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  • WHO considers raising global pandemic alert level

    WHO considers raising global pandemic alert level



    HELEN BRANSWELL
    Canadian Press
    April 24, 2009 at 12:25 PM EDT

    <!-- dateline -->TORONTO<!-- /dateline --> ? Mexican authorities today confirmed they have found human cases of the same swine flu virus that has caused illness in the southwestern United States, a development that raises questions about whether the world is watching the start of a flu pandemic.
    The World Health Organization expressed serious concern, saying it is considering whether it needs to raise the global pandemic alert level and whether to launch an effort to try to contain the spread of a virus with possible pandemic potential.
    ?We can't say for sure that either a phase change or a rapid containment operation will happen. But both have been considered and are being considered,? spokesman Gregory Hartl said from Geneva.
    ?I still don't think we have enough information to be able to say that this is a pandemic or not. Because there are questions over transmissibility, let's say, of the virus. And we need to know more about how easily transmitted the virus is.?
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    Mr. Hartl said there have been no reports of infections in any other countries to date.
    Mexican authorities confirmed that samples tested both at the National Microbiology Laboratory in Winnipeg and the U.S. Centers for Disease Control tested positive for swine flu viruses. The unusual influenza A H1N1 viruses were first reported earlier this week, when the CDC announced it had found two human cases of infection with this never-before-seen virus.
    Though human H1N1 viruses have been circulating for decades, it is not clear how much protection previous infection with them would confer against a virus made up predominantly of swine flu genes. The virus also has some bird genes and one human gene.
    U.S. authorities have confirmed seven cases of swine flu infection in people in Southern California and Texas over the past few days. The seven range in age from nine to 54 years of age. All have recovered from the infection; one needed hospitalization.
    But the news coming out of Mexico paints a different story, with reports of a fairly high attack rate and more than 20 deaths.
    Reports suggest the majority of the cases are occurring in young, previously healthy adults in their mid 20s to mid 40s. There are said to have been over 800 cases so far, but it remains unclear if all of those people are sick with this virus or if other flu or respiratory viruses are also circulating and muddling the picture.
    Mr. Hartl said the WHO is sending staff to Mexico to help authorities there get a better handle on the scope of the problem. ?We're extremely concerned because we're looking at five different influenza events which may or may not be connected,? he said, referring to California, Texas and three possibly linked outbreaks in Mexico.
    ?But they are unusual events, either because of the time of the year that they happened and or because of the people that have been affected. This is a great concern to us and we have activated our strategic health operation centre which is a 24-hour around-the-clock command and control centre.?
    Canada and the United States have also launched their emergency control centres, signalling this is an event they want to track around the clock.
    The world is currently at level 3 of the WHO's six-rung pandemic alert ladder, because of ongoing sporadic cases of human infection with the H5N1 avian flu virus. Phase 3 means there are occasional human cases with a novel flu virus.
    WHO would need the advice of an expert panel to move up to Phase 4 or beyond. Phase 6 is a pandemic.
    Mr. Hartl's comments suggest that panel has been put on alert that they may be drawn together at any time.



  • #2
    Re: WHO considers raising global pandemic alert level

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    • #3
      Re: WHO considers raising global pandemic alert level

      Machine translation

      Porcine influenza: the director of WHO in liaison with Americans and Mexicans

      GENEVA - the managing director of the World Health Organization (WHO), Dr. Margaret Chan, was ?in contact? Friday with ?persons in charge Mexican and American? on the cases of porcine influenza announced to Mexico City and the United States, to AFP a spokesperson WHO indicated.
      Several hundreds of human cases of porcine influenza were announced to Mexico, from which an about sixty fatality, and nearly ten case in the United States, announced WHO Friday.

      Mrs. Chan, who was Friday in Washington ?for a visit without relation with the file of the porcine influenza, was in liaison with Mexican and American persons in charge for an information exchange?, declared in AFP the spokesperson of WHO, Fad?la Cha?b.

      She was also ?in contact during several hours Friday afternoon by teleconference with the center of operations of the organization in Geneva?, she added.

      WHO, which fears that a new stock of the porcine influenza does not give rise to a pandemia, indicated Friday ?to have activated its center of operations? to collect all information and to centralize the action of the organization in the emergencies.

      Dr. Chan, a specialist universally recognized in pandemias, will be of return Saturday to Geneva where it will direct the operations in person, the spokesperson added.

      Before reaching the head of WHO, Mrs. Chan was principal the person in charge of the service of the pandemic influenza of the organization, charged to prepare the reaction to a possible world-wide crisis.

      It had been pointed out for its firm reaction to a first avian flu epidemic, which had caused the death of six people in HongKong in 1997.
      In the United States, the medical experts declared themselves ?very anxious? and set up ?emergency operational centres?.

      Concerns relate in particular to the fact that this new virus is transmitted between human and consists of several stocks, avian, porcine and human.
      ?In the United States, there is a total of seven proven cases: five in California and two in Texas?, specified Mrs. Cha?b. No death was recorded in the United States, where the virus responsible for the disease was identified as being stock A/H1N1, she added.

      ?In the area of Mexico City, it there has today approximately 800 suspect cases of porcine influenza, with 57 died?, explained Mrs. Cha?b. ?Of the similar cases were discovered in the area of Potosi San Luis, in the center of Mexico, where 24 patients were counted, of which three died?, she added.

      (?AFP/April 24, 2009 19:44)

      Comment


      • #4
        Re: WHO considers raising global pandemic alert level

        How long before we know what there decision will be with regards to the threat level.

        Comment


        • #5
          Re: WHO considers raising global pandemic alert level

          #1:
          "The World Health Organization expressed serious concern, saying it is considering whether it needs to raise the global pandemic alert level and whether to launch an effort to try to contain the spread of a virus with possible pandemic potential.
          We can't say for sure that either a phase change or a rapid containment operation will happen. But both have been considered and are being considered,” spokesman Gregory Hartl said from Geneva."


          If such an worldwide containment operation must be conducted it must be NOW, or better "yesterday".

          With all the respect to the WHO officials, what it be to be considered to start, when it is known that by starting after (and a month later from the begining) it would be impossible to make any diference.

          If such containment was conducted earlier at the initial hotspots, now we do not be where we are.
          But stil could be maybe a chance.

          Or if not, the containment effort must be already conducted to slow it how much it would be possible.

          Comment


          • #6
            Re: WHO considers raising global pandemic alert level

            Originally posted by vinny View Post
            How long before we know what there decision will be with regards to the threat level.
            The same fact that they are in the operational center speak that is worying.

            Supposition:
            Probably if it is nasty, the raise would came in days or a week,
            and if it would be downplaying it would be set to 4 only (clusters/sustained).

            If the raise goes to 5, than good luck, maybe it loose power during further spreadings, and than deminish.

            Comment


            • #7
              Re: WHO considers raising global pandemic alert level

              Originally posted by tropical View Post
              The same fact that they are in the operational center speak that is worying.

              Supposition:
              Probably if it is nasty, the raise would came in days or a week,
              and if it would be downplaying it would be set to 4 only (clusters/sustained).

              If the raise goes to 5, than good luck, maybe it loose power during further spreadings, and than deminish.
              Where does one find the "alert" levels?

              Comment


              • #8
                Re: WHO considers raising global pandemic alert level

                Welcome BeauD -


                Current phase of alert in the WHO global influenza preparedness plan

                - WHO global influenza preparedness plan

                <table border="0" cellpadding="1" cellspacing="0" width="550"> <tbody><tr> <td> </td> </tr> </tbody></table>
                Experts at WHO and elsewhere believe that the world is now closer to another influenza pandemic than at any time since 1968, when the last of the previous century's three pandemics occurred. WHO uses a series of six phases of pandemic alert as a system for informing the world of the seriousness of the threat and of the need to launch progressively more intense preparedness activities.

                The designation of phases, including decisions on when to move from one phase to another, is made by the Director-General of WHO.

                Each phase of alert coincides with a series of recommended activities to be undertaken by WHO, the international community, governments, and industry. Changes from one phase to another are triggered by several factors, which include the epidemiological behaviour of the disease and the characteristics of circulating viruses.

                The world is presently in phase 3: a new influenza virus subtype is causing disease in humans, but is not yet spreading efficiently and sustainably among humans.



                Comment


                • #9
                  Re: WHO considers raising global pandemic alert level

                  Originally posted by BeauD View Post
                  Where does one find the "alert" levels?
                  Hello BeauD,
                  as Florida1 post you, these famous levels were nailed on 3 until now.

                  But seems that now we have "increased human to human transmission" in one country.

                  Comment


                  • #10
                    Re: WHO considers raising global pandemic alert level

                    there should be alert levels for each strain separately

                    H5N1 alert is not affected
                    I'm interested in expert panflu damage estimates
                    my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgT

                    Comment


                    • #11
                      Re: WHO considers raising global pandemic alert level

                      Originally posted by gsgs View Post
                      there should be alert levels for each strain separately

                      H5N1 alert is not affected
                      maybe, but that one is for "pandemic alerts",

                      any - capable pandemic virus

                      Comment


                      • #12
                        Re: WHO considers raising global pandemic alert level

                        Does anyone have a link to the text of the definitions, as recently revised immediately to hand? I think it would be worth posting here at this time, but cannot find it.

                        Comment


                        • #13
                          Re: WHO considers raising global pandemic alert level

                          Interpandemic period

                          Phase 1 : No new influenza virus subtypes have been detected in humans. An influenza virus subtype that has caused human infection may be present in animals. If present in animals, the risk of human infection or disease is considered to be low.

                          Phase 2: No new influenza virus subtypes have been detected in humans. However, a circulating animal influenza virus subtype poses a substantial risk of human disease.

                          Pandemic alert period

                          Phase 3: Human infection(s) with a new subtype but no human-to-human spread, or at most rare instances of spread to a close contact.

                          Phase 4: Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.

                          Phase 5: Larger cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming increasingly better adapted to humans but may not yet be fully transmissible (substantial pandemic risk).

                          Pandemic period

                          Phase 6: Pandemic: increased and sustained transmission in general population.

                          Notes: The distinction between phases 1 and 2 is based on the risk of human infection or disease resulting from circulating strains in animals. The distinction is based on various factors and their relative importance according to current scientific knowledge. Factors may include pathogenicity in animals and humans, occurrence in domesticated animals and livestock or only in wildlife, whether the virus is enzootic or epizootic, geographically localized or widespread, and other scientific parameters.

                          The distinction among phases 3, 4, and 5 is based on an assessment of the risk of a pandemic. Various factors and their relative importance according to current scientific knowledge may be considered. Factors may include rate of transmission, geographical location and spread, severity of illness, presence of genes from human strains (if derived from an animal strain), and other scientific parameters.

                          Page last modified on October 17, 2005
                          CDC’s pandemic preparedness efforts include ongoing surveillance of human and animal influenza viruses, risk assessments of influenza viruses with pandemic potential.
                          "The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation

                          Comment


                          • #14
                            Re: WHO considers raising global pandemic alert level

                            From CIDRAP - I think this highlights the meaning of the revised phases quite well.



                            WHO's draft pandemic flu guidance revises phases
                            Robert Roos News Editor


                            Oct 24, 2008 (CIDRAP News) ? The World Health Organization (WHO) has drafted a revised pandemic influenza preparedness plan that updates the definitions of pandemic phases and puts more emphasis on the social and economic effects of a global epidemic, among other changes.

                            snip

                            Pandemic phases
                            The draft guidance has six main pandemic phases, like the 2005 version. "However, the grouping and description of pandemic phases have been revised to be simpler, more precise and based upon verifiable phenomena rather than inference," the document states.

                            Changes in the phase definitions are clearest for phases 1, 5, and 6, with lesser changes in the other phases. In the existing guidance, phase 1 is defined as a time when, though no new flu viruses have been found in humans, a flu virus that has caused human infection "may be present in animals," but the risk of human infection is considered low. In the new draft, the phase 1 definition states simply: "No animal influenza virus known to have caused infection in humans has been identified in animals."

                            Phase 3 as defined in the current guidance?the phase the WHO puts us in now?is described as "human infections with a new subtype, but no human-to-human spread, or at most rare instances of spread to a close contact." In the draft, this changes to: "An animal or hybrid animal-human influenza virus has caused sporadic cases or small clusters of disease in people but has not resulted in human-to-human transmission sufficient to cause community level outbreaks."

                            For phase 5, the draft guidance uses a more specific geographic criterion than the existing document. The existing guidance speaks of larger case clusters but ones still confined to a localized area, suggesting that the virus is not yet fully transmissible. The draft document defines phase 5 as featuring a virus that "has established human-to-human transmission in two or more non-contiguous countries in one geographical region."

                            Similarly, the new phase 6 definition uses a specific geographic criterion, this one signaling intercontinental spread. Whereas the existing guidance defines this phase only as "increased and sustained transmission among the general population," the draft defines it as featuring a virus that "has caused clusters of disease in at least two of the following geographical regions: Africa, Asia, Europe, Americas, and Oceania."

                            The draft also defines three more phases after phase 6, none of which is numbered: the "post-peak period" (cases in most countries have dropped from peak levels), a "possible new wave" (flu activity is rising again), and the "post-pandemic period" (cases have returned to the normal range for seasonal flu).

                            Snip

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                            • #15
                              Re: WHO considers raising global pandemic alert level

                              #15: phase 5

                              plain words, from the upgrade version, we could be now at stage 5 instead of the proclamed 3 ...

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