WHO Chief Prepares for Pandemic

世界卫生组织(WHO)总干事周日预作铺垫说，该机构有可能正式宣布，甲型H1N1这种新型流感已出现全球性流行。但她也表示，即使做了这种宣布，也未必意味着该流感属于高致命性疾病，或者将席卷全球。联合国旗下这家公共卫生机构的总干事陈冯富珍(Margaret Chan)接受采访时说，在恐慌和死亡方面存在许多误解，目前的情形并不意味着大规模死亡将会发生。Associated Press上周日，WHO总干事陈冯富珍（中）在日内瓦总部部署工作。在获知一种新型猪流感在墨西哥引发疫情在美国引发感染一周半之后，陈冯富珍正面临着一种明显的可能性：如果甲型H1N1流感在美洲之外的其他地区开始持续扩散，她将不得不正式宣布这种流感出现了全球性流行。她说，WHO规程将要求这么做，即使目前这种流感尚未造成大多数人一听到“全球性流行”一词就会联想到的严重灾难，而且它在墨西哥导致的死亡病例也比当地政府原来认为的要少。在甲型H1N1流感过去11天来迅速蔓延的过程中，WHO曾两次提高了这一疫情的全球警戒级别，从最初的3级提高到目前的5级，这意味着这种流感至少在同一个WHO所划定地区的至少两个国家发生了人际间传播。此类警戒的最高级别为6级，即至少在两个WHO所划定地区的至少3个国家发生了人际间传播。目前，这种新型流感已在美国和墨西哥部分地区蔓延，它在加拿大的致病人数也在上升。公共卫生部门官员表示，甲型H1N1病毒尚未在其他地区出现持续传播，但在已出现多个病患的国家有可能发生这种情况。陈冯富珍表示，她现在还不能说WHO何时会将警戒级别提升到6级。她说，这非常难以预料，我们将继续监控并非常细致地关注事态发展。她说，提升至6级对世界各地的公共卫生部门是一个信号，表明他们需要启动流行病疫情防备预案，但这并不意味着全世界每个国家都将受到这轮疫情的影响。她还说，目前数据显示，大多数感染甲型H1N1流感的人都会完全康复，一些人甚至不需要服药。但她强调，虽然有迹象显示，甲型H1N1流感病毒迄今造成的病情相当温和，但这并不意味着各国可以对它放松警觉。她说，WHO针对这种新型流感病毒提高全球警戒级别的做法是恰当的，因为没有人可以预言，这种在本次流感季节最后阶段首次出现的病毒，日后是否会演变成一种更危险的病毒。她指出，1918年的大流感在初次爆发后又接着爆发了第二轮情况远为严重的疫情，导致全球数百万人丧生。她说，我们不能反应过度，同时也不能自负，我们现在对这种疾病还没有全面的了解。陈冯富珍说，甲型H1N1流感有可能卷土重来，全世界应对此做好准备。她还说，即使是季节性流感也会造成重大损害；我们不应忘记，即使季节性流感每年也会导致大约五十万人因各种并发症而死亡。据WHO的数字，截至周日，已有17个国家出现甲型H1N1流感患者，总数达787人。WHO的统计数字仅包括已经实验室测试证实的病例。上述患者中，有506例在墨西哥，其中死亡病例19人，远低于墨西哥政府之前估计的数字。美国公布有160人感染病毒，死亡病例为1例。陈冯富珍指出，尽管全世界对流行疫情的准备情况总体上已比几年前好得多，但许多贫困的发展中国家仍面临特别大的风险。WHO周末期间表示，它正在向许多缺乏供应的贫困国家分发抗病毒药品。Betsy McKay相关阅读萨尔瓦多首次确认两例甲型H1N1流感病例 2009-05-04中国隔离墨西哥人 两国关系或现裂痕 2009-05-04原声视频：墨西哥外长责难邻国，劝本国旅客远离中国 2009-05-04香港证实首例人感染H1N1型流感病例 2009-05-02出现猪流感确诊病例的国家增多 2009-05-01


The World Health Organization's chief laid the groundwork Sunday for her agency potentially to declare a new strain of A/H1N1 swine flu a pandemic, saying such a move doesn't necessarily mean the disease is highly lethal or that it will sweep the entire globe.'There is a lot of misunderstanding in terms of fear and death,' Margaret Chan, the United Nations public health agency's director-general, said in an interview. 'It doesn't mean death in big numbers is going to happen.'A week and a half after learning that a new strain of swine flu was causing outbreaks in Mexico and infections in the U.S., the WHO chief is now faced with the distinct possibility that she will have to formally declare the disease a pandemic, once it begins spreading in a sustained way in other parts of the world beyond the Americas.WHO protocols will compel that to happen, she said, even though thus far the strain isn't producing the deadly sort of scourge most people associate with the word 'pandemic' and in fact looks to have exacted a lighter death toll in Mexico than authorities there originally believed.As the disease has spread quickly over the past 11 days, the agency has raised its global pandemic alert level twice, to phase 5 - signaling outbreaks in more than one country in one of the agency's geographical regions - from phase 3. Its highest level is a phase 6, meaning community outbreaks are occurring in at least three countries in at least two of the WHO's regions. The disease is spreading within communities in the U.S. and Mexico, and case counts are mounting in Canada. Public health officials have said sustained transmission hasn't been seen elsewhere yet, but is likely to emerge in countries that already have multiple case counts.Dr. Chan said she couldn't say when the agency would raise the alert level to phase 6. 'That is very unpredictable,' she said. 'We will continue to monitor and watch very carefully.''Phase 6 is a signal to all public health authorities in the world that they need to activate their pandemic preparedness plans,' Dr. Chan said. But 'it doesn't mean every country in the world will be affected by this wave of infection,' she said. Additionally, 'we know fully from the data that most people make a full recovery and some people don't even need to take medicine.'But signs that the virus thus far seems to produce predominantly mild disease don't mean countries can afford to let down their vigilance, she stressed. The WHO acted appropriately in raising the global alarm over the new strain because no one can predict whether it will morph into a more dangerous form at a later point after its initial emergence at the tail end of this flu season, she said. An initial outbreak of the 1918 flu in the spring was followed by a second, far deadlier wave which killed millions of people as it swept the globe, she noted.'We cannot overreact and we cannot be complacent either,' she said. 'We haven't seen the full spectrum of the disease.'It may come back. The world should prepare for it.'Moreover, even seasonal flu takes a hefty toll, she said. 'We should not forget that even with seasonal flu about half a million people die each year from complications.'As of Sunday, the new flu had spread to 17 countries and sickened 787 people, according to the WHO, which counts only cases that have been confirmed by a laboratory test. Those cases include 506 infections in Mexico, with 19 deaths - far lower than Mexican authorities originally believed. The U.S. has reported 160 infections and one death.While the world overall is much better prepared for a pandemic than just a few years ago, many poor, developing countries remain particularly exposed, she said. The WHO said this weekend it's dispatching antiviral medications to many poor countries that lack supplies.Betsy McKay