H1N1 in post-pandemic period

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http://www.who.int/mediacentre/news/statements/2010/h1n1_vpc_20100810/en/print.html

Director-General's opening statement at virtual press conference

10 August 2010

H1N1 in post-pandemic period

The world is no longer in phase 6 of influenza pandemic alert. We are now

moving into the post-pandemic period. The new H1N1 virus has largely run

its course.

These are the views of members of the Emergency Committee, which was

convened earlier today by teleconference.

The Committee based its assessment on the global situation, as well as

reports from several countries that are now experiencing influenza. I

fully agree with the Committee’s advice.

As we enter the post-pandemic period, this does not mean that the H1N1

virus has gone away. Based on experience with past pandemics, we expect

the H1N1 virus to take on the behaviour of a seasonal influenza virus and

continue to circulate for some years to come.

In the post-pandemic period, localized outbreaks of different magnitude

may show significant levels of H1N1 transmission. This is the situation

we are observing right now in New Zealand, and may see elsewhere.

In fact, the actions of health authorities in New Zealand, and also in

India, in terms of vigilance, quick detection and treatment, and

recommended vaccination, provide a model of how other countries may need

to respond in the immediate post-pandemic period.

Globally, the levels and patterns of H1N1 transmission now being seen

differ significantly from what was observed during the pandemic.

Out-of-season outbreaks are no longer being reported in either the

northern or southern hemisphere. Influenza outbreaks, including those

primarily caused by the H1N1 virus, show an intensity similar to that

seen during seasonal epidemics.

During the pandemic, the H1N1 virus crowded out other influenza viruses

to become the dominant virus. This is no longer the case. Many countries

are reporting a mix of influenza viruses, again as is typically seen

during seasonal epidemics.

Recently published studies indicate that 20–40% of populationss in some

areas have been infected by the H1N1 virus and thus have some level of

protective immunity. Many countries report good vaccination coverage,

especially in high-risk groups, and this coverage further increases

community-wide immunity.

Pandemics, like the viruses that cause them, are unpredictable. So is the

immediate post-pandemic period. There will be many questions, and we will

have clear answers for only some. Continued vigilance is extremely

important, and WHO has issued advice on recommended surveillance,

vaccination, and clinical management during the post-pandemic

period.

Based on available evidence and experience from past pandemics, it is

likely that the virus will continue to cause serious disease in younger

age groups, at least in the immediate post-pandemic period. Groups

identified during the pandemic as at higher risk of severe or fatal

illness will probably remain at heightened risk, though hopefully the

number of such cases will diminish.

In addition, a small proportion of people infected during the pandemic,

including young and healthy people, developed a severe form of primary

viral pneumonia that is not typically seen during seasonal epidemics and

is especially difficult and demanding to treat. It is not known whether

this pattern will change during the post-pandemic period, further

emphasizing the need for vigilance.

As I said, pandemics are unpredictable and prone to deliver surprises. No

two pandemics are ever alike. This pandemic has turned out to be much

more fortunate than what we feared a little over a year ago.

This time around, we have been aided by pure good luck. The virus did not

mutate during the pandemic to a more lethal form. Widespread resistance

to oseltamivir did not develop. The vaccine proved to be a good match

with circulating viruses and showed an excellent safety profile.

Thanks to extensive preparedness and support from the international

community, even countries with very weak health systems were able to

detect cases and report them promptly.

Had things gone wrong in any of these areas, we would be in a very

different situation today.

I will be happy to answer your questions.

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© WHO 2010

Sheri Nakken, R.N., MA, Hahnemannian

Homeopath

Vaccination Information & Choice Network, Washington State, USA

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