Posted: 21 May 2009 1748 hrs
A Chinese couple, wearing masks as a precaution against H1N1 flu, kiss each other at the Beijing airportGENEVA - A month after the world was alerted to a potential flu pandemic, the WHO was caught Thursday between the spread of the new Influenza A (H1N1) virus to 41 countries and doubts fostered by its mild symptoms.
More than 11,000 cases and 85 deaths have been recorded since the outbreak of A(H1N1) influenza emerged in Mexico and the United States, and the world remains at flu alert level five, signalling an "imminent pandemic".
But World Health Organisation Director General Margaret Chan is hesitating about declaring a fully-fledged pandemic by moving to phase six, even though travellers have carried it to other continents.
The top level would indicate sustained community transmission in a second region outside the Americas.
On Thursday, Japanese Prime Minister Taro Aso appealed for calm as a total of 281 A(H1N1) flu cases were reported in the country, including the first in greater Tokyo, the world's largest urban area.
Antoine Flahaut, an epidemiologist and head of the School of Public Health (EHESP), told AFP that the technical elements were in place to move into the pandemic phase.
"But the WHO senses that recommendations which go with that are not adapted to the situation," he explained, pointing to air travel restrictions or advice to wear surgical masks.
"Invoking phase six would be disproportionate with the current situation."
The doubts have grown because of the relatively mild symptoms of A(H1N1) flu, which experts acknowledge is no worse than seasonal influenza for now.
Many of the deaths have occurred among those who were suffering from other ailments, a common pattern for ordinary strains of flu.
During a meeting at the WHO's annual assembly Thursday, Chan listed the issue of A(H1N1) flu's severity among other criteria that were prompting caution.
"One of the things we're not seeing is the same spread in the southern hemisphere that we've seen in the first three countries," a WHO official added.
When the WHO's annual assembly opened on Monday, British Health Secretary Alan Johnson voiced doubts about phase six that had been growing behind the scenes after countries rushed to contain new cases of A(H1N1) flu.
"I think you, as you and others have said, need more time, we need more time to study this," Johnson told Chan, prompting nods of approval from other health officials afterwards, including China, Japan and New Zealand.
"She has taken that on board," WHO spokesman Thomas Abraham said late Thursday, underlining that most of the cases in Japan were largely confined to students or their close entourage.
Chan acknowledged this week that the WHO's pandemic response plan, introduced three years ago, was largely designed around the more deadly and virulent, but less transmissible, H5N1 bird flu virus.
"This scale was based on geographical distribution, but the public belief is that pandemic means seriousness," said Sylvie Briand, acting director of the WHO's Global Influenza Program.
But the WHO is also looking ahead at the potential progress of the new virus, and fears of its impact in poor countries, where millions of people are already weakened by chronic illness.
"Whatever the member states might say, we are in phase five," Abraham pointed out.
In studies released by the New England Journal of Medicine, scientists pointed out the similarities between the new A(H1N1) virus and ones behind pandemics that marked the 20th century.
Those pandemics in 1918-1919 -- which killed an estimated 50 million people -- in 1957-1963 and 1968-1970 started off as mild but went through waves that became more lethal at their peak, often the second season, and had different impacts in different regions.
They also affected young people -- a feature underlined by the WHO in the current outbreak -- and were highly transmissible, the researchers from the US National Institutes of Health and George Washington University said.
Abraham said it was still not clear if young people were more affected by A(H1N1) flu because of the nature of the virus, or because it was more likely to be passed around among students in the close confines of schools.
"This virus does affect younger people, we don't know the reason for this - whether it's viral or epidemiological," he explained.
- AFP/ir
From ChannelNewsAsia.com; see the source article here.
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