The World Health Organization is inching closer to raising the infectious-disease alert level for the H1N1 swine-flu outbreak to its highest level, indicating that a pandemic has arrived, but has delayed doing so in an effort to prepare national health organizations and populations for the effect of such an announcement, a top WHO official said Tuesday.
The number of confirmed cases of the disease rose above 1,200 in Australia on Monday, and the virus is no longer restricted to schools and other institutions in that country, suggesting that a communitywide spread has begun. Such a spread in a region outside North America is the primary criterion for raising the alert level to Phase 6.
“One of the critical issues is that we do not want people to overpanic if they hear that we are in a pandemic situation,” the official, Dr. Keiji Fukuda, assistant director general of the agency, said in a telephone news conference Tuesday.
WHO officials worry that a pandemic declaration would lead people with mild illnesses to flood emergency rooms and might lead to border closings, travel restrictions and other “unwarranted” actions.
In the early stages of the current outbreak, Fukuda said, people stopped eating pork, pig herds were killed, and imports of pork were restricted by some countries. But the illness has not been transmitted by pigs or pig meat.
“These are the kinds of potential adverse effects” the agency is trying to avoid, he said.
Reporters repeatedly pressed Fukuda about why, given the clear spread in Australia, the agency has not increased the alert level.
“We are really getting very close to that,” he said. “We are working very hard to ensure that everyone is prepared for that.”
In an effort to mitigate overreaction, the agency last week decided to augment the current warning system with three tiers inside Phase 6 to indicate the severity of the pandemic. Barring changes in the next few days, the agency will most likely indicate that the severity is at the lowest level when the stage is raised, indicating that the virus is spreading through populations, but that its effects remain relatively mild.
As of Tuesday, Fukuda said, there have been 126,563 laboratory-confirmed cases of H1N1 flu in 73 countries, with 140 deaths. In the United States, the most recent figures from the Centers for Disease Control and Prevention show 13,217 confirmed cases and 27 deaths. Officials believe the total number of cases, in this country and worldwide, are actually much higher because many people have mild cases and do not receive testing.
