Flu Experts Debate Potential Number of H1N1 Infections Worldwide
Infectious disease experts on Thursday debated the WHO's earlier statements that one-third of the world's population roughly 2 billion people could become infected with the H1N1 (swine flu) virus, ABC News reports (Childs/Schlief, ABC News, 5/7). The WHO Chief Keiji Fukada cautioned that the WHO's estimate was "a benchmark from the past," based on data from past epidemics, the AP/Boston Globe reports. He added, "Please do not interpret this as a prediction for the future."
"[The WHO's estimate] doesn't sound too outlandish to me for the simple reason that this is a very infectious virus," said Chris Smith, a flu virologist at Cambridge University in England. "You're talking about a virus that no one in the population has seen before and therefore everyone is immunologically vulnerable. Therefore it's highly likely that once it starts to spread, people will catch it. And since the majority of the world's population are in contact with one another, you're going to get quite a lot of spread" (Higgins/Engeler, AP/Boston Globe, 5/8).
But, others were more skeptical, according to ABC News. "I think that WHO could serve the world health better by providing a more evidence-based, sensible 'benchmark' of H1N1 infection," said Ed Hsu, associate professor of public health informatics at the University of Texas School of Health Information Sciences and School of Public Health. Hsu said that while the WHO's estimates are grounded in historic data, they fail to consider improvement in public health, and his research shows signs that the numbers of swine flu infections in the U.S. are stabilizing.
"One could reasonably question the reliability of WHO's statement of mass infection," Hsu said. "By making such statement without strong backing WHO may risk putting its accountability on the line" (ABC News, 5/7). In a commentary appearing in Forbes, Henry Miller, a physician and molecular biologist from Stanford University, questions the "decisions and pronouncements from the [WHO]," which "have not been reassuring"(Miller, Forbes, 5/7).
Still, Christian Sandrock, assistant professor of clinical medicine in the Division of Infectious Diseases at the UC Davis School of Medicine, said that debating the numbers cited by Fukada is less important than "the likelihood of larger spread [of H1N1] in the second wave" later this year, and what that could mean for vaccine development and worldwide preparedness. "Much better to do this now than later," Sandrock said (ABC News, 5/7).
The WHO on Friday reported that 24 countries have officially reported 2,384 cases swine flu. Laboratory tests have confirmed 1,112 cases of swine flu in Mexico, including 42 deaths and 896 cases in the U.S., including two deaths. The WHO writes, "The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (214), China, Hong Kong Special Administrative Region (1), Colombia (1), Costa Rica (1), Denmark (1), El Salvador (2), France (5), Germany (10), Guatemala (1), Ireland (1), Israel (6), Italy (5), Netherlands (2), New Zealand (5), Poland (1), Portugal (1), Republic of Korea (3), Spain (81), Sweden (1), Switzerland (1) and the United Kingdom (32)" (WHO Influenza A(H1N1) - update 21, 5/8).
"Even if the illnesses appear relatively mild on an individual level, with large numbers of infections on the global population, you can get large numbers of seriously ill people," Fukuda told health ministers from the Association of South East Asian Nations (ASEAN) plus three other countries at a meeting in Bangkok on Thursday (Fox, Reuters, 5/8).
H1N1, H5N1 Could Combine
Scientists on Friday expressed concerns over the possibility that the H1N1 flu and (H5N1) bird flu viruses could combine "into a new bug that is both highly contagious and lethal and can spread around the world," the AP/Google.com reports. While scientists are uncertain about the likelihood of the viruses mixing, the AP/Google.com writes that the swine flu virus "has shown itself to be especially adept at snatching evolutionarily advantageous genetic material from other flu viruses."
The WHO on Wednesday reported two new cases of bird flu in Egypt and Vietnam, including one death "a reminder that the H5N1 virus is far from gone," AP/Google.com writes. "Do not drop the ball in monitoring H5N1," WHO Director-General Margaret Chan told a meeting of Asia's top health officials in Bangkok on Friday by video link. "We have no idea how H5N1 will behave under the pressure of a pandemic," Chan added (Mason, AP/Google.com, 5/8).
Suspected Cases Surface In Africa
The WHO reported on Thursday that there are five suspected cases of swine flu in Africa one in Benin and four in Seychelles but none had yet to be confirmed, Xinhua reports (Xinhua, 5/8).
WHO Africa Director Luis Gomes Sambo on Thursday said that efforts are underway throughout Africa to stockpile medicines, ready disease surveillance and educate the public about how to prevent the spread of swine flu, VOA News reports. "More than 50 percent of member states have activated plans and are ready to respond. In terms of surveillance, it is being done," said Sambo (Heinlein, VOA News, 5/7). Sambo said that the WHO has ordered 1,000 doses of Tamiflu for every African country, and distribution is currently underway, Reuters reports (Malone, Reuters, 5/7).
Health ministers of the Southern African Development Community (SADC) on Wednesday released a statement advising Africans to postpone travel to areas where cases of swine flu have been confirmed, BuaNews/AllAfrica.com reports (BuaNews/AllAfrica.com, 5/7).
Medical Journals Examine H1N1
The CDC on Thursday released two formal reports on the swine flu virus in the New England Journal of Medicine (NEJM), which shed light on the virus' genetic makeup (Fox, Reuters, 5/7) and helped to characterize the cases of swine flu cases that occurred in the U.S. (Stobbe, AP/Google.com, 5/7). NEJM released further reports, commentaries and information on its H1N1 Information Center (NEJM release, 5/7).
The British Medical Journal (BMJ) examined ways that the WHO and World Bank are reaching out to low- and middle- income countries to prevent the spread of swine flu. Chan has reached out to manufacturers, major donors and financial institutions "to ensure that enough funds are earmarked to help poor nations buy antiviral drugs, diagnostic equipment, and other supplies and that adequate supplies are available," BMJ writes. The World Bank has designated $205 million to go to Mexico and is currently evaluating its country lending program to see if additional funds from current bank projects can be used to help beef up pandemic preparedness in other countries (Zarocostas, BMJ, 5/6).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.