WHO
revere | May 25, 2009The World Health Organization (WHO) is not the world's health department or the world's doctor. It is an intergovernmental agency that is part of the United Nations (UN). The UN, despite what hard right wingnuts might think, is not a world government. The international system is technically anarchic, meaning that there is no governing body above nationally sovereign states. For the most part, WHO has no powers beyond those granted it by its member nations (for more background, see our five part series over at the old site here, here, here, here, here). It is only within the last few years…
tlambert | May 24, 2009The United Nations Environment Programme and the World Health Organization have announced new projects to test methods for fighting malaria with less use of DDT:
Ten projects, all part of the global programme "Demonstrating and Scaling-up of sustainable Alternatives to DDT in Vector Management", involving some 40 countries in Africa, the Eastern Mediterranean and Central Asia are set to test non-chemical methods ranging from eliminating potential mosquito breeding sites and securing homes with mesh screens to deploying mosquito-repellent trees and fish that eat mosquito larvae.
The new…
revere | May 19, 2009Is it a pandemic or is it not a pandemic? Since the world has never had a chance to make a call like this at the outset of a pandemic, nobody is quite sure how to handle it. The usual definition -- an epidemic (an increase in cases beyond what is expected) of global dimension -- has a lot of wiggle room and WHO and everyone else is busy wiggling. One reason is not whether this meets the definition or not but what the consequences might be of calling this "a pandemic":
Britain, Japan, China and other nations urged the World Health Organization on Monday to change the way it decides to declare…
revere | May 5, 2009As I write this the US has 279 confirmed cases and one death from H1N1/2009 in 36 states. WHO has tallied 1085 1124 cases in 21 countries with 25 deaths. There is a backlog of samples waiting for confirmation, so by the time you read this the counters will probably have rolled upward, especially as state laboratories become facile with the new primers and are able to do their own confirmation. And predicting an increasing case count is about all anyone can say with certainty at this point. What we said once about flu pandemics can be said just as appropriately for the flu virus: "If you've…
tsmith | April 30, 2009I've been seeing a lot of comments mocking the current outbreak of H1N1, and a lot of people (and journalists) who don't understand what "big deal" is about the "snoutbreak" of swine influenza, or don't get what the raising of the World Health Organization's pandemic alert phase up to 5 means. I noted here what the alert level meant, but wanted to discuss it a bit more in a full post; after the jump.
So, some comments I've seen thrown about:
This is all just media hype! Lies about the Mexican cases! The WHO just revised their numbers down to 26 cases and 7 deaths! Why should I believe…
revere | April 30, 2009There is a tendency to be preoccupied with the latest in fast moving events, but I want to pause for a moment to make a point that has been lost in the discussion: we are witnessing a medical science landmark. Never before have we watched a flu outbreak of global dimensions unfold in real time. Nor have we ever had the opportunity to alter the course of such an outbreak.
I have been critical of WHO for being late to the party, but they are fully on board now and by raising the pandemic threat level to phase 5 have done something very important: served notice that it's time to mobilize…
revere | April 27, 2009The daily CDC conference call was not particularly informative, but these daily briefings are still extremely valuable. Things are happening fairly fast but nothing we didn't expect. There are now 40 confirmed US cases in the same 5 states (California, NY, Texas, Kansas, Ohio). The 28 new cases sere contributed by the New York prep school that had the state's first 8 cases. These additional ones are the result of continued case finding. Acting CDC Director said that the only laboratory confirmed human to human transmission is in the Kansas husband and wife (he had just returned from Mexico…
revere | April 25, 2009A concise summary of some additional developments, courtesy Bloomberg:
Three teachers and 22 students from Auckland’s Rangitoto high school are being tested for swine flu after returning to New Zealand’s most populous city from Los Angeles following a three week trip to Mexico, Stuff.co.nz reported on its Web site. Some of the travelers had symptoms of flu-like illness and were being isolated as a precaution pending test results, it said, citing the Auckland’s public health service.
In the U.K., a British Airways Plc crewmember with flu-like symptoms was taken to Northwick Park Hospital…
revere | April 25, 2009There may not have been much news at the CDC briefing, but it is coming thick and fast now. The CDC works through state health departments and defers to them on information about what is going on in their localities. Hence all questions about this were deflected at the 1 pm CDC briefing. I think I understand the thinking behind this but it doesn't serve the goal of getting the information out there quickly. CDC needs to be the information clearing house for all the swine flu news going on around the country and they need to do with absolute transparency. Here's what has developed since that…
revere | April 25, 2009There will be an update from CDC later today and WHO's expert committee established under the new International Health Regulations (IHR) meets via teleconference this morning North American east coast time at 10 am (4 pm Geneva time) to consider whether the swine flu situation merits declaring it “a public health event of international concern.” If they do, WHO Director General Margaret Chan may respond by raising the pandemic threat alert level from the current phase 3 (new virus: no or limited human to human transmission) to phase 4 (new virus, evidence of increased human to human…
revere | April 24, 2009Some end-of-the day (but not end-of-the-world) bits and pieces in the emerging swine flu story.
From Helen Branswell (Canadian Press):
In Mexico, Secretary of Health Jose Angel Cordova Villalobos said in a television interview that there have been 45 deaths, but only 16 of those were directly related to the flu in question.
An estimated 943 people are ill, the television report said.
The majority of the cases are occurring in young, previously healthy adults in their mid 20s to mid 40s, reports suggest. Experts aren’t certain if all of those people are sick with this virus or if other flu or…
revere | January 26, 2009The peanut butter/peanut paste ingredient based salmonella outbreak has been in the news lately and we've discussed it here (and here, here, here, here, here). There are now about 500 reported cases and six deaths. That's a case fatality ratio of just over 1%. So what if there were a disease outbreak of 100,000 cases with a case fatality ratio of 20%? I think we'd be pretty alarmed. But it happened in 2005. And it happened in 2006 and 2007 and last year, 2008 And it's happening, now, too. It isn't salmonella or or even HIV/AIDS, although it is estimated to kill more people in the US than both…
revere | October 5, 2008An article in The Straits Times from newswire Associated Press (AP) drew my attention to a festering disagreement between proponents of an innovative global sharing initiative for influenza information and the World Health Organization, the official UN Agency that has run the global influenza surveillance system for more than a half century. The new system, The Global Initiative on Sharing Avian Influenza Data (GISAID), began midway through 2006 and has made rapid progress. It came into being to deal with dissatisfaction with the existing system wherein WHO allowed influenza gene sequence…
revere | June 21, 2008The beach in Indonesia may look nice, but don't let that distract you:
There is an English word for deliberately neglecting to tell people something they have asked you about. It's called lying. On that basis, the Indonesian government, primarily in the person of their Minister of Health, Siti Fadillah Supari, are liars. They have publicly declared their intention to lie by announcing they will no longer notify the world promptly about new human cases of bird flu. The acknowledged motive is to improve the reputation of Indonesia in the eyes of the world. Currently the country is the world's…
revere | April 25, 2008For years we have been naming flu viruses in a particular way. Now Declan Butler has a news article in Nature observing that the system is being modified for bird flu to be more "politically correct." What is the system that's being modified (still in use for seasonal flu)?
It starts off with the type of influenza virus, either A, B or C. The type was originally based on a broad class of antibody response but now is related to genetic markers in two of the eleven proteins (matrix M1 or nuceoprotein, NP). The three types have a common ancestor but only types A and B are of public health…
revere | March 25, 2008We've covered the Indonesian refusal to cooperate with international influenza surveillance system to a fare thee well (see posts posts here, here, here, here, here, here, here, here, here, here, here, here, here and links therein), so this is just an update with some additional observations how Indonesia's deplorable behavior isn't that different than the US's deplorable behavior in the Middle East. First, Indonesia. When last we checked in Indonesia had sent off half a dozen flu specimens from the period after the end of January 2007 when it started its boycott. The hope was that the…
revere | March 6, 2008If you look at the bar chart below you will see that this year's bird flu season is shaping up to look pretty much like last year. In the first two months of the year there are a few more cases but essentially the picture looks much the same. If that is indeed true, then also expect a spike of cases this month (March) since you can also see that is the past pattern. Already cases are being reported in Egypt, and of course, Indonesia. The countries involved this season have been Vietnam, China, Egypt and Indonesia, just like last year. Whether you consider that reassuring or worrying probably…
revere | March 2, 2008The Indonesian virus sharing impasse is said to be over, and with the dénouement comes some fascinating new information. Many will remember the row started when an Australian vaccine maker took an Indonesian viral isolate and made an experimental vaccine from it (see many posts among those here). At the time it was said the Indonesian Health Minister objected that her country would never be able to afford the vaccine and she therefore stopped making the virus available to WHO. WHO was the source of the seed strain used by the Australian company to make a prototype vaccine.
It turns out,…
revere | February 15, 2008We've posted a bit (here and here) on this year's flu vaccine and some mismatches. Because of the time it takes to ramp up production the flu vaccines for the following season are made in the early spring of the year before, often, as now at the peak of the ongoing flu season. Yesterday WHO announced that they were changing all three of the strains in next year's vaccine, something that is unusual but not unprecedented.
This is all reported by the best of the best flu reporters, Canadian Press's Helen Branswell. I could do some pull quotes and summarize what she wrote, but instead I'll just…
revere | January 23, 2008In 2006 there were 115 confirmed cases (WHO case count) of H5N1 in humans with 79 deaths. In 2007 the figures are 86 cases and 59 deaths. Some have taken this as evidence H5N1 is less of a problem (latest data here). That's not how I read it, however. Seasonal flu numbers bounce around from year to year, too, and if this year is better than last year it isn't because flu is disappearing. Still, let's take a look at the numbers a little more closely and see where the differences are. Here's the WHO Table:
21 January 2008
Country
2003
2004
2005
2006
2007
2008
Total
cases
deaths…