Although the pace of new H1N1 infections seemingly slowed Saturday -- with a total of 195 cases now reported in the United States and 793 worldwide, and a few even turning up in pigs -- a World Health Organization official said he thought that the agency's infectious disease alert level ultimately would be raised to its highest point.
"At the present time, I would still propose that a pandemic is imminent because we are seeing the disease spread," said Michael Ryan, the agency's director of global alert and response, at a Geneva news conference. "We have to expect that Phase 6 will be reached; we have to hope that it is not."
The level will be raised when the agency sees evidence of sustained person-to-person transmission of the virus outside North America. So far, he emphasized, that has not occurred, with the exception of a handful of cases.
On Monday, the agency raised the alert level to Phase 4 from the normal Phase 3, a sign that a pandemic was imminent or inevitable. The triggering event for the increase was the sustained transmission of the virus in two countries, the United States and Mexico.
That increase had little effect on industrialized countries, which already were making extensive preparations to combat an outbreak of the disease, unofficially known as swine flu. But it was viewed as a call to less-developed countries to step up their planning.
On Wednesday, the WHO raised the alert level to Phase 5.
Ryan said the WHO would send 72 developing countries 2.4 million courses of the antiviral agent Tamiflu from its emergency stockpile. The drug's manufacturer, Roche, said that it would send an additional 3 million doses and that it was scaling up production of the drug.
The latest U.S. count includes six new cases in California, bringing the total to 24. The count also includes 12 new cases in New York, two in Florida, and one each in Connecticut, Missouri, Utah, New Hampshire and Rhode Island, the first cases in those states.
Ryan said that about one-third of U.S. cases resulted from people visiting Mexico. The rest contracted it through human-to-human transmission locally.
Worldwide, Italy confirmed its first H1N1 case in a man who recently returned from Mexico, and Ireland confirmed its first case. Costa Rica also confirmed a case, the first in the Caribbean outside Mexico.
