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Developing countries more susceptible to A(H1N1): WHO

Thiruvananthapuram: It is a daunting thought. “If you look at past [influenza] pandemics, it would be a reasonable estimate to say [that] perhaps a third of the world’s population would get infected with this virus,” observed Keiji Fukuda, Assistant Director-General of the World Health Organisation, at a press briefing on Thursday.

With a current global population of over six billion, that would translate into some two billion people who might be at risk worldwide in a pandemic that appears imminent. In the briefing, Dr. Fukuda explained why the WHO was so concerned about the swine flu virus known officially as Influenza A(H1N1). After all, so far most people outside Mexico infected by the virus have had only mild illness.

When so many people could be affected worldwide, even if the disease was relatively mild in most people, there would still be very large number of people across the globe who could develop severe respiratory problems and die as a result, pointed out Dr. Fukuda.

Seasonal flu epidemics had shown that a disease that could be relatively mild for population in the developed countries might be quite severe in its impact on the developing world. In addition, some people in developing countries could be more vulnerable to the disease, such as through malnutrition or war or HIV infection, added Dr. Fukuda.

Nor is there any guarantee that the virus will stay mild.

Previous flu pandemics have been characterised by multiple waves of disease, say Mark A. Miller of the Fogarty International Centre of the U.S. National Institutes of Health and his colleagues in a paper that has just been published by the New England Journal of Medicine. The three pandemics of the 20th century led to increased deaths for between two to five years.

In the case of the 1918-1919 pandemic, the lethal wave in the autumn of 1918 was preceded by mild outbreaks that summer in both the U.S. and Europe. In fact, recent studies have suggested the summer outbreaks might have helped to partially immunise some of the population, thereby reducing the numbers of those who died later on, they said.

The 1957-1963 pandemic had three waves in the U.S., with notably higher deaths in the winter seasons of 1959 and 1962. In the 1968-1970 pandemic, Britain had a mild first wave, followed by a severe second wave the following winter, the paper noted.

In a reference to the current situation, Dr. Miller and others point out that even if a vaccine could not be produced in time to cover all those exposed to the first pandemic wave, the period till the subsequent wave could be utilised to vaccinate people and thereby reduce the levels of sickness and death.

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