With high infections in some countries, too early to declare H1N1 pandemic over – UN

With continued elevated levels of H1N1 flu in a number of countries, it remains too early to say that the pandemic is over, a top United Nations health official said today in the first major assessment of the new year.

“The most intense pandemic activity continues to be in a couple of places in the world such as North Africa, in Southern Asia and then in parts of East and South-east Europe,” UN World Health Organization (WHO) Special Adviser on Pandemic Influenza Keiji Fukuda told a news briefing in Geneva.

“In other parts of the world, we see that activity is declining or has declined but we also continue to see in these areas a transmission of the virus, so it is not disappeared, and it is has not gone back to baseline,” he added, stressing that it is still unclear whether another significant wave will occur in the northern hemisphere during its winter and spring period, or what will happen in the southern hemisphere during its winter months.

Last month, WHO Director-General Margaret Chan said H1N1 might not be conquered until 2011.

Dr. Fukuda strenuously rebutted “misconceptions circuiting among the media” that H1N1 flu was not a pandemic or that WHO had overplay its severity. “The allegation by some, that the H1N1 pandemic is a fake is both scientifically wrong and historically inaccurate,” he said.

“At the most conservative count that we have, we estimate, we believe, or we know that about 13,000 people had been killed directly by this virus. When final estimates are made, for the world, at some point in the future, we anticipate that these figures will be much larger that what we see now.”

Likewise the agency had not overplayed the pandemic’s significance. “From the very beginning WHO has gone out of its way to let everybody know that the future course of the pandemic was uncertain, that we did not have a crystal ball,” he said. “Given this reality there's no health authority, including WHO, which can afford to sit back before making decisions.”

Asked about countries which now have an excess of the vaccine they have bought – Spain, for example, bought 37 million doses of vaccines of which only 13 million have been used – Dr. Fukuda said WHO was not involved in such decisions, but added that it was impossible to second guess them.

“At the beginning of the pandemic and during much of the pandemic, it was really not clear what the ultimate impact of the pandemic would be, how many people might die, how many people might suffer serious illnesses from it and so on. And in that kind of uncertainty, the health authorities still had to go ahead and make decisions about what to buy,” he stressed.

“I want to point out that the pandemic continues. If the pandemic virus changes and we begin to see much more serious illness from infections, it is quite possible that countries will also be asked why they did not buy more vaccines.”

Asked whether the current moderate nature of the disease could lead to a backlash that might harm future efforts to prepare for flu pandemics, Dr. Fukuda cited misinformation and misperceptions about what was done as the greatest danger.

“What health authorities, including WHO, most strongly hold forth as the most important goal is to make sure that everything can be done to protect people from harm,” he said. “So in this situation, I think that this is an application of the so-called precautionary principle: prepare for the worst and hope for the best.”