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Appendix D: World Health Organization (WHO) Pandemic Phases and the Federal Government Response Stages



The WHO Pandemic Phases are designed to provide guidance to the international community on preparedness and response for pandemic threats and pandemic disease. Recognizing that distinctions between the two inter-pandemic phases and the three pandemic alert phases may be unclear, the WHO Secretariat proposes to base classification on assessment of risk based on a range of scientific and epidemiological data.

The phase in which a country is in will differ from country to country based on whether the nation is affected by the novel influenza subtype. National subdivisions of phases will be designated by national authorities. In the United States, pandemic phases will be defined based on the global phase and determined by the Secretary of Health and Human Services. During the pandemic phase, additional subdivisions may be defined based on the extent of disease. In actual practice, the distinction between the various phases of pandemic influenza may be blurred or occur in a matter of hours, again underscoring the need for flexibility.

Interconnected with the WHO phases are the Federal Government Response Stages (FGRS) which provide a framework for U.S. Federal Government planning/preparatory, response, and recovery actions. Table D-1 provides the relationship between the two.

Table D-1. WHO Phases and the Federal Goverment Response Stages
WHO Phases Federal Government Response Stages
INTER-PANDEMIC PERIOD

1

No new influenza virus subtypes have been detected in humans.  An influenza virus subtype that has caused human infection may be present in animals.  If present in animals, the risk of human disease is considered to be low.

0

New domestic animal outbreak in at-risk country

2

No new influenza virus subtypes have been detected in humans.  However, a circulating animal influenza virus subtype poses a substantial risk of human disease.

PANDEMIC ALERT PERIOD

3

Human infection(s) with a new subtype, but no human-to-human spread, or at most rare instances of spread to a close contact.

0

New domestic animal outbreak in at-risk country

1

Suspected human outbreak overseas

4

Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.

2

Confirmed human outbreak overseas

5

Large cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming better adapted to humans, but may not yet be fully transmissible (substantial pandemic risk).

PANDEMIC PERIOD

6

Pandemic phase:  increased and sustained transmission in general population.

3

Widespread human outbreaks in multiple locations overseas

4

First human case in North America

5

Spread throughout United States

6

Recovery and preparation for subsequent waves