WHO Pandemic Alert classification system.

[Warren Stupidity]

WHO has not yet declared this a phase 4 condition, although this layman idiot can't figure out why not.


In Phase 3, an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks. Limited human-to-human transmission may occur under some circumstances, for example, when there is close contact between an infected person and an unprotected caregiver. However, limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemic.


Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion.

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region (Figure 4). 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.


http://www.who.int/csr/disease/avian_influenza/phase/en/index.html

[hlthe2b]

1. WHO Pandemic alert levels developed around H5N1 avian flu

and its inherent high human mortality level, currently at 61%, but in some countries, (Indonesia) as high as 80%.


THis current H1N1 variant swine flu has had no mortality (yet) outside Mexico. In Mexico, with the high morbidity, the mortality is still relatively low.

[uppityperson]

2. Upping it to 4 would open up other things, rather like declaring a county a "disaster"

after a disaster. I'm not sure what all would happen, but wouldn't be surprised if they do up it.

[Warren Stupidity]

3. They don't have enough information yet - or as you say

the implications of declaring this a phase 4 event are severe enough to cause a temporary stall.


The first meeting of the Emergency Committee was held on Saturday 25 April 2009. After reviewing available data on the current situation, Committee members identified a number of gaps in knowledge about the clinical features, epidemiology, and virology of reported cases and the appropriate responses.

The Committee advised that answers to several specific questions were needed to facilitate its work. The Committee nevertheless agreed that the current situation constitutes a public health emergency of international concern. Based on this advice, the Director-General has determined that the current events constitute a public health emergency of international concern, under the Regulations.

Concerning public health measures, in line with the Regulations the Director-General is recommending, on the advice of the Committee, that all countries intensify surveillance for unusual outbreaks of influenza-like illness and severe pneumonia.

The Committee further agreed that more information is needed before a decision could be made concerning the appropriateness of the current phase 3.

http://dotearth.blogs.nytimes.com/2009/04/26/contagion-on-a-small-planet/

[Dogmudgeon]

4. I think we are already at 5

"Two countries in the same area" -- Mexico AND the USA AND Canada. That's three.

I agree, we need a more technical approach than one that is dramatic, like the Homeland Insecurity Threat Level Color system. (a.k.a. Garanimals for adults.)

--d!

[Warren Stupidity]

5. Well that does sort of bother me.

They seem to have a set of technical criteria developed to mobilize global containment efforts, and they appear to be ignoring their own policies, most likely because of the political and economic cost.

[Dogmudgeon]

7. It could be that the criteria are more stringent, too

The public guidelines are not set in stone; they tend to not be as simple as they are explained to the public; they may be waiting for replicated confirmation. Public health organizations almost never bow to political pressure; they tend to soft-pedal the reportage, instead. During the first Bird Flu scares, the WHO was as painfully precise in their public writing as our own CDC.

My biggest worry is how cynical people are about this -- like it's a conspiracy to take our mind off of torturegate, added to the distractions of Susan Boyle initiated by the MI5, and the death of Bea Arthur by the AARP. It's not. Panic is never appropriate in epidemics, but are education, elementary precautions, and attention to the news too much to ask?

--d!

[Xicano]

6. Remember this deadly H5N1 & H3N2 avian flu virus contaminated vaccine recently?

The so-called media didn't seem to cover it. Here's a link:

People familiar with biosecurity rules are dismayed by evidence that human H3N2 and avian H5N1 viruses somehow co-mingled in the Orth-Donau facility. That is a dangerous practice that should not be allowed to happen, a number of experts insisted.

Accidental release of a mixture of live H5N1 and H3N2 viruses could have resulted in dire consequences.

While H5N1 doesn’t easily infect people, H3N2 viruses do. If someone exposed to a mixture of the two had been simultaneously infected with both strains, he or she could have served as an incubator for a hybrid virus able to transmit easily to and among people.

That mixing process, called reassortment, is one of two ways pandemic viruses are created.


http://www.torontosun.com/news/canada/2009/02/27/8560781.html

[Baby Snooks]

8. Reassortment may be what resulted in AIDS....

The Salk vaccine, using a live polio virus, used green monkey kidney tissue for culturing in one batch prepared in Africa in the 1960s. Which may or may not have resulted in the human AIDS virus when the simbian AIDS virus combined with the polio virus. Jonas Salk believed it did. He was trying to replicate it when he died.

The samples of the original batch that was at NIH in Washington, they keep samples of these vaccines the way studios in Hollywood keep master negatives, was destroyed for some reason on orders from the Reagan Administration. More than likely on orders from George HW Bush.

In any case, the "combinant" process is usually a fluke of nature. Not the result of a diabolical mind. Nature can prove far more deadly than man. Which we may discover at some point as we did in 1918.

Indications so far are that this is not a repeat of 1918. That is what worries WHO about these new strains. Particularly the avian strains.