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Today, the World Health Organization declared a swine flu pandemic. It is the first pandemic since the relatively mild Hong Kong flu in 1968. Most people who've contracted swine flu have recovered without problems, but the WHO says it would be a mistake to conclude this pandemic will turn out to be mild. NPR's Richard Knox has our story.

RICHARD KNOX: The formal declaration was widely expected. Still, it had a momentous feel. WHO Director-General Margaret Chan made the announcement at a Geneva press conference.

Dr. MARGARET CHAN (Director-General, World Health Organization): The world is now at the start of the 2009 influenza pandemic. We are in the earliest days of the pandemic. The virus is spreading under a close and careful watch.

KNOX: But that doesn't mean the smartest flu experts in the world can predict what will happen as the virus circulates among millions of people over the next few months.

Dr. CHAN: The virus writes the rules. And this one, like all influenza viruses, can change the rules without rhyme or reason at any time.

KNOX: The decision to declare a pandemic has tortured the WHO for seven weeks, ever since Chan announced that a flu pandemic is imminent. Over that time, the new H1N1 virus has spread to 74 countries. The WHO has recorded nearly 30,000 infections and 141 deaths. But the real number of cases may have reached over a half million. The number of cases and deaths can be misleading, Chan said during an earlier briefing for science reporters.

Dr. CHAN: People will say, so? What's the big deal about pandemic? So they have the tendency to go into complacency. The balance between overreaction or complacency is also another issue of great concern to WHO.

KNOX: She points out that this virus disproportionately affects young and middle-aged adults, and is especially dangerous for pregnant women. Others at high risk are people with asthma, immune deficiencies like AIDS and those with heart disease. And there are many more of those people in the world than there were when earlier flu pandemics hit. Dr. Arnold Monto of the University of Michigan says experts are concerned the world may face both seasonal flu and the pandemic strain in the months ahead.

Dr. ARNOLD MONTO (University of Michigan): We worry that we may have a one-two punch in the fall and into the winter: first, the H1N1 coming back in force, and then some seasonal strains occurring. So we want to be able to take care of all of that.

KNOX: Dr. Anne Schuchat of the Centers for Disease Control and Prevention says her agency expects to recommend vaccination against seasonal flu this fall and possibly the pandemic strain, as well.

Dr. ANNE SCHUCHAT (Centers for Disease Control and Prevention): I think we need to be prepared for a lot of illness in the fall or winter, and we also need to be prepared for things to be even worse than they are.

KNOX: So it appears the pandemic declaration is only the end of the beginning in the story of this new flu.

Richard Knox, NPR News.

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