WHO official says world edging towards pandemic

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WHO official says world edging towards pandemic

Reuters June 3, 2009, 3:59 am

GENEVA (Reuters) - 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. "

He added: " It is probably fair to call the situation something like moderate

right now. We do have some hesitation to call the situation mild. "

The new flu, a mixture of swine, bird, and human viruses, remains most prevalent

in North America but has infected nearly 19,000 people in 64 countries,

according to the U.N. agency's latest toll, which tends to lag behind national

figures but is considered more secure.

Fukuda said that, while many countries had reported only a small number of

infections linked to people traveling to the disease epicenters of Mexico and

the United States, others were starting to see more sustained patterns of

infection in schools, offices and neighborhoods.

" There are a number of countries that appear to be transition, moving from

travel-related cases to more established community types of spread, " he said,

citing Australia, Britain, Chile, Japan and Spain as examples.

" We still are waiting for evidence of really widespread community activity in

these countries. It is fair to say that they are in transition and are not quite

there yet which is why we are not in Phase 6 yet, " Fukuda said.

PANDEMIC PATTERNS

Experts say it is nearly impossible to gauge how widespread the H1N1 flu has

become because many patients suffer only mild symptoms and are not formally

diagnosed, treated and documented.

" We don't know the full number of people who are infected across the entire

spectrum. So right now it appears that the number of severe illnesses appears

relatively limited, but again we don't have a perfectly good handle on the

numerator and the denominator of what we are seeing, " Fukuda said.

In Chile, which is just entering its normal flu season, Fukuda said the H1N1

variety appeared to be eclipsing other strains in circulation.

" Most of the influenza viruses that they are seeing so far are the new influenza

A-H1N1 viruses, " he said. " They are seeing many fewer of the normal seasonal

influenza viruses and the majority of viruses are the H1N1.

" We need to see whether this pattern holds up in other countries, " Fukuda

continued. " This is one of the patterns that have been seen with earlier

pandemics so I think it bears very close watching. "

The WHO consulted more than 30 public health experts from 23 countries on Monday

about how to revamp its pandemic alert scale to reflect both the severity of the

flu and its geographic spread, as many governments have asked it to do.

One idea, Fukuda said, was to add three severity notches to the highest marker

of 6, so the overall level could reach the peak even if the flu's effects

remained moderate, and be adjusted later if the virus caused more serious health

problems.

" All pandemics are not the same. Some pandemics can be mild, other pandemics can

be more severe, " he said, also stressing that the same virus could have

drastically different effects in different countries and regions, for instance

posing greater risks in poor or disease-stricken communities.

Radical actions imposed in immediate response to the outbreak, including

quarantines, trade bans and the culling of swine " certainly didn't make people

safer " and caused undue concern about the safety of animals and food, Fukuda

said.

" Some of the things that we would like to do is improve how we are able to

communicate information, how we are able to provide guidance on what can be done

in this situation so that actions which are really unnecessary and potentially

anxiety provoking and unhelpful can really be modified or curtailed. "

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