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Definition and stages

According to the World Health Organization (WHO), a pandemic can start when three conditions have been met.

  • Emergence of a disease new to a population;
  • Agents infect humans, causing serious illness; and
  • Agents spread easily and sustainably among humans.

A disease or condition is not a pandemic merely because it is widespread or kills many people; it must also be infectious. For instance, cancer is responsible for many deaths but is not considered a pandemic because the disease is not infectious or contagious.

In a virtual press conference in May 2009 on the influenza pandemic Dr Keiji Fukuda, Assistant Director-General ad Interim for Health Security and Environment, WHO said "An easy way to think about pandemic ... is to say: a pandemic is a global outbreak. Then you might ask yourself: "What is a global outbreak"? Global outbreak means that we see both spread of the agent ... and then we see disease activities in addition to the spread of the virus.

In planning for a possible influenza pandemic the WHO published a document on pandemic preparedness guidance in1999, revised in 2005 and during the 2009 outbreak, defining phases and appropriate actions for each phase in an aide memoire entitled WHO pandemic phase descriptions and main actions by phase. All versions of this document refer to influenza. The phases are defined by the spread of the disease; virulence and mortality are not mentioned.

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