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WHO gearing up response to puzzling new flu virus

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Date: Saturday Nov. 26, 2011 11:04 PM ET

The spread of an odd new flu virus that has been jumping from pigs to people in parts of the United States has the World Health Organization gearing up its response planning, a senior official of the agency says.

The UN health body is figuring out what needs to be done if the virus continues to spread and a global response is required, Dr. Keiji Fukuda, assistant director-general for health security and environment said in an interview from Geneva.

The WHO wants to be ready to make recommendations and issue guidance to countries if the need arises -- though Fukuda stressed at this point it is far from certain there will be that need.

"We're very aware that we don't want to over-play or under-play. We're trying to get that right," says Fukuda, a leading influenza expert.

"(We're) trying to make sure that we're ready to move quickly, if we have to move quickly, but also trying not to raise alarm bells."

The desire to be prepared without raising alarm is a legacy of the 2009 H1N1 pandemic. The WHO was heavily criticized in Europe for declaring that event a pandemic when the outbreak turned out to be far milder than originally feared.

But what exactly the agency -- and the world -- might need to prepare for now is very unclear. With the public relations problems of the 2009 outbreak fresh in the minds of health officials, no one is using the "p" word these days.

Yet in some respects the parallels to 2009 are striking.

A new swine-origin flu virus is causing sporadic infections in parts of the United States. Since the new virus was first spotted in July, 10 cases have been confirmed in Maine, Indiana, Pennsylvania and Iowa. All have been children under 10, with a lone exception -- a 58-year-old adult. Three of the cases have required hospitalization but most of the infections have been mild, like regular flu.

It is an influenza A virus of the H3N2 subtype, a distant cousin of H3N2 viruses that circulate in humans.

Scientists at the U.S. Centers for Disease Control say the hemagglutinin gene, the H3, looks like that of H3N2 viruses that used to circulate in people in the early 1990s.

It is sufficiently different from contemporary human viruses that the H3N2 component of the seasonal flu shot is not expected to protect against this virus, though it might boost antibody levels in those who were exposed to the earlier H3N2 viruses.

The CDC is still doing serological work -- checking stored blood samples for antibodies that react to this virus -- to try to figure out how much vulnerability there is to the new virus. The current thinking is most people over the age of 21 or so would have had exposure to similar flu viruses and would therefore have some protection against it.

Teenagers and children might not, though even that's not 100 per cent certain. Flu expert Malik Peiris, chair of the department of microbiology at the University of Hong Kong, says he thinks exposure to contemporary H3N2 viruses might provide some protection against these swine viruses.

"It is important to see the serological data to see how much vulnerability or susceptibility there is in the human population," Peiris says.

Dr. Arnold Monto, a flu expert at the University of Michigan, says if a major part of the human population has antibodies that react to the virus, it may not be much of a threat.

"If there's a lot of immunity in the population, there probably will not be any kind of extensive spread except maybe in these little clusters where you have little folks who don't have much immunity to anything," he says.

Fukuda, on the other hand, says further spread cannot be ruled out: "I think that certainly there's no reason why this virus, if it continues to spread human to human couldn't move from country to country among young people."

The first seven infections appeared to have been instances where the virus passed from pigs to people. But the most recent cases, in Iowa, seem pretty clearly to have involved person-to-person spread.

There were three confirmed cases in that cluster, but it was likely larger. Two contacts of the first confirmed case were also ill, but were not tested. And the people in this cluster seemingly had no contact with pigs, suggesting they caught the virus from an unidentified person.

The virus was previously isolated from pigs in the U.S. Midwest, says Dr. Nancy Cox, head of the CDC's influenza division, though she won't specify where.

Canadian authorities say there are no reports of the virus in this country. And the WHO knows of no cases other than those in the United States, Fukuda says.

To some in the flu world, the situation is reminiscent of 1977. That year an H1N1 virus started circling the globe, causing infections mainly in young people. H1N1 viruses hadn't been spotted for 20 years at that point; it is widely believed the virus was accidentally released from a laboratory.

On some lists of pandemics, the 1977 outbreak is named. Most flu experts, though, do not consider it a pandemic. Some, like Monto, refer to it as a pseudo pandemic.

While the flu world doesn't want to over-react to this virus, it doesn't feel safe ignoring it either.

The CDC asked the laboratory that makes seed strains for vaccine companies to produce a vaccine candidate virus for this H3N2. It is already in the hands of manufacturers.

And the WHO is looking at what it needs to do to be ready. One of the tasks it is currently working on is trying to figure out what to call this virus, if it should continue to spread.

Naming the pandemic virus was a nightmare for public health officials in the start of the 2009 outbreak.

Flu experts accustomed to talking about viruses based on the animals they normally infected -- bird flu, swine flu, dog flu, human flu -- were caught in a political vise when powerful agricultural interests objected to references to the virus's swine origins.

But calling the virus simply H1N1 didn't differentiate it from the human H1N1 that was circulating before the pandemic. (It has since disappeared.) Recently the pandemic virus was officially named H1N1 pdm09.

This swine-origin H3N2 virus poses the same naming challenges.

And this time, the WHO wants to be prepared. Fukuda says the WHO has been in discussion with its animal health counterparts, the UN Food and Agriculture Agency and the OIE, the World Organization for Animal Health, to work out a possible name.

"We're pretty aware that we don't want to increase stigma, we're pretty aware that it is always possible for people to get afraid of food or to enact trade embargoes or things like that. So to the extent that naming the virus in a way which minimizes those things can be done, we think it's better," he says.

"It's just one of those lessons that we've learned. Take a look at those things early. So that's what we're doing."

Still, it's all being done with the realization that there may be no need for heightened public health responses, apart from the increased surveillance the U.S. has mounted.

"This is one of the things that we've discussed," Fukuda says.

"This could be the only cluster we see," he says, referring to the Iowa cases. "We could see some sort of stuttering picture for a long time. Or we could see things jump. All of those things are possible."

Comments are now closed for this story

Katie
said
0 0

Here we go again! I suppose they will want governments to stockpile more useless drugs. Are we going to have more mass hysteria so that the drug companies can make another massive profit while governments who can ill afford it shell out billions for a pandemic that is little more than a common cold.


Mandy
said
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I'm pretty sure the chicken pox were never gone. The vaccine is pretty new!


Jayme
said
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Chris
Ten years ago i got verty very sick i had to be rushed to the hospital yes its was a very bad flu by the way before the flu i was veery healthy and every since i have had the flu shot every year and have not had the flu since.


reidjr
said
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Heather
The other side of that is were seeing more and more virus's come back that at one point people thought were gone such as the chicken pox why because parents refuse to vaccine there kids.


Jason
said
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AWESOME! Cheap bacon again. I'm stocking up this time. Can't wait for the next over-blown "pandemic" to come around for cheap meat. Gotta get it while you can!


Old Ted
said
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Not only do we have these big factory farms, but the animals are given antibiotics in their feed whether they are sick or not. After a while the viruses and bacteria develop a resistance to the antibiotics and start killing people too. Then the peope in the CDC, FDA etc seem to go from big jobs in these organizations straight to a big job in one of the many drug companies. Smacks of collusion that needs to be investigated.


Joan
said
0 0

WHO has learned from the H1N1 virus and is making sure that it goes very slow in how it elevates this virus in the press.I know many like to think it is a grand conspiracy and this is all to make the pharma industry the big bucks.But remember, the so called Spanish Influenze killed millions worldwide - estimates are from 50 to 100 million dead over a two year period. According to wikipedia, at 50 million dead - that was 3 percent of the population at the time.Another killer virus will come and we must not be complacent. WHO carries the weight of having to not appear too complacent and yet not to over react. If they did nothing, you would all scream they did not do enough.


mark from BC
said
0 0

It is unfortunate that many people still underestimate the lethality of influenza. Every year the flu kills many people...mostly the sick/elderly/young children. We mass vaccinate people not to protect the young and healthy, but rather those at risk of dying from complications of influenza.Influenza can attack many different organs of your body. When it attacks the heart muscle (myocarditis) your body's only pump can fail and this leads to congestive heart failure and cardiogenic shock. The Spanish flu had a predisposition for causing myocarditis in healthy young adults. The early concerns with H1N1 was exactly this.....that absolutely no one had any immunity to a strain that outwardly appeared to be very dangerous.Although some may not respect novel flu strains, my condolences go out to all the families that lost loved ones during the H1N1 pandemic. Luckily it was not as aggressive as health proffesionals had originally thought. Imagine if WHO had not rang the alarm and it was......


Sue in Alberta
said
0 0

I don't think the WHO is crying wolf - just letting the public know what is happening. That is after all part of their job. Just remember that they (and the media) have to walk a fine line when informing the public and urging them to take flu outbreaks seriously. What if the 2009 H1N1 outbreak had been more serious and the health authorities underplayed it? The public would have blamed them and the media for underreacting. I for one am thankful that Canada and the US did react and learned valuable lessons so the next response to an outbreak or pandemic can be better managed (i.e. vaccinating high risk groups before the general public).


Sober
said
0 0

Good moneymaker. Think of Y2K, bird flu, etc. Flu season is bonus time for big pharma - and GST/HST recipients.


Marc, Sacramento
said
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We have industrial pig farming to thank for these novel virus outbreaks. Millions of pigs become a breeding ground for zoonotic diseases because of the unnatural and ecologically damaging way they are factory farmed.


Adrian from Hamilton
said
0 0

Used to be an hour long lineup for the flu shot. During the swine flu pandemic the lineup went through the Standard Life building, the lobby of the Sheraton Hotel, then down the Lloyd D Jackson Square mall for 2 weeks solid. Last year they had ropes set up for long lineups but I was 7th in line. This year I showed up, showed them my health card and was hustled over to a nurses station right away. Did not expect the backlash against the overblown swine flu scare to be that bad.


heather
said
0 0

Just another reason to pump more toxic vaccines into our kids, Its the flu, how many reported cases have thier been? 104 kids have died from the Gardasil vaccine. But some people will buy into this scare tactic, what a shame.... you wont know what I mean until you see a vaccine injury first hand, hope you never do.


Canadian Bob
said
0 0

And Canada will be right there with nothing to protect Canadians as usual. Sad, but the reality is there. The US punishes Canada for everything from Bad Beef to Softwood Lumber, and we just can't get enough of their bullying, their infected food products, or their complete ignorance and disrespect for this country. Get ready for their flu. It's similar to their listeriosis and e-coli foods we import, yet tastes different than their BP Gulf Seafood. Now on sale at a store near you right beside the Made in China products.


gunther
said
0 0

Geez! BIG PHARMA didn't make enough $BILLIONS$ the last time around (shame...), and from our taxes! Now they want more? Wake up people.


Darlene
said
0 0

I have to tell you I have had the flu shot for the past 20 years and without it I know for a fact that I would have gotten even sicker with the flu if I didn't receive it.
There are those on here that are very negative about flu shots but you have to realize that alot of people have to get these shots so they do not get sicker without them.
I am very thankful for being able to get the flu shots.


Chris
said
0 0

Yup... this is once again the WHO trying to scare people into the flu shot. I have NEVER taken a flu shot, and NEVER will!!! To all you paranoid people out there, I suggest you let your bodies develop anti-bodies NATURALLY instead of getting pumped full of crap that is only good for a year (IF THAT)!!!


reidjr
said
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Stan
More like 3 million people go the hospital in canada lone to do flu issues.


zrzzz
said
0 0

Even the stingiest health insurers in the US pay full price for inoculations. I would think if flu vaccines were bunk then those with a vested interest in paying as little as possible would point that out pretty quickly.


laura
said
0 0

People should read the book

BLOOD FEUD...Kathleen sharp

excellent book


Marc
said
0 0

3rd time's a charm? The WHO needs to stop crying wolf, because when something big comes along, no one will believe them.


reidjr
said
0 0

Blackice
We do need anti-biotics now with that said i do agree with you i think there given out to much but we can't just say sorry were not going to offer them any more.I think part of the thing is some who never gett he flu shot and don't get sick think no one gets sick thats not true many people not the flu shot if not they would get very ill.


Stan
said
0 0

3 people go to the hospital!oh god no it's the end of the world. Let's Report about something more important


Reece
said
0 0

What is different this time around? How do we know this isnt another H1N1-gate? Before I buy into anything the WHO has to say I'd like an open accounting of who conducted the science and whether the pharmaseutical companies had their dirty hands in this like they had during the h1n1 fiasco. As George Bush once said "There's an old saying in Tennessee - I know it's in Texas, probably in Tennessee - that says, fool me once, shame on - shame on you. Fool me - you can't get fooled again." - yeah, you can¨t get fooled again.


Reece
said
0 0

I still remember when 2 years ago they were talking about the H1N2 being a threat to mankind and that our very survival was at stake. Then I smelled a rat. Then it was discovered that the pharmasuetical companies were influencing the language these clowns used to direct fear onto innocent and largely naive people. ALWAYS FOLLOW THE MONEY. I dont buy this BS either. I certainly hope our govt doesnt go out and over supply their cupboards with this snake oil. I dont like calling it snake oil but its difficult not to when the h1n2 was such a lame virus not diserving the billions of dollars spent fighting it....its akin to spending billions to fight paper cuts. Greed.. thats what its all about.


Ken Humphreys
said
0 0

And the symptoms for this "new" flu are??????

Can't believe this much space would be given to an article that shocks us by stating the flu is jumping from pigs to humans and then proceeds to give us any specific info.

Just another attempt to alarm us into action.

I'm not buying it for a minute!


Pm
said
0 0

Maybe we should stop all travels to the states the same has we did to Mexico?


BlackIce
said
0 0

Where do we draw the line in this farce we call a medical society. I have never, in my 33 years, recieved a flu shot, I never recieved any other vacinations other than my booster shot as a kid. I got chicken pocks as a kid, I played outside like all kids did in the past... To this day, I rarely get a cold/flu.. if i do its once every 2-4yrs.. I work with the public in retail for 10 yrs.. still work in the coustomer service industry... What really needs to happen is society and doctors need to STOP giving out anti-biotics for every sniffle they see... There is a reason why so many virus' and infections that are getting harder and harder to fight... there are to many people that think their " illness " and problems can be solved by taking a " pill "... and there are to many doctors that support this thought process...


coffee maker
said
0 0

The fear factor in motion once again.
Just wait and we will see it rise like warm water till it boils the same story over and aver again .
An old tactic from those control freaks of the NWO. OH yeah they allways count on the uninformed sheeple to line up to get the vets inject them with manufactured poisons to keep em submisive and unprotesting .


B,J,
said
0 0

WHO made me very skeptical with the H1N1 fiasco. Doesnt seem they have their facts together before alarming the public. Just lining the pockets of the drug companies, nothing else. I take my chances no shot for me.


mike
said
0 0

"Just flu". Like "Spanish" influenza perhaps? Most likely not, but let's not be complacent about a type of virus known to kill humans. If it's a swine flu, why not call it a swine flu? Do football fans (pigskin), steel workers (pig iron), or pipeline workers (inspection pig) shy away from pork?


whocares
said
0 0

They lost all credibility with h1n1, convincing the whole country to get a shot against a flu that kills 0.001 (approx) of what the regular flu kills every year. WHO CARES!!


Tim
said
0 0

Glad to see the WHO is finally realizing that ringing all the alarms and panic'ing everyone is counter-productive. Find out if it's an actual threat before you go into full "WE'RE ALL GOING TO DIE" mode.


blowhole
said
0 0

@jons: I think you're overreacting just a tad. I found the article to be informative, as opposed to sensationalist. They are quite clear that at this point a lot of investigation is being done and that it is too early to know if this is anything to worry about or not. By being informed, both the medical profession and the general public will be more aware and reporting more accurate, so that if it turns out it IS something to be concerned about, we'll be ready that much sooner. Recent scares may invoke a "boy who cried wolf" attitude, but the reality is, there are on rare occasions strains that are true killers. Better safe than sorry.


chris/manitoba
said
0 0

WHO gearing up for another donation from the big pharmaceutical companies !!


jons
said
0 0

here we go again , spreading the fear of God its just a flu


Colin Hanshaw
said
0 0

Let's thank all those Black Friday bargain shoppers for bringing the virus back to Canada at a great discounted rate.


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