila, Philippines.


                      For a reminder on what constitutes Phase 4:

                      Phase 4: Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.
                      Those of you who accuse the WHO of changing the rules to suit the game will love the fact that the WHO have changed (or explained?) phase 4 as:

                      * Phase 4: Small cluster(s), meaning less than 25 people, lasting less than two weeks, with limited human to human transmission occur, but spread is still highly localized, suggesting that the virus is not well adapted to humans.

                      And Phase 5 has become:

                      * Phase 5: Larger cluster(s), meaning between 25-50 people, lasting from two to four weeks, appear. While human to human transmission is still localized, the virus appears to be increasingly better adapted to humans. Though it is not yet fully transmissible, there is a substantial pandemic risk.

                      Source: WHO Influenza Pandemic Handbook for Journalists (page 11) http://www.who.int/csr/don/Handbook_...emic_dec05.pdf

                      Comment

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