WHO Response to Influenza A (H1N1) CAPSCA December, 2011 Dr. Nasr Eltantawy Medical epidemiologist WHO/Egypt
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1 WHO Response to Influenza A (H1N1) 2009 CAPSCA December, 2011 Dr. Nasr Eltantawy Medical epidemiologist WHO/Egypt
2 Outline Background. Preparedness planning. Evolution of the pandemic. WHO and other UN support.
3 History of Human Pandemics : Spanish Flu [A (H1N1)] 20 to 40 million deaths : Asian Flu [A (H2N2)] 1 to 2 million deaths : Hong Kong Flu [A (H3N2)] 1 to 2 million deaths
4 Prerequisites for pandemic influenza A new influenza virus emerges to which the general population has little/no immunity The new virus must be able to replicate in humans and cause disease The new virus must be efficiently transmitted from one human to another
5 WHO pandemic expectations WHO Did not PREDICT: Which virus sub-type will be responsible? Where it will emerge? When it will start? Re-assortment of H1N1 virus (quadriple virus).
6 WHO Pandemic Phases Pandemic Prepared ness Guidance Six phases Current revision retains six-phased approach Grouping of phases Phases 1 3 Phases 5 6 post peak and post pandemic
7 April April 25 : Public Health Emergency of International Concern April 26 : 38 cases reported from Mexico and the US April 27: Canada and Spain reported confirmed cases April 28 : UK, New Zealand April 27 : WHO declared phase 4 April 29 : WHO declared phase 5 27 April 2009 Pandemic (H1N1) 2009 Countries, territories and areas with lab-confirmed cases and number of deaths as reported to WHO Public Health Emergency of International Concern Phase 4 declared Phase 5 declared MARCH APRIL 25 APRIL 27 APRIL 29 MARCH MARCH MARCH
8 May 27 May 2009 Pandemic (H1N1) 2009 Countries, territories and areas with lab-confirmed cases and number of deaths as reported to WHO May 2 : Diagnostic kits made globally available May 5 : Consultation on severity May 26 : Vaccine strain recommendation May 27 : Vaccine reassortants available Diagnostic kits made globally available Vaccine strain recommendation Vaccine reassortants available APRIL MAY 2 MAY 26 MAY 27 JUNE JULY AUGUST
9 June June 11 : WHO declared phase 6 Nearly 30,000 confirmed cases have been reported in 74 countries Further spread is considered inevitable Moderate severity June 24 : WHO consultation on school and mass gatherings 17 June 2009 Pandemic (H1N1) 2009 Countries, territories and areas with lab-confirmed cases and number of deaths as reported to WHO Phase 6 declared WHO consultation on School and mass gatherings APRIL MAY JUNE 11 JUNE 24 JULY AUGUST SEPTEMBER
10 July (77,201 cases/332 deaths) July 13 : Target groups for vaccination recommended by SAGE (Established in 1999) 1 July 2009 Pandemic (H1N1) 2009 Countries, territories and areas with lab-confirmed cases and number of deaths as reported to WHO Immunize HCWs and special groups. Target groups for Vaccination recommended by SAGE MARCH APRIL MAY JUNE JULY 13 AUGUST SEPTEMBER
11 August WHO/Julienne Anoko 6 August 2009 Pandemic (H1N1) 2009 Countries, territories and areas with lab-confirmed cases and number of deaths as reported to WHO August 17 : Collaborative call to action to reduce impact of pandemic (H1N1) 2009 WHO, IFRC, UNSIC, OCHA and UNICEF, prompted by the humanitarian imperative, will work with partners such as the Red Cross and Red Crescent Societies, NGOs and civil society to support governments and communities to reduce the impact from the pandemic (H1N1) "Call to Action" MARCH APRIL MAY JUNE JULY AUGUST 17 SEPTEMBER
12 October / November Northern hemisphere peaked between late October and late November 2009 and has continued to decline since 4 October 2009 Pandemic (H1N1) 2009 Countries, territories and areas with lab-confirmed cases and number of deaths as reported to WHO AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER JANUARY FEBRUARY
13 January 2010 (12799 deaths) 3 January 2010 Pandemic (H1N1) 2009 Countries, territories and areas with lab-confirmed cases and number of deaths as reported to WHO WHO WHO has coordinated the distribution of pandemic (H1N1) 2009 vaccine donated by several countries and vaccine manufacturers AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER JANUARY FEBRUARY
14 February 2010 (212 countries/15292deaths) 7 February 2010 Pandemic (H1N1) 2009 Countries, territories and areas with lab-confirmed cases and number of deaths as reported to WHO 7 th Meeting of the Emergency Committee Premature to conclude that all parts of the world have experienced peak transmission No change in the pandemic phase AUGUST DECEMBER JANUARY SEPTEMBER OCTOBER NOVEMBER FEBRUARY
15 3 May 2009 Pandemic (H1N1) 2009: Spread in an unprecedented speed 26 September 2009
16 WHO support activities Provision of technical assistance: Pandemic preparedness planning. Coordination of response activities. Containment. Mitigation. Selection of the pandemic vaccine strain and production. Oseltimivir and vaccine task forces (negotiation with manufacturers - distribution).
17 WHO Response Emergency response rooms mobilized 24/7 Operations Field team of 26 experts to Mexico (from WHO and CDC/GOARN) Initiated distribution of oseltamivir stockpile Global monitoring and assessment Coordination with Regions and National Focal Points (NFP) Case report form EIS web updates Anti-virals Taskforce Oseltamivir stockpile distribution to regions and 72 priority countries (including Mexico) Consultation with manufacturers.
18 THANK YOU
19 WHO Response (2) Technical guidance Analysis of available data (modelling) Guidelines on surveillance, lab and diagnostic, infection control, health care management, pandemic response plan, vaccines made available to the public Vaccine Taskforce Consultation with manufacturers Consultation with scientific experts
20 WHO Response (3) Communication daily press conference interviews will hundreds of media Disease Outbreak News web updates media monitoring
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