Margaret Chan , Director-General of WHO , World Health Organization on June 11 , 2009 Press Conference:
“ Ladies and Gentlemen – In late April, WHO announced the emergence of a novel influenza A virus. This particular H1N1 strain has not circulated previously in humans. The virus is entirely new.
The Virus is Contagious – spreading easily from one person to another – and from one country to another. As of today, nearly 30,000 confirmed cases have been reported in 74 countries and can no longer be traced to clearly-defined chains of human-to-human transmission. Further spread is considered Inevitable.
I have conferred with leading influenza experts , virologists and public health officials. In line with procedures set out in the International Health Regulations, I have sought guidance and advice from an Emergency Committee established for this purpose. On the basis of available evidence, and these expert assessments of the evidence, the scientific criteria for an influenza pandemic have been met.
I have therefore decided to raise the level of Influenza Pandemic alert from phase 5 to Phase 6.
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. No previous pandemic has been detected so early or watched so closely in real time – right at the very beginning. The world can now reap the benefits of investments over the past five years in pandemic preparedness.
We have a head start. This places us in a strong position. But it also creates a demand for advice and reassurance in the midst of limited data and considerable scientific uncertainty. Thanks to close monitoring , thorough investigations and frank reporting from countries – we have some early snapshots depicting spread of the virus and the range of illness it can cause.
We know too that this early picture can change very quickly. The virus writes the rules and this one , like all influenza viruses , can change the rules – without rhyme or reason – at any time.
Globally – we have good reason to believe that this pandemic , at least in its early days , will be of moderate severity. As we know from experience , severity can vary, depending on many factors – from one country to another.
On present evidence , the overwhelming majority of patients experience mild symptoms and make a rapid and full recovery – often in the absence of any form of medical treatment.
Worldwide , the number of deaths is small. Each and every one of these deaths is tragic , and we have to brace ourselves to see more. However, we do not expect to see a sudden and dramatic jump in the number of severe or fatal infections.
We know that the novel H1N1 virus preferentially infects younger people. In nearly all areas with large and sustained outbreaks , the majority of cases have occurred in people under the age of 25 years. In some of these countries , around 2% of cases have developed severe illness , often with very rapid progression to life-threatening pneumonia.
Most cases of severe and Fatal Infections have been in adults between the ages of 30 and 50 years.
This pattern is significantly different from that seen during epidemics of seasonal influenza , when most deaths occur in frail elderly people. Many severe cases have occurred in people with underlying chronic conditions. Based on preliminary data – conditions most frequently seen include respiratory diseases, notably asthma, cardiovascular disease, diabetes, autoimmune disorders, and obesity.
It is important to note that around one third to half of the severe and fatal infections are occurring in previously healthy young or middle-aged people.
Without question – Pregnant Women are at increased risk of complications. This heightened risk takes on added importance for a virus like this one – that preferentially infects younger age groups.
Finally, and perhaps of greatest concern, we do not know how this virus will behave under conditions typically found in the developing world. To date , the vast majority of cases have been detected and investigated in comparatively well-off countries.
85% of the burden of chronic diseases is concentrated in low- and middle-income countries. Although the pandemic appears to have moderate severity in comparatively well-off countries , it is prudent to anticipate a bleaker picture as the virus spreads to areas with limited resources , poor health care and a high prevalence of underlying health problems.
A characteristic feature of pandemics is their rapid spread to all parts of the world. In the previous century , this spread has typically taken around 6 to 9 months , when most international travel was by ship or rail.
Countries should prepare to see cases – or the further spread of cases , in the near future. Countries where outbreaks appear to have peaked should prepare for a second wave of infection. Guidance on specific protective and precautionary measures has been sent to ministries of health in all countries.
WHO has been in close dialogue with influenza vaccine manufacturers. I understand that production of vaccines for seasonal influenza will be completed soon. Full capacity will be available to ensure the largest possible supply of pandemic vaccine in the months to come.
Pending the availability of vaccines , several non-pharmaceutical interventions can confer some protection. WHO continues to recommend no restrictions on travel and no border closures.
Influenza pandemics are remarkable events because of the almost universal susceptibility of the world’s population to infection.We are all in this together, and we will all get through this , together. Thank you. ”