What is a Pandemic?

I am sure that most of you have heard about the strain of Swine Influenza (SI) currently affecting multiple regions of the world.  Regardless of the source that you may reference, the consensus is that SI is having a global impact. 

It is my understanding that there has been an extremely positive/efficient response from the scientific and medical community.  More specifically, information is being shared on a global scale and consequently advances regarding information/treatment/management are be made that may not have been otherwise possible.  With a current global political climate that does not always make the exchange of such information possible, it is great to see the global community “stepping up” and acting not as citizens of a specific country, but instead as citizens of a global population. 

As expected with an issue of this magnitude, there has been a massive amount of media coverage.  While the majority of the coverage has been quite accurate, I have noted that several of the popular media outlets have been less than precise in their reporting of the subject.  More specifically, there has been a great deal of misinformation regarding the concept of a “pandemic”.  This term seems to be thrown around a lot in the media without any real indication as to what it actually means.  Although it is entirely possible that some media outlets may be ignorant of intended meaning of the term, I would argue that several of the major media outlets are following the tried and true “if it bleeds it leads” mantra and are misusing the term “pandemic” in order to get ratings.    

So with the above information in mind, let us focus our skeptical eye on the above situation and take a closer look at the term pandemic shall we:

To get the best understanding of the term pandemic, we shall look to the definition outlined by the world health organization (WHO).  Attached below is a brief overview of the classifications that the WHO utilizes to classifies the outbreak of a new disease/illness/influenza/etc (information below is taken from the following link: http://www.who.int/csr/disease/avian_influenza/phase/en/index.html)

In nature, influenza viruses circulate continuously among animals, especially birds. Even though such viruses might theoretically develop into pandemic viruses, in Phase 1 no viruses circulating among animals have been reported to cause infections in humans.

In Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans, and is therefore considered a potential pandemic threat.

In Phase 3, an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks. Limited human-to-human transmission may occur under some circumstances, for example, when there is close contact between an infected person and an unprotected caregiver. However, limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemic.

Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion.

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.

During the post-peak period, pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels. The post-peak period signifies that pandemic activity appears to be decreasing; however, it is uncertain if additional waves will occur and countries will need to be prepared for a second wave.

Previous pandemics have been characterized by waves of activity spread over months. Once the level of disease activity drops, a critical communications task will be to balance this information with the possibility of another wave. Pandemic waves can be separated by months and an immediate “at-ease” signal may be premature.

In the post-pandemic period, influenza disease activity will have returned to levels normally seen for seasonal influenza. It is expected that the pandemic virus will behave as a seasonal influenza A virus. At this stage, it is important to maintain surveillance and update pandemic preparedness and response plans accordingly. An intensive phase of recovery and evaluation may be required

So what does this all mean?

As per the CDC (http://www.cdc.gov/swineflu/) and the WHO (http://www.who.int/csr/don/2009_04_29/en/index.html) the SI is currently classified as “phase 5”.  As noted above this indicates the extent to which SI has spread throughout the globe.  It DOES NOT indicate the number of individuals that have been infected.  A pandemic can effect anywhere from hundreds to billions of individuals.  This seems to be a major bit of information that the major news outlets are neglecting to mention, and consequently misleading the general public about.

To put things in perspective as of April 29/2009 the WHO has confirmed 148 cases of SI WORLDWIDE.  As of April 30/2009, there has only been 1 confirmed death.

Now please do not misunderstand me.  I am not attempting to down play the potential severity of SI, or the impact that it has had (on a personal, community, national, and global level).  Instead I am attempting to help arm you with knowledge so that you can be better prepared to make informed decisions about your life and well being.  Additionally, in the words of my mother “you have to keep things in perspective”.

SI is a serious potential healthcare concern.  But according to my understanding of the situation, currently, the potential threat/concern of SI is no more serious than the yearly influenza threat/concern that the health care community deals with every year!  I am not saying that SI will not evolve into a global health crisis (potentially effecting millions).  It very well could.  However, at present it has not and this must be noted.  Although the current state of SI is considered a pandemic, this does not mean that millions of individuals have been infected.  Continued involvement and diligence will be required to monitor, treat and manage this new potential threat.  It is my hope that this blog post has helped you, the reader, better understand the current situation surrounding SI, and has better equipped you with the proper tools to make decisions regarding your own health and well being. 

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2 Responses to “What is a Pandemic?”

  1. rich martens Says:

    What a great read! Looking forward to more posts.

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