Wednesday, July 8, 2009

International Agencies Try to End Flu Naming Wars - pandemic (H1N1) 2009

JULY 7, 2009

Repeat after me: "Pandemic H1N1 2009." That's the new name three international agencies, including the World Health Organization, have picked to end the chronic confusion about what to call the influenza pandemic and the virus that causes it. But some scientists are only half-happy with the solution.
From the outset, health agencies and scientists have used a variety of monikers to describe the pathogen. "Mexican flu" and "swine flu" were considered controversial because they could stigmatize Mexicans or induce irrational fears of pigs or pork. So a plethora of alternatives has resulted. WHO has stuck with "influenza A(H1N1)," a term criticized by scientists as ambiguous because there's a seasonal A(H1N1) strain circulating as well. Others have called the pathogen anything from "swine-origin influenza virus" and "novel influenza H1N1" to "influenza A(H1N1)v," in which "v" stands for "variant."
Now, WHO, the Food and Agriculture Organization of the United Nations (FAO), and the World Organisation for Animal Health (OIE) have chosen to use "pandemic (H1N1) 2009" for the disease. For example: "Hundreds of new cases of pandemic (H1N1) 2009 were reported." And: "pandemic (H1N1) 2009 virus" for the agent. In scientific papers, genome databases, et cetera, researchers can use the existing, complex naming scheme for individual viral isolates, but add a "v" to indicate that it's the pandemic strain, as in "A/California/7/2009(H1N1)v."
The new nomenclature was first reported yesterday on ProMED, an online outbreak reporting system, where it had arrived through a "personal communication" from someone within WHO, says ProMED Viral Diseases Moderator Craig Pringle. At a telephone press conference today, WHO flu chief Keiji Fukuda said the three agencies picked the new name after a virtual consultation with virus experts several weeks ago. They didn't issue an official statement to introduce the name, however; WHO simply started using it in its Situation updates on the web on 1 July. OIE and FAO have yet to introduce it on their Web sites, where various other names are in use.
Virologist Ron Fouchier of Erasmus Medical Center in Rotterdam, the Netherlands, says the name is a lot better than WHO's previous choice because it's not ambiguous. But it's hard to use in online literature searches, he says: The individual words "H1N1," "pandemic," and "2009" are bound to result in too many hits, but their combination in too few. Fouchier is still rooting for "Mexican flu," which is easier to use in searches, catchier, and in line with tradition, given that 20th century pandemics were called Spanish, Asian, and Hong Kong influenza.
Pringle says he finds the use of the "v" for "variant" in the names for individual isolates "illogical", because other "variants" of H1N1 may exist, or could appear in the future. But ProMEd will adopt the new terminology anyway, he says, because it wants to promote consistency. And with tens of thousands of subscribers around the world, its could well tip the balance in favor of the new name.
—Martin Enserink

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