Whos Chan Warns Nations Not to Overreact to Swine Flu Pandemic
Margaret Chan, the WHOs director-general, may declare an influenza pandemic within days, said three people familiar with the organizations plans. Chan, in an interview late yesterday, said a final decision hasnt been taken, and authorities must use the time before swine flu becomes global to revise emergency plans and convey the measures to their countries populations.
Most pandemic plans were crafted for the H5N1 bird flu virus, deadly in three out of five cases. Swine flu, the new bug racing across the world, so far causes little more than a fever and a cough in most patients. Governments must resist the temptation to restrict travel, close borders and adopt other measures that arent justified, according to Chan.
“Every country has some kind of pandemic preparedness plan originally meant for H5N1,” she said in a telephone interview from her office at WHOs Geneva headquarters. “Now they need to look at the plan and make appropriate revisions. It is most important to get the messages right.”
The new H1N1 flu strain, discovered in April, has turned up in 66 countries as far removed as Japan, Iceland and New Zealand. The virus is now starting to spread in Australia, Japan, U.K., Spain and Chile among people with no travel history and outside of schools and institutional settings, Keiji Fukuda, the WHOs assistant director-general of health security and environment, said on a conference call with reporters June 2.
Extremely Cautious
The United Nations health agency currently is at phase 5 on its six-step pandemic alert scale, meaning a global epidemic is imminent.
“We are closer to phase 6 than we were one week ago, but I dont want to come out and make an announcement of phase 6 and cause debate,” Chan said. “I am extremely cautious in a sense. By the time I come out, no countries will dispute the evidence that we have on hand.”
The new virus has sickened 19,273 people and caused 117 deaths since it was discovered in Mexico and the U.S. in April, WHO said yesterday. Bird flu, which isnt easily transmitted among people, has killed 262 of the 433 people known to have been infected since 2003.
WHOs guidelines say a pandemic is imminent when a new virus causes outbreaks in at least “two countries in one WHO region.” Its under way when the disease is widespread in “at least one other country in another WHO region.”
Living With Uncertainty
The new bug is showing signs of becoming the dominant flu strain this winter in Chile, where as least 360 people have fallen ill, Chan said. A similar picture is emerging in Australia, where 634 cases have been confirmed, said Ian Barr, deputy director of the WHO Collaborating Center for Influenza in Melbourne.
“We need to monitor for the next week or two” signs that swine flu is supplanting seasonal flu, Chan said. “If this is indeed the case, it may have an impact on our decision on when and how to take into action the pandemic vaccine manufacturing.”
WHO also wants to ensure adequate supplies of immunizations against the influenza strains that circulate every winter.
The agency has said the new virus is more contagious than the germs that cause annual epidemics, which kill 250,000 to 500,000 people each year. A study in the journal Science estimates the virus is as severe as the 1957 Asian flu pandemic that caused about 2 million deaths.
Chan has said its possible the pig-derived strain might become more virulent later, a pattern that occurred with the 1918 Spanish flu, killing at least 40 million people.
“The most certain thing about the influenza virus is uncertainty,” Chan said. “Health officials worldwide, including those of us working in WHO, have to live with this level of uncertainty for the weeks and months ahead.”