WHO under pressure to declare flu epidemic

The World Health Organisation yesterday resisted pressure to declare a full-fledged swine flu pandemic even as cases in Japan and the United States soared and a New York teacher died of the virus.

WHO chief Margaret Chan told member states on the first day of the UN health body's annual assembly they may be facing a "calm before the storm," but that the organisation had so far held off on raising the alert.

"We remain in phase five," she said, following speculation the alert would be raised to the maximum six after new cases forced Japan to close more than 2,000 schools. Level five only indicates a pandemic is imminent.

WHO officials have warned that sustained transmission in a country outside the Americas, where it first emerged, without a direct link to travellers, would warrant declaration of a pandemic, or global spread of the virus.

Japan shuttered schools and kindergartens after swine flu cases there shot up to 129 and authorities warned the real number of infections from the (A)H1N1 virus could already be in the hundreds.

Officials in New York, where six schools had already been closed, were reported to have ordered the closure of five more after the death of a 55-year-old assistant principal at a school in the borough of Queens.

Separately, the US government reported yesterday more than 400 new cases to take the nation's total number of infections above 5,000.

"We do not know how long this period will take, if this is the calm before the storm," Ms Chan told the assembly, adding there was "every reason to be concerned with the interaction with other viruses."

Experts have expressed concern about the possible mutation of the virus that could make it more resistant to antiviral drugs such as Tamiflu and Relenza, which have been stockpiled by countries to treat severe flu.

Besides not raising the alert level, the WHO also advised the pharmaceutical industry against switching its production focus onto the new swine flu virus, recommending that making seasonal flu vaccines was still the priority.

"We are taking double insurance, I want to make sure countries get sufficient supplies of seasonal influenza vaccine," said Ms Chan.

Ms Chan said the industry was still not in a position to make a potential swine flu vaccine.

Health officials faced a delicate task in seeking to raise the appropriate level of alarm, and Chan spoke of a "difficult balancing act" during a special debate on the new influenza A(H1N1) virus.

"We're all under pressure to make urgent and far-reaching decisions in an atmosphere of considerable scientific uncertainty," she said.

Britain's Health Secretary, Alan Johnson, led calls for caution over the raising of the alert level. He was backed by New Zealand, Switzerland, and the head of the Pan American Health Organisation, the WHO's regional body for the Americas.

Mr Johnson said it was crucial to ensure that there was public support and confidence in the influenza alert system.

"I think you, as you and others have said, need more time, we need more time to study this," Mr Johnson told the WHO's Chan during the debates in Geneva.

More than 8,800 swine flu cases have been confirmed in 40 countries and more than 70 people have died since the virus first emerged in Mexico and the United States a month ago.

The New York assistant principal, Mitchell Wiener, was "overwhelmed by the illness despite treatment with an experimental drug," a spokesman for Flushing Hospital Medical Centre, where he had been treated since Wednesday, told the New York Times.

His death brought the toll in the United States to six. While only a fraction of the 66 deaths in Mexico, the US has accounted for more than half of the overall caseload from the virus.

Until Friday, Japan thought it had kept the virus at bay after detecting four people who tested positive when they flew in from North America and immediately quarantining fellow passengers.

The majority of the scores of new cases are concentrated in Kobe and Osaka after two high schools from those areas met for a volleyball tournament, with some players and coaches feeling feverish after the games.

Residents of Kobe have rushed to hospitals and emergency fever clinics, while pharmacies have quickly run out of face masks.

The WHO has shortened its assembly from 10 days to five to minimise the time officials are away from their countries during the crisis.