Phase Description
1 No new influenza virus subtypes have been detected in humans. An influenza virus subtype that has caused human infection may be present in animals. If present in animals, the risk of human infection or disease is considered to be low.
2 No new influenza virus subtypes have been detected in humans. However, a circulating animal influenza virus subtype poses a substantial risk of human disease.
Pandemic alert phase
3 Human infection(s) with a new subtype but no human-to-human spread, or at most rare instances of spread to a close contact.
4 Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.
5 Larger cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming increasingly better adapted to humans but may not yet be fully transmissible (substantial pandemic risk).
Pandemic period
6 Pandemic: increased and sustained transmission in general population.
The
World Health Organisation warned a global swine flu pandemic was imminent as it raised the global alert level on Wednesday to five out of six.
By Thursday morning, 236 cases had been confirmed worldwide, said Keiji Fukuda, the WHO’s assistant director general in charge of tackling the crisis. The disease has hit at least 13 countries, but Mexico remained the epicentre of the outbreak.
Margaret Chan, the WHO director-general, said anti-flu measures must now be undertaken with increased urgency. “All countries should immediately now activate their pandemic preparedness plans,” she told reporters in Geneva. “It really is all of humanity that is under threat in a pandemic.”
The phase five alert means that a pandemic is imminent and the disease can be spread from humans to humans in a sustainable manner.
The move came after the US reported the first death from the disease outside
Mexico, where the new virus has killed up to 176 people though only a handful have been confirmed as stemming from infection.
Switzerland became the most recent country to confirm a case, saying a man returning from Mexico had tested positive. A three-year-old child in the Netherlands was also infected, while closer to Mexico, Costa Rica and Peru also reported cases. The US Centers for Disease Control and Prevention confirmed 109 cases in the US on Thursday.
Following the WHO’s Wednesday announcement, Felipe Calderon, the Mexican president, ordered government offices and private businesses not crucial to the economy to stop work for five days from Friday to avoid further infections.
”There is no safer place than your own home to avoid being infected with the flu virus,” Mr Calderon said in his first televised address since the crisis erupted last week.
Mexico’s peso currency weakened sharply early on Thursday in response, falling 1.6 percent to 13.83 per dollar, but world stocks, powered by gains in Asia on Thursday, struck a four-month peak after the outbreak initially weighed on markets.
Texas health officials said a 23-month-old child on a visit from Mexico had died from the disease in a Houston hospital.
Rick Perry, Texas governor, issued a disaster proclamation for the state which has 16 cases of the disease. He said closing the Mexican border was an option but would be premature.
Ms Chan said: “The world is better prepared for an influenza pandemic than at any time in history.”
Speaking shortly before Ms Chan’s announcement in Geneva, Janet Napolitano, US homeland security secretary, said: “We’ve been preparing all along as if this is going to be stage 6. We are preparing for the worst and hoping for the best.”
The WHO said the new flu strain appeared to be spreading from person to person, with its dissemination exacerbated by international travel.
France said it would seek European Union support for a continent-wide ban on flights to Mexico. The EU, US and Canada have already advised against non-essential travel to Mexico.
Mr Fukuda, the WHO’s assistant director-general, said earlier that analysis showed, “this was a new swine influenza virus behaving like a human virus”. He noted that most cases outside Mexico had so far been mild.
Before the Texas death, all deaths had been confined to Mexico, where 159 may have died from the disease, although only seven cases have been confirmed as resulting from the new flu strain.
US authorities extended the availability of anti-viral drugs and released 12m doses of the Tamiflu drug from federal stockpiles, as health officials reported the number of confirmed US cases had risen from 64 to 91 in New York and nine other states.
Egypt began a precautionary cull of the country’s 300,000 pigs, a move described by the UN’s Food and Agriculture Organisation as “a real mistake”. Russia and China have banned US pork products, although Mr Fukuda repeated on Wednesday there was no evidence that people were being infected by exposure to pigs.
In Mexico, schools were also suspended until May 6 and the government assumed new powers to isolate infected people.
As companies worldwide stepped up precautions to protect employees, Patricia Espinosa, Mexican foreign minister, called at the United Nations Security Council for all countries to work together to respond to the crisis.
The southern African regional bloc is holding talks with WHO about increasing its stocks of drugs to treat swine flu, Barbara Hogan, South Africa’s health minister, said on Thursday, after the country reported the continent’s first two suspected cases of the virus.
”We have no confirmed cases of swine flu in the country yet [but] we have everything on high alert,” Ms Hogan told local radio.
additional reporting from Tom Burgis
Copyright The Financial Times Limited 2009
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