Last Updated: May 27, 2009 01:46 EDT
May 27 (Bloomberg) -- The World Health Organization may alter its pandemic warning system after some countries including the U.K. said raising the alert over the current swine flu threat could incite confusion and cause a loss of confidence.
The agency will ask a group of scientists and public health officials for advice on how to improve the decade-oldalert system over the next few weeks, said Keiji Fukuda, the WHO’s assistant director-general of health security and environment. Dozens of cases in Chile and Australia indicate the virus is spreading in communities in the Southern Hemisphere.
U.K. Health Secretary Alan Johnson told the WHO’s annual meeting last week that the organization should have greater flexibility in deciding whether the new H1N1 flu strain is sufficiently serious to raise the pandemic alert to the highest of its six-level scale. The virus causes fever and a cough in most people, unlike the H5N1 bird flu strain which influenced pandemic plans and is lethal in three out of five cases.
“We have a virus spreading which is significantly different to avian influenza,” Fukuda told reporters on a conference call from Geneva yesterday. “Countries are saying we want you to take a look at these criteria because if you apply them in the wrong way, they may not help us, in fact they may cause more difficulties.”
Forty-six countries have officially reported 12,954 cases, including 92 deaths, the Geneva-based WHO said yesterday. The tally excludes 47 new cases in the U.K., 45 in Chile, 42 in Australia, 8 in South Korea, 2 in Ireland and 1 in Singapore that were announced subsequently.
Among Chile’s new cases, 19 resulted from community transmission in four regions, Osvaldo Sagrado, an official in charge of health-care networks at the ministry, said yesterday.
Cases Double
Global cases have more than doubled in the past two weeks as the pig-derived virus became established in countries outside North America, where it was discovered about six weeks ago. Still, the WHO wants to see more evidence of widespread community transmission before declaring the first influenza pandemic since 1968, Fukuda said.
A pandemic occurs when a new strain of flu to which few people, if any, have immunity spreads globally.
“We have an evolving situation in which a new influenza virus is clearly spreading but it has not reached all parts of the world and it has not established community activity in all parts of the world,” Fukuda said.
Disease Severity
Criteria for determining the pandemic alert level need to include disease severity among a broader range of indicators, health ministers from China, South Korea, Japan and the Association of Southeast Asian Nations said in a May 8 statement.
The severity of the new flu strain doesn’t warrant it being described as a pandemic, Kamnuan Ungchoosak, an official at Thailand’s department of disease control in Bangkok, said in a telephone interview today. Thailand holds the rotating chairmanship of the 10-member association.
“Pandemic should refer to something that is severe and has a big impact on the economy and social activities,” Kamnuan said. “At this moment, the mental suffering and social worry is bigger than the physical disease itself.”
“If we announce the pandemic based on the geographical area only, then people will think this is a very bad situation and it will unnecessarily add to social and mental distress,” the official said.
The United Nations agency should have the flexibility to use emerging knowledge about the disease, rather than being driven by a purely “mechanistic approach,” the U.K. health department’s Johnson told WHO Director-General Margaret Chan last week. The recommendation was supported by Japan, China and four other countries, the health department said.
‘Passed its Peak’
In the U.S., the virus “may have passed its peak,” Anne Schuchat, the Centers for Disease Control and Prevention’s interim deputy director for science and public health, said yesterday on a conference call. That’s based on reports of flu- like illnesses that have returned to normal levels in most of the country, she said.
Flu levels remain high in New York, New Jersey and New England, Schuchat said. New, localized outbreaks may occur, she said. Still, the Atlanta-based agency is likely to turn its attention toward tracking H1N1’s spread in the Southern Hemisphere, as well as preparing for any return in the north this fall, she said. The U.S. confirmed 6,764 cases in 48 states, the CDC said.
“It is very possible that this virus will continue to circulate and cause illness again next winter” in the U.S., Schuchat said. Whether it returns with more or less virulence “is not predictable right now.”
To contact the reporters on this story: Jason Gale in Singapore at j.gale@bloomberg.net; Dermot Doherty in Geneva at ddoherty9@bloomberg.net.
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