WHO close to raising alert to highest level for swine flu

The World Health Organization is inching closer to raising the infectious disease alert level for the novel H1N1 influenza outbreak to its highest level, indicating that a pandemic has arrived, but has delayed doing so in an effort to prepare national health organizations and populations for the impact of such an announcement, a top agency official said Tuesday in a telephone news conference.

The number of confirmed cases in Australia surpassed 1,200 on Monday, and the virus is no longer restricted to schools and other institutions there, suggesting that community-wide spread has begun.

Such a spread in two regions of the world -- it already has been observed in North America -- is the primary criterion for raising the alert level to Phase 6.

"One of the critical issues is that we do not want people to over-panic if they hear that we are in a pandemic situation," said Dr. Keiji Fukuda, assistant director general of WHO.

WHO officials worry that a pandemic declaration will lead people with mild illnesses to overwhelm emergency rooms.

"In earlier outbreaks, we have often seen that people who are in the category of being worried, but who are not particularly sick, have overrun hospitals," Fukuda said.

In the early stages of the current outbreak, he said, governments closed borders and issued travel restrictions. People stopped eating pork, pig herds were killed, and imports of pork were restricted by some countries.

"These are the kinds of potential adverse effects" that the agency is trying to avoid, he said.

Reporters pressed Fukuda about why, given the clear spread in Australia, the agency has not increased the alert level.

"We are really getting very close to that," he said. "We are working very hard to ensure that everyone is prepared for that."

In a separate talk with reporters, WHO Director-General Margaret Chan said she would confer with heads of governments around the world today to verify some of the reports the agency has received.

"Once I get indisputable evidence, I will make the announcement," she said.

In an effort to prevent overreaction to an increase in the alert level, the agency last week decided to divide Phase 6 into three tiers to indicate the severity of the pandemic. Barring changes in the next few days, the agency probably will indicate that the severity is at the lowest level when the alert stage is raised, indicating that the virus is spreading through populations, but that its effects remain relatively mild.