[influenza] Meldung der WHO vom 24.8.2005 - Influenza H5
- From: "Heckler, Rolf" <Rolf.Heckler@xxxxxxxxxxxxxxxxxxxxx>
- To: "Influenza Listserver (E-Mail)" <Influenza@xxxxxxxxxxxxx>
- Date: Thu, 25 Aug 2005 08:44:03 +0200
Die DGVI informiert:
(25.08.2005)
zum Thema "Influenza": Eine Nachricht der WHO, News Release WHO/36
24 August 2005
WHO home page: <http://www.who.int/> http://www.who.int/.
DONATION OF THREE MILLION TREATMENTS OF OSELTAMIVIR TO WHO WILL HELP EARLY
RESPONSE TO AN EMERGING INFLUENZA PANDEMIC
Geneva - Today, the World Health Organization (WHO) welcomes Roche's
donation of three million treatment courses of the antiviral oseltamivir to
a WHO international antiviral stockpile. WHO would use this stockpile to
respond quickly to an emerging influenza pandemic.
As part of its work to prepare for, detect and mitigate the impact of an
influenza pandemic, WHO is creating an international stockpile of antiviral
drugs for rapid response at the start of a pandemic. In an agreement signed
today, Roche has committed to providing three million treatment courses (30
million capsules) of oseltamivir (Tamiflu) to WHO, which would be dispatched
to people in greatest need at the site of an emerging influenza pandemic.
Oseltamivir could help to reduce illness and death, and when combined with
other measures, could potentially contain an emerging pandemic virus or slow
its national and international spread. If it reaches the site of an outbreak
quickly, an antiviral stockpile could especially help people in poorer
countries.
"If a flu pandemic were to emerge, these drugs could be flown quickly to the
centre of a potential pandemic," said Dr LEE Jong-wook, Director-General of
WHO, during an influenza news conference today in Geneva. "We urge other
countries to help us build up the international stockpile."
The WHO stockpile is meant to complement other measures of international and
national preparedness, including any national stockpiles.
WHO is carefully monitoring the ongoing avian influenza outbreaks in parts
of Asia, Russia and Kazakhstan. WHO warns that these and other outbreaks
could evolve into a global influenza pandemic if the avian influenza virus
changes into a form which could transmit easily between people. The longer
the current avian influenza strain (H5N1) continues to circulate, the
greater the possibility that people will be infected with H5N1, and
therefore the greater the risk that the virus will adapt to people and
trigger a pandemic.
Should a pandemic strain emerge, slowing its spread will be vital as this
could buy valuable time to produce vaccines against the virus and introduce
other emergency measures. Antivirals, used intensively in an area where a
pandemic is emerging, combined with other measures such as quarantine and
isolation, could help to delay spread.
Roche has agreed to reserve three million treatment courses (30 million
capsules) for up to five years. The first one million treatment courses (10
million capsules) will be ready early next year, with the remaining two
million (20 million capsules) ready before mid-2006.
The timing and severity of a flu pandemic is uncertain, but experts predict
a pandemic will occur. Therefore WHO continues to urge countries to develop
preparedness plans. Planning must include international cooperation between
wealthy and poor countries to reduce the opportunity for national and
international spread, and to reduce the death, illness and social disruption
which have been a feature of all previous influenza pandemics.
For more information, please contact Christine McNab, WHO Director-General's
Office, Tel.: +41 22 791 4688, Mobile: +41 79 254 6815, Email:
<mailto:mcnabc@xxxxxxx> mcnabc@xxxxxxx or Dick Thompson, WHO Communications
Officer for Communicable Diseases, Tel.: +41 22 791 2684, Mobile: +41 79 475
5475, Email: <mailto:thompsond@xxxxxxx> thompsond@xxxxxxxx
All WHO Media Releases, Fact Sheets and Features as well as other
information on this subject can be obtained on Internet on the WHO home
page: <http://www.who.int/> http://www.who.int/.
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H5N1 avian influenza: background for journalists
Overview of the present situation
Outbreaks of highly pathogenic H5N1 avian influenza in poultry are now known
to have begun in parts of South-east Asia in mid-2003. These outbreaks have
been historically unprecedented in their geographical size and the number of
birds affected. So far, around 150 million birds have died during the
outbreaks or been destroyed as part of the containment effort.
While some of the initially affected countries have successfully contained
the disease in poultry, the virus is now considered entrenched in many parts
of Viet Nam and Indonesia and in some parts of Cambodia, China, Thailand,
and possibly also Laos.
To date, human cases have been confirmed in four countries: Viet Nam,
Thailand, Cambodia, and Indonesia.
During early August 2005, highly pathogenic H5N1 avian influenza was
confirmed in poultry in parts of Siberia, Russia and in adjacent parts of
Kazakhstan. Both countries have reported deaths of migratory birds in the
vicinity of poultry outbreaks. These events mark the first detection of
highly pathogenic H5N1 avian influenza in the two countries. Last week,
avian influenza of the H5 subtype was confirmed in dead migratory birds in
Mongolia. No human cases have been reported in conjunction with any of these
newer outbreaks.
Assessment of the pandemic threat
WHO considers the present risk of a pandemic great, but unpredictable in
terms of its timing and severity. All conditions for the start of a pandemic
have been met save one: changes in the virus that would make it contagious
among humans, thus allowing easy and sustainable human-to-human
transmission. The likelihood that this will happen is a matter of
opportunity and probability.
The expanding geographical range of the virus increases opportunities for
human cases to occur and these, in turn, increase opportunities for the
virus to improve its transmissibility. The fact that the virus is now
endemic in poultry populations in several countries increases the
probability that this will occur.
In response to the pandemic threat, WHO has recommended a series of
strategic actions to be undertaken by affected and at-risk countries, by
WHO, and by the international community. These actions are phase-wise
according to escalating levels of risk, and pertain to the present
pre-pandemic situation, the first emergence of a contagious virus, and the
declaration of a pandemic and subsequent international spread. In the
present situation, recommended strategic actions aim to reduce opportunities
for human infection (by controlling the outbreaks in poultry and avoiding
contact between humans and infected birds), and to strengthen the early
warning system.
Experts anticipate that a virus with improved transmissibility will announce
itself in the form of clusters of human cases, closely related in time and
space. Surveillance and reporting systems in all countries experiencing
outbreaks in birds need to be strong enough to detect such clusters of human
cases.
Internal stockpile of antiviral drugs
If the first signs of improved transmissibility are picked up quickly, there
is a chance that rapid intervention, involving mass prophylactic
administration of antiviral drugs, might contain the pandemic at its source
or at least delay international spread, gaining time to intensify
preparedness. An international stockpile of antiviral drugs is needed for
this purpose.
The prospect of halting a pandemic at its source or delaying its
international spread is attractive, but untested, as no attempt has ever
been made to alter the natural course of a pandemic. Successful intervention
requires that at least 5 conditions be met:
1. The first viruses that show an ability to sustain transmission among
humans will not yet be highly contagious.
2. The emergence of such viruses will be limited to a small
geographical area.
3. The first clusters of human cases caused by the virus will be
rapidly detected and reported.
4. Antiviral drugs will be rapidly mobilized from the stockpile, made
available to the affected population, and administered to sufficiently large
numbers of people.
5. Movement of people in and out of the area will be effectively
restricted.
Given the unpredictable nature of influenza viruses, it is impossible to
know in advance if the first two conditions will be borne out in reality
when a pandemic virus emerges. The remaining conditions require excellent
surveillance and logistics capacity in the initially affected area, combined
with an ability to enforce movement restrictions.
While mass intervention with antiviral drugs has no guarantee of success, it
nonetheless needs to be undertaken as it represents one of the few
preventive options for an event with predictably severe consequences for
every country in the world. As drugs in the stockpile can also be used for
treatment purposes, having such a stockpile provides the best guarantee that
populations affected at the start of a pandemic and thus in greatest need
will have drugs available for treatment.
Once the virus has become fully contagious, its spread to all parts of the
world is considered unstoppable. However, some non-medical interventions,
such as quarantine, movement restrictions, and the banning of public
gatherings, could potentially delay introduction of the virus to new areas.
Vaccines, if available early enough and in sufficient quantities, can reduce
the high morbidity and mortality typically experienced during influenza
pandemics.
_________________
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