Hold The Panic: Swine Flu Falls Short Of Pandemic

Why has the World Health Organization decided not to call the swine flu a pandemic, even though more than three weeks ago it declared that a pandemic was "imminent?"

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From NPR News, this is WEEKEND EDITION. I'm Liane Hansen.

The World Health Organization has decided not to call swine flu a pandemic, even though many say that outbreaks in 42 countries meet that definition. More than three weeks ago, the organization had declared that a pandemic was imminent.

NPR's Richard Knox explains what happened.

RICHARD KNOX: The turning point came in Japan. Last weekend swine flu was diagnosed there in four school girls who brought the virus home from a trip to Canada. By week's end, there were at least 300 cases. Japanese officials talked about widespread infection in three areas of the country.

Peter Cordingley of the WHO is watching the situation from the agency's regional office in Manila.

Mr. PETER CORDINGLEY (World Health Organization): There's a good chance that what's going on in Japan is basically silent transmission - people are spreading the virus without even knowing that they're sick.

KNOX: But at headquarters in Geneva, WHO officials were resisting any notion that swine flu was spreading widely outside of North America. That would've forced the agency either to acknowledge a pandemic had started, or abandoned its carefully worked out definition of a flu pandemic. Cordingley sees the situation very differently.

Mr. CORDINGLEY: There's nowhere that should assume that it's safe from this virus. It's a flu virus. It's unstoppable once it's out of the bottle and that's what's going to happen. But it's not the Armageddon that some people are describing.

KNOX: And that's the rub. Everybody in WHO thought the next pandemic would be caused by a very different virus. On Friday, WHO Director-General Margaret Chan addressed the closing session of the annual World Health Assembly.

Dr. MARGARET CHAN (Director-General, World Health Organization): We were expecting and fearing that the highly lethal H5N1, avian virus, would spark the next pandemic.

KNOX: The deadly bird flu virus that's occasionally infected people over the past several years, killed 60 percent of its victims. If the new swine flu virus were that deadly, the world would've counted thousands of deaths by now, maybe tens of thousands, instead of the current total, 86. Chan says the swine flu bug is more insidious.

Dr. CHAN: This is a subtle sneaky virus. It does not announce its presence or arrival in a new country with a sudden explosion of patients seeking medical care or requiring hospitalization.

KNOX: But as it circulates in people around the globe, it could become more dangerous. Chan says there's little doubt the new virus will spread within the countries already infected and beyond. But she's not going to declare pandemic any time soon. In other words, the WHO is junking its old definition of a pandemic.

At a press briefing on Friday, Dr. Keiji Fukuda, WHO's chief flu expert, said the organization's member states basically said, don't do this to us. That is, don't go up to Phase 6, a pandemic.

Dr. KEIJI FUKUDA (Chief Flu Expert, World Health Organization): What the countries said is that we are concerned that if we go to a Phase 6, the message to our population will be you should be very afraid. Whereas, in fact, we think that it indicates that the virus is spreading out, but the level of fear should not go up and there should not be an increase in anxiety.

KNOX: Fukuda says WHO will draw up a new definition of a pandemic. It won't be based just on the geographic spread of flu, like the current one, but also on its severity. He wouldn't say how long that will take.

Meanwhile, preparations continue. Drug companies are gearing up to turn out a vaccine against the new flu. Policymakers will have to decide whether to use it. By next fall, the world may know if swine flu is going to cause the next pandemic by the new definition.

Richard Knox, NPR News.

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