BANGKOK, Apr 29 (IPS) - When the World Health Organisation (WHO) raised the influenza pandemic alert from phase three to an ominous phase four warning this week, it went beyond the alarm associated with the killer avian influenza virus in Asia.
The global health body's warning came as the outbreak of a lethal strain of swine flu has killed more than 150 people in Mexico - the epicentre of the virus - and has also been detected in parts of the United States, Canada, Europe, the Middle East and Asia.
The WHO warning for a possible global pandemic emerging from avian influenza always remained a "phase three alert," says Peter Cordingley, spokesman for the WHO's Western Pacific division. "The difference now is that we have raised the pandemic alert to phase four."
"This is WHO's way of saying [the lethal virus] has edged close to a pandemic situation," he added during a telephone interview from Manila, where the WHO's regional office is based. "It can spread internationally."
A phase four alarm is often sounded when there are reports of "community- level outbreaks," which has been the case with the recent strain of the H1N1 strain of the swine flu virus, but not so with the cases of human-to-human transmission of the H5N1 strain of bird flu virus across Asia.
According to the WHO, a phase five alert is sounded when there is human-to- human transmission of a deadly virus "into at least two countries in WHO region." And the final phase six alert is declared when the virus enters the "pandemic phase," where community level outbreaks are detected in "at least one other country in a different WHO region in addition to the criteria defined in phase five."
It was fear of the avian influenza virus mutating and re-assorting itself with other viruses and emerging as a global pandemic that promoted the WHO to first sound the alarm in early 2004 that the world was on the brink of a public health crisis. At the time, grim pictures were painted, including mention of the 1918 "Spanish" flu pandemic that killed over 50 million people across the world.
But when and where such a lethal virus would emerge remained elusive.
"The current situation was, at least technically, what we were worried about at the height of the avian influenza scare," says Cordingley. "It was a situation we were always worried about: the virus going through pigs - the mixing vessel - and emerging as a new virus, infecting humans."
Such a scenario is behind the current lethal virus that is spreading between humans. "There has been a re-assortment of genes from poultry, swine and human virus strains," says Subhash Morzaria, regional manager of the Bangkok-based emergency centre for trans-boundary animal diseases at the Food and Agriculture Organisation (FAO). "It has been confirmed that human and poultry viruses infected swine and got mixed."
"This combination is not rare. Re-assortment of viruses in swine is frequent," he told IPS. "But the re-assortment of the virus we have now is new; we have not seen this before."
Worries that the new virus is more potent than the bird flu virus are not out of place. In the over six years since the H5N1 strain emerged in Asia and then spread to other corners of the world, there have been 257 reported deaths out of 421 cases. The worst affected country has been Indonesia, where 115 people have died out of the 141 infected.
Even the 2003 outbreak of severe acute respiratory syndrome, or SARS, which prompted concern in the region, did not trigger a pandemic alarm with the speed that the H1N1 virus has. SARS spread to humans from animals and was associated with flu-like symptoms, such as high fever, headaches and respiratory problems.
By the time it was contained, SARS had killed 774 people out of the 8,000 who had been infected in over 20 countries in Asia, Europe and the Americas.
Yet as Asian countries take preventive measures to respond to the latest threat of a global pandemic, the region's experience - having combated SARS and contained bird flu - sees it at a better level of readiness. The Association of South-east Asian Nations (ASEAN), a 10-member regional bloc, reflects this confidence.
"ASEAN member states are better prepared now following the experience from recent SARS and avian-influenza outbreaks," states the regional grouping, which includes Brunei, Burma, Cambodia, Indonesia, Laos, Malaysia, Philippines, Singapore, Thailand and Vietnam. "ASEAN has the existing mechanisms and networks for strengthening preparedness and response to a possible pandemic."
Such resources include "500,000 courses of antivirals stockpiled in Singapore, while 500,000 more courses have already been distributed," reports 'The Nation', an English-language daily in Thailand. There is equipment that "is readily available for ASEAN countries for rapid response and containment of outbreaks that may occur in the region."
The picture is also true for most of Asia, confirms the WHO's Cordingley. "Each country has committed resources to strengthen their health systems. Doctors and nurses have been trained and hospitals have been improved."
"The health systems in Asia are vastly different than in 2003, when SARS struck," he added. "Now they will have to monitor the virus. We don't know what this virus will do."