WHO: World Closer to Swine Flu Pandemic
World Health Organization
Pandemic Alert Will Come With 'Moderate' Severity Warning
By Daniel J. DeNoon
WebMD Health News
Reviewed by Louise Chang, MD
June 2, 2009 -- The world is "getting closer" to a
full-scale swine flu
pandemic, the World Health Organization (WHO) warns.
The official declaration of a pandemic alert -- triggered by widespread H1N1
swine flu beyond the Americas -- will come with a new severity rating, said
Keiji Fukuda, WHO interim assistant director-general for health security and
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The WHO has been dragging its feet over declaring a worldwide pandemic to
avoid causing undue alarm and to allow it time to develop specific guidance for
different parts of the world.
When swine flu broke out, the world was already at phase 3 of its six-phase
pandemic warning system. That was because the deadly H5N1 bird flu was infecting
humans but not spreading from person to person.
When swine flu burst upon the world in April, the WHO rapidly raised its
warning level from phase 4 and then to phase 5 as it became clear a flu virus
new to humans was spreading easily -- and widely -- from person to person.
"Globally we believe we are at phase 5 but getting closer to phase 6," Fukuda
said today at a news conference. "It is clear the virus continues to spread
internationally. There are a number of countries that appear to be in transition
[to widespread infections at the community level]. These countries include the
U.K., Spain, Japan, Chile, and also Australia."
When the WHO finally does declare a global swine flu pandemic, it likely will
rate the severity of the disease as moderate, not mild or severe.
"It is fair to call the situation moderate," Fukuda said. "We know this
infection can be fatal in a number of individuals. This includes people who have
some underlying medical conditions and it includes women who are
pregnant -- but
it also includes people who are perfectly healthy. So we do have some hesitation
calling such an infection mild."
Fukuda noted that severity does not solely depend on the virulence of the
"Severity is not just a quality of the virus and its
ability to harm people, but a combination of that virulence and the
vulnerability of populations -- how well off they are in terms of chronic
conditions and poverty and
malnourishment," he said. "And it's also a matter of the resilience of nations,
how well they are able to cope with diseases."
Fukuda said the WHO's rating would be flexible in order to change as the
pandemic becomes more or less severe.
Meanwhile, all eyes are on the Southern Hemisphere -- particularly Chile and
Australia -- as swine flu hits that part of the world just as it's entering
normal flu season. At this early point in their flu season, Fukuda said, nearly
all flu cases appear to be swine flu and not seasonal flu.
"We will look carefully to see if the kind of illness typical of flu is seen
in the Southern Hemisphere, and particularly at which age groups," Fukuda said.
"Will there be a change in the number of people who develop serious illness?
Will there be a change in the virus itself? We expect the virus to drift, but
does that really lead to any changes in the behavior of the virus, and to the
antigenicity of the virus [that would affect vaccine development]? We will be
monitoring that carefully."
Keiji Fukuda, interim assistant director-general for health security and
environment, World Health Organization.
World Health Organization web site.
CDC web site.
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