WHO considers flu alert overhaul

[Guest guest]

from the Financial Times

The move comes against a backdrop of intensifying attacks on the WHO,

which has been accused of " crying wolf " over its decisions to raise

its pandemic alert from level three to an

<http://www.ft.com/cms/s/0/95684290-349d-11de-940a-00144feabdc0.html>unprecedent\

ed

five.

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http://www.ft.com/cms/s/0/e89de9ea-3b11-11de-ba91-00144feabdc0.html?ftcamp=rss

WHO considers flu alert overhaul

By Jack in London

Published: May 7 2009 15:42 | Last updated: May 7 2009 15:42

The <http://www.who.int/en/>World Health Organisation is considering

an overhaul of its pandemic ratings system amid growing criticism

that it provoked unnecessary alarm by rapidly escalating its warnings

over <http://www.ft.com/indepth/swine-flu>swine flu.

Officials at the agency's headquarters in Geneva said they were

discussing changes to the six-point scale to make clear in the future

the gravity of the threat posed by a new virus.

The move comes against a backdrop of intensifying attacks on the WHO,

which has been accused of " crying wolf " over its decisions to raise

its pandemic alert from level three to an

<http://www.ft.com/cms/s/0/95684290-349d-11de-940a-00144feabdc0.html>unprecedent\

ed

five. This comes amid indications it may even go to the maximum level six.

Media organisations initially seized on the raising of the alerts in

front page headlines around the world, but as it has emerged that the

death toll has stayed relatively low, so the criticism has mounted.

As of Thursday morning the WHO had confirmed 2,099 cases in 23

countries, including 44 deaths.

While designed to identify and classify the spread of a new flu virus

between humans around the world, the WHO's system of pandemic alerts

provides no indication of the danger of the virus.

Even if the A (H1N1) virus in Mexico proves no more lethal than a

typical seasonal flu, it could still soon trigger the highest level

six WHO pandemic alert once it has been identified as spreading

widely between humans in different parts of the world.

<http://www.ft.com/cms/s/0/1c319e14-37d9-11de-9211-00144feabdc0.html>Margaret

Chan, WHO director general, has stressed that an increase to level

six is a technical change which does not mean that people around the

world are at serious threat.

In an interview with the FT earlier this week Ms Chan defended the

organisation's public statements. " I am not predicting the pandemic

will blow up but if I miss it and we don't prepare, I fail. I'd

rather over-prepare than not prepare, " she said.

But her reassurances clash with a widely-held public understanding of

a pandemic as a serious infectious disease.

Only two weeks after the Mexican virus was first decoded, health

officials are still struggling to understand which age groups and

what overall proportion of a population are infected by the flu, and

how many are at risk of dying or becoming seriously ill as a result.

With such limited data, they still want to be able to alert health

authorities around the world to the potential risks so that they can

step up their response while gathering more information.

Scientists also warn that even if outside Mexico the virus has so far

proved relatively mild, there is a significant danger that it could

mutate on mixing with some of the seasonal flu viruses now starting

to circulate in the southern hemisphere. These are widely resistant

to antiviral treatments such as Tamiflu.

The " Armageddon " scenario is that it might mix with the H5N1 bird flu

virus, which is highly lethal in humans but so far has not proved to

be easily transmitted between humans.

The WHO had already sparked concerns from a number of health

authorities for changing its pandemic alert scale last month, just

after the Mexican virus was identified. This had the effect of

speeding up the escalation from level 3 and was out of step with many

national pandemic plans.

Kessel, from the UK's Health Protection Agency, said the

current arrangements were " a necessary alert system " but added: " It

will be important for the WHO's member states and advisory bodies to

determine whether in the future a link with the severity of the

infection is feasible, and whether it would add value to our current system. "

Sheri Nakken, R.N., MA, Hahnemannian Homeopath

Vaccination Information & Choice Network, Washington State, USA

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