On June 11, 2009, WHO declared an influenza pandemic, officially moving to phase 6, the highest level in the pandemic alert scale.
What does this mean?
The declaration of a pandemic was based on the continued spread of the novel H1N1 flu virus strain from person-to-person in multiple countries across the globe. We expect to see more outbreaks, especially in the southern hemisphere where the flu season is beginning. A WHO pandemic declaration means that further spread of this virus is likely and that accelerated preparedness and vigilance are critical. It does not mean that outbreaks in your country or community are imminent.
How severe will the pandemic be?
Currently, WHO is referring to this pandemic as “moderate.”
So far, the H1N1 virus is causing mostly mild illness – similar to that experienced during annual seasonal influenza. Because flu viruses can change (“mutate”), health officials will be carefully watching the situation, assessing who becomes ill and how serious that illness is. While the severity of illness in past pandemics has varied, two characteristics that have been constant among the three 20th century pandemics are: 1) a much greater number of people will become infected than with seasonal influenza, and 2) previously healthy people and young adults are at risk for developing severe illness, something we rarely see in seasonal flu.
Does a pandemic declaration mean that travel will be restricted?
WHO is not recommending any restrictions on travel and is unlikely to do so. Travelers should be alert to where outbreaks are occurring and take appropriate precautions (see previous communications).
When are outbreaks likely to occur in my country or community?
The spread of the new H1N1 influenza virus cannot be predicted with any certainty. Nevertheless, experience in past pandemics and seasonal influenza may give us clues. Influenza infections occur at a low level across the globe throughout the entire year. Small outbreaks may occur at any time if someone who is infected comes in very close contact with others (e.g., at a camp, on a cruise ship). In temperate regions, influenza outbreaks are defined by cycles or seasons. Flu activity usually increases during the colder months in these temperate climates. Outbreaks also occur in tropical regions, though seasonality is less defined. The seasonality of flu is related to the virus itself, the host, and the environment. Flu viruses survive less well at higher temperature and humidity. Seasonal variations in human behaviors, such as greater crowding indoors or at school may also play a role in flu seasonality.
Over the next few months, we will keep a close eye on the level of activity and the severity of the new H1N1 infections in the southern hemisphere, as these regions go into their colder months. This will provide more information about the virus in general while also helping countries in the northern hemisphere understand what they might expect during their own flu season.
What does a pandemic declaration mean for me?
Whether or not pandemic infection has been recognized in your country or community, now is the time to practice good hygiene that will decrease risk of pandemic infection if, or more likely when, illness occurs in your area. Be alert to information and recommendations from your national or local public health officials. Recommended actions will depend on whether pandemic infections are occurring locally, the extent and severity of disease, and other factors.
In the workplace, it is important to increase sanitation and hygiene (recommendations and posters can be found in the left-hand column under the section entitled "Staff Safety and Security") and to re-emphasize that employees who are sick should stay home and not come to work.
CDC is recommending that people who have underlying health conditions and develop flu like symptoms (fever and cough) seek care. Common underlying health conditions seen in severe cases in the United States include: asthma, heart disease, lung disease, diabetes, HIV/AIDS, autoimmune diseases, pregnancy and possibly others.
CDC is also recommending seeking care for children under two years of age who become ill with flu like symptoms (fever and cough).
What actions should CARE offices take to prepare?
We now have an important window of opportunity to prepare.
1) Internal preparedness planning - Country Offices should consider what measures they would take during a pandemic. How would the CO plan to operate? How can the CO ensure staff safety? How will communications be handled? How will essential business continuity issues be addressed?
2) Programmatic preparedness to respond to the emergency – For country offices that have the capacity to assist with preparedness activities and/or to respond to humanitarian needs during a pandemic, we have an excellent set of global materials for working at the national, district and community level. The materials are available in the left-hand column under the section entitled "Pandemic Preparedness" and at the Humanitarian Pandemic Preparedness website: http://www.pandemicpreparedness.org .
If your country office has questions about preparedness and would like the flu team to review your preparedness plans, please email AvianFluWG@CARE.org .