Officials urge WHO to change swine flu alert criteria

By Thomas H. Maugh II
May 19, 2009
As the World Health Organization inched closer Monday to raising the infectious disease alert level to its highest stage -- and to a decision on whether to manufacture a vaccine against the novel H1N1 influenza virus -- some delegates to the WHO congress in Geneva urged the agency to change its criteria for increasing the alert level.

Current rules call for the alert to be raised to Phase 6 if community transmission of the new virus is observed in two different WHO regions. So far, such transmission has been observed only in North America, which accounts for about 95% of the nearly 9,000 confirmed infections that have been observed worldwide.

But an outbreak of the virus in Japan detected over the weekend hints that such transmission may soon be observed in Asia as well. -snip-

"We need to give you and your team [the WHO] more flexibility as to whether we move to Phase 6," said British Health Secretary Alan Johnson in a speech to the congress.

Governments in many countries, including China, Japan and Britain, fear that raising the alert level will put more pressure on their health systems, impede international travel and cause panic even though the new strain of virus appears to be no more lethal than seasonal flu.

The United States has so far remained noncommittal, with newly installed Health and Human Services Secretary Kathleen Sebelius saying she wants to study the issue more before making a recommendation.

But WHO officials noted that severity will differ from country to country, making it hard to agree on an objective measure of the virus' effects. Transmission, however, provides a clear, objective measure of viral spread. The criteria, moreover, were set largely in response to the avian flu virus, which is much more lethal than H1N1 but not readily transmissible among humans.
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