WHO on verge of declaring H1N1 flu pandemic

[Tab]

Source: Reuters

GENEVA (Reuters) – The World Health Organization (WHO) is on the verge of declaring the first influenza pandemic in more than 40 years, but wants to ensure countries are well prepared to prevent a panic, its top flu expert said on Tuesday.

Keiji Fukuda, acting WHO assistant director-general, voiced concern at the sustained spread of the new H1N1 strain -- including more than 1,000 cases in Australia -- following major outbreaks in North America, where it emerged in April.

Confirmed community spread in a second region beyond North America would trigger moving to phase 6 -- signifying a full-blown pandemic -- from the current phase 5 on the WHO's 6-level pandemic alert scale.

"The situation has really evolved a lot over the past several days. We are getting really very close to knowing that we are in a pandemic situation, or I think, declaring that we are in a pandemic situation," Fukuda told a teleconference.

Fukuda said a move to phase 6 would reflect the geographic spread of the new disease.

"It does not mean that the severity of the situation has increased or that people are getting seriously sick at higher numbers or higher rates than they are right now," he said.

A decision to declare a pandemic involved more than simply making an announcement, he said. The United Nations agency had to ensure that countries were able to deal with the new situation and also handle any public reaction.

"One of the critical issues is that we do not want people to 'over-panic' if they hear that we are in a pandemic situation. That they understand, for example, that the current assessment of the situation is that this is a moderate level," Fukuda said.

The WHO and its 193 member states are working hard to prepare for a pandemic, for instance developing vaccines and building up supplies of anti-viral drugs, he said.

The disease, which has infected over 26,500 people in 73 countries, with 140 deaths, has been most severe in Mexico, which has reported the highest number of fatalities, more than 100. These include infections in otherwise healthy young people.
...
(For a WHO note on its pandemic alert scale go to:

http://www.who.int/csr/disease/influenza/GIPA3AideMemoire.pdf )

Read more: http://news.yahoo.com/s/nm/20090609/ts_nm/us_flu_who

[Demeter]

1. I Thought As Much

All that backing and filling and denial--signs of a major development being shoved under the sofa.

[elocs]

2. "Over-panic". That reminds me of the weatherman who screams "the sky is falling" with every storm.

People then lose faith in their credibility which is tragic when there really is something worthy of concern.

[MercutioATC]

3. You DO realize that declaring a pandemic is based on the spread of a disease

and not its severity, right?

By its own standards, the WHO should have already declared Level 6. They've been delaying it for political reasons.

[BumRushDaShow]

6. Exactly.

The criteria (http://www.who.int/csr/disease/avian_influenza/phase/en/index.html):

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.

which happened months ago (i.e., H1N1 is all over Europe)...

Every other week, the media keeps dragging this out - you know they're about to do it, you know they're about to do it, you know... Like a broken record. Just DO IT!

[SkyDaddy7]

10. Thank-you...

For a bit of reality. It seems many think it is ridiculous to take such outbreaks seriously.

[elocs]

21. Does your average person on the street realize that?

That question is more to the point.

[Sigh Sister]

22. My understanding is that they wanted to declare a pandemic earlier

but they were concerned about people panicking.

[MercutioATC]

24. Actually, they were pressured by governments not to raise the level.

At Level 6, many governments automatically activate programs that restrict travel. They were concerned about the economic impact.

[Sigh Sister]

26. It think it's both pressure from governments and concern about panic

The agency said on Tuesday it was on the verge of declaring the first influenza pandemic in more than 40 years, but wanted to ensure countries were well prepared to prevent a panic over the disease, widely known as swine flu


http://www.reuters.com/article/worldNews/idUSTRE5583US20090610

[MercutioATC]

23. If the "average person" spent more time being informed and less time

watching American Idol, they would.

It's not a secret.

[Buns_of_Fire]

4. No offense intended, but I don't think Pete Townshend or Roger Daltrey are qualified

to declare pandemics.

[a la izquierda]

8. LOL...that's funny.

[FailureToCommunicate]

14. WHO's NEXT?

[tiptoe]

5. H1N1 Flu and Vitamin D (What to do re the possibility of an H1N1 flu pandemic)- John Cannell, MD -x

H1N1 Flu and Vitamin D - x (What to do about the possibility of an H1N1 flu pandemic) -- May 2009, John Cannell, MD

[TZ]

12. Read up on Vitamin D toxicity

It doesn't prevent infection from novel viri either...as that article tells you.

[tiptoe]

15. Vitamin D3 Cholecalciferol Toxicity -- The Truth About Vitamin D Toxicity ("fears unwarranted")

http://www.vitamindcouncil.org/vitaminDToxicity.shtml
John Jacob Cannell MD Executive Director, 2003.09.05

Vitamin D Toxicity Fears Unwarranted

Is vitamin D toxic? Not if we take the same amount nature intended when we go out in the sun.¹ Vieth attempted to dispel unwarranted fears in medical community of physiological doses of vitamin D in 1999 with his exhaustive and well-written review.

His conclusions: fear of vitamin D toxicity is unwarranted, and such unwarranted fear, bordering on hysteria, is rampant in the medical profession.² Even Ian Monroe, the chair of the relevant IOM committee, wrote to the Journal to compliment Vieth's work and to promise his findings will be considered at the time of a future Institute of Medicine review.³ That was more than two years ago.
...

Cholecalciferol, Not Ergocalciferol, Is Safe

Although there are documented cases of pharmacological overdoses from ergocalciferol, the only documented case of pharmacological—not industrial—toxicity from cholecalciferol we could find in the literature was intoxication from an over-the-counter supplement called Prolongevity.⁴...Although D can be toxic in excess, the same can be said for water.

Therapeutic Index
...

Sun Supplies 10,000 Units Of Vitamin D
...

Hypersensitivity, Not Toxicity
...

It seems clear that restoring physiological serum levels of 25(OH)D will help many more patients that it will hurt. In fact, living in America today while worrying about vitamin D toxicity is like dying of thirst in the desert while worrying about drowning.

¹Vieth, R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr. 1999;69:842–56
²Vieth R, Chan PC, MacFarlane GD. Efficacy and safety of vitamin D3 intake exceeding the lowest observed adverse effect level. Am J Clin Nutr. 2001 Feb;73(2):288–94.
³Munro I. Derivation of tolerable upper intake levels of nutrients. Letter, Am J Clin Nutr. 2001;74:865.
⁴Koutkia P, Chen TC, Holick MF Vitamin D intoxication associated with an over-the-counter supplement. N Engl J Med. 2001 Jul 5;345(1):66-7.

http://www.vitamindcouncil.org/newsletter/h1n1-flu-and-vitamin-d.shtml
John Jacob Cannell MD Executive Director, May 2009

...

Dr. Cannell:
Will Vitamin D protect me against acquiring the H1N1 flu?
George, Utah

I don't know, no one does. I am concerned about people who take low doses of Vitamin D (1,000–2,000 IU/day) and only achieve a 25(OH)D blood level of 30 ng/mL. If the virus mutates into a virus as lethal as the 1918 virus, I doubt Vitamin D will totally protect you. Several facts about the 1918 pandemic concern me.
...
After rereading Jordan, I doubt vitamin D was the controlling factor in the 1918 Pandemic. Furthermore, some of the above data—highest death rates in whites and young adults—suggests having some vitamin D was a risk factor for death. Thus, take enough Vitamin D.

However, other facts suggest Vitamin D was protective in 1918:
...
My best guess is that 5,000 IU/day and a 25(OH)D of > 50 ng/mL will be at least partially protective. Remember, at 50 ng/mL, you are assured that you are not suffering from substrate starvation, that is, your body has enough Vitamin D for its needs and some left over to store. At a level of 30 ng/mL, most people are still suffering from Vitamin D substrate starvation.⁵

⁵Heaney RP, Armas LA, Shary JR, Bell NH, Binkley N, Hollis BW. 25-Hydroxylation of vitamin D3: relation to circulating vitamin D3 under various input conditions. Am J Clin Nutr. 2008 Jun;87(6):1738-42

.

[Turborama]

7. BBC: Australia flu 'may tip pandemic'

Australia flu 'may tip pandemic'

A sharp increase in swine flu cases in Australia may mean the infection has become a pandemic, the World Health Organization says.

For that to happen, officials would have to verify that the disease had become established outside North America, where the crisis began.

"Once I get indisputable evidence, I will make the announcement," said WHO director general, Margaret Chan.

More than 1,200 people have contracted the virus in Australia - none fatally.

The total means Australia has seen a four-fold increase in a week.

Read more: http://news.bbc.co.uk/2/hi/asia-pacific/8092474.stm

[Tab]

16. At those numbers

You are looking at a pandemic

[Turborama]

25. My thoughts exactly. n/t

[tocqueville]

9. quarantine Wall Street

the most infected pigs are there

[Sigh Sister]

11. For those that are interested

Here's a list of the people and their ages in the US who have died . Although most were young, it appears underlying health conditions contributed to their deaths. I understand that thousands die during regular flu season, but it's usually those <5 or >65. I'm not a "we're all gonna die" type, I just find it interesting.

Fatalities: 40 deaths
The United States reported its first death in late April, in Texas (a state bordering Mexico). It was the first H1N1 death recorded outside of Mexico.

Almost all deaths in the United States have involved people in "high risk" flu groups: pregnant women, young children, and people with underlying health conditions. People from these populations die each flu season, in the US and elsewhere.

Arizona, week of May 4: a woman in her late 40s with an underlying lung condition died.

Arizona, week of May 11: a 57-year-old woman with an underlying health condition died on the Gila River Indian Reservation in Pinal county.

Arizona, May 15: a 13-year old boy from Tuscon, Pima County was hospitalized May 10 and died five days later. He had an underlying health condition.

Arizona, May 17: A 10-year-old girl from Pima County fell ill May 12 and died five days later. She had underlying health conditions.

California, June 1: a middle-aged man with underlying health problems died in San Bernardino County. (case not confirmed by CDC as of June 9)

California, June 1: a middle-aged woman from Los Angeles County died. She had an underlying health condition. (case not confirmed by CDC as of June 9)

California, June 3: an elementary-school-aged girl died. After contracting the flu, she developed a secondary bacterial infection. (case not confirmed by CDC as of June 9)

California, June 8: a middle aged man died in Orange County. (case not confirmed by CDC as of June 9)

California, June 9: a middle aged man died in Alameda County. he had underlying medical conditions. (case not confirmed by CDC as of June 9)

Connecticut June 3: a 50-year-old woman with underlying health problems died after a short hospitalization.

Illinois, May 24: in Chicago, a woman of unspecified age with underlying medical conditions died.

Illinois, May 27: a woman from Cook county who had underlying medical conditions has died.

Illinois, May 28: a 42-year-old man from Kane county died from complications of H1N1 flu. He had other medical problems.

Illinois, May 30: State health officials confirmed another fatality in Chicago. Media reports say she was a 20-year-old pregnant woman who was hospitalized May 23, gave birth May 29 and died the next day with pneumonia.

Illinois, June 4: 74-year old man with a significant underlying health condition died.

Michigan, June 2: A 53-year-old woman from Warren, a town in Macomb County, died. No additional details were provided.

Missouri, May 19: a 44-year old man's death was announced May 19.

New York, May 17: the 55-year-old assistant principal of an affected school died of the disease, despite being put on a ventilator and receiving intensive treatment for a week.

New York, May 25: a woman in her 50's with underlying medical conditions died.

New York, May 26: a 41-year-old woman from Queens with underlying medical conditions died.

New York, May 26: a 34-year-old man from Brooklyn with underlying medical conditions died.

New York, June 2: A "child under two years old" died in New York City. Additional details were not available due to privacy concerns.

New York, June 3: officials said an adult (aged 25-64) died, without giving additional details. Appears to have had an underlying health condition.

New York, June 3: officials said an adult (aged 25-64) died, without giving additional details. The person may have been completely healthy prior to H1N1 infection, with no underlying health conditions.

New York, June 5: an adult over 65 years old, with an underlying condition, died.

New York, June 8: an adult over 50 years of age, with underlying medical conditions, died. (case not confirmed by CDC as of June 9)

New York, June 9: an adult from Onondaga County died and had underlying medical conditions.(case not confirmed by CDC as of June 9)

Oklahoma, June 8: a 43-year-old man with underlying chronic medical conditions, including asthma, died. (case not confirmed by CDC as of June 9)

Oregon, June 8: A Marion county woman, with multiple underlying health conditions, died. (case not confirmed by CDC as of June 9)

Pennsylvania, June 5: a 55-year-old woman from Berks County who had a significant underlying health condition died. (case not confirmed by CDC as of June 9)

Pennsylvania, June 7: a 26-year-old woman in Philadelphia who was already very ill when hospitalized died. (case not confirmed by CDC as of June 9)

Texas, April 29: A 23-month old baby boy from Mexico traveled to Brownsville, Texas in early April, was hospitalized in Houston and died there April 29. He had several chronic underlying medical problems, including a heart defect and an autoimmune disorder. He was the nation's first fatality.

Texas, May 5: A 33-year-old pregnant woman was hospitalized in mid-April in Cameron county and died some time around May 4. She had several underlying health conditions, including asthma, rheumatoid arthritis and psoriasis (an autoimmune condition). Doctors say H1N1 contributed to her death, but do not directly attribute her death to the disease. Her baby was successfully delivered via Caesarean section.

Texas, week of May 11: a man in his 30s with an underlying health condition died in Nueces county, Texas.

Texas, May 19: a 42-year-old man from El Paso County, no additional details available. (case not confirmed by CDC as of June 9)

Texas, May 24: a pregnant 24-year-old woman in El Paso County, (case not confirmed by CDC as of June 9)

Texas, early June: a 43 year old man from El Paso County, died.(case not confirmed by CDC as of June 9)

Utah, May 20: a 21-year-old man's death was reported May 20. He had chronic medical conditions (respiratory issues, obesity).

Utah, June 5: The June 5 CDC update lists 2 total fatalities for Utah state. Both had underlying health conditions. Details on the second death are unavailable.

Virginia, June 2: a woman from the Chesapeake Health District died. She had an underlying medical condition.

Washington, May 6: a man in his 30s died in Snohomish County. He had a heart condition.

Washington, June 5: A woman in her 20s from Pierce County. She had underlying health conditions and was hospitalized for two weeks before dying. (case not confirmed by CDC as of June 9)

Wisconsin, June 3: an adult with underlying health conditions died (case not confirmed by CDC as of June 9)

http://www.internationalsos.com/pandemicpreparedness/CountryLevel.aspx?languageID=ENG&countryID=111&catID=27

[uppityperson]

17. Thank you.As far as "underlying health condition", who DOESN'Thave 1. CDC info/map here...

have some sort of underlying health condition. I had an asthma attack 23 yrs ago so have that as an "underlying health condition" even though I have never had another attack. Have had colds, and pneumonia in the past too. Was even pregnant once.

I wish they'd clarify "underlying health condition" as it can mean something or nothing.

Rant not directed at you, just a rant in general. thank you for the link and info.

Edited to add CDC info
http://www.cdc.gov/h1n1flu/update.htm
TOTAL*(52 states)
13,217 cases
27 deaths

[Sigh Sister]

18. I wish "underlying health condition" was clarified too

I know the man in New York who was a teacher or principal was said to have "an underlying health condition" His son said the only thing he had was gout which would not make you more susceptible to complications from the flu.

[uppityperson]

20. gout? Unless it was bad enough to have him bedridden, I don't see that either

and being a principal, don't think he was bedridden.

[TZ]

13. Good. This will make things more efficient

in terms of developing a vaccine (which has just started) and getting key health organizations to cooperate and communicate well, something thats very important.
I'm wondering what's going to happen this fall with H1N1. Hopefully not a repeat of the 1918 increase of lethality.

[uppityperson]

19. Glad they will up it and glad they are educating it is spread, not mortality

I was posting these in another thread, but quit a few days ago because it is obvious that the official numbers as nowhere near the true numbers. Also I got tired of checking and putting numbers down daily, still watching though.

10 June 2009 -- As of 06:00 GMT, 10 June 2009, 74 countries have officially reported 27,737 cases of influenza A(H1N1) infection, including 141 deaths.
http://www.who.int/csr/don/2009_06_10a/en/index.html