BioWorld Today Staff Writer

As the number of infections and deaths continue to rise - and for the first time in four decades - the World Health Organization has declared a pandemic influenza outbreak of an entirely new virus: swine (H1N1) influenza.

"The world is now at the start of the 2009 pandemic," said Margaret Chan, WHO director general, during a press conference Thursday. "We are in the earlier phase of the pandemic. The virus is spreading. No previous pandemic has been detected so early or watched so closely in real time."

As of June 11, 74 countries have reported 28,774 cases of lab-confirmed swine flu infections and 144 people have died.

Chan told a global audience of news reporters via teleconference that even though the virus has not been comparatively deadly since it emerged in April, "We do not know how this virus will behave under conditions typically found in the developing world. To date, the vast majority of cases have been detected and investigated in comparatively well-off countries."

But, she said, "it is prudent to anticipate a bleaker picture as the virus spreads to areas with limited resources, poor health care and a high prevalence of underlying medical problems."

Chan and other WHO authorities earlier in the day met in an emergency meeting. Before raising the alert from 5 to the highest level, 6, she said they consulted with leading influenza experts, virologists and public health officials. The decision was made in line with procedures set out in International Health Regulations.

H1N1 was first isolated from a pig in 1930, and the current human outbreak was first noted in early spring. What is notable about this version of the flu is that it attacks a very different population of people. Most of the people who have gotten sick from H1N1 are between the ages of 5 and 24, and 40 percent of those hospitalized are between the ages of 19 and 49, a twist that has alarmed public health officials.

Many of those who have developed severe cases have underlying conditions. The WHO reported that the most frequent conditions are respiratory diseases (notably asthma), cardiovascular disease, diabetes, autoimmune disorders and obesity.

"We know, too, that this early, patchy picture can change very quickly," Chan said. "The virus writes the rules, and this one, like all influenza viruses, can change the rules, without rhyme or reason, at any time. "

She predicted that the first batches of vaccine will be ready in mid-September. Those likely will be rationed to people at greatest risk.

Vaccine makers are shifting into high gear so that vaccines will be available "soon" to ensure the largest possible supply of pandemic protection in the months to come. But a more specific timetable or plan of action for widespread vaccination has not yet been determined.

"Pending the availability of vaccines, several nonpharmaceutical interventions can confer some protection," she said. "Normally it takes four to six months to make a vaccine. For the next few months, no country will have vaccine. The challenge of the world is to look at who should get the vaccine, which groups get the vaccines."

Specific guidance on vaccine distribution will be coming in the next few weeks.

When asked if health authorities have noted any sort of mutation in the H1N1 virus, Chan said no. But interestingly, an analysis of the genomic data for H1N1 reveals that there is an increasing lethality related to the infection.

Biotech company Replikins Ltd., of Boston, this week published a new sequence showing an increase in the Replikin count of H1N1 using the company's FluForecast software. Replikins are a new group of peptides related to the rapid replication function in viral and other diseases.

"Last month the H1N1 genomic data indicated some bad and some good news. While it indicated an increase in the infectivity of the H1N1 virus, its lethality appeared to remain relatively low," Sam Bogoch, chairman of Replikins, said in a statement.

"However, the FluForecast analysis of new data of the past few weeks on 144 new specimens published on PubMed, indicate an increase in the current H1N1 outbreak's capacity for lethality. Since the software also permitted the automated analysis of all sequence data available on PubMed for all previous years, it was noted that this is the first such significant increase in the Replikin Count of the H1N1 Lethality Gene in 76 years. This is cause for concern and an accelerated vaccine effort," he added.