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WHO chief says she's not raising swine flu alert to highest level yet

Shiloh

Editor, Senior Moderator
Source: http://www.am1150.ca/news/19/930309

WHO chief says she's not raising swine flu alert to highest level yet

By: Frank Jordans, THE ASSOCIATED PRESS

GENEVA - China, Britain, Japan and other countries urged the World Health Organization on Monday to be very cautious about declaring the arrival of a swine flu pandemic, fearing that a premature announcement could cause worldwide panic and confusion. WHO bent to their wishes.

As the agency opened its annual meeting, WHO Director General Dr. Margaret Chan said she had listened carefully to the concerns of member states and would follow their instructions.

The new swine flu virus continues to spread rapidly, but the world is still short of facing a pandemic, Chan said, keeping the alert level at the current Phase 5 out of a possible six, indicating a global outbreak is likely.

"This virus may have given us a grace period, but we do not know how long this grace period will last," Chan said. "No one can say whether this is just the calm before the storm."

At Phase 6, the world has a swine flu pandemic - meaning there is an epidemic in at least two world regions.

Health experts from dozens of countries urged WHO to change its standards for declaring a pandemic, saying it should take into account whether the virus was causing severe or mild illness, not just how quickly it was spreading.

"We need to give you and your team more flexibility as to whether we move to Phase 6," said British Health Secretary Alan Johnson.

Chan repeated her warning that the virus could pose a grave threat to humans, even though only 76 out of 8,829 cases have proven fatal.

"A new influenza virus with great pandemic potential, the new influenza A (H1N1) strain, has emerged," she said.

Most deaths have occurred in Mexico, but there is global unease that the virus seems to be spreading easily from person to person and rapidly from country to country.

"We expect this pattern to continue," Chan said, adding it was unclear whether or when the world moves to the highest flu alert.

At least 40 countries now have confirmed cases - and the number of swine flu infections in Japan rose from four Friday to over 130 on Monday.

Chan said the virus has now spread to the Southern Hemisphere after breaking out in North America, and there was a risk it can combine with other flu strains circulating now among humans south of the equator.

Another concern is that swine flu might combine with the bird flu virus that has been circulating for several years, she said. Bird flu is much more deadly but less easily transmitted among humans than the swine flu virus.

She said WHO had not yet given manufacturers the signal to produce a specific swine flu vaccine for the new flu strain, but said it was essential that countries be very careful with their medical resources.

"Manufacturing capacity for antiviral drugs and influenza vaccines is finite and insufficient for a world with 6.8 billion inhabitants," Chan said. "It is absolutely essential that countries do not squander these precious resources through poorly targeted measures."
 
Re: WHO chief says she's not raising swine flu alert to highest level yet

Current WHO phase of pandemic alert

Current phase of alert in the WHO global influenza preparedness plan

Pandemic preparedness In the 2009 revision of the phase descriptions, WHO has retained the use of a six-phased approach for easy incorporation of new recommendations and approaches into existing national preparedness and response plans. The grouping and description of pandemic phases have been revised to make them easier to understand, more precise, and based upon observable phenomena. Phases 1–3 correlate with preparedness, including capacity development and response planning activities, while Phases 4–6 clearly signal the need for response and mitigation efforts. Furthermore, periods after the first pandemic wave are elaborated to facilitate post pandemic recovery activities.

The current WHO phase of pandemic alert is 5.

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</td> </tr> </tbody></table>
In nature, influenza viruses circulate continuously among animals, especially birds. Even though such viruses might theoretically develop into pandemic viruses, in Phase 1 no viruses circulating among animals have been reported to cause infections in humans.

In Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans, and is therefore considered a potential pandemic threat.

In Phase 3, an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks. Limited human-to-human transmission may occur under some circumstances, for example, when there is close contact between an infected person and an unprotected caregiver. However, limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemic.

Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion.

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.

During the post-peak period, pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels. The post-peak period signifies that pandemic activity appears to be decreasing; however, it is uncertain if additional waves will occur and countries will need to be prepared for a second wave.

Previous pandemics have been characterized by waves of activity spread over months. Once the level of disease activity drops, a critical communications task will be to balance this information with the possibility of another wave. Pandemic waves can be separated by months and an immediate “at-ease” signal may be premature.

In the post-pandemic period, influenza disease activity will have returned to levels normally seen for seasonal influenza. It is expected that the pandemic virus will behave as a seasonal influenza A virus. At this stage, it is important to maintain surveillance and update pandemic preparedness and response plans accordingly. An intensive phase of recovery and evaluation may be required.
 
Re: WHO chief says she's not raising swine flu alert to highest level yet

2009 novel H1N1 (swine) influenza is spreading community wide in more than one WHO region. North America is one region. Japan is another.

This scale does not consider severity.

Unless this scale is re-written to consider current known severity, we are, by the WHO definition, at level 6.
 
Re: WHO chief says she's not raising swine flu alert to highest level yet

hat tip Fla Medic for the link -

Also this is a new change:

Levels of pandemic alert

Revised 12 May 2009 (original posting: 1 May 2009)

What does pandemic alert phase 5 mean?

According to WHO definitions of phases - the virus has caused sustained community-level outbreaks in at least two countries in one WHO region. At phase 5 a pandemic is considered imminent.

What is a sustained community-level outbreak?

A sustained community-level outbreak is when people are getting infected by others but it is not clear where they got infection from. For example, in this outbreak, person-to-person transmission cannot be traced back to a traveler, or a single closed community such as a school or workplace.

What is the difference between a probable case and a confirmed case?

A probable case is one that shows the symptoms of influenza such as cough, fever, headache, chills and fatigue and either tests positive for type A influenza or is considered linked to another probable or confirmed case.
A confirmed case is one which tests positive in a laboratory for the influenza A(H1N1) virus.

At what point does WHO consider a pandemic to have started?

Phase 6, as defined by the WHO pandemic preparedness guidelines. However, during both phase 5 and phase 6, national and local actions to respond to the outbreak shift from preparedness to response at a global level. The goal of recommended actions during these phases is to reduce the impact of the pandemic on society.


http://www.who.int/csr/disease/swin...questions/levels_pandemic_alert/en/index.html
 
Re: WHO chief says she's not raising swine flu alert to highest level yet

hat tip Fla Medic for the link -



A sustained community-level outbreak is when people are getting infected by others but it is not clear where they got infection from. For example, in this outbreak, person-to-person transmission cannot be traced back to a traveler, or a single closed community such as a school or workplace.

Yes, they keep changing the rules just ahead of when they have to make a decision, it would seem...
 
Re: WHO chief says she's not raising swine flu alert to highest level yet

hat tip Fla Medic for the link -

Also this is a new change:

Levels of pandemic alert

Revised 12 May 2009 (original posting: 1 May 2009)

What does pandemic alert phase 5 mean?

According to WHO definitions of phases - the virus has caused sustained community-level outbreaks in at least two countries in one WHO region. At phase 5 a pandemic is considered imminent.

What is a sustained community-level outbreak?

A sustained community-level outbreak is when people are getting infected by others but it is not clear where they got infection from. For example, in this outbreak, person-to-person transmission cannot be traced back to a traveler, or a single closed community such as a school or workplace.

What is the difference between a probable case and a confirmed case?

A probable case is one that shows the symptoms of influenza such as cough, fever, headache, chills and fatigue and either tests positive for type A influenza or is considered linked to another probable or confirmed case.
A confirmed case is one which tests positive in a laboratory for the influenza A(H1N1) virus.

At what point does WHO consider a pandemic to have started?

Phase 6, as defined by the WHO pandemic preparedness guidelines. However, during both phase 5 and phase 6, national and local actions to respond to the outbreak shift from preparedness to response at a global level. The goal of recommended actions during these phases is to reduce the impact of the pandemic on society.


http://www.who.int/csr/disease/swin...questions/levels_pandemic_alert/en/index.html



In Japan:


"..The newly confirmed domestic cases included high school students, college students, their family members and teachers, as well as bank clerk and people working at a local railway ticketing office..."



"..The Japanese government on Monday convened an emergency task force meeting to discuss countermeasures on the spread of the epidemic. .."


"..The WHO is launching investigation on the situation in Japan..."



http://www.flutrackers.com/forum/showthread.php?p=234910#post234910
 
Re: WHO chief says she's not raising swine flu alert to highest level yet

Yes, they keep changing the rules just ahead of when they have to make a decision, it would seem...


WHO has an impossible job. Everyone there is very dedicated but they operate at the pleasure of member states, each with its own agenda.
 
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