WHO: World In Post-Pandemic Period

 

# 4794

 

 

Almost 14 months after it was first declared, the first pandemic of the 21st century has been officially downgraded by the World Health Organization to a `post-pandemic’ status.

 

Here are excerpts from Director-General Margaret Chan’s prepared statement.

 

 

10 August 2010

H1N1 in post-pandemic period

To be checked against delivery

The world is no longer in phase 6 of influenza pandemic alert. We are now moving into the post-pandemic period. The new H1N1 virus has largely run its course.

 

Related links

Frequently asked questions

WHO recommendations for the post-pandemic period – Briefing Note # 23

 

These are the views of members of the Emergency Committee, which was convened earlier today by teleconference.

 

The Committee based its assessment on the global situation, as well as reports from several countries that are now experiencing influenza. I fully agree with the Committee’s advice.

 

As we enter the post-pandemic period, this does not mean that the H1N1 virus has gone away. Based on experience with past pandemics, we expect the H1N1 virus to take on the behaviour of a seasonal influenza virus and continue to circulate for some years to come.

 

In the post-pandemic period, localized outbreaks of different magnitude may show significant levels of H1N1 transmission. This is the situation we are observing right now in New Zealand, and may see elsewhere.

 

In fact, the actions of health authorities in New Zealand, and also in India, in terms of vigilance, quick detection and treatment, and recommended vaccination, provide a model of how other countries may need to respond in the immediate post-pandemic period.

 

Globally, the levels and patterns of H1N1 transmission now being seen differ significantly from what was observed during the pandemic. Out-of-season outbreaks are no longer being reported in either the northern or southern hemisphere. Influenza outbreaks, including those primarily caused by the H1N1 virus, show an intensity similar to that seen during seasonal epidemics.

 

During the pandemic, the H1N1 virus crowded out other influenza viruses to become the dominant virus. This is no longer the case. Many countries are reporting a mix of influenza viruses, again as is typically seen during seasonal epidemics.

 

Recently published studies indicate that 20–40% of populations in some areas have been infected by the H1N1 virus and thus have some level of protective immunity. Many countries report good vaccination coverage, especially in high-risk groups, and this coverage further increases community-wide immunity.

 

Pandemics, like the viruses that cause them, are unpredictable. So is the immediate post-pandemic period. There will be many questions, and we will have clear answers for only some. Continued vigilance is extremely important, and WHO has issued advice on recommended surveillance, vaccination, and clinical management during the post-pandemic period.

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WHO: H1N1 Remains A Pandemic

 

 

 

# 4618

 

 

After two days of delays and (presumably) deliberations, the World Health Organization announced this morning that the pandemic declared in June of 2009 continues, albeit at reduced intensity across most of the globe.

 

Countries are urged to `maintain vigilance concerning the pandemic, including all necessary public health measures for disease control as well as influenza virus and disease surveillance.’

 

The WHO advisory committee will revisit the question again in mid-July.

 

 

3 June 2010

Director-General statement following the eighth meeting of the Emergency Committee

The Emergency Committee held its eighth meeting by teleconference on 1 June 2010.

 

A global update was provided to the Committee on the pandemic situation, including a particular focus on developments in Africa and the Southern Hemisphere. The most active areas of pandemic influenza virus transmission are currently in tropical areas, primarily in parts of the Caribbean and Southeast Asia. These areas are now experiencing a relatively low level of resurgence of cases after experiencing more intense activity during July 2009.

 

In temperate zones of the Southern Hemisphere, countries are not reporting increases in influenza activity above epidemic thresholds, or unusually early influenza activity. Pandemic influenza activity across the African continent is low or sporadic; data from West Africa indicates that the active transmission of pandemic influenza virus has largely subsided after peaking during February and March 2010.

 

After extensive discussions and questions, the Committee expressed the unanimous view that from a global perspective while pandemic activity is continuing, the period of most intense pandemic activity appears likely to have passed for many parts of the world.

 

Committee members stressed that it remains critical for countries to continue to maintain vigilance concerning the pandemic, including all necessary public health measures for disease control as well as influenza virus and disease surveillance.

 

Following the advice of the Emergency Committee, the Director-General determined that while the period of most intense pandemic activity has passed, pandemic disease is expected to continue to occur and that a further meeting of the Emergency Committee to reassess the epidemiological situation would be convened by mid July 2010, when information from the winter influenza season in the Southern Hemisphere will be available.

 

On a separate issue, the Director-General noted that the secretariat is following the practice of the Organization for public disclosure of the names of the Emergency Committee members to take place once the work of the Committee had been completed. The purpose of this practice is to protect the integrity and independence of the Members while doing this critical work - but also to ensure transparency by publically providing the names of the members as well as information about any interest declared by them at the appropriate time. The Committee Members strongly concurred with this approach.

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WHO To Review Pandemic Status Tomorrow

 

 

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On June 1st the World Health Organization will convene a special teleconference with their influenza advisory committee to decide on the current status of the pandemic.   We should have some word later in the day as to what they decide.

 

Here is the Reuters report.

 

Experts to review status of flu pandemic on Tuesday

GENEVA

Mon May 31, 2010 2:23pm BST

GENEVA (Reuters) - An expert panel that advises the World Health Organization on pandemics will meet Tuesday to decide whether to declare the H1N1 flu outbreak over.

 

The WHO said in a statement Monday that its emergency committee will begin a teleconference at 1200 GMT Tuesday and results will be posted later in the day on its website.

 

Earlier this month, a WHO spokesman said the committee would consider three main options.

 

These would be to conclude that the pandemic was still in force and retain the WHO's current phase 6 on its 6-level pandemic scale; state that pandemic had moved into a transitional "post-peak" phase; or declare that the pandemic was over.

 

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WHO Statement On Pandemic Status

 

 

# 4376

 

 

Trying to second guess the course of a pandemic, particularly when our understanding of how the influenza virus works is (to put it kindly) incomplete, is a quick way to get egg on your face.  

 

While levels of novel H1N1 influenza in North America and Europe have declined dramatically over the past couple of months, and it looks like the pandemic of 2009 may have run its course, we’ve been fooled before.

 

NEJM 2009

 

The 1957 pandemic, for example, appeared to have run out of steam by the spring the following year - but roared back to life two years later, and then again 3 years after that.

Influenza is often full of surprises.

 

So one can understand why the WHO (World Health Organization) isn’t particularly anxious to declare the pandemic of 2009 as being over.  

 

With rising levels of immunity in the developed world (from exposure and/or vaccination), it would be a bit surprising to see another major wave of illness in North America or Europe.   

 

Surprising, but not impossible.

 

And many parts of the world have no access to vaccine, and immunity levels remain relatively low. 

 

There also remains the possibility that the virus will pick up antigenic changes that would allow it to evade existing immunity – something that could spark a new round of illness.

 

So one can understand the reluctance of scientists to declare that this pandemic has peaked.

 

Although the WHO telegraphed their intentions not to roll back the pandemic phase last night, this morning they’ve released an official statement.     

 

They will revisit the issue again in a few weeks.

 

 

24 February 2010

Director-General statement following the seventh meeting of the Emergency Committee

The Emergency Committee held its seventh meeting by teleconference on 23 February 2010. The Director-General sought the Committee's views on the determination of the pandemic status.

 

A detailed update was provided to the Committee on the global pandemic situation. After asking additional questions and reviewing the evidence and holding extensive discussion, the Committee was of the view that there was mixed evidence showing declining or low pandemic activity in many countries, but new community level transmission activity in West Africa. Moreover, they expressed concern that the winter months of the Southern Hemisphere had not yet started and there was uncertainty whether additional generalized waves of activity might occur and the need to not undermine preparations. The Committee advised that it was premature to conclude that all parts of the world have experienced peak transmission of the H1N1 pandemic influenza and that additional time and information was needed to provide expert advice on the status of the pandemic. The Committee accordingly suggested that the Committee be re-convened in a few weeks to review intervening developments and related epidemiological information.

 

Having considered these views, the current epidemiological evidence and other relevant information, the Director-General determined that there had been no change in the pandemic phase, and decided to continue to monitor the situation and developments closely and to convene the Committee again within the next several weeks.

 

The WHO Director-General asked the Committee for their views on continuance of the three current temporary IHR recommendations issued for the public health emergency of international concern. The consensus view of the Committee was in favor of continuation but to update the second recommendation by replacing "Intensify" with "Maintain" in recognition of the increased pandemic surveillance already implemented by countries and the need to maintain this activity. Having considered the views of the Emergency Committee, and the ongoing pandemic situation, the Director-General determined to continue the three temporary recommendations, as modified, namely:

• countries should not close borders or restrict international traffic and trade;
• maintain surveillance of unusual flu-like illness & severe pneumonia;
• if ill, it is prudent to delay travel.

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