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Health Officials Brace for Pandemic

The World Health Organization's decision Thursday to declare the first influenza pandemic in nearly half a century has prompted public health experts worldwide to plan for an extended siege of global illness.

"When you're talking about pandemic influenza, you're talking about a marathon, not a sprint," says the WHO's top flu expert, Keiji Fukuda.

The WHO decision marked the agency's formal recognition of the magnitude of the challenge posed by a novel H1N1 flu virus that is spreading globally among people who, because the virus is new, are universally susceptible to it.

The WHO is working closely with vaccine manufacturers who are just wrapping up production of seasonal flu vaccine for fall and are gearing up to produce the first doses of an H1N1 vaccine by September. The agency urged member nations to maintain their vigilance to detect changes in the virus's behavior and, if the virus is widespread, to focus on caring for patients.

Although WHO chief Margaret Chan described the pandemic as "moderate in severity," she stressed that flu viruses are unpredictable.

"The virus writes the rules," she said. "This one, like all influenza viruses, can change the rules without rhyme or reason, at any time."

Centers for Disease Control and Prevention Director Thomas Frieden, who led New York City's response to the epidemic as health commissioner until he took over at the CDC this month, said federal, state and local health officials long ago set in motion appropriate steps for responding to a pandemic. "This is not a surprise," Frieden said. "It was expected based on the data."

Frieden said they have stockpiled millions of doses of antiviral drugs, prodded makers to vastly increase their capacity to produce flu vaccine and staged desktop simulations to explore the best strategies for coping with an epidemic.

Fortunately, most cases of the new H1N1 flu, also known as swine flu, run their course without complications. Most patients require no medical treatment, but about 2 percent of patients develop severe disease, often life-threatening pneumonia, Chan said. Most deaths have occurred in adults between the ages of 30 and 50, a marked change from seasonal influenza, when most deaths occur in fragile elderly people, Chan says.

Most of those who have died suffer from underlying illnesses, including asthma, heart disease, diabetes, obesity and immune deficiencies.

On Thursday, the WHO said 74 countries had reported nearly 28,774 cases of H1N1 flu, including 144 deaths.

About 8 percent of the 13,217 patients in the USA have been hospitalized, according to the CDC.

The last pandemic, the Hong Kong flu of 1968, killed about 1 million people worldwide. Ordinary flu kills 250,000 to 500,000 people worldwide each year.

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