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Swine Flu: Confusion Over W.H.O.'s Pandemic Levels

by Yuliya Talmazan | May 4, 2009 at 10:32 am

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As NP reported earlier today, W.H.O. is set to raise the global pandemic alert to level 6, the highest alert level on W.H.O.’s one-to-six alert scale, which would signify a global pandemic. W.H.O. officials claim raising pandemic alert to level 6 does not mean ‘the end of the world,’ but should prevent governments around the world from becoming ‘overconfident’ about the H1N1 Influenza A virus global spread.

However, today the United Nations chief Ban Ki-moon said that the UN wouldn't raise the alert level if the outbreak continues as is.

So, what is really going on with the pandemic alert levels?

In order for W.H.O. to increase the pandemic alert to level 6, the virus has to establish itself in one other continent other than the Americas. This stems from the way W.H.O. defines levels 5 and 6 on its pandemic alert scale:

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.

W.H.O. identifies the following six epidemiological sub-regions.

Epidemiological Sub-Regions
- African Region
- Eastern Mediterranean Region
- European Region
- Region of the Americas
- South-East Asian Region
- Western Pacific Region

Currently, only the region of the Americas (i.e.: North and South America) is seeing human-to-human spread in at least two countries (Mexico, the United States, Canada, Costa Rica, Colombia, and El Salvador to be exact). The H1N1 Influenza A virus will have to firmly establish itself and cause ‘community level outbreaks’ in Africa, Middle East, Asia, Pacific region or Europe before it is really considered a global pandemic. Sparse cases in different European and Asian countries that have been observed so far do not qualify as 'community level outbreaks.' Hence, there is no need for W.H.O. to switch to level 6 alert yet.

For more information on what pandemic alert levels really mean, see NP’s previous coverage here.

The World Health Organization has no immediate plans to raise its flu alert to the top level of six and declare a pandemic following the outbreak of the H1N1 virus, despite recent reports suggesting the contrary.

United Nations chief Ban Ki-moon said on Monday that the agency wouldn't bump up the alert level if the outbreak continues as is.

However Margaret Chan, WHO's director-general, warned that countries shouldn't be fooled into thinking the worst is over just because the number of new cases reported in Mexico has recently stabilized.

Before issuing a Level 6 alert the organization would have to see the strain spreading through Asia or Europe.

The number of confirmed cases of swine flu has risen to 1,025 in 20 countries, the World Health Organization said Monday, after UN Secretary General Ban Ki-moon said the health agency has no immediate plans to raise its pandemic alert to the highest level.

Despite the fact there are now over 1,000 cases of H1N1 Influenza A virus worldwide, the number of cases is stabilizing. In addition, Mexican government is to allow some of the ‘non-essential’ businesses (i.e.: stores, cafes and bars) that it has shut down on Friday to reopen starting Wednesday of this week. Schools will still remain closed, however. The shutdown was a temporary measure aimed at stopping the spread of the H1N1 Influenza virus in Mexico.

Mexican officials announced today they would allow most nonessential businesses to reopen Wednesday, after it ordered them closed Friday after the deadly outbreak of the swine flu virus.

The virus has entered into a stabilization phase. The cases are starting to decrease," President Felipe Calderon said, predicting that Mexico would soon begin to get back on its feet.

Mexico City Marcelo Ebrard says cafes, museums and libraries will reopen this week.

But he says health officials need to finish inspecting schools before students can return to class.

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Yuliya Talmazan

at 12:18 on May 4th, 2009

Yes, generaldecay, indeed it is quite confusing. It seems the W.H.O. is realizing the cases are stabilizing, but at the same time they don't want to reassure people that the situation is under control, so that governments do not ease their quarantine and surveillance measures.

A. Tran

at 13:14 on May 4th, 2009

Dr. Chan from WHO would have to justify the reasons to raise the alert level, but for now, WHO updates #14 re. influenza A H1N1.

4 May 2009 -- As of 18:00 GMT, 4 May 2009, 21 countries have officially reported 1085 cases of influenza A (H1N1) infection.

Mexico has reported 590 laboratory confirmed human cases of infection, including 25 deaths. The United States has reported 286 laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (101), China, Hong Kong Special Administrative Region (1), Costa Rica (1), Colombia (1), Denmark (1), El Salvador (2), France (4), Germany (8), Ireland (1), Israel (4), Italy (2), Netherlands (1), New Zealand (6), Portugal (1), Republic of Korea (1), Spain (54), Switzerland (1) and the United Kingdom (18).

Karl Gotthardt - albertacowpoke

at 13:36 on May 4th, 2009

Thanks for this Yuls. I heard the conflicting reports as well. It is definitely spreading, albeit slowly, in Alberta. Most cases have been linked to Mexico, except for the young girl that is hopitalized and has been classified as a severe case. She is in stable condition. They are now investigating to determine where she may have picked it up.