WHO chief does not raise swine flu alert level

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GENEVA (AP) — The chief of the World Health Organization says she is not raising the world swine flu alert level just yet.

Several countries including Britain, Japan and China had urged the U.N. health agency to change how it decides to raise the alert level.

WHO chief Dr. Margaret Chan says the swine flu epidemic is in "a grace period" with the WHO alert remaining at phase 5 out of a possible six for the last month. She told the WHO annual assembly on Monday that no one can say how long this period will last.

Chan says the danger now is that the swine flu virus could mix with other flu strains and become more dangerous.

THIS IS A BREAKING NEWS UPDATE. Check back soon for further information. AP's earlier story is below.

GENEVA (AP) — Britain, Japan, China and other nations urged the World Health Organization on Monday to change the way it decides to declare a pandemic __ saying the agency must consider how deadly the virus is, not just how fast it is spreading.

The debate arose as WHO began its annual meeting, a five-day event attended by hundreds of health experts from the agency's 193 member nations. Swine flu is expected to dominate this year's conference — and WHO must consider whether it should raise its alert level or tell manufacturers to begin making a specific swine flu vaccine.

WHO's current system focuses on how widespread the disease has become without regard to its severity. Some member nations are anxious to avoid having the agency declare a swine flu pandemic, because the ramifications of that scientific decision could be very costly and politically charged.

"We need to give you and your team more flexibility as to whether we move to phase 6," British Health Secretary Alan Johnson said.

Japan also called for changes in WHO's system, which would move to pandemic if the virus starts to be transmitted among people outside schools, hospitals and other institutions where viruses typically pass quickly.

"It's certainly something we will look at very closely," Dr. Keiji Fukuda, WHO's flu chief, said of the proposal.

So far, the United States was noncommittal on the issue. U.S. Health and Human Services Secretary Kathleen Sebelius told The Associated Press she wanted more information on the proposal before taking a position, but that she was impressed how many countries supported it.

Health experts were examining new swine flu cases in Spain, Britain and especially Japan, where more than 130 people, the vast majority of them teenagers, have been infected, prompting the government to close 2,000 schools and cancel public events. A good number of the new cases were transmitted in-country, infecting people who had not traveled overseas recently.

WHO says transmission rates in countries outside the Americas is the key factor in whether the agency should raise its pandemic alert scale to the highest level. Right now it is at phase 5 — out of a possible 6 — meaning a global outbreak is "imminent."

Dr. Richard Besser, acting director of the U.S. Centers for Disease Control and Prevention, told the WHO meeting that the outbreak is "not winding down" in the United States and "widespread transmission" continues. He also said the epidemic also was not over in Mexico.

Speaking a day after New York school assistant principal Mitchell Wiener died of swine flu, Besser said the world needed to maintain its vigilance against the virus.

Dr. Margaret Chan, WHO director-general, said scientists were working to provide as much detail about the disease as possible.

"What we need now most of all is information," Chan said. "We must guard against complacency."

But WHO officials did not appear to welcome the concept of a universal severity measure.

"Severity and the broader impact on society is something that we really can't set globally, because of the unique conditions in every community," WHO spokesman Dick Thompson told the AP. "Severity is going to be different in different countries. And within a country, it will be different in different populations."

As of Monday, the swine flu virus has sickened at least 8,829 people in 40 countries, including 76 deaths. Chile on Sunday became the latest country to confirm a case of swine flu.

A pandemic announcement would likely have severe economic consequences: it could trigger expensive trade and travel restrictions like border closures, airport screenings and quarantines, as countries not yet affected struggle to keep the virus out.

Governments may also fear outbreaks of mass panic, social disruption and increased pressures on their health systems. Under public pressure, extraordinary measures such as large-scale pig slaughters like the recent one in Egypt could be taken, whether or not they are scientifically justified.

In one of their first moves Monday, delegates unanimously elected Sri Lanka's Health Minister Nimal Siripala de Silva to preside over the assembly, a largely ceremonial post.

That vote surprised about 200 protesters demonstrating outside the U.N.'s European headquarters against Sri Lanka's assault on ethnic Tamil rebels.

"We are really shocked about this," said Safeena Mohamed Rawfal, claiming de Silva has cared only for majority Sinhalese and ignored the needs of the Tamils in the country's long civil war.

Sometime during the meeting, Chan is expected to reveal experts' recommendations on whether to produce a swine flu vaccine.

U.N. Secretary-General Ban Ki-moon will visit WHO on Tuesday to meet with senior representatives from the vaccine industry. The U.N. declined to name the companies but major vaccine producers include Sanofi-Aventis, GlaxoSmithKline and Baxter International.

The issue of producing a vaccine is sensitive, particularly for southern hemisphere countries where the annual flu season is about to begin. Seasonal flu can claim as many as 500,000 lives a year globally. But to have enough vaccine to confront a pandemic from a new strain such as swine flu, companies would have to switch from producing vaccine for seasonal flu.

WHO estimates up to 2 billion doses of swine flu vaccine could be produced yearly, though the first batches would not be available for four to six months.

Swine flu cases in Japan rose from four on Friday to over 130 on Monday. Most of the new cases involved high school students in the western prefectures of Hyogo and Osaka who had not traveled overseas.

Spain and Britain have the highest numbers of cases in Europe, reporting 103 and 101 cases, respectively.

Taiwan was taking part in the World Health Assembly as an observer with the approval of Beijing, the first time the island has participated in a U.N. meeting since its seat was given to China in 1971.

Associated Press Writers Mari Yamaguchi in Tokyo and AP Medical writer Maria Cheng in London contributed to this report.

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