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WHO official predicts highest-level flu warning

Phase 6 invoked during sustained virus transmission

Although the pace of new H1N1 infections seemingly slowed on Saturday – with a total of 195 cases reported in the United States and 793 worldwide – 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,” Michael Ryan, the agency’s director of global alert and response, said in a Geneva news conference.

“We have to expect that Phase 6 will be reached; we have to hope that it is not,” he said.

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.

“Is it stabilizing or not? I think it is too early to say,” said Dr. Steve Waterman of the U.S. Centers for Disease Control and Prevention. “But I think we are getting systems in place where we are going to be able to get a handle on this soon.”

On Monday, the WHO 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 U.S. 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 wake-up 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.

Worldwide, Italy confirmed its first case of the disease, and Ireland confirmed its first case. Costa Rica also confirmed a case, the first in the Caribbean outside Mexico.


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