The World Health Organization, whose duties include directing and coordinating authority for health within the United Nations system, will soon be writing science textbooks.
That statement isn’t true, of course. But it was my reaction to reading the latest announcement from Geneva:
Bowing to pressure, the World Health Organization announced Friday that it would rewrite its rules for alerting the world to new diseases, meaning the swine flu circling the globe will probably never be declared a full-fledged pandemic. Dr. Keiji Fukuda, the deputy director general making the W.H.O. announcement, said that he could not predict exactly what the new rules would be but that criteria would include a “substantial risk of harm to people,†not just the geographic spread of a relatively benign virus.
Apparently members of the United Nations don’t like the fact that WHO has been using ‘pandemic’ to describe the global spread of the new H1N1 influenza strains. They feel that the word pandemic implies that the virus is lethal and capable of causing many deaths – like the 1918 strain of influenza. Problem is, the new H1N1 strain isn’t any more lethal than seasonal strains of the virus. Apparently using the p-word gets everyone frightened as pandemic preparedness plans shift into gear.
According to the virology textbooks (one of which I wrote), the word pandemic means ‘global epidemic’. Even wikipedia has a benign definition: “A pandemic (from Greek παν pan all + δήμος demos people) is an epidemic of infectious disease that spreads through populations across a large region; for instance a continent, or even worldwide.”
I can already see how the WHO edict will influenza future versions of textbooks. For example, the current edition of  Clinical Virology states “Over the past 300 years, at least six pandemics of influenza have probably occurred, including three well-characterized ones in the 20th century”. In the next edition, this will have to be rewritten: “Until recently, at least six pandemics of influenza have probably occurred, including three well-characterized ones in the 20th century. In 2009, a new strain of H1N1 influenza emerged and spread globally, but it was not considered a pandemic by the new WHO rules”.
WHO redefining pandemic is absurd. Pandemic is an epidemiological definition that has nothing to do with virulence. A pandemic of influenza occurs when a new viral strain emerges to which the population has little or no immunity. Although pandemic is most frequently associated with influenza virus, other infectious agents may cause worldwide epidemics. The world is currently in the midst of an AIDS pandemic, one of the worst in history.
WHO should leave textbook writing to others. To paraphrase Andre Lwoff, a pandemic is a pandemic. The word implies nothing about virulence – and has little to do with politics.
The second RNA segment of the influenza virus genome encodes two proteins, PB1 and PB1-F2. The latter protein is believed to be an important determinant of virulence of influenza virus. Can we learn anything about the virulence of the new influenza virus H1N1 strains from a study of this protein?