Downgrading the 2009 H1N1 scare

No one opposes the promotion of hand-washing as a good hygienic practice in general, but it has been misleading for public health agencies to claim it is vital for preventing transmission of influenza viruses. Blind adherence to this scientifically unsupported measure threatens to erode the credibility of all public agencies that have aggressively implemented this recommendation. It is bizarre that many government health agencies, including the U.S. Centers for Disease Control, continue to promote it, despite lack of evidence.

It is now clear that the 2009 H1N1 virus is not as deadly as current seasonal influenza viruses, and that public health efforts to contain the spread of this virus were largely wasted. The WHO's graded alert phases for influenza pandemics may imply, but do not take into account, the severity (as measured by deaths) of the pandemic.

The WHO's alert for the 2009 H1N1 pandemic still stands at its top phase 6 which merely denotes “widespread human infections.”

Based on the global influenza surveillance data collected, the WHO influenza forecast and advisory for 2010 should say: “The severity of the 2009 H1N1 influenza pandemic virus has been reduced from a potential maximum severity virus to a baseline severity seasonal influenza virus that may cause scattered outbreaks during the 2010 respiratory disease season. All of the additional high-risk populations identified in the 2009 pandemic should receive the 2010 seasonal influenza vaccine, and everyone should continue to wash their hands regularly, even though this practice does not prevent transmission of influenza viruses.”

James Chin MD MPH is Clinical Professor of Epidemiology at the School of Public Health, University of California, Berkeley, and former chairperson of the U.S. national Advisory Committee for Immunization Practices (ACIP).

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