Global Health Officials Warn Flu Still Spreading

The World Health Organization is telling everyone to brace for the next flu pandemic. The WHO cites a steady increase in the number of people in nine countries who have fallen ill from a new virus that started in pigs and jumped to humans. The fast-moving virus has leaders all over the world struggling to find the right balance between preparedness and alarm.

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RENEE MONTAGNE, host:

The big question for the rest of the world is how far the virus will spread. The World Health Organization is telling us to brace for a flu pandemic. Political leaders are working to find the right balance between preparedness and alarm.

NPR's Richard Knox reports.

RICHARD KNOX: It was the first item of business at President Obama's press conference last night. He struck a measured tone.

President BARACK OBAMA: The most important thing right now that public health officials have indicated is that we treat this the same way that we would treat other flu outbreaks, just understanding that because this is a new strain, we don't yet know how it will respond. So, we have to take additional precautions, essentially take out some additional insurance.

KNOX: The president put aside the possibility of trying to seal the nation's border with Mexico.

Pres. OBAMA: It would be akin to closing the barn door after the horses are out, because we already have cases here in the United States.

KNOX: But he did prepare Americans for a fair amount of disruption in the days and weeks ahead as new cases of swine flu emerge.

Pres. OBAMA: Our public health officials have recommended that schools with confirmed or suspected cases of this flu strongly consider temporarily closing. And if more schools are forced to close, we recommended that both parents and businesses think about contingency plans if their children do have to stay home.

KNOX: In Geneva, the director-general of the WHO, Margaret Chan, urged all governments to activate their pandemic preparedness plans and be ready for the unexpected.

Ms. MARGARET CHAN (Director-General, WHO): Pandemic virus is precarious, unpredictable and will take us by surprise.

KNOX: Chan decided to raise the pandemic alert from Phase 4 to Phase 5. There's only one more step, an outright pandemic. It was only Monday that WHO declared a Phase 4 alert. Chan's latest decision took many public health officials by surprise. One California health official, who said she wasn't authorized to speak publicly, said she didn't think anyone expected the WHO to go from Phase 3 to Phase 5 in 48 hours.

The WHO was expected to make the decision this morning but instead announced it at a late evening press conference last night. Chan did not explain the factors that led to her decision.

During a media briefing just a few hours before her announcement, her chief flu advisor, Dr. Keiji Fukuda, said WHO would wait until it saw evidence that the swine flu virus was causing illness in widely scattered communities.

Dr. KEIJI FUKUDA (Chief Flu Advisor, WHO): What we are also looking for is whether we are seeing transmission of this virus out in the community itself, in neighborhoods, among ordinary people who are just going around.

KNOX: But apparently that's not what's happening in the United States. Ira Longini of the University of Washington is collecting data on U.S. outbreaks.

Mr. IRA LONGINI (University of Washington): We are now seeing community-wide transmissions. Those would be contacts in casual settings, such as subways or movie houses or restaurants or places where people come close to one another but don't spend a lot of time together.

KNOX: Longini says all the U.S. cases of swine flu so far involve someone who was infected in Mexico who then infected close contacts in schools or their own families, not casual contacts. Fukuda of the WHO says the agency expects swine flu to become pandemic.

U.S. health officials were a little more circumspect. Dr. Dan Jernigan is deputy director of the Influenza Division at the Centers for Disease Control and Prevention.

Dr. DAN JERNIGAN (Deputy Director, Influenza Division, Centers for Disease Control and Prevention): Phase 5 means that it is very likely that this will continue to spread from person to person and likely to become a new influenza virus that becomes circulating in the population.

KNOX: That does sound as scary as a pandemic, but the virus may become more dangerous as it circulates and reemerge as something different next fall. Meanwhile, President Obama dispensed some advice that jittery Americans are going to hear a lot of in the coming weeks and months - wash your hands frequently, cover your cough and stay home if you're feeling fluish.

Pres. OBAMA: I know it sounds trivial, but it makes a huge difference.

KNOX: Richard Knox, NPR News.

MONTAGNE: We'll be updating the flu story throughout the day on our new blog, FluShots@npr.org. You'll also find an interactive map tracking swine flu outbreaks here in the U.S. and around the world.

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