WHO: World Edging Toward PandemicThe spread of H1N1 flu in Australia, Britain, Chile, Japan and Spain has pushed the world closer to a pandemic, says the World Health Organization (WHO).
The newly-discovered flu strain has caused more infections than seasonal influenza at the start of Chile's flu season, heightening concern about the spread in the southern hemisphere, reports Keiji Fukuda, WHO's acting assistant director-general.
The virus continues to affect mostly people below the age of 60, causing 117 deaths around the world, Fukuda notes. At this point, the WHO's pandemic scale remains at the second highest level, 5, but that threshold may be crossed soon, Fukuda says. Globally WHO believes the world is at Phase 5, but getting closer to Phase 6. The future impact of this infection has yet to unfold, he says.
It is probably fair to call the situation something like moderate right now, he says. "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 the North American hemisphere, but has infected nearly 19,000 people in 64 countries, reports WHO in its latest toll. WHO's figures tend to be behind national reporting numbers, but is considered more secure.
Fukuda says many countries have reported only a small number of infections linked to people traveling to the disease epicenters of Mexico and the United States. Others were beginning to see more sustained patterns of infection in schools, offices and neighborhoods.
"There are a number of countries that appear to be in transition, moving from travel-related cases to more established community types of spread," he notes, pointing as examples to Australia, Britain, Chile, Japan and Spain.
WHO is still waiting for evidence of 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 explains.
Experts note 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.
Health officials don't know the full number of people who are infected across the entire spectrum. It appears now 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 says.
In Chile, which is just entering its normal flu season, Fukuda states the H1N1 variety appeared to be in higher numbers than other strains in circulation.
Most of the influenza viruses that Chile is seeing so far are the new influenza A-H1N1 viruses. 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 notes. "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 posed 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, Fukuda says.
All pandemics are not the same. Some pandemics can be mild; other pandemics can be more severe, Fukuda says, 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 says.