Recent Updates:

WHO guidelines for humanitarian agencies
Pandemic influenza preparedness and mitigation in refugee and displaced populations
MAY 2006
WHO/CDS/NTD/DCE/2006.2
© World Health Organization 2006

This document provides background information on pandemic influenza, describes WHO pandemic phases and strategies to deal with a pandemic according to phase, and outlines preparedness activities needed during the pre-pandemic period. The remainder of the document will focus on response during an influenza pandemic.

An influenza pandemic occurs when a new influenza virus appears against which the human population has limited or no immunity, resulting in several, simultaneous epidemics worldwide with the potential for considerable morbidity and mortality. With the increase in global transport and communications, as
well as urbanization and overcrowded conditions, epidemics caused by the new influenza virus are likely to quickly take hold around the world. The impact of a novel pandemic influenza virus on refugee and displaced populations is expected to be severe. Risk factors for increased morbidity and mortality of pandemic influenza in these populations include:
• overcrowding, particularly in camp settings;
• poor access to basic health-care services that will be accentuated by a pandemic;
• limited or no access to hospitals for supportive care;
• high prevalence of malnutrition;
• high incidence/prevalence of other communicable diseases, e.g. acute respiratory illnesses, malaria, human immunodeficiency virus (HIV);
• logistic challenges resulting from often remote locations or ongoing active conflict;
• lack of adequate surveillance/early warning systems to detect cases or clusters;
• poor links to national disease surveillance systems;
• possible exclusion from national influenza preparedness and response activities;
• lack of trained and equipped staff to investigate cases/clusters detected.

In addition, WHO and the United Nations (UN) have encouraged each country to create a national pandemic preparedness plan (PPP). These national plans, developed by government ministries including health and agriculture, may not sufficiently take refugee and displaced populations into account. This is particularly of concern in countries where health-care programmes for these populations are implemented by humanitarian agencies, often under coordination of UN organizations. This gap could leave these populations more vulnerable to a pandemic.