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WHO could declare end of H1N1 pandemic this week
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Author:  stephensons [ Sun Aug 08, 2010 11:24 am ]
Post subject:  WHO could declare end of H1N1 pandemic this week

http://www.ctv.ca/CTVNews/Health/201008 ... er-100808/

The Canadian Press

Date: Sunday Aug. 8, 2010 11:11 AM ET

TORONTO — The H1N1 pandemic is likely to be officially consigned to the history books in the next week or so, says Dr. Margaret Chan, director general of the World Health Organization.

Chan suggests that the global health agency and the experts that advise it on this matter are feeling increasingly confident the virus responsible for the 2009 pandemic is acquiring the patterns of seasonal flu viruses.

"All in all, people feel that the overall picture looks like we are ready to declare post-pandemic globally very soon," Chan said in an interview from Hong Kong.

The so-called emergency committee is likely to convene a meeting this week, she suggests. The committee is a panel of external and as yet unidentified experts who have advised Chan on major matters related to the pandemic. Chan, who has been harshly criticized for not identifying the members of the committee, has promised to do so once the pandemic is declared over.

The "all clear" could be sounded after that meeting, though outbreaks of H1N1 in schools in parts of New Zealand may delay the decision a little.

"We need to look at the situation. Another week or two? I cannot predict," Chan says.

The call will be made on advice from the emergency committee and with input of the countries currently most affected by H1N1 activity. New Zealand officials will be questioned on how the virus is behaving there. And the committee will likely want to hear from India, which is reporting quite a bit of H1N1 activity of late.

The fact that the announcement still remains to be made may take some people by surprise. In much of the Northern Hemisphere, H1N1's second wave peaked last fall and there's been remarkably little flu activity since the start of the year.

Chan concedes she's been queried about why the WHO hasn't declared the pandemic over before now.

"If I were a scientist, a minister of health living in a country in the Northern Hemisphere, I would ask the same question," she says.

"(But) I can't do it just for the Northern Hemisphere. Because I have no idea how the Southern Hemisphere will behave (during its winter). And what if they turn a bad corner?"

The WHO has been watching for a number of signs it believes are key to determining that H1N1 is morphing into a seasonal flu virus.

One critical indicator is the timing of flu activity. In the Northern and Southern Hemispheres, flu viruses mainly circulate during winter months. But during pandemics, widespread out-of-season transmission can occur.

That's exactly what happened last summer in parts of the Northern Hemisphere. But H1N1 hasn't given a repeat performance this summer.

The WHO has also been looking for evidence that -- as is normal with seasonal flu -- a variety of viruses are circulating. For months after H1N1's emergence, there was virtually no sign of other influenza A or influenza B viruses. Lately it's been much more of a mixed picture.

"In a nutshell I'm looking for several things," explains Chan, who concedes most of these criteria appear to have been satisfied.

"Lack of out-of-season outbreaks. Reduced intensity of outbreaks. And reduced dominance of the H1N1 pandemic virus and evidence of some population immunity (to the virus)."

Chan admits she's eager to move to the post-pandemic phase so the agency can focus on analyzing what happened and incorporating the knowledge gained into plans for future pandemics.

While it has claimed at least 18,500 lives globally, the outbreak was far milder than flu experts had been anticipating. Hospitals didn't get pushed beyond capacity. Doctors didn't have to make the awful choice of who got a ventilator and who did not.

But despite the relative mildness of the disease H1N1 caused, plenty of cracks appeared in the public health responses.

Estimates of how soon vaccine could be made proved to be overly optimistic and redistributing donated vaccine to developing countries proved to be a far slower process than anticipated.

In Canada, mass vaccination efforts were chaotic in places. As Ontario's chief medical officer of health, Dr. Arlene King, put it in her report on the outbreak, there wasn't enough vaccine when people wanted it, and when vaccine was plentiful people were no longer interested.

Chan knows already there are changes that need to be made.

"We planned for the worst case scenario," she says, referring to the fact that pandemic planners were driven by fears the dangerous H5N1 bird flu virus would trigger the next pandemic.

"If there's something we can do better ... I think we would advise people in pandemic preparedness planning in future, (that) we should look at the best case scenario, the intermediate scenario and the worst case scenario."

"That would provide us flexibility to move up and down the scale."

The difficulty of tailoring the plans on the fly to a much milder threat created the impression that the response was expensive overkill. In Europe, in particular, the WHO and national governments have come under heavy fire for wasting money on vaccine and drugs that critics graced with the luxury of hindsight have deemed were unneeded.

The WHO has even faced allegations it called the pandemic to pad the pockets of Big Pharma -- a charge Chan has fiercely denied.

Instead of excruciating medical dilemmas, this pandemic posed tough communications issues, Chan suggests.

"Having a virus causing a mild disease is the biggest challenge for all of us to manage the perception and the expectation," she says.

"And that is actually why we say that next time around, we really need to provide flexibility for different scenarios."

"And then countries need to upgrade or downgrade based on their country-specific situation. And when they do that, they should not be criticized for changing the goal posts."

She says she doesn't mind criticism; in a position like hers, she expects it and doesn't personalize it. But Chan does see irony in the flak aimed at her agency and at pandemic preparedness planners in general, who for years operated under the mantra "Hope for the best and prepare for the worst."

"You look at the criticism against BP," she says, referring to the disastrous oil spill in the Gulf of Mexico.

"One of the very fierce criticisms is that they have no worst case scenario planning for contingency. And in this case I have to say public health officials in all the countries where they can afford it have really done their best in terms of planning a worst case scenario. And that's why they have spare vaccines."

Author:  Pandora [ Sun Aug 08, 2010 12:37 pm ]
Post subject:  Re: WHO could declare end of H1N1 pandemic this week

I'd be willing to bet just about anyone that not long after they declare this pandemic over, the worst will hit - and they won't bother to call it a pandemic then - just a bad case of the flu that is taking lives. They couldn't risk reversing their decision or their spoiled reputation would spoil more. My distrust of them is overwhelming and complete, now.

Author:  stephensons [ Sun Aug 08, 2010 1:33 pm ]
Post subject:  Re: WHO could declare end of H1N1 pandemic this week

I watched a documentary on the Spanish Flu this afternoon about survivors and their families, was fascinating. Err on the side of caution Ms Chan. I think H1N1 will tell us once all said and done.

Author:  niman [ Sun Aug 08, 2010 1:48 pm ]
Post subject:  Re: WHO could declare end of H1N1 pandemic this week

Pandora wrote:
I'd be willing to bet just about anyone that not long after they declare this pandemic over, the worst will hit - and they won't bother to call it a pandemic then - just a bad case of the flu that is taking lives. They couldn't risk reversing their decision or their spoiled reputation would spoil more. My distrust of them is overwhelming and complete, now.

WHO is as lost as ever, They don't understand how the virus evolves and can't even properly track the most significant changes (low reactors at positions 157-159 as well as D225G/N). These changes are most easily seen in egg isolates, but most isolates are from mammalian cells where wild type is selected.

The vaccine came out late, in part because it grew poorly in egg cells because changes at positions 157-159 and D225G were excluded. WHO consultants are focused on reassortment and since it is not playing a role in pandmeic H1N1 evolution, they have lost interest. They also ignore the fact that the deaths from H1N1 remain in the under 65 age group, which is clearly NOT a seasonal flu pattern.

WHO is a VERY reactive group, so they are ALWAYS chasing the virus and always coming up short. A declaration of the end of the pandmeic will almost assure a re-emerence of a more lethal pandemic.

Author:  stephensons [ Sun Aug 08, 2010 3:41 pm ]
Post subject:  Re: WHO could declare end of H1N1 pandemic this week

http://www.torontosun.com/news/canada/2 ... 60461.html

OTTAWA - It was the flu that would end all flus, and then H1N1 fizzled out failing to bring the death and destruction that so many feared would come when swine flu swept through Canada.

Health officials haven’t recorded any significant activity for months and the last death attributed to swine flu in Canada was back in January, but the World Health Organization has yet to call off its global pandemic.

That could soon change.

Dr. Margaret Chan says in published reports that the United Nations-based WHO could drop the global pandemic alert within the next few weeks.

Swine flu, or H1N1, came to world attention in April 2009 after reports of hundreds of infections in Mexico.

Infections began appearing in Canada and the United States and were first restricted to people who had visited Mexico or come in contact with others who had. By June 11, 2009, the virus had spread to 74 countries with 141 deaths. At that point the WHO declared a global pandemic.

In Canada, H1N1 is cited as a contributing cause in just 426 deaths, well below the range of 4,000-8,000 deaths attributed to seasonal flu each year in this country.

Around the world the WHO says 18,449 people have died from H1N1. Government officials say the pandemic threat in Canada evaporated this past spring.

No comment :doh:

Author:  niman [ Tue Aug 10, 2010 5:59 am ]
Post subject:  Re: WHO could declare end of H1N1 pandemic this week

* Flu experts make recommendation on H1N1 pandemic status

* Could declare a "post-peak" or "post-pandemic" phase

* Focus is on infection rates in southern hemisphere winter

(Adds quotes from news briefing)

By Stephanie Nebehay

GENEVA, Aug 10 (Reuters) - The World Health Organisation will announce later on Tuesday whether the H1N1 flu outbreak has been downgraded from a pandemic after influenza experts reviewed its status in previously undisclosed talks, the WHO said.

The Emergency Committee of experts has given its assessment to the WHO, a United Nations agency, and its director-general Margaret Chan, after reviewing epidemiological data about current cases, mainly from the southern hemisphere, spokesman Gregory Hartl said.

"The Emergency Committee made its recommendation to the director-general who is in the process of finalising the wording of the recommendation," Hartl told a news briefing.

Chan, who participated in the experts' debate from her native Hong Kong, will make the announcement at a virtual news conference starting at 1300 GMT, a WHO statement said.

The experts' discussions by teleconference -- shrouded in secrecy -- lasted nearly three hours on Tuesday, Hartl said.

Health officials from countries currently reporting human cases of H1N1 -- including Argentina, Australia, India, New Zealand and South Africa -- made presentations about the situation to the experts, according to Hartl.

In June 2009, the WHO declared that a new swine flu virus, H1N1, which emerged in the United States and Mexico, was causing the first pandemic in more than 40 years. A full pandemic corresponds to phase 6 on the WHO's six-point scale for measuring the spread of a disease.

Experts have advised Chan on whether the world is still in a pandemic or has moved either to a "post-peak" or "post-pandemic" phase, Hartl said.

They analysed the current level of infections in the southern hemisphere, where it is winter, and examined whether H1N1 is behaving more like a seasonal flu.

The WHO's assessment of whether the disease is a pandemic or not is important for national health authorities, and would affect government plans to stockpile and distribute vaccines.

Dozens of companies make influenza vaccines, including Sanofi-Aventis <SASY.PA>, GlaxoSmithKline <GSK.L>, Novartis <NOVN.VX>, AstraZeneca <AZN.L> and CSL <CSL.AX>.

The WHO, in its latest weekly update issued last Friday, said: "Globally, pandemic influenza transmission remains most active in parts of South Asia and in limited areas of tropical South and Central America. In the temperate zone of the southern hemisphere, overall seasonal and pandemic influenza activity remains low, except in South Africa..."

In Argentina, Chile, New Zealand, and Australia, "overall influenza activity remains low and below levels observed during recent, mild, pre-pandemic influenza seasons", it added.

More than 18,449 people worldwide are confirmed to have died from H1N1 infections, including many pregnant women and young people. But the WHO says that it will take at least a year after the pandemic ends to determine the true death toll, which is likely to be much higher.

John MacKenzie, an Australian expert, chairs the committee of 15 external international experts.

The identities of the experts apart from MacKenzie are kept secret to shield them from influence from the pharmaceutical industry, governments and other interest groups. (Editing by Jonathan Lynn and David Stamp)

Author:  niman [ Tue Aug 10, 2010 7:18 am ]
Post subject:  Re: WHO could declare end of H1N1 pandemic this week


http://www.recombinomics.com/News/08101 ... Hopes.html

Author:  stephensons [ Tue Aug 10, 2010 7:49 am ]
Post subject:  Re: WHO could declare end of H1N1 pandemic this week

Excellent commentary :thumbsup:

Author:  cpg [ Tue Aug 10, 2010 8:44 am ]
Post subject:  Re: WHO could declare end of H1N1 pandemic this week

Yes Excellent

Thanks for all you do.

Author:  CopitoSP [ Tue Aug 10, 2010 9:00 am ]
Post subject:  Re: WHO could declare end of H1N1 pandemic this week

Prof. Angus Nicoll, flu program coordinator at the European Center for Disease Prevention and Control, said a decision to declare the pandemic over would be consistent with the Stockholm-based body's recent findings. (???)

While flu activity in the northern hemisphere is seasonally low, monitoring in southern hemisphere countries shows that few people are falling seriously ill from swine flu, said Nicoll.

Local spikes in flu deaths, such as seen recently in India, are likely due to better surveillance, he said....

Source: http://www.washingtonexaminer.com/lifestyle/who-says-decision-on-whether-to-downgrade-swine-flu-pandemic-is-likely-tuesday-100333544.html

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