WHO advisors still waiting for clear pandemic flu signals

Jul 21, 2010 (CIDRAP News) – Amid media reports that the World Health Organization (WHO) might be on the verge of setting a date to discuss a step-down in the pandemic alert level, the agency said today that it's too early to determine if tropical and Southern Hemisphere countries have transitioned to normal seasonal flu patterns.

The WHO said it is in close touch with public health authorities in countries across the world to gauge current flu trends, which indicate that influenza activity is low in temperate regions of the Southern Hemisphere, currently in the midst of its normal winter flu season. Health officials are reporting a mix of flu strains, including pandemic H1N1, influenza A (H3N1), and influenza B, the WHO said, adding that severe illnesses and deaths have been reported in countries where the pandemic H1N1 virus is prevalent.

Active transmission of the pandemic virus also persists in some tropical areas, such as South and Southeast Asia, the Caribbean, Central America, and West Africa, the WHO said.

Earlier this week Bloomberg News reported that the WHO Emergency Committee, a group that advises the WHO on pandemic-phase issues, might meet next week to review the latest data and advise a shift to the post-peak pandemic phase. The report cited unnamed sources familiar with the emergency committee. However, a WHO spokesman said the WHO had not set a date for an announcement.

According to Australia's most recent flu surveillance report, for the week ending Jul 9, some surveillance systems and labs showed signs of increasing flu activity. Most of the confirmed influenza cases were the pandemic H1N1 virus, though H3N2 is circulating as well. Two hospitalizations and three intensive care unit (ICU) admissions were reported.

Meanwhile, New Zealand's health ministry said in a Jul 16 update that two pandemic H1N1 deaths have been reported so far and that doctor's visits for flu-like illnesses are slowly rising.

Several states in India are reporting fresh outbreaks of pandemic flu, including several deaths, according to media reports. For example, health authorities in Andhra Pradesh state yesterday confirmed that three women recently died of pandemic flu, The Hindu reported today. Another Indian newspaper reported the first pandemic flu death in West Bengal state, in a man who had been undergoing cancer treatment.

Health officials in India have said recent monsoon rains have contributed to a surge in pandemic flu activity, with Kerala, Maharashtra, Karnataka, and Andhra Pradesh as the hardest-hit areas.

In Central America, flu activity is widespread in Costa Rica and Panama, with regional activity reported in Nicaragua, according to a Jul 19 update from the Pan American Health Organization (PAHO). The pandemic H1N1 virus is dominant in Costa Rica, while seasonal H3N2 is more common in Panama and Nicaragua.

The WHO's emergency committee has met eight times since the pandemic virus emerged. At its last meeting, in early June, it advised holding at the current pandemic alert level, based on recurring but low-level activity in come parts of the world and an unclear picture of how the Southern Hemisphere's flu season was unfolding. At the time, WHO Director-General Margaret Chan said the committee would meet again in mid July to reassess the epidemiologic status of the flu pandemic.

See also:

Jul 21 WHO briefing note

Jul 15 New Zealand health ministry flu update

Jul 19 PAHO influenza update

Jun 3 CIDRAP News story "WHO advisors again hold at current pandemic phase"

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