WHO Warns of Imminent World-Wide Pandemic

U.N. Agency Raises Alert Level to Phase 5, Citing Sustained Person-to-Person Transmission in the U.S. and Mexico

Margaret Chan, director general of the World Health Organization, with deputy Anarfi Asamoa-Baah, said Wednesday that “all countries should immediately activate their pandemic preparation plans.” (AP)

The World Health Organization warned countries Wednesday that a global pandemic from a new strain of flu appeared imminent, as the number of ill continued to grow and the first death outside Mexico was reported in Texas.

The United Nations public-health agency raised its global pandemic alert level to phase 5 from phase 4, indicating the A/H1N1 virus has caused outbreaks in at least two countries in one region. “All countries should immediately activate their pandemic preparation plans” and be on “high alert” for outbreaks, said WHO Director-General Margaret Chan.

WHO Director-General Margaret Chan issues a statement on the decision to raise the influenza pandemic alert to phase 5 and urging everyone to take the alert seriously.

Dr. Chan said the decision was made after the agency established that sustained person-to-person transmission was occurring in the U.S., in addition to Mexico. The outbreak at a private school in the New York City borough of Queens caught the attention of WHO officials, because students who had traveled to Mexico returned to campus and infected others. Several hundred people associated with the school are thought to have caught the flu strain. Mexico urged its citizens to stay in their homes for five days to protect against swine flu.

The Centers for Disease Control and Prevention said that 51 people in New York have been confirmed with swine flu. The total number of cases in the U.S. grew Wednesday to 91 people in 10 states.

On Thursday, the Obama administration stood solidly against closing the U.S.-Mexico border, with Vice President Joe Biden calling this health emergency option “a monumental undertaking” with only limited benefits now that the swine flu virus already has penetrated many states and forced roughly a hundred school closures.

The WHO had raised its pandemic alert level to 4 from 3 earlier this week. Wednesday’s move reflected the rapid spread of the disease by international travelers. The WHO said nine countries had reported 148 cases, though several countries had many more suspected cases.

Mexico says its death toll may be as high as 159 people. The country’s top government epidemiologist said Wednesday it was “highly improbable” that a pig farm in the state of Veracruz suspected of originating the new strain was responsible for the global outbreak.

Keiji Fukuda, the WHO’s top flu official, said the agency could soon declare a pandemic, which is designated as level 6. “We think we are in the process of moving there,” he said. “The spread of this is clearly related to travel. It is possible we will move to seeing established transmission in other countries relatively quickly.”

The escalating alert levels reflect the speed with which the virus is spreading, not its lethality, officials and scientists said.

Some Mexican doctors say they think many more people had the virus than initially thought and have since made a full recovery, suggesting it could turn out to be a relatively mild pandemic — like new viruses that swept the world in 1957 and 1968. Or, say flu scientists, it could evolve into a deadlier bug, like the one in 1918.

Dr. Chan said the WHO could not risk waiting to determine the precise mortality rate of this strain before acting. “The biggest question right now is this: How severe will the pandemic be?” she said.

“The virus is very unpredictable, and we are still at an early stage,” she said. “It may be possible that the virus will die out and stop. But it can turn the other way, which is why it’s important for us to continue to be vigilant and track its movements.”

In Texas, a toddler who traveled from Mexico with his family died in a Houston hospital, the first confirmed U.S. death.

The boy, who was a few weeks shy of his second birthday, came down with a fever on April 8, four days after traveling with his parents and grandparents to Brownsville, at the southern tip of Texas. He was admitted to a hospital a few days later and treated for flu symptoms.

By then, “the child was very sick,” said state Sen. Eddie Lucio Jr., who was briefed by medical authorities. “He appeared to be suffering from a compromised immune system from a previous illness.”

The boy’s condition deteriorated rapidly, Mr. Lucio said; his kidneys began to fail and he was put on a ventilator. He was transferred to a Houston hospital, where he died Monday. Tests later showed the new strain.

Gov. Rick Perry issued a disaster proclamation in Texas, where probable cases ranged in age from an 11-month-old patient to a 72-year-old. Some were in contact with people ill with the virus, while others had no known contact, nor had they traveled to Mexico.

State officials canceled or postponed academic, athletic and arts competitions that would have brought together students from across the state.

President Barack Obama said the boy’s death underscored the government’s decision to take aggressive action. He said the U.S. continued to closely monitor the outbreak. “This is obviously a serious situation — serious enough to take the utmost precaution,” he said.

A spokesman for the U.S. Department of Education said 104 schools, with about 56,000 students, had been closed in eight states by noon Wednesday. Seventy-four of the schools were shuttered because of confirmed or suspected cases of swine flu. The remainder were closed as a precaution. About 44,000 of the affected students were in Texas, he said.

Among the new cases was a U.S. Marine stationed in Southern California.

-Gautam Naik, Mike Esterl and David Luhnow contributed to this article.

Write to Betsy McKay at betsy.mckay@wsj.com and Stephanie Simon at stephanie.simon@wsj.com

APRIL 30, 2009, 9:28 A.M. ET

Source: The Wall Street Journal

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