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Thursday, August 12, 2010


A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases

Date: Tue 10 Aug 2010
Source: CIDRAP (Center for Infectious Disease Research & Policy) News [edited]

WHO says H1N1 pandemic is over
The head of the World Health Organization (WHO) today [10 Aug 2010]
declared the H1N1 influenza pandemic over, saying worldwide flu activity
has returned to typical seasonal patterns and many people have immunity to
the virus.

"The world is no longer in phase 6 of influenza pandemic alert," said WHO
director-general Margaret Chan in a press briefing from Hong Kong. "We are
now moving into the post-pandemic period. The H1N1 virus has largely run
its course." But she cautioned that the virus has not gone away and bears
continued watching, commenting, "We expect the H1N1 virus to take on the
behavior of a seasonal influenza virus and continue to circulate for some
years to come."

WHO's Emergency Committee met earlier today [10 Aug 2010] and recommended
that the agency move to the post-pandemic phase, Chan said, adding that she
fully supports the step. The declaration comes almost exactly 14 months
after WHO moved to a full phase 6 pandemic alert on 11 Jun 2009, and about
1.5 months after US health officials called off their public health
emergency declaration on 23 Jun 2010. Many had expected WHO to take the
step months ago, but the Emergency Committee said in June 2010 and again in
July that it was waiting for more information on the Southern Hemisphere's
flu season.

Considerable H1N1 activity has been reported recently in India, New
Zealand, and a few other places, with 942 new cases confirmed in India last
week [week of 2 Aug 2010]. But the current global picture is one of fairly
typical seasonal flu activity, Chan said. "Globally, the levels and
patterns of H1N1 transmission now being seen differ significantly from what
was observed during the pandemic," she said in a prepared statement.
"Out-of-season outbreaks are no longer being reported in either the
Northern or Southern Hemisphere. Influenza outbreaks, including those
primarily caused by the H1N1 virus, show an intensity similar to that seen
during seasonal epidemics.

"During the pandemic, the H1N1 virus crowded out other influenza viruses to
become the dominant virus. This is no longer the case. Many countries are
reporting a mix of influenza viruses, again as is typically seen during
seasonal epidemics." Chan added that recent studies show that 20 per cent
to 40 per cent of populations in some areas gained some immunity to the
H1N1 virus through infection. Further, "Many countries report good
vaccination coverage, especially in high-risk groups, and this coverage
further increases community-wide immunity," she said.

The WHO move is not expected to have a big impact on public health measures
in the United States, the Centers for Disease Control and Prevention (CDC)
said today [10 Aug 2010]. In an emailed statement, CDC said the only impact
of the WHO step is that CDC will stop sending weekly reports of flu
activity to WHO and the Pan American Health Organization [PAHO], in accord
with the International Health Regulations. "There are no changes for the
United States in terms of CDC's recommendations for the upcoming influenza
season, and the United States is already proceeding with the understanding
that the 2009 H1N1 virus is now part of seasonal influenza circulation,"
the agency said. The trivalent flu vaccine for the upcoming flu season
includes the pandemic H1N1 virus along with H3N2 and influenza B strains,
the statement noted.

Chan, answering a reporter's question at the briefing, said, "I feel both
[tired and happy], because this has been a long year of hard work, not just
by colleagues in WHO, but by public health officials worldwide. We need to
continue our vigilance and not be complacent." Looking forward, she said,
"It is likely that the virus will continue to cause serious disease in
younger age groups, at least in the immediate post-pandemic period. Groups
identified during the pandemic as at higher risk of severe or fatal illness
will probably remain at heightened risk, though hopefully the number of
such cases will diminish." She added that a small percentage of people
infected during the pandemic, including young and healthy people, developed
a form of severe viral pneumonia that is not usually seen during seasonal
epidemics. "It is not known whether this pattern will change during the
post-pandemic period, further emphasizing the need for vigilance," she said.

Chan reflected that the world was helped by "pure good luck" in this
pandemic: "The virus did not mutate during the pandemic to a more lethal
form. Widespread resistance to oseltamivir did not develop. The vaccine
proved to be a good match with circulating viruses and showed an excellent
safety profile."

Some critics, particularly in Europe, have accused WHO of exaggerating the
pandemic threat, with some arguing that the agency was improperly
influenced by profit-hungry pharmaceutical companies. As she has
previously, Chan today defended WHO's record, but also acknowledged that it
has learned some lessons from the episode, particularly concerning
communication and flexibility.

Margaret Chan's statement can be viewed at

[byline: Robert Roos]

communicated by:

[Presumably this strain of influenza A (H1N1) will no longer be designated
'influenza pandemic (H1N1) virus'? We trust that it is appropriate now to
cut this thread. - Mod.CP]

[see also:
Influenza pandemic (H1N1) (63): WHO update 112 20100807.2680
Influenza pandemic (H1N1) (62): human adaptation 20100806.2671
Influenza pandemic (H1N1) (61): seasonal strain replacement 200920100805.2648
Influenza pandemic (H1N1) (60): New Zealand (WA) 20100804.2632
Influenza pandemic (H1N1) (50): WHO update 108 20100710.2311
Influenza pandemic (H1N1) (40): WHO update 104 20100612.1970
Influenza pandemic (H1N1) (30): WHO update 20100417.1250
Influenza pandemic (H1N1) (20): China, update 20100303.0702
Influenza pandemic (H1N1) (10): PAHO update 20100121.0240
Influenza pandemic (H1N1) (01): China, 2009 20100105.0040]


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