What Does the WHO and CDC H1N1 Flu Response Mean?

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The new strain of H1N1 flu (“swine flu”) that emerged in Mexico in April 2009 has caused a major response from the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). By the end of April, the WHO had raised its pandemic alert level to phase 5, indicating “widespread human infection” [1]. Meanwhile, the CDC “continues to take aggressive action to respond to an expanding outbreak” [2]. What does all of this mean?

The CDC H1N1 Flu Response

The CDC’s mission is to play the central role in preventing and controlling diseases in the United States. In its official mission statement, it claims to be “responsible for controlling the introduction and spread of infectious diseases” [3]. In the case of a potentially serious pandemic such as H1N1 flu, the CDC does not play around. It acts quickly and aggressively to be able to mitigate the spread and impact of the disease, even in the worst case scenario. The CDC response is designed for the gravest possible situation with H1N1 flu: a very contagious, very virulent virus with a high death rate.

The CDC H1N1 response does not mean that we actually are in the worst case scenario. On the contrary, at the current time the situation is far less severe than our worst fears, with confirmed cases increasing fairly slowly [4].

The WHO H1N1 Flu Response

The WHO, a part of the United Nations, “is responsible for providing leadership on global health matters” [5]. Like the CDC, its H1N1 flu response is fast and aggressive in order to minimize the effects of a worldwide outbreak. The WHO’s actions are designed to control the global pandemic in case the swine flu virus proves highly deadly and easily spread.

When the WHO raised its Epidemic and Pandemic Alert and Response (EPR) from Phase 4 to Phase 5 on April 29, the entire world took notice. Phase 5 indicates that there is “human-to-human spread of the virus into at least two countries in one WHO region” (in this case, Mexico and the United States) and that a “pandemic is imminent” [6]. While the WHO’s language seems alarming, a very important point must be remembered: the EPR has to do only with the spread of a flu virus, not with its virulence (severity) or mortality. Phase 5 does not mean that the virus is likely to cause deaths, only that it is likely to spread.

What Does the H1N1 Flu Response Mean to Me?

To the average citizen in an H1N1-affected area, the WHO and CDC responses actually mean very little, other than to take basic precautions against catching and spreading the disease. If you have symptoms of a flu-like illness (fever, coughing, sore throat, fatigue), see a health care provider to be tested. This allows health authorities to monitor the spread of the disease, and it also allows you to receive a prescription, if appropriate, to reduce the severity of the illness. Keep in mind that, in some areas at least, there is at least a 95% chance that a flu-like illness actually is not H1N1 swine flu [7]!

If you have any flu-like illness (whether it is confirmed to be H1N1 flu or not), stay at home, wash your hands often, and cover your cough with your elbow (not your hands, which can spread infection). The WHO and CDC responses tell us that we should be responsible about our roles in keeping this outbreak under control. They are no cause for panic, though; WHO and CDC are just doing their jobs.

Notes and References

1. Current WHO Phase of Pandemic Alert from the WHO website (https://www.who.int), accessed May 1, 2009. See also the Swine Flu Statement by the WHO Inspector General, Dr. Margaret Chan, dated April 29, 2009.

2. H1N1 Swine Flu daily online update from the CDC, accessed May 1, 2009.

3. CDC Mission Statement from CDC website (https://www.cdc.gov)

4. There were 91 laboratory-confirmed U.S. cases on April 29, 104 on April 30, and 141 on May 1, an increase of only about 50% over two days. There has been only one death, a toddler on April 28, with no new deaths being reported.

5. “About WHO” from the WHO website.

6. See Note 1.

7. Eric Berger, Houston Chronicle science blogger, reports that the spokeswoman for the health department of Houston, Texas, site of the only U.S. death, stated that only 5% of flu-like illnesses in Houston are type A influenza and therefore could be H1N1 flu. The other 95% of cases are not type A influenza and therefore cannot be the H1N1 strain.