December 13, 2005

New WHO Rules May Help Fight Bird Flu: Official

By Maggie Fox, Health and Science Correspondent

WASHINGTON -- New regulations aimed at making it easier for countries to share information about disease outbreaks will help fight avian influenza, a senior World Health Organization official said on Monday.

The new regulations, along with the experience in controlling Severe Acute Respiratory Syndrome (SARS), should ease the way for cooperation should there be an influenza pandemic, said Dr. David Heymann, executive director for communicable diseases at WHO.

"SARS showed us that countries are willing to give up just a little bit of their sovereignty for the good of the world," Heymann said in an interview.

SARS swept out of southern China in 2002 and by the time it was contained in mid-2003 it had infected close to 8,000 people and killed 800.

It was caused by a virus in the coronavirus family that had never been seen before. Unprecedented public health measures helped control it before it spread widely, although it got as far as Canada via jet.

H5N1 bird flu is considered much more dangerous. It is entrenched in flocks across much of Asia and as far west as Ukraine and Romania. It is not yet easily passed to people but WHO has reported 137 cases and 70 deaths in five Asian countries.

WHO is urging affected countries to report H5N1 outbreaks right away and to get help in controlling them.

New rules, called the International Health Regulations and adopted by the World Health Assembly in May, build on lessons learned from SARS, Heymann said before describing the new rules to a meeting of the American Society of Tropical Medicine and Hygiene.

Under previous rules, WHO member states only had to report cases of cholera, plague and yellow fever. Now they must report "all events that may constitute a public health emergency of international concern."


Countries must also put into place the infrastructure to make sure they can do this -- meaning laboratories and staff who can diagnose disease outbreaks. And countries must report any public health risks they are aware of, even if they fall outside their territories.

Heymann said the new rules will help if H5N1 does cause a pandemic.

"What certainly would occur is collaboration between clinicians, virologists and biologists," Heymann said.

"Every day (during SARS) there were telephone conferences and video conferences and sharing of information." This was new since scientists and doctors previously jealously guarded their research for publication in prestigious journals.

Heymann was sent to meet with heads of state during the SARS crisis and found they were willing to take the serious consequences of having the virus present in their countries, including trade and travel restrictions.

"Never once did they try to push WHO to lift the regulations," he said.

But H5N1 could cause much greater disruption than SARS.

"SARS was much easier to control because it was such a low-transmissibility disease," Heymann said. "SARS you didn't spread probably until 10 days after you got sick."

People spread flu before they even know they are ill.

If you rate infectious diseases from one to 100, based on how infectious they are, SARS would rate at 20 to 30 percent while influenza rates 90 to 100 percent, Heymann said.

SARS also did not get into developing countries that had no way to monitor or report epidemics, Heymann added. That is something influenza could easily do with disastrous consequences.

There would be a "massive disruption of services," he said. "You have to distance yourself. You have to fend for yourself."