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WHO designates pandemic alert on swine flu

Sharp rise in global cases triggers move

An Egyptian woman wore a surgical mask as another covered her nose in Cairo's underground yesterday. An Egyptian woman wore a surgical mask as another covered her nose in Cairo's underground yesterday. (Eman Helal/Associated Press)
By Nick Cumming-Bruce and Andrew Jacobs
New York Times / June 12, 2009
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GENEVA - The World Health Organization raised its alert on swine flu to the highest level yesterday, in its first designation of a global pandemic in 41 years.

Calling further spread of the virus "inevitable," the organization's director general, Margaret Chan, said, "We are at the earliest days of a global pandemic." The new H1N1 strain, she said, is "spreading easily from one person to another, and from one country to another" in more than one region of the world.

Meanwhile, Swiss pharmaceuticals company Novartis AG said today that it has successfully produced a first batch of swine flu vaccine weeks ahead of expectations.

The vaccine was made in cells, rather than grown in eggs as is usually the case with vaccines, the company said.

Chan said the current pandemic is "moderate" in severity, with the overwhelming majority of patients experiencing only mild symptoms and a full recovery, often in the absence of any medical treatment. And scientists are painstakingly tracking its every movement.

"The virus is spreading under a close and careful watch," Chan said. "No previous pandemic has been detected so early or watched so closely."

The heightened alert came after an emergency meeting with flu specialists here that was convened after a sharp rise in cases in Australia, which reported 1,263 cases yesterday, and rising numbers in Britain, Japan, Chile, and elsewhere. The declaration will trigger drug makers to speed production of a swine flu vaccine - expected to take a minimum of four to six months - and prompt governments to devote more money to containing the virus.

In the United States, while swine flu appears to be abating in many states, the virus is causing an increasing level of respiratory illness in New England and elsewhere in the Northeast, federal disease trackers said yesterday.

The new leader of the US Centers for Disease Control and Prevention, Dr. Thomas Frieden, said it was unclear why the Northeast was experiencing a higher level of transmission.

"Influenza is one of - if not the most - unpredictable infectious diseases," said Frieden, formerly the top health officer in New York City.

As of yesterday, 1,153 cases of the disease had been confirmed through laboratory testing in Massachusetts, although disease specialists said they suspect that is only a small fraction of the total.

So far, 80 patients have been so ill they needed to spend at least one night in a hospital. More than three-fourths of the confirmed cases in the state have been reported in children and young adults.

As the disease moves into the developing world, where rates of chronic disease are high and health systems typically poor, Chan said, "it is prudent to anticipate a bleaker picture"

The virus itself may also change quickly, becoming more lethal, she said, and even those nations that have already experienced a rash of cases "should prepare for a second wave."

"The virus writes the rules, and this one, like all influenza viruses, can change the rules without any rhyme or reason," Chan said.

Unlike seasonal flus, which have taken their highest toll on the very young and the very old, Chan said, most severe cases of the new H1N1 virus have involved people between the ages of 30 and 50, while overall, the majority of all infections have occurred in people under 25.

Some 2 percent of infections, Chan said, have resulted in severe illness, with rapid progression to pneumonia.

Based on preliminary data, asthma, cardiovascular disease, autoimmune disorders, and obesity are the underlying conditions that seem to put people at greater risk.

Pregnant women are also at heightened risk, a particular concern for the developing world, Chan said, which already reports 99 percent of maternal childbirth deaths worldwide.

Stephen Smith of the Globe staff contributed to this report.