The World Health Organization raised its pandemic alert for swine flu to the second highest level Wednesday, meaning that it believes a global outbreak of the disease is imminent.
WHO Director General Margaret Chan declared the phase 5 alert after consulting with flu experts from around the world. The decision could lead the global body to recommend additional measures to combat the outbreak, including for vaccine manufacturers to switch production from seasonal flu vaccines to a pandemic vaccine.
"All countries should immediately now activate their pandemic preparedness plans," Chan told reporters in Geneva. "It really is all of humanity that is under threat in a pandemic."
A phase 5 alert means there is sustained transmission among people in at least two countries. Once the virus shows effective transmission in two different regions of the world, a full pandemic outbreak — level 6 — would be declared, meaning a global epidemic of a new and deadly disease.
"It is important to take this very seriously," Chan told a news conference watched around the globe on Wednesday. But for the average person, the term "pandemic" doesn't mean they're suddenly at greater risk.
Nearly a week after the H1N1 virus, or swine flu, was first identified in California and Texas, about 100 cases have now been confirmed in the U.S. across 11 states, and health officials reported Wednesday that a 23-month-old Mexican boy had died in Texas.
But in Mexico, where up to 159 people have died from the virus and around 1,300 more are being tested for infection, people struggled with an emergency that has brought normal life virtually to a standstill over the past week.
Almost all cases outside of Mexico have had only light symptoms, and only a handful of cases have needed hospitalization.
Officials warned more deaths could be expected as surveillance of the illness increases.
Pharmaceutical companies should ramp up manufacturing, Chan said. Two antiviral drugs — Relenza, made by GlaxoSmithKline and Tamiflu, made by Roche AG — have been shown to work against the H1N1 strain.
Flu viruses are notorious for rapid mutation and unpredictable behavior, she warned. But she also offered words of reassurance.
“The world is better prepared for an influenza pandemic than at any time in history,” Chan said. “For the first time in history we can track the pandemic in real time.”
As fear and uncertainty about the disease ricocheted around the globe, Chan added that WHO did not recommend closing borders or forgoing pork.
No signs of slowing
Germany and Austria reported cases of the illness, bringing the number of affected countries to 9.
Spain has reported the first case in Europe of swine flu in a person who had not been to Mexico, illustrating the danger of person-to-person transmission.
Nations are taking all sorts of precautions, some more useful than others.
Egypt ordered the pig slaughter even though there hasn’t been a single case of swine flu there. Britain, with only five cases, is trying to buy 32 million masks. And in the United States, President Barack Obama said more of the country’s 132,000 schools may have to be shuttered.
At airports from Japan to South Korea to Greece and Turkey, thermal cameras were trained on airline passengers to see if any were feverish. And Lebanon discouraged traditional Arab peck-on-the-cheek greetings, even though no one has come down with the virus there.
The U.S., the European Union and other countries have discouraged nonessential travel to Mexico.
The World Health Organization said total bans on travel to Mexico — such as one imposed by Argentina, which hasn’t had any confirmed cases — were questionable because the virus is already fairly widespread.
“WHO does not recommend closing of borders and does not recommend restrictions of travel,” said Dr. Keiji Fukuda, the Geneva-based organization’s flu chief. “From an international perspective, closing borders or restricting travel would have very little effect, if any effect at all, at stopping the movement of this virus.”
Nor will killing pigs, as Egypt began doing Wednesday, infuriating pig farmers who blocked streets and stoned Health Ministry workers’ vehicles in protest. While pigs are banned entirely in some Muslim countries because of religious dietary restrictions, they are raised in Egypt for consumption by the country’s Christian minority.
H1N1 swine flu is seen as the biggest risk since H5N1 avian flu re-emerged in 2003, killing 257 people of 421 infected in 15 countries. In 1968 a “Hong Kong” flu pandemic killed about 1 million people globally, and a 1957 pandemic killed about 2 million.
Seasonal flu kills 250,000 to 500,000 people in a normal year, including healthy children in rich countries.