Swine Flu Pandemic Declared by World Health Organization

The H1N1 virus is spreading in distinct regions of the globe. But the WHO says the pandemic is only 'moderate in severity' and cautions against overreaction by the public.

By Thomas H. Maugh II / Los Angeles Times
9:06 AM PDT, June 11, 2009

The World Health Organization this morning acknowledged what many health experts have been saying for weeks: The outbreak of novel H1N1 virus is now a pandemic.

In a letter sent to its member countries, the WHO said it is officially raising its infectious diseases alert to Phase 6, its highest level, in recognition of the fact that the virus is now undergoing communitywide transmission in Australia as well as in North America. Such spread in two distinct regions of the world is the primary criterion for raising the alert level.

But the agency said that the pandemic is only "moderate in severity" and cautioned against overreactions to the increased alert level.

The announcement marks the advent of the first global influenza epidemic in 41 years. The last one was the Hong Kong flu epidemic of 1968, which killed an estimated 1 million people worldwide.

So far, the H1N1 or swine flu pandemic this year has accounted for 27,737 laboratory-confirmed cases and 141 deaths, although health officials believe many times that number have been infected but have not been tested because their disease was mild.

A normal seasonal flu outbreak kills about 250,000 to 500,000 people worldwide.

In most industrialized countries, the rise in the alert level will have little practical effect because health authorities were already behaving as though a pandemic had been declared. In the United States, where there have been more than 13,000 cases and at least 27 deaths, "Our actions in the past month have been as if there was a pandemic in this country," said Glen Nowak, a spokesman for the Centers for Disease Control and Prevention.

But it will accelerate the production of a vaccine against the new virus. Several countries have signed contracts for the vaccine with manufacturers that call for its production if a pandemic is declared. Most of them have received so-called seed stock viruses from the CDC in the past two weeks, allowing them to begin the lengthy process of growing the virus in eggs and producing vaccines. But it will still take a minimum of four to six months for the vaccines to be available for use.

The announcement will have more impact on Third World countries, freeing up additional funds for treatment and prevention and helping to make stocks of antiviral drugs more readily available.

The WHO has hesitated to raise the alert level for fear that such an announcement would be misconstrued as an indication that the virus has become more pathogenic. WHO spokesman Gregory Hartl emphasized today that "Phase 6 doesn't mean anything concerning severity, it is concerning global spread. . . . Pandemic means global, but it doesn't have any connotation of severity or mildness."

In fact, he said, all evidence to date is overwhelming that the virus is mild in its effects. Experts fear, however, that as it passes through populations, it could mutate to become more lethal and return with increased force in the winter influenza season. That is what happened with the Spanish flu pandemic of 1918.

Officials had said they feared that the announcement would lead frightened people who are not really sick to overrun hospital emergency rooms, impairing the healthcare system's ability to treat the truly sick. That has happened in past outbreaks, and there is already some evidence that it is happening in South America, particularly in Chile, where the numbers of infected have been growing.

Dr. Keiji Fukuda, assistant director general of the WHO, also said earlier this week that he fears imposition of travel restrictions, border closing and bans on food imports -- all of which have already happened in the earlier stages of the outbreak.

thomas.maugh@latimes.com