Is the world staring at the worst health crisis in 90 years?

New Delhi, May 01: This could be the worst health crisis facing the world in 90 years.

With the World Health Organisation (WHO) on Thursday raising its People wait outside a mobile clinic in Mexico City to get tested for swine flu. (Reuters Photo)
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alert level to phase five for swine flu — just one step short of seeing a full-blown pandemic affecting at least two regions of the world — health experts were fearing a situation similar to the 1918 Spanish Flu which killed at least 50 million people. That’s because H1N1 (the swine flu virus) is the closest so far to the Spanish Flu virus.

While that kind of mortality is ruled out now, given the advance of medical science and the quick spread of information and awareness in today’s world, WHO was taking no chances as it now knows that the disease can spread easily between humans and hence raised the alert which is read as a signal that a pandemic is imminent. The Avian Flu (also known as bird flu) had an alert which was two notches lower, which means the danger this time is much higher.

Worldwide, at least 13 countries have confirmed cases of swine flu. Switzerland became the fifth European country to report a case of the disease in a 19-year-old student, and the Netherlands soon after became the sixth, reporting a case of the virus in a three-year-old who had recently returned from Mexico. Britain, Germany, France and Austria are the other European countries where authorities have begun a campaign urging people to sneeze into tissues and wash their hands after that. The campaign was called, “Catch it, bin it, kill it.” The disease has also spread to Costa Rica and Peru.

Raising the alert — the second in three days — WHO’s director general Dr Margaret Chan asked all countries to activate pandemic flu plans and called on them to be on high alert for a H1N1 swine flu outbreak. Describing Influenza viruses as notorious for their rapid mutation and unpredictable behaviour, Dr Chan said, “Influenza pandemics must be dealt with seriously and precisely because of their capacity to spread rapidly to every country in the world. New diseases are, by definition, poorly understood. WHO and health authorities in affected countries will not have all the answers immediately, but we will get them.”

According to Dr Chan, at this stage, effective and essential measures include heightened surveillance, early detection and treatment of cases, and infection control in all health facilities. “This change to a higher phase of alert is a signal to governments, to ministries of health and to the pharmaceutical industry that actions should now be undertaken with increased urgency and at an accelerated pace,” Dr Chan added.

Preparedness measures undertaken because of the threat from H5N1 avian influenza were an investment, and we are now benefiting from it, said experts. According to WHO, the biggest question, right now, is how severe will the pandemic be, especially now at the start? Dr Chan says it is possible that the full clinical spectrum of this disease goes from mild illness to severe disease.

“From past experience, we know that influenza may cause mild disease in affluent countries, but more severe disease, with higher mortality, in developing countries. This is an opportunity for global solidarity. After all, it really is all of humanity that is under threat during a pandemic,” Dr Chan said.

Justifying raising the pandemic alert to phase five, WHO’s assistant director-general Keiji Fukuda said in a global teleconference on Thursday night, “Phase 5 indicates the spread of the virus among communities, normal people who haven’t visited Mexico or come in contact with travellers.”

WHO has been tracking the spread of the virus at the epidemiological, clinical and virological levels.

Dr Fukuda said, “We found sustained human to human transmission in multiple generations. When we looked at the virus in Mexico and US, we found that it was beginning to behave like a human virus and was becoming part of our community and not just being spread by travellers. This therefore made us increase the pandemic threat.”

He added, “Pandemic phases aren’t intended to be a barometer of epidemiology of the virus but a clear warning and alert that the risk of the virus to reach your country is now significantly high.”