WHO: "Pandemic is 3 or more deaths..."

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WHO draws up plan to fight global outbreak of bird flu

(Filed: 22/03/2006)

The first measures thought to be capable of containing a global flu outbreak have been agreed by the World Health Organisation (WHO), a leading British scientist said yesterday.

The plan makes it clear that there would be a window of opportunity of only around three weeks after an outbreak to prevent a pandemic that could sicken 20 per cent of the global population and put 30 million people in hospital, of whom around 20 per cent could die.

Two computer models of an outbreak, one by Prof Neil Ferguson of Imperial College London, demonstrated last year that early antiviral treatment would be critical if H5N1 began to spread between people.

In the past few days the WHO has published its first recommendations on how to carry out the plan. "This is remarkable," Professor Ferguson said yesterday. "This is the first time it has even been thought a possibility." The plan, or protocol, which was drawn up by more than 70 international experts and WHO staff, suggests for the first time that it may be possible "to alter the natural course of a pandemic near its start".

By May the WHO will have a stockpile of three million courses of the antiviral drug oseltamivir in warehouses in America and Switzerland, after donations from industry. The modelling studies suggest that the mass administration of antiviral drugs must begin within 21 days after the detection of the first case, which would represent improved human-to-human transmission of the virus.

The meeting agreed a point that would mark the start of a pandemic: "Three or more persons with unexplained moderate-to-severe acute respiratory illness (or who died of an unexplained acute respiratory illness) and with onset of illness within seven to 10 days of each other and with a history strongly suggesting potential exposure to the H5N1 virus."

Two types of changes to the virus would be considered causes for concern: detection of a virus with new features, for example a "reassortant" virus containing both human and avian genetic material, or the isolation of a virus from a human case showing a number of mutations not seen in the avian strains.

The national health authority should notify the WHO "immediately following detection of a credible signal". If the WHO agreed that this were a potential pandemic, a range of logistical measures and tests would be carried out along with control measures, notably the use of antivirals, quarantine and hygiene measures.

But the document said that it would not be able to contain the pandemic if the number or geographical distribution of the affected people were too large at the time of detection, exceeded supplies of antivirals or the capacity of medical and emergency services, or if more than four to six weeks had passed since the detection of the initial cluster.

    http://news.telegraph.co.uk/news/main.jhtml?view=DETAILS&xml=/news/2006/03/22/nflu22.xml