WHO chief lists main threats from H1N1 flu

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WHO chief lists main threats from H1N1 flu

* Reuters, Monday May 18 2009

* Poor in developing countries at heightened risk, Chan says

* Pregnant women, chronic patients are most vulnerable

* If virus shed in faeces, could spread due to bad sewage.

GENEVA, May 18 (Reuters) - The new H1N1 flu poses a particular threat to

chronically ill people and pregnant women, and experts fear it could take on new

momentum if it starts to spread through human waste or to combine with other

viruses, the head of the World Health Organisation said on Monday.

" The world of today is more vulnerable to the adverse effects of an influenza

pandemic than it was in 1968, when the last pandemic of the previous century

began, " WHO Director-General Margaret Chan said.

Most patients with underlying chronic conditions such as heart disease or

diabetes -- already shown to be most vulnerable to the new H1N1 virus -- live in

the developing world, Chan said in her main speech to the WHO's annual assembly

of ministers.

The global burden of chronic diseases has shifted dramatically from rich

countries to poor ones in recent years, she said. About 85 percent of all cases

and deaths from such ailments are concentrated in low-and middle-income

countries.

" The implications are obvious. The developing world has, by far, the largest

pool of people at heightened risk for severe and fatal H1N1 infections, " Chan

declared.

The new virus -- a genetic mixture of swine, bird and human viruses -- has

officially infected 8,829 people in 40 countries, killing 74 people, according

to the United Nations agency.

Separately, the bird flu virus H5N1 is firmly entrenched in poultry in several

countries, mainly in southeast Asia. " No one can say how this avian virus will

behave when pressured by large numbers of people infected with the new H1N1

virus, " Chan said.

If the new H1N1 swine flu virus is shown to be shed in faeces, it would

introduce an additional route of transmission, especially in developing

countries, according to the WHO chief.

People living in crowded, squalid urban shantytowns with poor sanitation systems

could face additional risk, she said.

Both the cholera and polio viruses, which have killed and maimed in developing

countries, are spread through weak sanitation and sewage systems.

Millions of people already depend on life-extending drugs to survive HIV/AIDS

and resurgent forms of tuberculosis, Chan said. " Most of these people live in

countries where health systems are already overburdened, understaffed and poorly

funded, " she said.

Chan said pregnant women seemed to be at heightened risk of severe or fatal H1N1

infections, posing the threat the new strain would increase already unacceptable

levels of maternal mortality, which are closely linked to weak health systems.

The situation was expected to worsen as the financial crisis drives more people

to forego private health care and turn to publicly-financed systems, according

to Chan, a former director of health in Hong Kong.

" What will happen if sudden surges in the number of people requiring care for

influenza push fragile health systems over the brink?, " she asked. (Reporting by

Nebehay; Editing by Lynn and Janet McBride)

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