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Last update: August 15, 2014.
1

Pandemic Flu  

MedlinePLUS

... address the pandemic. Characteristics and Challenges of a Flu Pandemic Rapid Worldwide Spread When a pandemic flu ... exposure could result in significant employee absenteeism. Seasonal Flu versus Pandemic Flu Pandemic Flu Seasonal Flu Rarely ...

2

Pandemic Flu  

NSDL National Science Digital Library

With the recent rise in flu outbreaks both across the United States and the rest of the world, the United States government has developed a broad range of strategies for keeping citizens up to date on the current status of these developments. The Pandemic Flu website is the official US government website for information on the subject (along with coverage of avian influenza) and should be of interest both to the general public and to those working in the fields of public health and policy. First-time visitors may want to begin by looking through the general information area on the homepage. Here they will find answers to basic questions as âÂÂWhat is an influenza pandemic?â and also be able to peruse materials about avian flu and vaccines and medications designed to treat both conditions. Most visitors will also want to learn about the official national strategy designed to both prepare and respond to an influenza pandemic. This document is available from the siteâÂÂs homepage in its entirety, as is information about what agencies (nationally and internationally) are monitoring outbreaks of these diseases.

3

Preparing for a Pandemic Flu Outbreak  

ERIC Educational Resources Information Center

This article discusses the things college leaders should know and do in case of a pandemic influenza outbreak. The author talks about four principles that will guide college leaders in developing a pandemic influenza plan and presents the 10 elements of an effective college pandemic planning process.

Dittbenner, Richard

2009-01-01

4

Pandemic Flu: A Planning Guide for Educators  

ERIC Educational Resources Information Center

An influenza (flu) pandemic is a global outbreak of disease that occurs when a new flu virus appears that can spread easily from person to person. Although it is difficult to predict when the next influenza pandemic will occur or how severe it will be, effects can be lessened if preparations are made ahead of time. The illness rates for both…

US Department of Education, 2006

2006-01-01

5

How Does Seasonal Flu Differ From Pandemic Flu?  

MedlinePLUS

... Home Current Issue Past Issues How Does Seasonal Flu Differ From Pandemic Flu? Past Issues / Fall 2006 Table of Contents For ... of this page please turn Javascript on. Seasonal Flu Pandemic Flu Outbreaks follow predictable seasonal patterns; occurs ...

6

Managing a Bird Flu Pandemic  

ERIC Educational Resources Information Center

Concern about a possible bird flu pandemic has grown in the medical community with the spread of the avian flu virus around the globe. Health officials say there is no immediate threat but add that an influenza pandemic occurs every 30 to 40 years, and prudence demands planning now. That planning will increasingly involve local school officials,…

Stover, Del

2006-01-01

7

Global Activities: Pandemic Flu, H1N1 (Swine Flu), and H5N1 (Avian Flu)  

MedlinePLUS

... response to a potential pandemic. Monitoring Potential Pandemic Flu Influenza Update Read summaries of the World Health ... information on potential flu pandemics. Monitoring H5N1 (Avian) Flu Cumulative Number of Confirmed Human Cases of Avian ...

8

WHO and the pandemic flu “conspiracies”  

Microsoft Academic Search

Key scientists advising the World Health Organization on planning for an influenza pandemic had done paid work for pharmaceutical firms that stood to gain from the guidance they were preparing. These conflicts of interest have never been publicly disclosed by WHO, and WHO has dismissed inquiries into its handling of the A\\/H1N1 pandemic as “conspiracy theories.” Deborah Cohen and Philip

Deborah Cohen; Philip Carter

2010-01-01

9

Don't Confuse Common Flu with a Flu Pandemic  

ERIC Educational Resources Information Center

It is the time of year once again when students and staff members who are going around with coughs, colds, fevers, and sneezes abound in schools everywhere. Although it may seem more immediate to focus on the matter of how the seasonal/common flu will affect a particular school during the course of this school year, the fact of the situation is…

St. Gerard, Vanessa

2007-01-01

10

Deciphering the Swine-Flu Pandemics of 1918 and 2009  

NASA Astrophysics Data System (ADS)

The devastating "Spanish flu" of 1918 killed an estimated 50 million people worldwide, ranking it as the deadliest pandemic in recorded human history. It is generally believed that the virus transferred from birds directly to humans shortly before the start of the pandemic, subsequently jumping from humans to swine. By developing 'non-homogeneous' substitution models that consider that substitution patterns may be different in human, avian, and swine hosts, we can determine the timing of the host shift to mammals. We find it likely that the Spanish flu of 1918, like the current 2009 pandemic, was a 'swine-origin' influenza virus. Now that we are faced with a new pandemic, can we understand how influenza is able to change hosts? Again by modelling the evolutionary process, considering the different selective constraints for viruses in the different hosts, we can identify locations that seem to be under different selective constraints in humans and avian hosts. This allows us to identify changes that may have facilitated the establishment of the 2009 swine-origin flu in humans.

Goldstein, Richard; Dos Reis, Mario; Tamuri, Asif; Hay, Alan

11

Flu Plan: Colleges Struggle with How They Would React to a Pandemic  

ERIC Educational Resources Information Center

Administrators of various education schools have vowed to ready their institutions for the next major disaster of flu pandemic. While a few colleges with expertise or interest in the area are trying to determine how their campuses should react to a flu pandemic, most seem to be struggling with how to fit all the unknowns of such a crisis into…

Guterman, Lila

2005-01-01

12

Schools Urged to Prepare for Flu  

ERIC Educational Resources Information Center

If a flu pandemic breaks out in the United States, as many as 4 in 10 school-age children will become sick, according to the U.S. Department of Health and Human Services, which released a comprehensive plan on how it would deal with such an outbreak. The nearly 400-page plan says the department would consider measures such as closing schools early…

Honawar, Vaishali

2005-01-01

13

Flu  

MedlinePLUS

... Child Need? Flu Center Too Late for a Flu Shot? Your Child's Immunizations: Influenza Vaccine Immunization Schedule What ... Get the Flu Flu Center Who Needs a Flu Shot? Flu Center The Flu Vaccine Contact Us Print ...

14

Five Thorny Questions to Ask when Planning for an Avian Flu Pandemic  

ERIC Educational Resources Information Center

Public health experts project a strong possibility that an avian flu pandemic will occur in the next 4 years, and the federal government has already warned that states and localities must make their own plans for this event since such a broad scale public health crises would far outstrip federal capacity to respond. Colleges and universities are…

Ostroth, D. David; Frias, Mary Lou; Turrentine, Cathryn G.

2006-01-01

15

Documents Related to the Flu Pandemic of 1918  

ERIC Educational Resources Information Center

This article discusses a worldwide epidemic--a pandemic--that appeared in the United Sates during the latter part of the summer of 1918. During 1918 and 1919, between 50 and 100 million people around the globe fell victim to a rapidly spreading and untreatable strain of influenza. The pandemic so severely affected the U.S. population that roughly…

Mazzone, Raphael; Potter, Lee Ann

2006-01-01

16

Crying wolf? Biosecurity and metacommunication in the context of the 2009 swine flu pandemic.  

PubMed

This article explores how the 2009 pandemic of swine flu (H1N1) intersected with issues of biosecurity in the context of an increasing entanglement between the spread of disease and the spread of information. Drawing on research into metacommunication, the article studies the rise of communication about ways in which swine flu was communicated, both globally and locally, during the pandemic. It examines and compares two corpora of texts, namely UK newspaper articles and blogs, written between 28 March and 11 June 2009, that is, the period from the start of the outbreak till the WHO announcement of the pandemic. Findings show that the interaction between traditional and digital media as well as the interaction between warnings about swine flu and previous warnings about other epidemics contributed to a heightened discourse of blame and counter-blame but also, more surprisingly, self-blame and reflections about the role the media in pandemic communication. The consequences of this increase in metacommunication for research into crisis communication are explored. PMID:21470893

Nerlich, Brigitte; Koteyko, Nelya

2012-07-01

17

New pandemics: HIV and AIDS, HCV and chronic hepatitis, Influenza virus and flu  

PubMed Central

New pandemics are a serious threat to the health of the entire world. They are essentially of viral origin and spread at large speed. A meeting on this topic was held in Lyon, France, within the XIXth Jacques Cartier Symposia, a series of France-Québec meetings held every year. New findings on HIV and AIDS, on HCV and chronic hepatitis, and an update on influenza virus and flu were covered during this meeting on December 4 and 5, 2006. Aspects of viral structure, virus-host interactions, antiviral defenses, drugs and vaccinations, and epidemiological aspects were discussed for HIV and HCV. Old and recent data on the flu epidemics ended this meeting.

Gatignol, Anne; Dubuisson, Jean; Wainberg, Mark A; Cohen, Eric A; Darlix, Jean-Luc

2007-01-01

18

Global response to pandemic flu: more research needed on a critical front  

PubMed Central

If and when sustained human-to-human transmission of H5N1 becomes a reality, the world will no longer be dealing with sporadic avian flu borne along migratory flight paths of birds, but aviation flu – winged at subsonic speed along commercial air conduits to every corner of planet Earth. Given that air transportation is the one feature that most differentiates present day transmission scenarios from those in 1918, our present inability to prevent spread of influenza by international air travel, as reckoned by the World Health Organization, constitutes a major weakness in the current global preparedness plan against pandemic flu. Despite the lessons of SARS, it is surprising that aviation-related health policy options have not been more rigorously evaluated, or scientific research aimed at strengthening public health measures on the air transportation front, more energetically pursued.

Lim, Meng-Kin

2006-01-01

19

Development of a resource modelling tool to support decision makers in pandemic influenza preparedness: The AsiaFluCap Simulator  

PubMed Central

Background Health care planning for pandemic influenza is a challenging task which requires predictive models by which the impact of different response strategies can be evaluated. However, current preparedness plans and simulations exercises, as well as freely available simulation models previously made for policy makers, do not explicitly address the availability of health care resources or determine the impact of shortages on public health. Nevertheless, the feasibility of health systems to implement response measures or interventions described in plans and trained in exercises depends on the available resource capacity. As part of the AsiaFluCap project, we developed a comprehensive and flexible resource modelling tool to support public health officials in understanding and preparing for surges in resource demand during future pandemics. Results The AsiaFluCap Simulator is a combination of a resource model containing 28 health care resources and an epidemiological model. The tool was built in MS Excel© and contains a user-friendly interface which allows users to select mild or severe pandemic scenarios, change resource parameters and run simulations for one or multiple regions. Besides epidemiological estimations, the simulator provides indications on resource gaps or surpluses, and the impact of shortages on public health for each selected region. It allows for a comparative analysis of the effects of resource availability and consequences of different strategies of resource use, which can provide guidance on resource prioritising and/or mobilisation. Simulation results are displayed in various tables and graphs, and can also be easily exported to GIS software to create maps for geographical analysis of the distribution of resources. Conclusions The AsiaFluCap Simulator is freely available software (http://www.cdprg.org) which can be used by policy makers, policy advisors, donors and other stakeholders involved in preparedness for providing evidence based and illustrative information on health care resource capacities during future pandemics. The tool can inform both preparedness plans and simulation exercises and can help increase the general understanding of dynamics in resource capacities during a pandemic. The combination of a mathematical model with multiple resources and the linkage to GIS for creating maps makes the tool unique compared to other available software.

2012-01-01

20

Bench-to-bedside review: Vaccine protection strategies during pandemic flu outbreaks  

PubMed Central

Vaccination is the most effective means for the prevention of influenza, including pandemic strains. An ideal pandemic influenza vaccine should provide effective protection with the fewest number of doses in the shortest amount of time, and among the greatest proportion of the population. The current manufacturing processes required for embryonated chicken-egg-based influenza vaccines are limited in their ability to respond to pandemic situations - these limitations include problems with surge capacity, the need for egg-adapted strains, the possibility of contamination, and the presence of trace egg protein. Several vaccine strategies to circumvent the deficiencies intrinsic to an egg-based influenza vaccine are in various phases of development. These include the use of cell-culture-based growth systems, concomitant use of adjuvants, whole virus vaccines, recombinant protein vaccines, plasmid DNA vaccines, virus-like particle vaccines, and universal flu vaccines.

2010-01-01

21

Convalescent transfusion for pandemic influenza: preparing blood banks for a new plasma product?  

PubMed

Due to the potential of a severe pandemic to limit efficacy or availability of medical countermeasures, some researchers have begun a search for new interventions that could complement the planned antiviral- and vaccine-based response to an influenza pandemic. One such countermeasure-the transfusion of pandemic influenza-specific antibodies from surviving patients to the clinically ill-is the focus of this commentary. Passive immunotherapy, which includes the use of monoclonal antibodies (MoAbs), hyperimmune globulin, or convalescent plasma, had been used before the advent of antibiotics and has recently reentered the limelight due to the accelerating development of MoAb therapies against cancer, a number of microbes, allograft rejection, and a host of other conditions. After the plausible biologic mechanism and somewhat limited data supporting the efficacy for this modality against influenza are reviewed, safety and logistical concerns for utilization of this potential new product (fresh convalescent plasma against influenza [FCP-Flu]) are discussed. FCP-Flu could indeed prove useful in a response to a pandemic, but two necessary items must first be satisfied. Most importantly, more research should be conducted to establish FCP-Flu efficacy against the current and other pandemic strains. Second, and also importantly, blood banks and donor centers should examine whether offering this new product would be feasible in a pandemic and begin planning before a more severe pandemic forces us to respond without adequate preparation. PMID:20158681

Leider, Jonathon P; Brunker, Patricia A R; Ness, Paul M

2010-06-01

22

Crisis communication in the event of a flu pandemic.  

PubMed

When we talk about planning we cannot avoid discussing information, prevention and reaction, three notions that underlie communication in times of emergency. From a management point of view, emergency information in the event of an influenza pandemic comes under two headings: preventive information and reactive information. An example of preventive information provided by GEIG has aimed to sensitize public opinion about the phenomenon of influenza, correcting various preconceived ideas about the illness and reinforcing faith in the influenza vaccine. The strategy adopted by GEIG is founded on a few simple rules: (1) One message/one voice, GEIG unites its areas of competence by relying on a Scientific Council that guarantees the legitimacy of its influenza information, (2) the collection and coordination of information, (3) the identification and prioritisation of target groups, (4) an understanding of the media based on working relationships, making GEIG a reference when it comes to opinion, (5) the conception of information packs adapted to different categories of the public (press packs, documents for health professionals, leaflets for the general public, etc.), and (6) side-by-side with its role as broadcaster, the GEIG has set up a mechanism for listening and for evaluation (public opinion surveys, special enquiries, etc.). These are reliable monitoring tools allowing constant updating of our information policy. Emergency strategy: reactive information. An influenza pandemic is a special kind of crisis, since it is a crisis of collective responsibility, requiring a rapid deployment of adapted communication techniques.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7843373

Saliou, P

1994-08-01

23

Flu  

MedlinePLUS

... than 9, you will need one or two flu shots. It depends on whether you had the flu shot before and when you received those vaccinations. If ... are younger than 9, you will get two flu shots if: you are getting the flu vaccine for ...

24

Potential of Complementary and Alternative Medicine in Preventive Management of Novel H1N1 Flu (Swine Flu) Pandemic: Thwarting Potential Disasters in the Bud  

PubMed Central

The emergence of novel H1N1 has posed a situation that warrants urgent global attention. Though antiviral drugs are available in mainstream medicine for treating symptoms of swine flu, currently there is no preventive medicine available. Even when available, they would be in short supply and ineffective in a pandemic situation, for treating the masses worldwide. Besides the development of drug resistance, emergence of mutant strains of the virus, emergence of a more virulent strain, prohibitive costs of available drugs, time lag between vaccine developments, and mass casualties would pose difficult problems. In view of this, complementary and alternative medicine (CAM) offers a plethora of interesting preventive possibilities in patients. Herbs exhibit a diverse array of biological activities and can be effectively harnessed for managing pandemic flu. Potentially active herbs can serve as effective anti influenza agents. The role of CAM for managing novel H1N1 flu and the mode of action of these botanicals is presented here in an evidence-based approach that can be followed to establish their potential use in the management of influenza pandemics. The complementary and alternative medicine approach deliberated in the paper should also be useful in treating the patients with serious influenza in non pandemic situations.

Arora, Rajesh; Chawla, R.; Marwah, Rohit; Arora, P.; Sharma, R. K.; Kaushik, Vinod; Goel, R.; Kaur, A.; Silambarasan, M.; Tripathi, R. P.; Bhardwaj, J. R.

2011-01-01

25

The Bird Flu: A New Emerging Pandemic Threat And Its Pharmacological Intervention  

PubMed Central

Bird flu is an infection caused by avian influenza viruses, which are of different types A, B and C. Type A avian influenza viruses are the most frequently associated with avian influenza epidemics and pandemics. There are 16 hemagglutinin (H1 to H16) and 9 neuraminidase types (N1 to N9) identified till date. A peculiar characteristic of influenza A viruses is their propensity for genetic change by two main processes: antigenic drift (small, gradual changes) and antigenic shift (abrupt, major change producing a novel influenza A virus subtype). There are various modes of transmission of human influenza including inhalation, direct or indirect (fomite) contact etc., can have manifestations ranging from mild to severe or fatal disease, depend on the viral subtype causing the disease. Avian influenza A (H5N1) results in high death rate amongst infants and young children. The first outbreak of human infection by avian influenza viruses (H5N1) was observed in 1997 in Hong Kong. Since then a large number of outbreaks have been reported in different parts of the world. In fact, the spread of avian influenza H5N1 in various species including humans has lead to a current pandemic threat. Human avian influenza infections in persons at high risk of exposure can be prevented by adopting a series of protective measures, anti-viral vaccination and health monitoring. Drugs currently available for the treatment or prophylaxis of influenza infections include the adamantanes (amantadine and rimantadine) and the newer class of neuraminidase inhibitors (zanamivir, oseltamivir and peramivir). However, vaccines are considered the first line of defense for reducing the excess morbidity and mortality that invariably accompany pandemics and a number of clinical trials are under way to test them.

Mittal, Niti; Medhi, Bikash

2007-01-01

26

Assessing Google Flu Trends Performance in the United States during the 2009 Influenza Virus A (H1N1) Pandemic  

Microsoft Academic Search

BackgroundGoogle Flu Trends (GFT) uses anonymized, aggregated internet search activity to provide near-real time estimates of influenza activity. GFT estimates have shown a strong correlation with official influenza surveillance data. The 2009 influenza virus A (H1N1) pandemic [pH1N1] provided the first opportunity to evaluate GFT during a non-seasonal influenza outbreak. In September 2009, an updated United States GFT model was

Samantha Cook; Corrie Conrad; Ashley L. Fowlkes; Matthew H. Mohebbi

2011-01-01

27

Pandemic influenza response  

Microsoft Academic Search

Recent incidents of avian flu (H5N1) in Asia and the pandemic influenza cases in history (1918, 1957 and 1968) suggest that a future pandemic influenza is inevitable and likely imminent. Governments and non-governmental organizations prepare response plans on how to react to a pandemic influenza. In this paper, we study the logistics side of the problem, specifically, food distribution logistics

Ali Ekici; Pinar Keskinocak; Julie L. Swann

2008-01-01

28

Flu Facts  

MedlinePLUS

... severe cases. These large-scale outbreaks are called epidemics . If they spread worldwide, they're called pandemics . ... before you even know you're sick. Flu epidemics often start in schools and then move quickly ...

29

An Assessment of Hickam Air Force Base's Capability to Support Strategic Airlift Throughput when Operating under an Avian Flu Pandemic  

SciTech Connect

Hickam Air Force Base (AFB), Hawaii provides an ideal waypoint for U.S. strategic airlift aircraft to refuel and receive other services on their way to Northeast and Southeast Asia from the continental United States. Hickam AFB also serves as a critical aerial port of debarkation (APOD) for deploying U.S. forces and equipment to more distant lands as needed. Making use of the United States Transportation Command’s Aerial Port of Debarkation Plus model, this paper examines the ability of Hickam AFB to serve in its important role as an APOD when operating under the effects of a major avian flu pandemic. In this regard, the major influence on Hickam AFB will be a serious degradation to the number of available personnel to service aircraft and operate Hickam AFB’s aerial port. It is noted that the results presented herein are based on simplistic attrition rate assumptions. Nonetheless, it is envisioned that this work is applicable to more realistic input attrition rates as avian flu epidemiological models are refined, as well as attrition associated with other types of contagious pandemic disease or willful biological warfare attack.

Brigantic, Robert T.; Campbell, James R.; Doctor, Pamela G.; Johnson, Alan; Coomber, P.

2006-03-10

30

Reassessing Google Flu Trends Data for Detection of Seasonal and Pandemic Influenza: A Comparative Epidemiological Study at Three Geographic Scales  

PubMed Central

The goal of influenza-like illness (ILI) surveillance is to determine the timing, location and magnitude of outbreaks by monitoring the frequency and progression of clinical case incidence. Advances in computational and information technology have allowed for automated collection of higher volumes of electronic data and more timely analyses than previously possible. Novel surveillance systems, including those based on internet search query data like Google Flu Trends (GFT), are being used as surrogates for clinically-based reporting of influenza-like-illness (ILI). We investigated the reliability of GFT during the last decade (2003 to 2013), and compared weekly public health surveillance with search query data to characterize the timing and intensity of seasonal and pandemic influenza at the national (United States), regional (Mid-Atlantic) and local (New York City) levels. We identified substantial flaws in the original and updated GFT models at all three geographic scales, including completely missing the first wave of the 2009 influenza A/H1N1 pandemic, and greatly overestimating the intensity of the A/H3N2 epidemic during the 2012/2013 season. These results were obtained for both the original (2008) and the updated (2009) GFT algorithms. The performance of both models was problematic, perhaps because of changes in internet search behavior and differences in the seasonality, geographical heterogeneity and age-distribution of the epidemics between the periods of GFT model-fitting and prospective use. We conclude that GFT data may not provide reliable surveillance for seasonal or pandemic influenza and should be interpreted with caution until the algorithm can be improved and evaluated. Current internet search query data are no substitute for timely local clinical and laboratory surveillance, or national surveillance based on local data collection. New generation surveillance systems such as GFT should incorporate the use of near-real time electronic health data and computational methods for continued model-fitting and ongoing evaluation and improvement.

Olson, Donald R.; Konty, Kevin J.; Paladini, Marc; Viboud, Cecile; Simonsen, Lone

2013-01-01

31

Reassessing Google Flu Trends data for detection of seasonal and pandemic influenza: a comparative epidemiological study at three geographic scales.  

PubMed

The goal of influenza-like illness (ILI) surveillance is to determine the timing, location and magnitude of outbreaks by monitoring the frequency and progression of clinical case incidence. Advances in computational and information technology have allowed for automated collection of higher volumes of electronic data and more timely analyses than previously possible. Novel surveillance systems, including those based on internet search query data like Google Flu Trends (GFT), are being used as surrogates for clinically-based reporting of influenza-like-illness (ILI). We investigated the reliability of GFT during the last decade (2003 to 2013), and compared weekly public health surveillance with search query data to characterize the timing and intensity of seasonal and pandemic influenza at the national (United States), regional (Mid-Atlantic) and local (New York City) levels. We identified substantial flaws in the original and updated GFT models at all three geographic scales, including completely missing the first wave of the 2009 influenza A/H1N1 pandemic, and greatly overestimating the intensity of the A/H3N2 epidemic during the 2012/2013 season. These results were obtained for both the original (2008) and the updated (2009) GFT algorithms. The performance of both models was problematic, perhaps because of changes in internet search behavior and differences in the seasonality, geographical heterogeneity and age-distribution of the epidemics between the periods of GFT model-fitting and prospective use. We conclude that GFT data may not provide reliable surveillance for seasonal or pandemic influenza and should be interpreted with caution until the algorithm can be improved and evaluated. Current internet search query data are no substitute for timely local clinical and laboratory surveillance, or national surveillance based on local data collection. New generation surveillance systems such as GFT should incorporate the use of near-real time electronic health data and computational methods for continued model-fitting and ongoing evaluation and improvement. PMID:24146603

Olson, Donald R; Konty, Kevin J; Paladini, Marc; Viboud, Cecile; Simonsen, Lone

2013-01-01

32

Preparing for the Flu (Including 2009 H1N1 Flu): A Communication Toolkit for Schools (Grades K-12)  

ERIC Educational Resources Information Center

The purpose of "Preparing for the Flu: A Communication Toolkit for Schools" is to provide basic information and communication resources to help school administrators implement recommendations from CDC's (Centers for Disease Control and Prevention) Guidance for State and Local Public Health Officials and School Administrators for School (K-12)…

Centers for Disease Control and Prevention, 2010

2010-01-01

33

Surveillance of illness associated with pandemic (H1N1) 2009 virus infection among adults using a global clinical site network approach: the INSIGHT FLU 002 and FLU 003 studies.  

PubMed

The novel pandemic influenza A (H1H1) 2009 virus spread rapidly around the world in 2009. The paucity of prospective international epidemiologic data on predictors of clinical outcomes with pandemic (H1N1) 2009 virus infection stimulated the INSIGHT network, an international network of community and hospital-based investigators, to commence two worldwide clinical observational studies to describe pandemic (H1N1) 2009 virus activity. The purpose of these two studies was to estimate the percent of adult patients with illness due to laboratory-confirmed pandemic (H1N1) 2009 virus infection that experience clinically significant outcomes and to study factors related to these outcomes. Enrollment commenced in October 2009 and will continue until August 2011: as of the end of 2010, 62 sites in 14 countries in Australasia (12 sites), Europe (37) and North America (13) have enrolled 1365 adult patients, with 1049 enrollments into the FLU 002 outpatient study and 316 into the FLU 003 hospitalization study. These 'in progress' INSIGHT influenza observational studies may act as a model for obtaining epidemiological, clinical and laboratory information in future international disease outbreaks. PMID:21757105

Dwyer, Dominic E

2011-07-22

34

Modeling influenza epidemics and pandemics: insights into the future of swine flu (H1N1)  

Microsoft Academic Search

Here we present a review of the literature of influenza modeling studies, and discuss how these models can provide insights into the future of the currently circulating novel strain of influenza A (H1N1), formerly known as swine flu. We discuss how the feasibility of controlling an epidemic critically depends on the value of the Basic Reproduction Number (R0). The R0

Brian J Coburn; Bradley G Wagner; Sally Blower

2009-01-01

35

Avian Flu  

ScienceCinema

Since 2003, a severe form of H5N1 avian influenza has rapidly spread throughout Asia and Europe, infecting over 200 humans in 10 countries. The spread of H5N1 virus from person-to-person has been rare, thus preventing the emergence of a widespread pandemic. However, this ongoing epidemic continues to pose an important public health threat. Avian flu and its pandemic potential in humans will be discussed.

36

Avian Flu  

SciTech Connect

Since 2003, a severe form of H5N1 avian influenza has rapidly spread throughout Asia and Europe, infecting over 200 humans in 10 countries. The spread of H5N1 virus from person-to-person has been rare, thus preventing the emergence of a widespread pandemic. However, this ongoing epidemic continues to pose an important public health threat. Avian flu and its pandemic potential in humans will be discussed.

Eckburg, Paul

2006-11-06

37

Understanding the risk of an avian flu pandemic: rational waiting or precautionary failure?  

PubMed

The precautionary principle (PP) has been proposed as the proper guide for the decision-making criteria to be adopted in the face of the new catastrophic risks that have arisen in the last decades. This article puts forward a workable definition of the PP based on the so-called alpha-maximin expected utility approach, applying it to the possible outbreak of the avian flu disease among humans. Moreover, it shows how the shortage and/or lack of effective drugs against the infection of the virus A(H5N1) among humans can be considered a precautionary failure. PMID:16834622

Basili, Marcello; Franzini, Maurizio

2006-06-01

38

How integration of global omics-data could help preparing for pandemics - a scent of influenza.  

PubMed

Pandemics caused by novel emerging or re-emerging infectious diseases could lead to high mortality and morbidity world-wide when left uncontrolled. In this perspective, we evaluate the possibility of integration of global omics-data in order to timely prepare for pandemics. Such an approach requires two major innovations. First, data that is obtained should be shared with the global community instantly. The strength of rapid integration of simple signals is exemplified by Google's(TM) Flu Trend, which could predict the incidence of influenza-like illness based on online search engine queries. Second, omics technologies need to be fast and high-throughput. We postulate that analysis of the exhaled breath would be a simple, rapid and non-invasive alternative. Breath contains hundreds of volatile organic compounds that are altered by infection and inflammation. The molecular fingerprint of breath (breathprint) can be obtained using an electronic nose, which relies on sensor technology. These breathprints can be stored in an online database (a "breathcloud") and coupled to clinical data. Comparison of the breathprint of a suspected subject to the breathcloud allows for a rapid decision on the presence or absence of a pathogen. PMID:24795745

Bos, Lieuwe D J; de Jong, Menno D; Sterk, Peter J; Schultz, Marcus J

2014-01-01

39

How integration of global omics-data could help preparing for pandemics - a scent of influenza  

PubMed Central

Pandemics caused by novel emerging or re-emerging infectious diseases could lead to high mortality and morbidity world-wide when left uncontrolled. In this perspective, we evaluate the possibility of integration of global omics-data in order to timely prepare for pandemics. Such an approach requires two major innovations. First, data that is obtained should be shared with the global community instantly. The strength of rapid integration of simple signals is exemplified by Google’sTM Flu Trend, which could predict the incidence of influenza-like illness based on online search engine queries. Second, omics technologies need to be fast and high-throughput. We postulate that analysis of the exhaled breath would be a simple, rapid and non-invasive alternative. Breath contains hundreds of volatile organic compounds that are altered by infection and inflammation. The molecular fingerprint of breath (breathprint) can be obtained using an electronic nose, which relies on sensor technology. These breathprints can be stored in an online database (a “breathcloud”) and coupled to clinical data. Comparison of the breathprint of a suspected subject to the breathcloud allows for a rapid decision on the presence or absence of a pathogen.

Bos, Lieuwe D. J.; de Jong, Menno D.; Sterk, Peter J.; Schultz, Marcus J.

2014-01-01

40

Avian Flu / Earthquake Prediction  

NSDL National Science Digital Library

This radio broadcast includes a discussion of the avian flu spreading though Southeast Asia, Russia and parts of Europe. Topics include whether the outbreak is a pandemic in the making, and what preparations might be made to control the outbreak. The next segment of the broadcast discusses earthquake prediction, in light of the 2005 earthquake in Pakistan. Two seismologists discuss what was learned in the Parkfield project, an experiment in earthquake prediction conducted in California. Other topics include the distribution of large versus small earthquakes; how poor construction magnifies earthquake devastation; and the relationship of plate tectonics to the Pakistan earthquake.

41

Applying machine learning techniques to classify H1N1 viral strains occurring in 2009 flu pandemic  

Microsoft Academic Search

A phase 6 alert has been declared by the World Health Organization (WHO) in response to the ongoing global spread of the influenza H1N1 virus in humans. Genetic sequence analysis suggests that this pandemic strain evolves from reassortment of swine viruses. The objective of this research is to conduct a series of bioinformatics analyses to characterize currently circulating pandemic influenza

Pavan K. Attaluri; Ximeng Zheng; Zhengxin Chen; Guoqing Lu

42

Swine Flu (Swine Influenza-A (H1N1) Virus): A Review  

Microsoft Academic Search

4 Abstract: Swine flu has been confirmed in a number of countries and it is spreading from human to human, which could lead to what is referred to as a pandemic flu outbreak. Pandemic flu is different from ordinary flu because it's a new flu virus that appears in humans and spreads very quickly from person to person worldwide. The

Ravi Shekhar; Pooja Sharma; Lalit Kumar Tyagi; A. K. Gupta; M. L. Kori

2009-01-01

43

The Scourge of Asian Flu: In Utero Exposure to Pandemic Influenza and the Development of a Cohort of British Children  

ERIC Educational Resources Information Center

This paper examines the impact of in utero exposure to the Asian influenza pandemic of 1957 upon childhood development. Outcome data are provided by the National Child Development Study (NCDS), a panel study where all members were potentially exposed in the womb. Epidemic effects are identified using geographic variation in a surrogate measure of…

Kelly, Elaine

2011-01-01

44

Influenza pandemic planning  

Microsoft Academic Search

Periodically, novel influenza viruses emerge and spread rapidly through susceptible populations, resulting in worldwide epidemics or pandemics. Three pandemics occurred in the 20th century. The first and most devastating of these, the “Spanish Flu” (A\\/H1N1) pandemic of 1918–1919, is estimated to have resulted in 20–50 million or more deaths worldwide, with unusually high mortality among young adults [C.W. Potter, Chronicle

Nancy J. Cox; Susan E. Tamblyn; Theresa Tam

2003-01-01

45

Forecasting Flu  

MedlinePLUS

... flu forecasting follows a similar, but more accelerated, evolution." Forecasting the Peak To first test the concept ... Getting a Better Grasp on Flu Fundamentals Everyday Evolution What Drives Seasonal Flu Patterns? This Inside Life ...

46

The Efficacy of Echinacea Compound Herbal Tea Preparation on the Severity and Duration of Upper Respiratory and Flu Symptoms: A Randomized, Double-Blind Placebo-Controlled Study  

Microsoft Academic Search

Objectives: The aim of this study was to determine the efficacy of an echinacea compound herbal tea preparation (Echinacea Plus®) given at early onset of cold or flu symptoms in a ran- dom assignment double-blind placebo-controlled study. Design and Subjects: A total of 95 subjects with early symptoms of cold or flu (runny nose, scratchy throat, fever) were randomly assigned

G. Frank Lindenmuth; Elise B. Lindenmuth

2000-01-01

47

An alternative method for preparation of pandemic influenza strain-specific antibody for vaccine potency determination.  

PubMed

The traditional assay used to measure potency of inactivated influenza vaccines is a single-radial immunodiffusion (SRID) assay that utilizes an influenza strain-specific antibody to measure the content of virus hemagglutinin (HA) in the vaccine in comparison to a homologous HA reference antigen. Since timely preparation of potency reagents by regulatory authorities is challenging and always a potential bottleneck in influenza vaccine production, it is extremely important that additional approaches for reagent development be available, particularly in the event of an emerging pandemic influenza virus. An alternative method for preparation of strain-specific antibody that can be used for SRID potency assay is described. The approach does not require the presence or purification of influenza virus, and furthermore, is not limited by the success of the traditional technique of bromelain digestion and purification of virus HA. Multiple mammalian expression vectors, including plasmid and modified vaccinia virus Ankara (MVA) vectors expressing the HAs of two H5N1 influenza viruses and the HA of the recently emerging pandemic H1N1 (2009) virus, were developed. An immunization scheme was designed for the sequential immunization of animals by direct vector injection followed by protein booster immunization using influenza HA produced in vitro from MVA vector infection of cells in culture. Each HA antibody was highly specific as shown by hemagglutination inhibition assay and the ability to serve as a capture antibody in ELISA. Importantly, each H5N1 antibody and the pandemic H1N1 (2009) antibody preparation were suitable for use in SRID assays for determining the potency of pandemic influenza virus vaccines. The results demonstrate a feasible approach for addressing one of the potential bottlenecks in inactivated pandemic influenza vaccine production and are particularly important in light of the difficulties in preparation of potency reagent antibody for pandemic H1N1 (2009) virus vaccines. PMID:20074687

Schmeisser, Falko; Vodeiko, Galina M; Lugovtsev, Vladimir Y; Stout, Richard R; Weir, Jerry P

2010-03-11

48

Swine flu is back again: a review.  

PubMed

Flu viruses have mainly affected humans, birds and pigs worldwide. During the past 10 years these viruses are in limelight at a global level due to pandemic threats of Avian/Bird Flu and Swine Flu and their public health impacts, with added pandemic of swine flu virus recently. The current ongoing episodes of bird flu and swine flu are beyond the control, when and where or which country they start with nobody can predict. The continuous evolution and emergence of new strains indicate that the flu viruses are becoming more and more dangerous and this situation has posed a challenge to researchers to discover effective vaccines and therapeutics. Moreover, the role of pig as 'mixing bowl' for the virus to get reassorted has added to the complicated epidemiological scenario. The swine flu H1N1 reassorted subtype caused the first global pandemic in last 40 years, resulting in substantial illness, hospitalizations of millions of peoples and thousands of deaths throughout the world. A pace is there within these novel and emerging flu viruses and the scientific community, where the scientific community has to win the race so as to save the mankind. In this review, a brief overview on swine flu is presented highlighting the characteristics of the causative virus, the disease and its public health consequences, advances made in its diagnosis, vaccine and control, precautionary measures to be adapted in the wake of an outbreak. PMID:24163942

Dhama, Kuldeep; Verma, Amit Kumar; Rajagunalan, S; Deb, Rajib; Karthik, K; Kapoor, Sanjay; Mahima; Tiwari, Ruchi; Panwar, Parmod Kumar; Chakraborty, Sandip

2012-11-01

49

"Stomach Flu"  

MedlinePLUS

... a Flu Shot? The Pink Locker Society "Stomach Flu" KidsHealth > Kids > Illnesses & Injuries > I Feel Sick! > "Stomach Flu" Print A A A Text Size Many people talk about the "stomach flu" when they're feeling sick to their stomachs. ...

50

Are we prepared to help low-resource communities cope with a severe influenza pandemic?  

PubMed

Recent research involving lab-modified H5N1 influenza viruses with increased transmissibility and the ongoing evolution of the virus in nature should remind us of the continuing importance of preparedness for a severe influenza pandemic. Current vaccine technology and antiviral supply remain inadequate, and in a severe pandemic, most low-resource communities will fail to receive adequate medical supplies. However, with suitable guidance, these communities can take appropriate actions without substantial outside resources to reduce influenza transmission and care for the ill. Such guidance should be completed, and support provided to developing countries to adapt it for their settings and prepare for implementation. PMID:23145978

Starbuck, Eric S; von Bernuth, Rudolph; Bolles, Kathryn; Koepsell, Jeanne

2013-11-01

51

Adjuvant solution for pandemic influenza vaccine production.  

PubMed

Extensive preparation is underway to mitigate the next pandemic influenza outbreak. New vaccine technologies intended to supplant egg-based production methods are being developed, with recombinant hemagglutinin (rHA) as the most advanced program for preventing seasonal and avian H5N1 Influenza. Increased efforts are being focused on adjuvants that can broaden vaccine immunogenicity against emerging viruses and maximize vaccine supply on a worldwide scale. Here, we test protection against avian flu by using H5N1-derived rHA and GLA-SE, a two-part adjuvant system containing glucopyranosyl lipid adjuvant (GLA), a formulated synthetic Toll-like receptor 4 agonist, and a stable emulsion (SE) of oil in water, which is similar to the best-in-class adjuvants being developed for pandemic flu. Notably, a single submicrogram dose of rH5 adjuvanted with GLA-SE protects mice and ferrets against a high titer challenge with H5N1 virus. GLA-SE, relative to emulsion alone, accelerated induction of the primary immune response and broadened its durability against heterosubtypic H5N1 virus challenge. Mechanistically, GLA-SE augments protection via induction of a Th1-mediated antibody response. Innate signaling pathways that amplify priming of Th1 CD4 T cells will likely improve vaccine performance against future outbreaks of lethal pandemic flu. PMID:23045649

Clegg, Christopher H; Roque, Richard; Van Hoeven, Neal; Perrone, Lucy; Baldwin, Susan L; Rininger, Joseph A; Bowen, Richard A; Reed, Steven G

2012-10-23

52

Influenza Pandemic: Continued Focus on the Nation's Planning and Preparedness Efforts Remains Essential. Testimony before the Ad Hoc Subcommittee on State, Local, and Private Sector Preparedness and Integration, Senate Committee on Homeland Security and Governmental Affairs. GAO-09-760T  

ERIC Educational Resources Information Center

As the recent outbreak of the H1N1 (swine flu) virus underscores, an influenza pandemic remains a real threat to our nation and to the world. Over the past 3 years, the US Government Accountability Office (GAO) has conducted a body of work to help the nation better prepare for a possible pandemic. In a February 2009 report, GAO synthesized the…

Steinhardt, Bernice

2009-01-01

53

How Lou Got the Flu  

NSDL National Science Digital Library

This article from the American Museum of Natural History's family magazine series traces the spread of the flu virus from a duck in China to a young girl in Kansas. The article begins by introducing kids to Louise and the symptoms of influenza. On a series of clickable screens, they learn how the flu virus traveled from a duck to a pig to a farmer to a shopper to a student to Louise. A sidebar (But I Got a Flu Shot Last Year...) explains why influenza is trickier to outsmart than smallpox and polio. Another sidebar (Microbes on the Go) explains the difference between an epidemic and a pandemic.

54

How Colleges Can Plan for Bird Flu  

ERIC Educational Resources Information Center

Media coverage of the worldwide outbreak of avian flu and the potential for a pandemic has resulted in anxiety and consternation among members of the US public. The US President George W. Bush has released the federal pandemic-preparedness plan that calls on communities to coordinate plans with local and state health departments and other…

Turner, James C.

2005-01-01

55

A Systematic Analytic Approach to Pandemic Influenza Preparedness Planning  

Microsoft Academic Search

The World Health Organization warns that a flu pandemic is inevitable, and possibly imminent. Barnett and colleagues discuss a tool called the Haddon Matrix that could help in pandemic influenza planning.

Daniel J. Barnett; Ran D. Balicer; Daniel R. Lucey; George S. Everly; Saad B. Omer; Mark C. Steinhoff; Itamar Grotto

2005-01-01

56

Preparing for the Flu During the 2009-10 School Year: Questions and Answers for Schools  

ERIC Educational Resources Information Center

This brochure provides answers to the following questions: (1) Why do school districts, schools, teachers, parents, and communities need to plan for the continuation of learning for students during flu season this year? (2) How should districts and schools go about planning to continue students' education when they are at home because of H1N1?…

US Department of Education, 2009

2009-01-01

57

The flu...and you.  

PubMed

Seasonal influenza is primarily an upper respiratory illness that recurs yearly in slightly different forms. The "flu shot," or yearly vaccine, is the best precaution for preventing flu. All health care workers at risk are advised to be vaccinated every year. Occasionally more dangerous or even deadly forms develop, possibly leading to epidemics and pandemics. Both type A and B can cause epidemics, but influenza type A has greater potential to develop new and deadly subtypes and is responsible for the current "bird flu" that threatens to mutate to a form capable of a human pandemic. The flu is spread by droplets of oral and respiratory secretions. In dental facilities, in addition to Standard Precautions, Droplet Precautions should be observed when people with highly contagious respiratory infections such as influenza are present. Consistent use of masks and careful hand hygiene, including use of alcohol-based waterless agents in both treatment and public areas by both employees and patients, are the most important precautions to control influenza. CDC Respiratory Hygiene/Cough Etiquette (available in posters from the CDC) is the perfect starting point to inform workers and patients how to keep the dental office "a safe place to be healed" rather than a place to contract the flu. PMID:16696496

Andrews, Nancy

2006-01-01

58

Swine Flu -A Comprehensive View  

NASA Astrophysics Data System (ADS)

The present article is aimed on comprehensive view of Swine flu. It was first isolated from pigs in 1930 in USA. Pandemic caused by H1N1 in 2009 brought it in limelight. Itís a viral respiratory disease caused by viruses that infects pigs, resulting in nasal secretions, barking cough, decreased appetite, and listless behavior. Swine virus consist of eight RNA strands, one strand derived from human flu strains, two from avian (bird) strains, and five from swine strains. Swine flu spreads from infected person to healthy person by inhalation or ingestion of droplets contaminated with virus while sneezing or coughing. Two antiviral agents have been reported to help prevent or reduce the effects of swine flu, flu shot and nasal spray. WHO recommended for pandemic period to prevent its future outbreaks through vaccines or non-vaccines means. Antiviral drugs effective against this virus are Tamiflu and Relenza. Rapid antigen testing (RIDT), DFA testing, viral culture, and molecular testing (RT-PCR) are used for its diagnosis in laboratory

Singh, Vandana; Sood, Meenakshi

2012-07-01

59

Pandemic Influenza: Appropriations for Public Health Preparedness and Response.  

National Technical Information Service (NTIS)

The spread of H5N1 avian influenza ('flu') on three continents, and the human deaths it has caused, raise concern that the virus could morph and cause a global human pandemic. Congress has provided specific funding for pandemic flu preparedness since FY20...

S. A. Lister

2007-01-01

60

Technologies to Mitigate Climate Change / Avian Flu Update  

NSDL National Science Digital Library

Though the Kyoto Protocol went into effect in February of 2005, it will not be a quick fix: global temperatures are predicted to rise well into this century. This radio broadcast takes a look at some technologies - from wind power to hydrogen fuel cells - that could curb climate change by reducing greenhouse gases. There is discussion about what countries are doing to reduce global warming, such as supporting renewable energy, and what needs to be done in the United States. This climate change broadcast is 30 minutes in length. The broadcast also discusses preparations for a possible bird flu pandemic.

61

The nonadaptive nature of the H1N1 2009 Swine Flu pandemic contrasts with the adaptive facilitation of transmission to a new host  

Microsoft Academic Search

BACKGROUND: The emergence of the 2009 H1N1 Influenza pandemic followed a multiple reassortment event from viruses originally circulating in swines and humans, but the adaptive nature of this emergence is poorly understood. RESULTS: Here we base our analysis on 1180 complete genomes of H1N1 viruses sampled in North America between 2000 and 2010 in swine and human hosts. We show

Juwaeriah Abdussamad; Stéphane Aris-Brosou

2011-01-01

62

Pandemic influenza computer model (no soundtrack)  

SciTech Connect

Simulation of a pandemic flu outbreak in the continental United States, initially introduced by the arrival of 10 infected individuals in Los Angeles. ----------The spatiotemporal dynamics of the prevalence (number of symptomatic cases at any point in

Los Alamos National Lab

2009-05-01

63

E-Learning's Potential Scrutinized in Flu Crisis  

ERIC Educational Resources Information Center

The closing of hundreds of U.S. schools in recent weeks because of concerns about swine flu underscores the need for administrators to make plans for continuing their students' education during any extended shutdown, emergency experts and federal officials say. Fears about a severe flu pandemic had eased as of late last week, but experts say…

Ash, Katie; Davis, Michelle R.

2009-01-01

64

Utah Pandemic Influenza Response Plan  

Microsoft Academic Search

An influenza pandemic has the potential to cause widespread illness and death. Planning and preparedness before the next pandemic strikes are critical for an effective response. Utah’s Pandemic Influenza Response Plan describes a coordinated strategy to prepare for and respond to an influenza pandemic. Influenza causes seasonal worldwide epidemics of disease that result in an average of 36,000 deaths each

David Sundwall; Robert T. Rolfs

2005-01-01

65

1918 Flu  

NSDL National Science Digital Library

In this Science Update from Science NetLinks, features an interview with Yoshihiro Kawaoko a virologist at the University of Wisconsin. In this interview, Kawako describes what made 1918 flu virus, which killed 20 million people, so deadly.

Science Update;

2004-11-22

66

2009 H1N1 'Swine Flu' Outbreak: An Overview.  

National Technical Information Service (NTIS)

On April 29, 2009, the World Health Organization (WHO) raised its influenza ('flu') pandemic alert level to Phase 5, one level below declaring that a global influenza pandemic was underway. According to WHO, 'the declaration of Phase 5 is a strong signal ...

C. S. Redhead S. A. Lister

2009-01-01

67

Preventing the Flu  

MedlinePLUS

... to protect you from getting the flu. The flu shot contains dead viruses. The nasal-spray vaccine contains ... viruses. You cannot get the flu from the flu shot or the nasal-spray vaccine. You can also ...

68

Seasonal Flu Shot  

MedlinePLUS

... Añadir en... Favorites Delicious Digg Google Bookmarks Seasonal Flu Shot Questions & Answers On this Page What is the ... the 2013-14 flu season. What is the flu shot? The flu shot is a vaccine given with ...

69

Prevention of Flu (Influenza)  

MedlinePLUS

... There are two types of flu vaccines: the flu shot, made from killed flu virus and given with ... seasonal influenza vaccine. Credit: CDC Currently, three seasonal flu shots are being produced for the United States market: ...

70

Difference in immune response in vaccinated and unvaccinated Swedish individuals after the 2009 influenza pandemic  

PubMed Central

Background Previous exposures to flu and subsequent immune responses may impact on 2009/2010 pandemic flu vaccine responses and clinical symptoms upon infection with the 2009 pandemic H1N1 influenza strain. Qualitative and quantitative differences in humoral and cellular immune responses associated with the flu vaccination in 2009/2010 (pandemic H1N1 vaccine) and natural infection have not yet been described in detail. We designed a longitudinal study to examine influenza- (flu-) specific immune responses and the association between pre-existing flu responses, symptoms of influenza-like illness (ILI), impact of pandemic flu infection, and pandemic flu vaccination in a cohort of 2,040 individuals in Sweden in 2009–2010. Methods Cellular flu-specific immune responses were assessed by whole-blood antigen stimulation assay, and humoral responses by a single radial hemolysis test. Results Previous seasonal flu vaccination was associated with significantly lower flu-specific IFN-? responses (using a whole-blood assay) at study entry. Pandemic flu vaccination induced long-lived T-cell responses (measured by IFN-? production) to influenza A strains, influenza B strains, and the matrix (M1) antigen. In contrast, individuals with pandemic flu infection (PCR positive) exhibited increased flu-specific T-cell responses shortly after onset of ILI symptoms but the immune response decreased after the flu season (spring 2010). We identified non-pandemic-flu vaccinated participants without ILI symptoms who showed an IFN-? production profile similar to pandemic-flu infected participants, suggesting exposure without experiencing clinical symptoms. Conclusions Strong and long-lived flu-M1 specific immune responses, defined by IFN-? production, in individuals after vaccination suggest that M1-responses may contribute to protective cellular immune responses. Silent flu infections appeared to be frequent in 2009/2010. The pandemic flu vaccine induced qualitatively and quantitatively different humoral and cellular immune responses as compared to infection with the 2009 H1N1 pandemic H1N1 influenza strain.

2014-01-01

71

Simply speaking, Swine Flu is just a new, unexpected strain of Influenza A - we all are familiar with the concept of new strains of flu * it's why we need to revaccinate every year to keep up with changes in the makeup of flu viruses. But since Swine Flu only comes around once ortwice a century, most humans have no acquired or natural immunity. Swine flu strains are typically not included in flu vaccines, and thus more people may be susceptible to illness in a pandemic situation  

Microsoft Academic Search

The good news is that, unlike many strains of Influenza that are not responsive to therapy, this Swine Flu strain, H1N1 is TREATABLE with Tamiflu or Relenza. In the ast year our practice alone treated 390 cases of documented influenza - some, but not all patients received Tamiflu, but many were treated conservatively with rest, fluids, supportive care and staying

72

Cause of Flu (Influenza)  

MedlinePLUS

... JavaScript on. Read more information on enabling JavaScript. Flu (Influenza) Skip Content Marketing Share this: Main Content Area Cause About the Flu Virus Influenza, or flu, is a respiratory infection ...

73

Transmission of Flu (Influenza)  

MedlinePLUS

... JavaScript on. Read more information on enabling JavaScript. Flu (Influenza) Skip Content Marketing Share this: Main Content Area Transmission How Flu Spreads Coughing and Sneezing People with flu can ...

74

Pregnancy and the flu  

MedlinePLUS

... flu-related complications. Pregnant women who get the flu shot get sick less often. They are also very ... not harmful to mother or child. However, the flu shot can prevent the rare severe cases of the ...

75

Pregnant Women and Influenza (Flu)  

MedlinePLUS

... and even protect the baby after birth. The Flu Shot is the Best Protection Against Flu Getting a ... pregnant.) Learn more about the flu vaccine . The Flu Shot is Safe for Pregnant Women Flu shots are ...

76

Association between the 2008–09 Seasonal Influenza Vaccine and Pandemic H1N1 Illness during Spring–Summer 2009: Four Observational Studies from Canada  

Microsoft Academic Search

In three case-control studies and a household transmission cohort, Danuta Skowronski and colleagues find an association between prior seasonal flu vaccination and increased risk of 2009 pandemic H1N1 flu.

Danuta M. Skowronski; Gaston De Serres; Natasha S. Crowcroft; Naveed Z. Janjua; Nicole Boulianne; Travis S. Hottes; Laura C. Rosella; James A. Dickinson; Rodica Gilca; Pam Sethi; Najwa Ouhoummane; Donald J. Willison; Isabelle Rouleau; Martin Petric; Kevin Fonseca; Steven J. Drews; Anuradha Rebbapragada; Hugues Charest; Marie-Ève Hamelin; Guy Boivin; Jennifer L. Gardy; Yan Li; Trijntje L. Kwindt; David M. Patrick; Robert C. Brunham

2010-01-01

77

H1N1 Flu (Swine Flu)  

MedlinePLUS

... prevent or treat swine flu. There is a vaccine available to protect against swine flu. You can help prevent the spread of germs that cause respiratory illnesses like influenza by Covering your nose and mouth with a ...

78

Pandemic Influenza: Implications for Preparation and Delivery of Critical Care Services  

PubMed Central

In a five week span during the 1918 influenza A pandemic, more than 2,000 patients were admitted to Cook County Hospital in Chicago with a diagnosis of either influenza or pneumonia; 642 patients, approximately 31% of those admitted, died with deaths occurring predominantly in patients twenty-five to thirty years of age.1 This review summarizes basic information on the biology, epidemiology, control, treatment and prevention of influenza overall, and then addresses the potential impact of pandemic influenza in an Intensive Care Unit setting. Issues that require consideration include workforce staffing and safety, resource management, alternate sites of care surge of patients, altered standards of care and crisis communication.

Manuell, Mary-Elise; Co, Mary Dawn T.; Ellison, Richard T.

2014-01-01

79

Pandemic influenza: implications for preparation and delivery of critical care services.  

PubMed

In a 5-week span during the 1918 influenza A pandemic, more than 2000 patients were admitted to Cook County Hospital in Chicago, with a diagnosis of either influenza or pneumonia; 642 patients, approximately 31% of those admitted, died, with deaths occurring predominantly in patients of age 25 to 30 years. This review summarizes basic information on the biology, epidemiology, control, treatment and prevention of influenza overall, and then addresses the potential impact of pandemic influenza in an intensive care unit setting. Issues that require consideration include workforce staffing and safety, resource management, alternate sites of care surge of patients, altered standards of care, and crisis communication. PMID:21220275

Manuell, Mary-Elise; Co, Mary Dawn T; Ellison, Richard T

2011-01-01

80

Colds and the Flu  

MedlinePLUS

... to protect you from getting the flu. The flu shot contains dead viruses. The flu shot is safe for adults and all children 6 ... to 59 months of age get a yearly flu shot. The nasal-spray vaccine contains live but weakened ...

81

Epidemic and pandemic influenza, who cares and how?  

PubMed

The 2005 hurricanes, Katrina and Rita, demonstrated that Mother Nature remains a bigger threat to mankind than bioterrorism or even terrorism. This is no less the case in the expected influenza pandemic that could infect up to 1 billion people worldwide killing millions and disrupting the supply of essential services and provoking social disruption. With influenza however, mankind does have the opportunity to make necessary preparations for the threat of a pandemic that could break out tomorrow, next year or within the next decade. Indeed, the events in New Orleans have sent "a strong message that knowledge is not enough, everyone predicted it [referring to hurricane Katrina], but no one did much about it--you need a detailed plan to deal with these threats," explained Dr. J.S. Oxford to the conference seminar on "epidemic and pandemic influenza, who cares and how?" During this session, participants discussed the state of pandemic preparedness listening to representatives from the UK and Canada who presented overviews of their preparedness plans, viewed as among the best examples of current practice and to a study on compliance with the WHO guidelines on flu vaccination. PMID:17167879

2006-11-10

82

Confronting an influenza pandemic: ethical and scientific issues.  

PubMed

The prolonged concern over the potential for a global influenza pandemic to cause perhaps many millions of fatalities is a chilling one. After the SARS (severe acute respiratory syndrome) scares [1], attention has turned towards the possibility of an avian influenza virus hybridizing with a human influenza virus to create a highly virulent, as yet unknown, killer, on a scale unseen since the Spanish flu outbreak of 1918, which produced more fatalities than the Great War. In deciding how countries should react to this potential pandemic, individually and collectively, a reasonable and practical balance must be struck between the rights and obligations of individual citizens and protection of the wider community and, indeed, society as a whole. In this communication, ethical issues are discussed in the context of some of the scientific questions relating to a potential influenza pandemic. Among these issues are the rights and obligations of healthcare professionals, difficulties surrounding resource allocation, policies that have an impact on liberty and trade, when and how to introduce any vaccine or other form of mass treatment, global governance questions and the role of health policies in contemporary society. By considering these issues and questions in advance of an influenza, or indeed any other, pandemic commencing, countries can be better prepared to deal with the inevitably difficult decisions required during such events, rather than dusting down outdated previous plans, or making and implementing policy in an ad hoc manner with a resultant higher risk of adverse consequences. PMID:17073773

Schuklenk, U; Gartland, K M A

2006-12-01

83

Department of Health and Human Services Pandemic Planning Update.  

National Technical Information Service (NTIS)

We are in a race against a fast moving virulent virus with the potential to cause an influenza pandemic. In November when President Bush announced the National Strategy for Pandemic Influenza, the highly pathogenic H5N1 avian flu virus was confirmed in bi...

2006-01-01

84

Pulmonary sequelae in a patient recovered from swine flu.  

PubMed

The pandemic of swine flu (H1N1) influenza spread to involve the whole world rapidly. Many patients manifested a mild clinical illness but some developed pneumonia and respiratory failure. High mortality was observed in patients with severe disease. Among survivors, studies are limited. Ground-glass opacities on a high-resolution computerized tomography scan and reduced diffusion capacity were noted after 3 months in a study. But long-term complications in patients with swine flu pneumonia have not been studied well. We are presenting an unusual case of swine flu pneumonia who developed interstitial lung disease after recovery. PMID:22919170

Singh, Virendra; Sharma, Bharat Bhushan; Patel, Vivek

2012-07-01

85

Developing vaccines against pandemic influenza.  

PubMed Central

Pandemic influenza presents special problems for vaccine development. There must be a balance between rapid availability of vaccine and the safeguards to ensure safety, quality and efficacy of vaccine. Vaccine was developed for the pandemics of 1957, 1968, 1977 and for the pandemic alert of 1976. This experience is compared with that gained in developing vaccines for a possible H5N1 pandemic in 1997-1998. Our ability to mass produce influenza vaccines against a pandemic threat was well illustrated by the production of over 150 million doses of 'swine flu' vaccine in the USA within a 3 month period in 1976. However, there is cause for concern that the lead time to begin vaccine production is likely to be about 7-8 months. Attempts to reduce this time should receive urgent attention. Immunogenicity of vaccines in pandemic situations is compared over the period 1968-1998. A consistent feature of the vaccine trials is the demonstration that one conventional 15 microg haemagglutinin dose of vaccine is not sufficiently immunogenic in naive individuals. Much larger doses or two lower doses are needed to induce satisfactory immunity. There is some evidence that whole-virus vaccines are more immunogenic than split or subunit vaccines, but this needs substantiating by further studies. H5 vaccines appeared to be particularly poor immunogens and there is evidence that an adjuvant may be needed. Prospects for improving the development of pandemic vaccines are discussed.

Wood, J M

2001-01-01

86

2009 Influenza A(H1N1) 'Swine Flu' Outbreak: An Overview.  

National Technical Information Service (NTIS)

On April 29, 2009, in response to the global spread of a new strain of influenza, the World Health Organization (WHO) raised its influenza ('flu') pandemic alert level to Phase 5, one level below declaring that a global influenza pandemic was underway. Ac...

C. S. Redhead S. A. Lister

2009-01-01

87

Estimation of the reproductive number of the Spanish flu epidemic in Geneva, Switzerland  

Microsoft Academic Search

The 1918 influenza pandemic known as the “Spanish Flu” has been the worst in recent history with estimated worldwide mortality ranging from 20 to 100 million deaths. Using epidemic modeling and hospital notification data during the 1918 influenza pandemic in the Canton of Geneva, Switzerland, we estimated the reproductive numbers of the first and second waves of influenza infection to

G. Chowell; C. E. Ammon; N. W. Hengartner; J. M. Hyman

2006-01-01

88

Flublok Seasonal Influenza (Flu) Vaccination  

MedlinePLUS

... FluBlok were similar to those reported for other flu shots produced in eggs, including pain at the injection ... Drug Resistance Cell-based Flu Vaccines Febrile Seizures Flu Shot Flublok Seasonal Influenza Vaccination Fluzone High-Dose Seasonal ...

89

Flu and People with Asthma  

MedlinePLUS

... That kind of flu vaccine (commonly called a ‘flu shot’) is given with a needle, usually in the ... Drug Resistance Cell-based Flu Vaccines Febrile Seizures Flu Shot Flublok Seasonal Influenza Vaccination Fluzone High-Dose Seasonal ...

90

Biocommunicability and the Biopolitics of Pandemic Threats  

Microsoft Academic Search

In this article we assess accounts of the H1N1 virus or “swine flu” to draw attention to the ways in which discourse about biosecurity and global health citizenship during times of pandemic alarms supports calls for the creation of global surveillance systems and naturalizes forms of governance. We propose a medical anthropology of epidemics to complement an engaged anthropology aimed

Charles L. Briggs; Mark Nichter

2009-01-01

91

FluShuffle and FluResort: new algorithms to identify reassorted strains of the influenza virus by mass spectrometry  

PubMed Central

Background Influenza is one of the oldest and deadliest infectious diseases known to man. Reassorted strains of the virus pose the greatest risk to both human and animal health and have been associated with all pandemics of the past century, with the possible exception of the 1918 pandemic, resulting in tens of millions of deaths. We have developed and tested new computer algorithms, FluShuffle and FluResort, which enable reassorted viruses to be identified by the most rapid and direct means possible. These algorithms enable reassorted influenza, and other, viruses to be rapidly identified to allow prevention strategies and treatments to be more efficiently implemented. Results The FluShuffle and FluResort algorithms were tested with both experimental and simulated mass spectra of whole virus digests. FluShuffle considers different combinations of viral protein identities that match the mass spectral data using a Gibbs sampling algorithm employing a mixed protein Markov chain Monte Carlo (MCMC) method. FluResort utilizes those identities to calculate the weighted distance of each across two or more different phylogenetic trees constructed through viral protein sequence alignments. Each weighted mean distance value is normalized by conversion to a Z-score to establish a reassorted strain. Conclusions The new FluShuffle and FluResort algorithms can correctly identify the origins of influenza viral proteins and the number of reassortment events required to produce the strains from the high resolution mass spectral data of whole virus proteolytic digestions. This has been demonstrated in the case of constructed vaccine strains as well as common human seasonal strains of the virus. The algorithms significantly improve the capability of the proteotyping approach to identify reassorted viruses that pose the greatest pandemic risk.

2012-01-01

92

A neighborhood susceptibility index for planning of local physical interventions in response to pandemic influenza outbreaks  

PubMed Central

The global spread of a novel A (H1N1) influenza virus in 2009 has highlighted the possibility of a devastating pandemic similar to the ‘Spanish flu’ of 1917–1918. Responding to such pandemics requires careful planning for the early phases where there is no availability of pandemic vaccine. We set out to compute a Neighborhood Influenza Susceptibility Index (NISI) describing the vulnerability of local communities of different geo-socio-physical structure to a pandemic influenza outbreak. We used a spatially explicit geo-physical model of Linköping municipality (pop. 136,240) in Sweden, and employed an ontology-modeling tool to define simulation models and transmission settings. We found considerable differences in NISI between neighborhoods corresponding to primary care areas with regard to early progress of the outbreak, as well as in terms of the total accumulated share of infected residents counted after the outbreak. The NISI can be used in local preparations of physical response measures during pandemics.

Timpka, Toomas; Eriksson, Henrik; Stromgren, Magnus; Eriksson, Olle; Ekberg, Joakim; Grimvall, Anders; Nyce, James; Gursky, Elin; Holm, Einar

2010-01-01

93

Avoiding the Flu  

MedlinePLUS

... of this page please turn Javascript on. Feature: Flu Avoiding the Flu Past Issues / Fall 2009 Table of Contents Children ... should still get the 2009 H1N1 vaccine. H1N1 Flu: Who Should Be Vaccinated First The Centers for ...

94

Flu.gov  

MedlinePLUS

... Caring for children and infants Caring for seniors Flu Twitter Chatter Tweets about "from:CDCFlu, OR from: ... WhiteHouse.gov USA.gov GobiernoUSA.gov BusinessUSA.gov Flu Basics Symptoms Prevention Treatment Vaccination Types of Flu ...

95

75 FR 55776 - Request for Comments on Vaccine Production and Additional Planning for Future Possible Pandemic...  

Federal Register 2010, 2011, 2012, 2013

...pandemic influenza? 3. Improving availability for developing countries. How can we support and stimulate demand for seasonal flu vaccine in middle and lower income countries? Are there other [[Page 55777

2010-09-14

96

Your child and the flu  

MedlinePLUS

... other is sprayed into your child's nose. The flu shot contains killed (inactive) viruses. It is not possible ... the flu from this type of vaccine. The flu shot is approved for people age 6 months and ...

97

Flu and People with Diabetes  

MedlinePLUS

... who are 6 months and older, get a flu shot. (The nasal spray vaccine should not be given ... Drug Resistance Cell-based Flu Vaccines Febrile Seizures Flu Shot Flublok Seasonal Influenza Vaccination Fluzone High-Dose Seasonal ...

98

Your Medicare Coverage: Flu Shots  

MedlinePLUS

... service covered? Search Medicare.gov for covered items Flu shots How often is it covered? Medicare Part B (Medical Insurance) normally covers one flu shot per flu season. Who's eligible? All people with ...

99

Flu (Influenza): Information for Parents  

MedlinePLUS

... complications. • Helps protect others. Side effects of the flu shot The most common side effects are usually mild ... medical conditions (which includes asthma) should get the flu shot instead. Neither vaccine can cause the flu because ...

100

Seasonal Influenza (Flu) Questions & Answers  

MedlinePLUS

... and infection, particularly in the elderly. So, a flu shot given during one season, or an infection acquired ... Drug Resistance Cell-based Flu Vaccines Febrile Seizures Flu Shot Flublok Seasonal Influenza Vaccination Fluzone High-Dose Seasonal ...

101

Your baby and the flu  

MedlinePLUS

... other is sprayed into your child's nose. The flu shot contains killed (inactive) viruses. It is not possible ... the flu from this type of vaccine. The flu shot is approved for people age 6 months and ...

102

Flu I.Q.  

MedlinePLUS

... to test your flu knowledge." /> Button 5: Summer Copy the code below for this "Test Your ... http://www.cdc.gov/images/campaigns/seasonalflu/flu0613-Summer-150x172.gif" style="width:150px; height:172px; border: ...

103

["Hardly a house without ill people" The Spanish Flu in Styria].  

PubMed

This article examines the impact of the Spanish flu at the microscopic level. Main question was if the pandemic killed more people in a selected mountain village than the total men of the village who were being killed during the First World War. Other topics are the reaction of the local government on the flu and which prophylaxis was ordered. The main focus lies on the analysis of the parish registers by graphs. PMID:22614540

Hörzer, Thomas; Kunze, Ursula

2012-04-01

104

Pandemic Panic  

NSDL National Science Digital Library

In this lesson, students engage in an inquiry into influenza A (H1N1), considering the virus and the pandemic from multiple perspectives and acting as advisers to share factual information they learn with their classmates and school communities.

2010-01-01

105

The Spanish Flu and Its Legacy: Science Cases for Classroom Use  

NSDL National Science Digital Library

This book offers an interdisciplinary approach to teaching about the events surrounding the Spanish flu in 1918. By presenting three case studies of the flu from different perspectives, students will be able to use scientific, historical and medical evidence as well as a developed sense of curiosity to investigate how this pandemic emerged. This resource is organized into different sections which offer teaching approaches, activities and resources to facilitate the understanding of a pandemicâÂÂits nature, transmission and prevention methods for middle school to high school students.

The College Board The College Board (The College Board;)

2012-10-24

106

Tracking avian flu on the Web.  

PubMed

To some the term avian flu or H5N1 has become synonymous with the pandemic flu of 1918. Like the former pandemic, this current threat has the potential to cause up to 7.4 million deaths worldwide. Yet as of mid-2006, the viability of this threat is still unclear. There is no doubt that birds, especially poultry, have been the primary target of this particular strain of influenza. Human illnesses and deaths have resulted from direct contact with birds; farmers and food handlers are most at risk. Fortunately there has not been a shift to human-to-human transmission. However, it is imperative for public heath officers, health professionals, and other appropriate officials to keep current on the progress of this virus within the bird population, and its spread around the world. Preventative measures including worst case scenarios have been widely discussed and even resulted in a made-for-TV movie. The need for up-to-date information is essential in order to track the extent of transmission, location of current outbreaks, and most importantly steps for preparedness that could be vital for prevention and containment. This article explores and identifies major Web sites along with basic Internet search techniques to find informative and credible Webbased resources. doi:10.1300/J115v26n01_06. PMID:17210550

Gruwell, Cindy A

2007-01-01

107

Seasonal Flu FAQs  

MedlinePLUS

... safe for me to travel? Additional resources about germs and infection control Additional resources about seasonal flu ... much you touch your eyes, nose and mouth. Germs spread this way. Staying away from others if ...

108

Flu and Heart Disease and Stroke  

MedlinePLUS

... take steps to fight the flu. Get a flu shot . Vaccination is the first and most important step ... regular doctor or nurse, you can get a flu shot. Flu vaccines are offered in many locations including ...

109

Key Facts about Influenza (Flu) and Flu Vaccine  

MedlinePLUS

... uses a much smaller needle than the regular flu shot, approved for people 18 through 64 years of ... one which only involved hives—may receive a flu shot with additional precautions. Make sure your health care ...

110

The general practice experience of the swine flu epidemic in Victoria — lessons from the front line  

Microsoft Academic Search

The swine influenza (H1N1 09) outbreak in Victoria has provided an excellent opportunity to review the Australian Health Management Plan for Pandemic Influenza (AHMPPI) and to assess its performance in practice. • General practitioners play a major role in seasonal flu management, and it was expected that the AHMPPI would enable GPs on the front line to maintain this central

Peter Eizenberg

2009-01-01

111

Cancer, the Flu, and You  

MedlinePLUS

... death. Should cancer patients and survivors get a flu shot? Yes. People with cancer or a history of cancer should receive the seasonal flu shot. People with cancer should NOT receive the nasal ...

112

H5N1 Avian Flu (H5N1 Bird Flu)  

MedlinePLUS

... Swine Flu) H5N1 (Avian/Bird Flu) H5N1 Avian Flu (H5N1 Bird Flu) H5N1 is a highly pathogenic avian (bird) flu ... WhiteHouse.gov USA.gov GobiernoUSA.gov BusinessUSA.gov Flu Basics Symptoms Prevention Treatment Vaccination Types of Flu ...

113

What Is Seasonal Flu?  

MedlinePLUS Videos and Cool Tools

... Vaccine Program Office, U.S. Department of Health and Human Services, talks about the seasonal flu and when ... website managed by the U.S. Department of Health & Human Services 200 Independence Avenue, S.W. - Washington, D.C. ...

114

The 1918 "Spanish flu" in Spain.  

PubMed

The 1918-1919 influenza pandemic was the most devastating epidemic in modern history. Here, we review epidemiological and historical data about the 1918-1919 influenza epidemic in Spain. On 22 May 1918, the epidemic was a headline in Madrid's ABC newspaper. The infectious disease most likely reached Spain from France, perhaps as the result of the heavy railroad traffic of Spanish and Portuguese migrant workers to and from France. The total numbers of persons who died of influenza in Spain were officially estimated to be 147,114 in 1918, 21,235 in 1919, and 17,825 in 1920. However, it is likely that >260,000 Spaniards died of influenza; 75% of these persons died during the second period of the epidemic, and 45% died during October 1918 alone. The Spanish population growth index was negative for 1918 (net loss, 83,121 persons). Although a great deal of evidence indicates that the 1918 A(H1N1) influenza virus unlikely originated in and spread from Spain, the 1918-1919 influenza pandemic will always be known as the Spanish flu. PMID:18652556

Trilla, Antoni; Trilla, Guillem; Daer, Carolyn

2008-09-01

115

A Fast Test to Diagnose Flu  

SciTech Connect

People with flu-like symptoms who seek treatment at a medical clinic or hospital often must wait several hours before being examined, possibly exposing many people to an infectious virus. If a patient appears to need more than the routine fluids-and-rest prescription, effective diagnosis requires tests that must be sent to a laboratory. Hours or days may pass before results are available to the doctor, who in the meantime must make an educated guess about the patient's illness. The lengthy diagnostic process places a heavy burden on medical laboratories and can result in improper use of antibiotics or a costly hospital stay. A faster testing method may soon be available. An assay developed by a team of Livermore scientists can diagnose influenza and other respiratory viruses in about two hours once a sample has been taken. Unlike other systems that operate this quickly, the new device, called FluIDx (and pronounced ''fluidics''), can differentiate five types of respiratory viruses, including influenza. FluIDx can analyze samples at the point of patient care--in hospital emergency departments and clinics--allowing medical providers to quickly determine how best to treat a patient, saving time and potentially thousands of dollars per patient. The FluIDx project, which is led by Livermore chemist Mary McBride of the Physics and Advanced Technologies Directorate, received funding from the National Institute of Allergy and Infectious Diseases and the Laboratory Directed Research and Development (LDRD) Program. To test the system and make it as useful as possible, the team worked closely with the Emergency Department staff at the University of California (UC) at Davis Medical Center in Sacramento. Flu kills more than 35,000 people every year in the US. The 2003 outbreak of severe acute respiratory syndrome and the ongoing concern about a possible bird flu pandemic show the need for a fast, reliable test that can differentiate seasonal flu from a potentially pandemic influenza. Such a test should also discriminate influenza from pathogens that cause illnesses with flu-like symptoms. When a precise diagnosis is required to treat an adult patient with serious respiratory symptoms, sample cells are usually obtained with a nasal or throat swab and analyzed with one of several laboratory methods. The gold standard test is viral culturing, a highly sensitive method that can identify the specific strain of virus. However, viral culturing is a labor-intensive process and requires 3-10 days to produce results, too long for early intervention. Enzyme and optical immunoassays offer results in 30 minutes, but these methods are less sensitive than viral culturing so they can produce false positives or negatives. They also cannot distinguish the type of virus found. Direct immunofluorescence antibody (DFA) staining is as sensitive as viral culturing. It also can detect multiple respiratory pathogens simultaneously by a process known as multiplexing. However, DFA staining requires expensive equipment, a skilled microscopist, and samples with enough target cells for testing. In addition, the results are ultimately subjective. Another method, called reverse transcriptase-polymerase chain reaction assay, offers sensitivity and specificity comparable to viral culturing and DFA staining. It also produces results in two hours and can rapidly test a large number of samples. The drawback with these tests, however, is that they must be performed in a laboratory. None of them can be used where they are needed most: in the clinic or emergency department where patients are being treated. Livermore's FluIDx diagnostic system, with its instrumentation and multiplexed assays, is designed specifically for point-of-care diagnosis. The fast, easy-to-use system is based on the Autonomous Pathogen Detection System, a homeland security technology developed by LLNL. This R&D 100 Award-winning technology constantly monitors the air to detect airborne bioterrorism agents, such as anthrax. FluIDx is an integrated system designed to perform highly multiplexed poly

Hazi, A U

2007-02-12

116

Decoding the Flu  

NSDL National Science Digital Library

This "clicker case" was designed to develop students' ability to read and interpret information stored in DNA. Making use of personal response systems ("clickers") along with a PowerPoint presentation, students follow the story of "Jason," a student intern at the Centers for Disease Control & Prevention (CDC). While working with a CDC team in Mexico, Jason is the only person who does not get sick from a new strain of flu. It is up to Jason to use molecular data collected from different local strains of flu to identify which one may be causing the illness. Although designed for an introductory biology course for science or non-science majors, the case could be adapted for upper-level courses by including more complex problems and aspects of gene expression, such as the excision of introns.

Armstrong, Norris

2011-01-01

117

Pandemic planning in the shipping industry--lessons learnt from the 2009 Influenza Pandemic.  

PubMed

The events around the 2009 A/H1N1 Influenza Pandemic highlighted the need for better planning to ensure protection of those on vessels, protection for ports of call, and protection of business assets (business continuity). The variety of stakeholders involved in the management of a pandemic made it difficult to achieve a cohesive plan during the event itself. By considering the actions during the last pandemic, and the literature available for the shipping industry on pandemic planning, a pathway to better preparation is suggested. PMID:22258847

Bunyan, Kate

2011-01-01

118

Key Facts about Canine Influenza (Dog Flu)  

MedlinePLUS

... Favorites Delicious Digg Google Bookmarks Key Facts about Canine Influenza (Dog Flu) Questions & Answers On this Page What is ... more information on canine influenza virus? What is canine influenza (dog flu) ? Dog flu is a contagious ...

119

Treating Influenza (Flu) (in High Risk People)  

MedlinePLUS

... you will get complications from the flu, like pneumonia . The flu also can make long-term health ... also can prevent serious flu-related complications (like pneumonia). This is especially important for people with a ...

120

Pregnant Women Need a Flu Shot  

MedlinePLUS

... Diseases Office of Director Pregnant Women Need a Flu Shot Flu vaccine comes in two forms: an injectable ... problems such as premature labor and delivery. The flu shot is the best protection for you – and your ...

121

Pandemic mitigation: Bringing it home.  

PubMed

In the US, national, regional and even institutional plans for ameliorating the effects of pandemic influenza focus on stockpiling antiviral medications, early production and distribution of vaccine, mass and personal social distancing, and a number of personal hygiene activities. Essential personnel are the first scheduled to receive preventive and therapeutic pharmaceuticals, followed by high risk groups, the largest of which are the elderly. Specific recommendations for protection embody a bunker mentality with a time horizon of two weeks, emulating preparation for a natural disaster. The epidemiology of pandemic influenza is scarcely considered. We summarize here the envelope of mortality attributable to epidemic and pandemic influenza in the last 90 years of the last century as a lead in to a presentation of the multinational case age distribution of the novel H1N1 pandemic of 2009. We discuss the sparing of elderly subpopulations in pandemics and the subsequent abrupt resurgence of mortality in the spared age groups as drift variants emerge. The general decline in the baseline of age-specific excess mortality in economically developed countries is characterized and its importance assessed. Models of acute and chronic care facilities are discussed and an argument is advanced that society as a whole as well as acute care facilities cannot be protected against incursion and widespread infection in pandemics of severity above low moderate. The key findings of models of chronic care institutions and others that can control public access, such as corporations, are used to describe programs with a realistic chance of providing protection in even severe pandemics. These principles are further mapped onto individual residences. Materials directing institutional and home planning are cited. PMID:21361400

Reichert, Tom

2011-01-01

122

Flu in the United States  

NSDL National Science Digital Library

Visitors to this Web site provided by the Centers for Disease Control and Prevention's National Center for Infectious Diseases will find detailed, authoritative answers to any questions they may have about the flu. In addition to explanations of flu transmission, treatment, vaccination, etc., this Web site offers updated surveillance reports on the status of influenza in the US. The Questions and Answers page is a good source for quick, easy-to-absorb information, and it clears up many misconceptions regarding the flu and the flu shot. Visitors looking for more detailed information will find many useful links, particularly for recent news and reports.

1999-01-01

123

Help Stop the Flu | NIH MedlinePlus the Magazine  

MedlinePLUS

... of this page please turn Javascript on. Feature: Flu Shot Help Stop the Flu Past Issues / Winter 2011 ... www.flu.gov to find nearby locations offering flu shots or nasal spray flu vaccine. Locations are being ...

124

Caring for Someone with the Flu  

MedlinePLUS

... with the Flu Caring for Someone with the Flu Keep the sick person comfortable and follow the ... WhiteHouse.gov USA.gov GobiernoUSA.gov BusinessUSA.gov Flu Basics Symptoms Prevention Treatment Vaccination Types of Flu ...

125

Should I Get a Flu Shot?  

MedlinePLUS

Should I Get a Flu Shot? The flu shot is recommended for most people with cancer and cancer survivors. The flu shot is a type of ... the protection you need. Can I get a flu shot during cancer treatment? People getting cancer treatment (radiation ...

126

[Mass communication during the "H1N1 flu"].  

PubMed

Nowadays communication plays a key role in healthcare, especially when a detailed risk analysis is important for correct information, as in the case of the H1N1 flu virus A. Through our study we have analyzed how the event "H1N1 flu" was addressed by the media, considering the period April 2009-June 2010. We collected the information from "Il Corriere della Sera", "La Repubblica" and "City", in addition to an online site for general information such as "TGCOM". The analyzed peak of daily news was seen a few weeks before the pandemic peak; in addition, after the peak of the pandemic, the interest of the press has completely collapsed, and eventually disappeared altogether. The media can influence the thought and consequentially how the recipients act, leading to a misperception of risk ('risk') and danger ('hazard'). Moreover the institutions and health professionals are not always able to communicate effectively to meet the needs for correct information. It is desirable in the future a greater degree of collaboration between media and authorities to have a clearer simpler and less misleading communication in the health field, helping recipients to act properly. PMID:22755497

Pellegrino, E; Martino, G; Balli, M; Puggelli, F; Tiscione, E; Bonaccorsi, G; Bonanni, P

2012-01-01

127

Swine-Flu Plans Put E-Learning in the Spotlight  

ERIC Educational Resources Information Center

Last school year, many educators were caught unprepared when schools closed in response to cases of swine flu. This time around, both the federal government and school districts are putting specific online-learning measures in place to get ready for possible closures or waves of teacher and student absences because of a flu outbreak. To prepare

Davis, Michelle R.; Ash, Katie

2009-01-01

128

Joining the dots on the emergence of pandemic influenza.  

PubMed

Extensive research in the last 20 years has unveiled some of the factors associated with the emergence of pandemic influenza A viruses. Nonetheless, numerous extrinsic and virological factors are yet to be fully understood, especially with reference to their interconnection and interdependence. Knowledge gathered so far has motivated the scientific community to embrace the One Health-One Flu concept and to explore new scientific approaches in the field of influenza infections in order to make educated decisions when it comes to pandemic preparedness. As a result of this awareness, risk assessment methodology is currently being explored as a new tool to estimate the pandemic potential of influenza viruses circulating in animals, underlining the urgency for interdisciplinary collaboration and the need to share updated and high quality scientific and surveillance data. PMID:23643193

Capua, Ilaria

2013-10-01

129

Avian flu: Isolation of drug-resistant H5N1 virus  

Microsoft Academic Search

The persistence of H5N1 avian influenza viruses in many Asian countries and their ability to cause fatal infections in humans have raised serious concerns about a global flu pandemic. Here we report the isolation of an H5N1 virus from a Vietnamese girl that is resistant to the drug oseltamivir, which is an inhibitor of the viral enzyme neuraminidase and is

Q. Mai Le; Maki Kiso; Kazuhiko Someya; Yuko T. Sakai; T. Hien Nguyen; Khan H. L. Nguyen; N. Dinh Pham; Ha H. Ngyen; Shinya Yamada; Yukiko Muramoto; Taisuke Horimoto; Ayato Takada; Hideo Goto; Takashi Suzuki; Yasuo Suzuki; Yoshihiro Kawaoka

2005-01-01

130

Structural Basis of Preexisting Immunity to the 2009 H1N1 Pandemic Influenza Virus  

SciTech Connect

The 2009 H1N1 swine flu is the first influenza pandemic in decades. The crystal structure of the hemagglutinin from the A/California/04/2009 H1N1 virus shows that its antigenic structure, particularly within the Sa antigenic site, is extremely similar to those of human H1N1 viruses circulating early in the 20th century. The cocrystal structure of the 1918 hemagglutinin with 2D1, an antibody from a survivor of the 1918 Spanish flu that neutralizes both 1918 and 2009 H1N1 viruses, reveals an epitope that is conserved in both pandemic viruses. Thus, antigenic similarity between the 2009 and 1918-like viruses provides an explanation for the age-related immunity to the current influenza pandemic.

Xu, Rui; Ekiert, Damian C.; Krause, Jens C.; Hai, Rong; Crowe, Jr., James E.; Wilson, Ian A. (Sinai); (Scripps); (Vanderbilt)

2010-05-25

131

Pandemic influenza: certain uncertainties  

PubMed Central

SUMMARY For at least five centuries, major epidemics and pandemics of influenza have occurred unexpectedly and at irregular intervals. Despite the modern notion that pandemic influenza is a distinct phenomenon obeying such constant (if incompletely understood) rules such as dramatic genetic change, cyclicity, “wave” patterning, virus replacement, and predictable epidemic behavior, much evidence suggests the opposite. Although there is much that we know about pandemic influenza, there appears to be much more that we do not know. Pandemics arise as a result of various genetic mechanisms, have no predictable patterns of mortality among different age groups, and vary greatly in how and when they arise and recur. Some are followed by new pandemics, whereas others fade gradually or abruptly into long-term endemicity. Human influenza pandemics have been caused by viruses that evolved singly or in co-circulation with other pandemic virus descendants and often have involved significant transmission between, or establishment of, viral reservoirs within other animal hosts. In recent decades, pandemic influenza has continued to produce numerous unanticipated events that expose fundamental gaps in scientific knowledge. Influenza pandemics appear to be not a single phenomenon but a heterogeneous collection of viral evolutionary events whose similarities are overshadowed by important differences, the determinants of which remain poorly understood. These uncertainties make it difficult to predict influenza pandemics and, therefore, to adequately plan to prevent them.

Morens, David M.; Taubenberger, Jeffery K.

2011-01-01

132

H1N1 and Seasonal Flu: The "New" Flu and the "Old" Flu  

MedlinePLUS

... hospitalization or death from the flu include: v Children with underlying medical problems, such as heart problems, neurologic disorders (like cerebral palsy), or metabolic disorders (like diabetes) vChildren who were ...

133

Laboratory diagnosis of swine flu: a review.  

PubMed

Human swine influenza A [H1N1], also referred to as "swine flu," is highly transmissible. The emergence of new strains will continue to pose challenges to public health and the scientific communities will have to prepare to detect them for appropriate treatment. Most sophisticated methods include immunofluorescence staining and antigen subtyping based on hemagglutination inhibition (HI). Another standard method is RT-PCR targeting hemagglutinin and neuraminidase genes. The recent availability of rapid, reliable, and easy-to-perform tests for detecting influenza virus infections has introduced rapid viral diagnosis. This review thus summarizes the current information on the present diagnostic methods for influenza virus H1N1. PMID:23140089

Chauhan, Nidhi; Narang, Jagriti; Pundir, Shikha; Singh, Sandeep; Pundir, C S

2013-06-01

134

FluBreaks: Early Epidemic Detection from Google Flu Trends  

PubMed Central

Background The Google Flu Trends service was launched in 2008 to track changes in the volume of online search queries related to flu-like symptoms. Over the last few years, the trend data produced by this service has shown a consistent relationship with the actual number of flu reports collected by the US Centers for Disease Control and Prevention (CDC), often identifying increases in flu cases weeks in advance of CDC records. However, contrary to popular belief, Google Flu Trends is not an early epidemic detection system. Instead, it is designed as a baseline indicator of the trend, or changes, in the number of disease cases. Objective To evaluate whether these trends can be used as a basis for an early warning system for epidemics. Methods We present the first detailed algorithmic analysis of how Google Flu Trends can be used as a basis for building a fully automated system for early warning of epidemics in advance of methods used by the CDC. Based on our work, we present a novel early epidemic detection system, called FluBreaks (dritte.org/flubreaks), based on Google Flu Trends data. We compared the accuracy and practicality of three types of algorithms: normal distribution algorithms, Poisson distribution algorithms, and negative binomial distribution algorithms. We explored the relative merits of these methods, and related our findings to changes in Internet penetration and population size for the regions in Google Flu Trends providing data. Results Across our performance metrics of percentage true-positives (RTP), percentage false-positives (RFP), percentage overlap (OT), and percentage early alarms (EA), Poisson- and negative binomial-based algorithms performed better in all except RFP. Poisson-based algorithms had average values of 99%, 28%, 71%, and 76% for RTP, RFP, OT, and EA, respectively, whereas negative binomial-based algorithms had average values of 97.8%, 17.8%, 60%, and 55% for RTP, RFP, OT, and EA, respectively. Moreover, the EA was also affected by the region’s population size. Regions with larger populations (regions 4 and 6) had higher values of EA than region 10 (which had the smallest population) for negative binomial- and Poisson-based algorithms. The difference was 12.5% and 13.5% on average in negative binomial- and Poisson-based algorithms, respectively. Conclusions We present the first detailed comparative analysis of popular early epidemic detection algorithms on Google Flu Trends data. We note that realizing this opportunity requires moving beyond the cumulative sum and historical limits method-based normal distribution approaches, traditionally employed by the CDC, to negative binomial- and Poisson-based algorithms to deal with potentially noisy search query data from regions with varying population and Internet penetrations. Based on our work, we have developed FluBreaks, an early warning system for flu epidemics using Google Flu Trends.

Pervaiz, Mansoor; Abdur Rehman, Nabeel; Saif, Umar

2012-01-01

135

Symptoms and Complications of Flu (Influenza)  

MedlinePLUS

... JavaScript on. Read more information on enabling JavaScript. Flu (Influenza) Skip Content Marketing Share this: Main Content ... Open All Influenza Symptoms People who have the flu often experience Fever Feeling feverish/chills Cough Sore ...

136

Report Questions Effectiveness of Flu Meds  

MedlinePLUS

... page, please enable JavaScript. Report Questions Effectiveness of Flu Meds 'Hidden' trial data reveals that some Tamiflu ... 2014) Thursday, April 10, 2014 Related MedlinePlus Pages Flu Medicines THURSDAY, April 10, 2014 (HealthDay News) -- No ...

137

Swine Influenza (Swine Flu) in Pigs  

MedlinePLUS

... Google Bookmarks Key Facts about Swine Influenza (Swine Flu) in Pigs Questions & Answers On This Page What ... similar to outbreaks in humans. How many swine flu viruses are there? Like influenza viruses in humans ...

138

Comparison: Flu prescription sales data from a retail pharmacy in the US with Google Flu trends and US ILINet (CDC) data as flu activity indicator.  

PubMed

The potential threat of bioterrorism along with the emergence of new or existing drug resistant strains of influenza virus, added to expanded global travel, have increased vulnerability to epidemics or pandemics and their aftermath. The same factors have also precipitated urgency for having better, faster, sensitive, and reliable syndromic surveillance systems. Prescription sales data can provide surrogate information about the development of infectious diseases and therefore serve as a useful tool in syndromic surveillance. This study compared prescription sales data from a large drug retailing pharmacy chain in the United States with Google Flu trends surveillance system data as a flu activity indicator. It was found that the two were highly correlated. The correlation coefficient (Pearson 'r') for five years' aggregate data (2007-2011) was 0.92 (95% CI, 0.90-0.94). The correlation coefficients for each of the five years between 2007 and 2011 were 0.85, 0.92, 0.91, 0.88, and 0.87 respectively. Additionally, prescription sales data from the same large drug retailing pharmacy chain in the United States were also compared with US Outpatient Influenza-like Illness Surveillance Network (ILINet) data for 2007 by Centers for Disease Control and Prevention (CDC). The correlation coefficient (Pearson 'r') was 0.97 (95% CI, 0.95-0.98). PMID:22952719

Patwardhan, Avinash; Bilkovski, Robert

2012-01-01

139

Computer-assisted resilience training to prepare healthcare workers for pandemic influenza: a randomized trial of the optimal dose of training  

PubMed Central

Background Working in a hospital during an extraordinary infectious disease outbreak can cause significant stress and contribute to healthcare workers choosing to reduce patient contact. Psychological training of healthcare workers prior to an influenza pandemic may reduce stress-related absenteeism, however, established training methods that change behavior and attitudes are too resource-intensive for widespread use. This study tests the feasibility and effectiveness of a less expensive alternative - an interactive, computer-assisted training course designed to build resilience to the stresses of working during a pandemic. Methods A "dose-finding" study compared pre-post changes in three different durations of training. We measured variables that are likely to mediate stress-responses in a pandemic before and after training: confidence in support and training, pandemic-related self-efficacy, coping style and interpersonal problems. Results 158 hospital workers took the course and were randomly assigned to the short (7 sessions, median cumulative duration 111 minutes), medium (12 sessions, 158 minutes) or long (17 sessions, 223 minutes) version. Using an intention-to-treat analysis, the course was associated with significant improvements in confidence in support and training, pandemic self-efficacy and interpersonal problems. Participants who under-utilized coping via problem-solving or seeking support or over-utilized escape-avoidance experienced improved coping. Comparison of doses showed improved interpersonal problems in the medium and long course but not in the short course. There was a trend towards higher drop-out rates with longer duration of training. Conclusions Computer-assisted resilience training in healthcare workers appears to be of significant benefit and merits further study under pandemic conditions. Comparing three "doses" of the course suggested that the medium course was optimal.

2010-01-01

140

Ecology and evolution of the flu  

Microsoft Academic Search

Influenza (flu) is a common infectious disease, but it is unusual in that the primary timescales for disease dynamics (epidemics) and viral evolution (new variants) are roughly the same. Recently, extraordinarily reliable phylogenetic reconstructions of flu virus evolution have been made using samples from both extant and extinct strains. In addition, because of their public health importance, flu epidemics have

David J. D. Earn; Jonathan Dushoff; Simon A. Levin

2002-01-01

141

Intranasal flu vaccine available this season.  

PubMed

FluMist provides a convenient alternative to the traditional flu shot. Use of a live attenuated virus that stimulates an immune response directly in the nasal passages has certain therapeutic advantages in some patients. However, the cost of this form of flu vaccine is likely to be borne entirely by the patient. PMID:14717271

Piascik, Peggy

2003-01-01

142

Structural Basis of Preexisting Immunity to the 2009 H1N1 Pandemic Influenza Virus  

Microsoft Academic Search

The 2009 H1N1 swine flu is the first influenza pandemic in decades. The crystal structure of the hemagglutinin from the A\\/California\\/04\\/2009 H1N1 virus shows that its antigenic structure, particularly within the Sa antigenic site, is extremely similar to those of human H1N1 viruses circulating early in the 20th century. The cocrystal structure of the 1918 hemagglutinin with 2D1, an antibody

Rui Xu; Damian C. Ekiert; Jens C. Krause; Rong Hai; Crowe Jr. James E; Ian A. Wilson

2010-01-01

143

2009 H1N1 Flu Vaccine Facts  

MedlinePLUS

... weeks before getting another nasal spray vaccine. 4 Flu shots are vaccines from dead or inactivated forms of ... flu virus. Both the seasonal and 2009 H1N1 flu shots are vaccines that contain killed/inactivated influenza virus. ...

144

Get Your Flu Shot!| NIH MedlinePlus the Magazine  

MedlinePLUS

... of this page please turn Javascript on. Feature: Flu Shot Get Your Flu Shot! Past Issues / Winter 2011 Table of Contents It's ... Vaccine There are two types of vaccines: The flu shot — an inactivated vaccine (containing killed virus) that is ...

145

Should I Get a Flu Shot if I Have Psoriasis?  

MedlinePLUS

... your anxiety. People who have psoriasis can get flu shots While people who have psoriasis should not get ... smallpox, they can get the 2009 - 2010: Seasonal flu shot H1N1 (a.k.a swine flu) shot Notice ...

146

What You Should Know and Do This Flu Season If You Are 65 Years and Older  

MedlinePLUS

... Actions To Take This Flu Season: Get Your Flu Shot The best way to prevent the flu is ... vaccination. People 65 years and older have two flu shots available to choose from - a regular dose flu ...

147

New Study Shows Flu Vaccine Reduced Children's Risk of Intensive Care Unit Flu Admission by Three-Fourths  

MedlinePLUS

... sick, it's important to remember to use our second line of defense against flu: antiviral drugs to treat flu illness,” Fry said. “People at high risk of complications should seek treatment if they get a flu-like illness. Their ...

148

Properly Folded Bacterially Expressed H1N1 Hemagglutinin Globular Head and Ectodomain Vaccines Protect Ferrets against H1N1 Pandemic Influenza Virus  

Microsoft Academic Search

BackgroundIn the face of impending influenza pandemic, a rapid vaccine production and mass vaccination is the most effective approach to prevent the large scale mortality and morbidity that was associated with the 1918 “Spanish Flu”. The traditional process of influenza vaccine production in eggs is time consuming and may not meet the demands of rapid global vaccination required to curtail

Surender Khurana; Swati Verma; Nitin Verma; Corey J. Crevar; Donald M. Carter; Jody Manischewitz; Lisa R. King; Ted M. Ross; Hana Golding; Ding Xiang Liu

2010-01-01

149

Interest of a simple on-line screening registry for measuring ICU burden related to an influenza pandemic  

PubMed Central

Introduction The specific burden imposed on Intensive Care Units (ICUs) during the A/H1N1 influenza 2009 pandemic has been poorly explored. An on-line screening registry allowed a daily report of ICU beds occupancy rate by flu infected patients (Flu-OR) admitted in French ICUs. Methods We conducted a prospective inception cohort study with results of an on-line screening registry designed for daily assessment of ICU burden. Results Among the 108 centers participating to the French H1N1 research network on mechanical ventilation (REVA) - French Society of Intensive Care (SRLF) registry, 69 ICUs belonging to seven large geographical areas voluntarily participated in a website screening-registry. The aim was to daily assess the ICU beds occupancy rate by influenza-infected and non-infected patients for at least three weeks. Three hundred ninety-one critically ill infected patients were enrolled in the cohort, representing a subset of 35% of the whole French 2009 pandemic cohort; 73% were mechanically ventilated, 13% required extra corporal membrane oxygenation (ECMO) and 22% died. The global Flu-OR in these ICUs was only 7.6%, but it exceeded a predefined 15% critical threshold in 32 ICUs for a total of 103 weeks. Flu-ORs were significantly higher in University than in non-University hospitals. The peak ICU burden was poorly predicted by observations obtained at the level of large geographical areas. Conclusions The peak Flu-OR during the pandemic significantly exceeded a 15% critical threshold in almost half of the ICUs, with an uneven distribution with time, geographical areas and between University and non-University hospitals. An on-line assessment of Flu-OR via a simple dedicated registry may contribute to better match resources and needs.

2012-01-01

150

Interest of a simple on-line screening registry for measuring ICU burden related to an influenza pandemic.  

PubMed

ABSTRACT: INTRODUCTION: The specific burden imposed on Intensive Care Units (ICUs) during the A/H1N1 influenza 2009 pandemic has been poorly explored. An on-line screening registry allowed a daily report of ICU beds occupancy rate by flu infected patients (Flu-OR) admitted in French ICUs. METHODS: We conducted a prospective inception cohort study with results of an on-line screening registry designed for daily assessment of ICU burden. RESULTS: Among the 108 centers participating to the French H1N1 research network on mechanical ventilation (REVA) - French Society of Intensive Care (SRLF) registry, 69 ICUs belonging to seven large geographical areas voluntarily participated in a website screening-registry. The aim was to daily assess the ICU beds occupancy rate by influenza-infected and non-infected patients for at least three weeks. Three hundred ninety-one critically ill infected patients were enrolled in the cohort, representing a subset of 35% of the whole French 2009 pandemic cohort; 73% were mechanically ventilated, 13% required extra corporal membrane oxygenation (ECMO) and 22% died. The global Flu-OR in these ICUs was only 7.6%, but it exceeded a predefined 15% critical threshold in 32 ICUs for a total of 103 weeks. Flu-ORs were significantly higher in University than in non-University hospitals. The peak ICU burden was poorly predicted by observations obtained at the level of large geographical areas. CONCLUSIONS: The peak Flu-OR during the pandemic significantly exceeded a 15% critical threshold in almost half of the ICUs, with an uneven distribution with time, geographical areas and between University and non-University hospitals. An on-line assessment of Flu-OR via a simple dedicated registry may contribute to better match resources and needs. PMID:22776231

Richard, Jean-Christophe Marie; Pham, Tài; Brun-Buisson, Christian; Reignier, Jean; Mercat, Alain; Beduneau, Gaëtan; Régnier, Bernard; Mourvillier, Bruno; Guitton, Christophe; Castanier, Matthias; Combes, Alain; Tulzo, Yves Le; Brochard, Laurent

2012-07-01

151

Epidemiology of pandemic H1N1 strains in a tertiary hospital of Maharashtra.  

PubMed

Swine-flu is a viral fever caused by a new mutated strain Influenza A virus subtype H1N1, which infects humans. Pandemic H1N1 (pH1N1/2009) virus was detected in the first quarter of 2009 in the west coastal region of North America and spread very rapidly to the other countries during April-June, 2009. This study was conducted to assess the epidemiology of pandemic H1N1 strains using a cross-sectional study design in a tertiary hospital. The symptomatic patients attending the flu outpatient department (OPD)/emergency from August 2009 to April 2011 at Indira Gandhi Government Medical College, Nagpur were included using a standard case definition. A total of 67 (27.01%) samples from 247 patients were pandemic influenza A/H1N1 positive. None of the patients had a history of foreign travel, whereas 23.88% of the patients gave history of travel to an endemic area. Overall, 22.38% of the patients came in contact with proven cases of pandemic H1N1. pH1N1 transmission activity has increased since May 2010. PMID:23229220

Shrikhande, Sunanda; Bhoyar, S K; Tenpe, S H; Deogade, N G

2012-01-01

152

[Epidemiology of Pandemic Influenza (H1N1) 2009 in Aichi Medical University Hospital].  

PubMed

We have analyzed epidemiology of pandemic influenza (H1N1) 2009 in Aichi Medical University hospital. As a result, the characteristics of pandemic influenza (H1N1) 2009 was as follows. (1) The number of ordered rapid diagnostic test was 2.8 times compared with the seasonal influenza period. The number of ordered rapid diagnostic test of the seasonal influenza period had the peak in January to March. However, the peak in pandemic influenza (H1N1) 2009 was November. Also, the number of samples on the weekend had been more than that of the weekday. (2) Positive rate of each diagnostic kit did not have the difference between the seasonal influenza (31.3 ± 1.8%) and pandemic influenza (H1N1) 2009 (29.6%). (3) Age on most ordered samples were less than ten years old, and the number of samples in 11 to 20 years old was twice in comparison with the seasonal influenza. (4) Pandemic influenza (H1N1) 2009 in influenza A accounted for 96.9%. (5) Sensitivity and specificity of ESPLINE Influenza A&B-N (FUJIREBIO, Inc., Tokyo, Japan) to the pandemic influenza (H1N1) 2009 were 100% and 100%, respectively. Also, sensitivity and specificity of prorasuto Flu (Mitsubishi Chemical Medience Corporation, Tokyo, Japan) were 77.3%and 98.5%, respectively. PMID:21128698

Tani, Hiroya; Yamagishi, Yuka; Fuzimaki, Eriko; Kishi, Takahiko; Goto, Minehiro; Mikamo, Hiroshige

2010-01-01

153

Pandemic (H1N1) 2009 influenza.  

PubMed

The clinical picture in severe cases of pandemic (H1N1) 2009 influenza is markedly different from the disease pattern seen during epidemics of seasonal influenza, in that many of those affected were previously healthy young people. Current predictions estimate that, during a pandemic wave, 12-30% of the population will develop clinical influenza (compared with 5-15% for seasonal influenza) with 4% of those patients requiring hospital admissions and one in five requiring critical care. This review covers the background, clinical presentation, diagnosis, and treatment. The role of immunization and antiviral drugs is discussed. Experience from the first wave of pandemic (H1N1) 2009 influenza suggests that a number of infected patients become critically ill and require intensive care admission. These patients rapidly develop severe progressive respiratory failure which is often associated with failure of other organs, or marked worsening of underlying airways disease. The critical care management of these patients and the implications for resources is reviewed. Guidance from a range of bodies has been produced in a relatively short period of time in response to pandemic (H1N1) 2009 influenza. Disease severity has the potential to change, especially if there is virus mutation. Clinicians must be prepared for the unexpected and continue to share their experiences to maximize patient outcomes. PMID:20053625

Patel, M; Dennis, A; Flutter, C; Khan, Z

2010-02-01

154

Development and Pre-Clinical Evaluation of Two LAIV Strains against Potentially Pandemic H2N2 Influenza Virus  

PubMed Central

H2N2 Influenza A caused the Asian flu pandemic in 1957, circulated for more than 10 years and disappeared from the human population after 1968. Given that people born after 1968 are naïve to H2N2, that the virus still circulates in wild birds and that this influenza subtype has a proven pandemic track record, H2N2 is regarded as a potential pandemic threat. To prepare for an H2N2 pandemic, here we developed and tested in mice and ferrets two live attenuated influenza vaccines based on the haemagglutinins of the two different H2N2 lineages that circulated at the end of the cycle, using the well characterized A/Leningrad/134/17/57 (H2N2) master donor virus as the backbone. The vaccine strains containing the HA and NA of A/California/1/66 (clade 1) or A/Tokyo/3/67 (clade 2) showed a temperature sensitive and cold adapted phenotype and a reduced reproduction that was limited to the respiratory tract of mice, suggesting that the vaccines may be safe for use in humans. Both vaccine strains induced haemagglutination inhibition titers in mice. Vaccination abolished virus replication in the nose and lung and protected mice from weight loss after homologous and heterologous challenge with the respective donor wild type strains. In ferrets, the live attenuated vaccines induced high virus neutralizing, haemagglutination and neuraminidase inhibition titers, however; the vaccine based on the A/California/1/66 wt virus induced higher homologous and better cross-reactive antibody responses than the A/Tokyo/3/67 based vaccine. In line with this observation, was the higher virus reduction observed in the throat and nose of ferrets vaccinated with this vaccine after challenge with either of the wild type donor viruses. Moreover, both vaccines clearly reduced the infection-induced rhinitis observed in placebo-vaccinated ferrets. The results favor the vaccine based on the A/California/1/66 isolate, which will be evaluated in a clinical study.

Smolonogina, Tatiana; Rekstin, Andrey; van Amerongen, Geert; van Dijken, Harry; Mouthaan, Justin; Roholl, Paul; Kuznetsova, Victoria; Doroshenko, Elena; Tsvetnitsky, Vadim; Rudenko, Larisa

2014-01-01

155

Influenza Pandemic: Gaps in Pandemic Planning and Preparedness Need to Be Addressed. Testimony before the Committee on Homeland Security, House of Representatives. GAO-09-909T  

ERIC Educational Resources Information Center

As the current H1N1 outbreak underscores, an influenza pandemic remains a real threat to our nation. Over the past 3 years, the US Government Accountability Office (GAO) conducted a body of work, consisting of 12 reports and 4 testimonies, to help the nation better prepare for a possible pandemic. In February 2009, GAO synthesized the results of…

Steinhardt, Bernice

2009-01-01

156

Flu Can Infect Many without Causing Symptoms: Study  

MedlinePLUS

... sharing features on this page, please enable JavaScript. Flu Can Infect Many Without Causing Symptoms: Study British ... Preidt Monday, March 17, 2014 Related MedlinePlus Pages Flu H1N1 Flu (Swine Flu) SUNDAY, March 16, 2014 ( ...

157

People Under 65 Hard Hit by Flu This Year  

MedlinePLUS

... enable JavaScript. People Under 65 Hard Hit by Flu This Year H1N1 strain predominated in season that ... 2014) Thursday, June 5, 2014 Related MedlinePlus Pages Flu H1N1 Flu (Swine Flu) THURSDAY, June 5, 2014 ( ...

158

What You Can Do to Stop the Flu  

MedlinePLUS

... of this page please turn Javascript on. Feature: Flu What You Can Do to Stop the Flu Past Issues / Fall 2009 Table of Contents To ... Health and Human Services: http://flu.gov NIH Flu Research to Results Scientists at the National Institute ...

159

The pandemic subject: Canadian pandemic plans and communicating with the public about an influenza pandemic.  

PubMed

In this paper, I examine the goals for pandemic public communication as outlined in two Canadian plans for pandemic planning and infection control. I critique these strategies by drawing on Foucault's notions of governmentality and biopower. My argument is that the public health communication campaign goals reviewed rest upon a particular conceptualization of health in the context of pandemic planning as an individual/family duty, and that scientific/medical expert knowledge is most appropriate for guiding pandemic planning. This study contributes to a sociological understanding of how pandemic preparedness and infection control are represented in Canadian pandemic plans, how public health shapes pandemic communication messages in Canada, and the implications of those messages for subjectivity and notions of citizenship. PMID:24289936

Maunula, Laena

2013-10-01

160

Flu  

MedlinePLUS

... and 106 °F. An adult usually has a lower fever than a child. Other common symptoms include: Body aches Chills Dizziness Flushed face Headache Lack of energy Nausea and vomiting The fever and aches and ...

161

Development of live attenuated influenza vaccines against pandemic influenza strains.  

PubMed

Avian and animal influenza viruses can sporadically transmit to humans, causing outbreaks of varying severity. In some cases, further human-to-human virus transmission does not occur, and the outbreak in humans is limited. In other cases, sustained human-to-human transmission occurs, resulting in worldwide influenza pandemics. Preparation for future pandemics is an important global public health goal. A key objective of preparedness is to gain an understanding of how to design, test, and manufacture effective vaccines that could be stockpiled for use in a pandemic. This review summarizes results of an ongoing collaboration to produce, characterize, and clinically test a library of live attenuated influenza vaccine strains (based on Ann Arbor attenuated Type A strain) containing protective antigens from influenza viruses considered to be of high pandemic potential. PMID:24867587

Coelingh, Kathleen L; Luke, Catherine J; Jin, Hong; Talaat, Kawsar R

2014-07-01

162

Flu epidemic: shots, new treatments available.  

PubMed

The flu can be more threatening to persons with HIV disease than to the general population. Persons with HIV disease need to contact their physician to determine if they should receive a flu shot. A physician should also provide information on how and when to obtain the shot, and the prevalence of an influenza epidemic in the persons' geographic area. If a person already has the flu, two new drugs, Tamiflu and Relenza (zanamivir), are now available. Advice from the Food and Drug Administration (FDA) to physicians on prescribing influenza drugs and contact information are provided. PMID:11367203

James, J S

2000-01-21

163

The changing nature and scope of public health emergencies in response to annual flu.  

PubMed

The rapid spread of influenza during the 2012-13 season brought a series of public health challenges and corresponding response efforts. For decades, responses to annual flu have been undertaken routinely without extensive legal intervention. With the recent declaration of states of public health emergencies in Boston (January 9, 2013) and New York State (January 12, 2013), however, the legal baseline is changing. Propelled by a slate of state and local emergency declarations during the 2009-10 H1N1 pandemic, public officials are beginning to show cause for the issuance of formal emergency declarations in support of flu response efforts. The legal effects of these types of declarations are profound. Public and private actors are given significant, expedited public health powers. Scarce resources like vaccines can be more efficiently allocated. Laws relating to licensure, scope of practice, and liability can be effectively waived. Though originally conceptualized and once reserved for catastrophic, long-term health-related or bioterrorism events, public health emergency declarations are evolving to address temporary impacts on health care and public health services arising annually from flu outbreaks. This commentary explores the changing nature of public health emergencies and their current and potential impact on the provision of healthcare services in response to national or regional threats to the public's health. PMID:23641729

Hodge, James G

2013-06-01

164

Getting a Better Grasp on Flu Fundamentals  

MedlinePLUS

... by more than $500 billion. Exploring Flu Protein Biology to Improve Antivirals A representation of the structure ... combat this drug resistance by exploiting the virus's biology. One target is pocket-shaped structures on the ...

165

Controlling avian flu at the source  

Microsoft Academic Search

Global agricultural authorities should harmonize with the public-health sector to ensure the exchange of flu virus samples, and establish a single international standard for vaccines, say Robert Webster and Diane Hulse.

Robert Webster; Diane Hulse

2005-01-01

166

Equity in the Receipt of Oseltamivir in the United States During the H1N1 Pandemic.  

PubMed

Objectives. We assessed the relationship between individual characteristics and receipt of oseltamivir (Tamiflu) in the United States during the H1N1 pandemic and other flu seasons. Methods. In a cohort of individuals enrolled in pharmacy benefit plans, we used a multivariate logistic regression model to measure associations between subscriber characteristics and filling a prescription for oseltamivir during 3 flu seasons (October 2006-May 2007, October 2007-May 2008, and October 2008-May 2010). In 19 states with county-level influenza rates reported, we controlled for disease burden. Results. Approximately 56 million subscribers throughout the United States were included in 1 or more study periods. During pandemic flu, beneficiaries in the highest income category had 97% greater odds of receiving oseltamivir than those in the lowest category (P?pandemics, and they call for improved approaches to distributing potentially life-saving treatments. PMID:24825206

Franklin, Jessica M; Choudhry, Niteesh K; Uscher-Pines, Lori; Brill, Gregory; Matlin, Olga S; Fischer, Michael A; Schneeweiss, Sebastian; Avorn, Jerry; Brennan, Troyen A; Shrank, William H

2014-06-01

167

Resilience Training for Hospital Workers in Anticipation of an Influenza Pandemic  

ERIC Educational Resources Information Center

Background: Well before the H1N1 influenza, health care organizations worldwide prepared for a pandemic of unpredictable impact. Planners anticipated the possibility of a pandemic involving high mortality, high health care demands, rates of absenteeism rising up to 20-30% among health care workers, rationing of health care, and extraordinary…

Aiello, Andria; Khayeri, Michelle Young-Eun; Raja, Shreyshree; Peladeau, Nathalie; Romano, Donna; Leszcz, Molyn; Maunder, Robert G.; Rose, Marci; Adam, Mary Anne; Pain, Clare; Moore, Andrea; Savage, Diane; Schulman, Rabbi Bernard

2011-01-01

168

Awareness and acceptance of the pandemic influenza (H1N1v 2009) vaccination among antenatal patients in a district general hospital.  

PubMed

Pandemic H1N1 influenza virus was the cause of worldwide respiratory infection in 2009. The majority of these infections were self-limiting, however, high-risk groups, including pregnant women were at increased risk of mortality and morbidity from swine flu. Because of these risks, the World Health Organization recommended that pregnant women should receive the swine flu vaccine during pregnancy. The swine flu vaccine, like the seasonal flu vaccine, is safe to use in pregnancy. In view of the obvious benefits and safety of the pandemic flu vaccine, we decided to undertake a survey to assess the awareness and uptake of the vaccine among pregnant women in our local community. In our survey, lack of counselling from healthcare providers and fears of risks from the vaccine are the main reasons for refusal. For these reasons, healthcare professionals are provided with up-to-date information about the vaccine and are asked to provide this information to pregnant women at all stages of pregnancy in order to increase their awareness and acceptance of the vaccine. PMID:22779956

Moukarram, H; Nargund, A; Photiou, A; Kiran, T S U

2012-08-01

169

Impact of flu on hospital admissions during 4 flu seasons in Spain, 2000–2004  

Microsoft Academic Search

BACKGROUND: Seasonal flu epidemics in the European region cause high numbers of cases and deaths. Flu-associated mortality has been estimated but morbidity studies are necessary to understand the burden of disease in the population. Our objective was to estimate the excess hospital admissions in Spain of diseases associated with influenza during four epidemic influenza periods (2000 – 2004). METHODS: Hospital

Annick D Lenglet; Victoria Hernando; Pilar Rodrigo; Amparo Larrauri; Juan DM Donado; Salvador de Mateo

2007-01-01

170

2009 H1N1 and Seasonal Flu: What You Should Know about Flu Antiviral Drugs?  

MedlinePLUS

... step in preventing flu, antiviral drugs are a second line of defense against the flu. Antiviral drugs are ... people with a weak immune system (such as diabetes, HIV) People younger than 19 years of age who are receiving long-term aspirin therapy y *It is also important to know that ...

171

Conformation and Linkage Studies of Specific Oligosaccharides Related to H1N1, H5N1, and Human Flu for Developing the Second Tamiflu  

PubMed Central

The interaction between viral HA (hemagglutinin) and oligosaccharide of the host plays an important role in the infection and transmission of avian and human flu viruses. Until now, this interaction has been classified by sialyl(?2-3) or sialyl(?2-6) linkage specificity of oligosaccharide moieties for avian or human virus, respectively. In the case of H5N1 and newly mutated flu viruses, classification based on the linkage type does not correlate with human infection and human-to-human transmission of these viruses. It is newly suggested that flu infection and transmission to humans require high affinity binding to the extended conformation with long length sialyl(?2-6)galactose containing oligosaccharides. On the other hand, the avian flu virus requires folded conformation with sialyl(?2-3) or short length sialyl(?2-6) containing trisaccharides. This suggests a potential future direction for the development of new species-specific antiviral drugs to prevent and treat pandemic flu.

Yoo, Eunsun

2014-01-01

172

Understanding influenza transmission, immunity and pandemic threats  

Microsoft Academic Search

The current pandemic threat can be best understood within an ecological framework that takes account of the history of past pandemics caused by influenza A, the relationships between pandemic and seasonal spread of influenza viruses, and the importance of immunity and behavioural responses in human populations. Isolated populations without recent exposure to seasonal influenza seem more susceptible to new pandemic

John D. Mathews; Joanne M. Chesson; James M. McCaw; Jodie McVernon

2009-01-01

173

I'm Pregnant. Should I Get a Flu Shot?  

MedlinePLUS

... Asthma? Are Organic Foods Healthier? What Is Dehydration? I'm Pregnant. Should I Get a Flu Shot? KidsHealth > Teens > Q&A > Health Conditions & Illnesses > I'm Pregnant. Should I Get a Flu Shot? ...

174

Study Finds Many Flu Patients Not Treated Appropriately  

MedlinePLUS

... this page, please enable JavaScript. Study Finds Many Flu Patients Not Treated Appropriately Antivirals underprescribed for high- ... Thursday, July 17, 2014 Related MedlinePlus Pages Antibiotics Flu THURSDAY, July 17, 2014 (HealthDay News) -- Antiviral drugs ...

175

Situation Update: Summary of Weekly FluView  

MedlinePLUS

... Variant Virus Infections Interim Guidance on Specimen Collection, Processing, and Testing for Patients with Suspect Influenza A ( ... Video Medscape Podcasts Public Service Announcements (PSAs) Virus Images Flu Prevention Toolkit Other Flu Websites CDC Resources ...

176

Is It a Cold or the Flu (For Parents)?  

MedlinePLUS

... Baby's Growth Is It a Cold or the Flu? KidsHealth > Parents > General Health > Sick Kids > Is It a Cold or the Flu? Print A A A Text Size What's in ... cough, and high fever — could it be the flu that's been going around? Or just a common ...

177

2009 H1N1 Flu and Pregnancy  

MedlinePLUS

... us online at: www.OTISpregnancy.org . 2009 H1N1 Flu and Pregnancy This sheet talks about the risks ... health care provider. What is the 2009 H1N1 flu? The flu (more formally known as influenza) is ...

178

Shot in the Dark? Debunking Myths About Swine Flu Vaccine  

NSDL National Science Digital Library

What precautions should you take against the H1N1 flu? Should you get the vaccine? In this lesson, students identify and debunk some of the myths surrounding H1N1 flu, or swine flu, and the new vaccine for it.

Hutchings, Catherine; Ojalvo, Holly E.

2009-10-16

179

[The influenza pandemic 1968-1970: crisis management in separated Germany - "Vodka and Raspberry Tea"].  

PubMed

The Hong Kong Flu in the years 1968-1970 challenged both German health care systems. This article intends to analyse the patterns of reaction to the pandemic. Both German states faced the threat according to their respective ideological orientation. This applied to the two parts of Berlin - West and East - as well. In the GDR the control of influenza was centrally organized. When the pandemic passed away an influenza guiding document ("Führungsdokument") was made obligatory for the fight against the plague. In the FRG hospital treatment maintained predominance while the outpatient sector was administrated by physicians in private practice. In West- Berlin outpatient clinics were declined by the Association of Physicians ("Kassenärztliche Vereinigung"). In 1970 a first concept of surveillance was presented on the level of the state in West Germany. In the years 1968-1970 vaccinations were not common in both German states. The essay is based on the analysis of archival sources, monographs, scientific and newspaper articles. PMID:22169920

Witte, W

2011-12-01

180

F-BF Flu on Campus  

NSDL National Science Digital Library

This is a task from the Illustrative Mathematics website that is one part of a complete illustration of the standard to which it is aligned. Each task has at least one solution and some commentary that addresses important asects of the task and its potential use. Here are the first few lines of the commentary for this task: Suppose the swine flu, influenza H1N1, is spreading on a school campus. The following table shows the number of students, $n$, that have the flu $d$ da...

181

Abbreviated Pandemic Influenza Planning Template for Primary Care Offices  

SciTech Connect

The Abbreviated Pandemic Influenza Plan Template for Primary Care Provider Offices is intended to assist primary care providers and office managers with preparing their offices for quickly putting a plan in place to handle an increase in patient calls and visits, whether during the 2009-2010 influenza season or future influenza seasons.

HCTT CHE

2010-01-01

182

Meeting the Challenge of Influenza Pandemic Preparedness in Developing Countries  

Microsoft Academic Search

Developing countries face unique difficulties in preparing for an influenza pandemic. Our current top-down approach will not provide these countries with adequate supplies of vaccines and antiviral agents. Consequently, they will have to use a bottom-up approach based on inexpensive generic agents that either modify the host response to influenza virus or act as antiviral agents. Several of these agents

David S. Fedson

2009-01-01

183

Behavioural responses to influenza pandemics  

PubMed Central

The emergence of the novel A/H1N1 virus has made pandemic preparedness a crucial issue for public health worldwide. Although the epidemiological aspects of the three 20th century influenza pandemics have been widely investigated, little is known about population behaviour in a pandemic situation. Such knowledge is however critical, notably for predicting population compliance with non pharmaceutical interventions. This paper reviews the relevant scientific literature for the 1918-1920, 1957-1958, 1969-1969 influenza epidemics and the 2003 SARS outbreak. Although the evidence base of most non pharmaceutical interventions (NPIs) and personal protection measures is debated, it appears on the basis of past experience that NPIs implemented the most systematically, the earliest, and for the longest time could reduce overall mortality rates and spread out epidemic peaks. Adequate, transparent, and targeted communication on the part of public health authorities would be also of crucial importance in the event of a serious influenza pandemic.

Balinska, Marta; Rizzo, Caterina

2009-01-01

184

Pandemic Influenza's 500th Anniversary  

PubMed Central

It is impossible to know with certainty the first time that an influenza virus infected humans or when the first influenza pandemic occurred. However, many historians agree that the year 1510 a.d.—500 years ago—marks the first recognition of pandemic influenza. On this significant anniversary it is timely to ask: what were the circumstances surrounding the emergence of the 1510 pandemic, and what have we learned about this important disease over the subsequent five centuries?We conclude that in recent decades significant progress has been made in diagnosis, prevention, control, and treatment of influenza. It seems likely that, in the foreseeable future, we may be able to greatly reduce the burden of influenza pandemics with improved vaccines and other scientific and public health approaches.

Morens, David M.; Taubenberger, Jeffery K.; Folkers, Gregory K.; Fauci, Anthony S.

2010-01-01

185

Pandemic influenza planning by videoconference.  

PubMed

Collaboration between nations and sectors is crucial to improve regional preparedness against pandemic influenza. In 2008, a Virtual Symposium was organized in the Asia-Pacific region by the Asia-Pacific Economic Cooperation Emerging Infections Network (APEC EINet) to discuss pandemic preparedness. The multipoint videoconference lasted approximately 4.5 hours and was attended by 16 APEC members who shared best practices in public-private partnerships for pandemic influenza preparedness planning. Twelve of the 16 APEC members who participated responded to a post-event survey. The overall experience of the event was rated highly. Partnering public health, technology and business communities to discuss best practices in preparedness using videoconferencing may be an effective way to improve regional preparedness. Utilization of videoconferencing on a routine basis should be considered to improve preparedness among APEC members and enhance its usability during a pandemic. PMID:19815907

Kimball, Ann Marie; Arima, Yuzo; French, H Matthew; Osaki, Carl S; Hoff, Rodney; Lee, Soo-Sim; Schafer, Lisa; Nabae, Koji; Chen, Chang-Hsun; Hsun, Chang; Hishamuddin, Pengiran; Nelson, Rodney; Woody, Karalee; Brown, Jacqueline; Fox, Louis

2009-01-01

186

Meeting the Challenge of Influenza Pandemic Preparedness in Developing Countries  

PubMed Central

Developing countries face unique difficulties preparing for an influenza pandemic. Our current top-down approach will not provide these countries with adequate supplies of vaccines and antiviral agents. Consequently, they will have to use a bottom-up approach based on inexpensive generic agents that either modify the host response to influenza virus or act as antiviral agents. Several of these agents have shown promise, and many are currently produced in developing countries. Investigators must primarily identify agents for managing infection in populations and not simply seek explanations for how they work. They must determine in which countries these agents are produced and define patterns of distribution and costs. Because prepandemic research cannot establish whether these agents will be effective in a pandemic, randomized controlled trials must begin immediately after a new pandemic virus has emerged. Without this research, industrialized and developing countries could face an unprecedented health crisis.

2009-01-01

187

Assessment of pandemic preparedness in a socially vulnerable community in south Texas.  

PubMed

The purpose of this research was to obtain information about general and pandemic preparedness efforts of residents within San Patricio County in South Texas, as well as to identify the most effective means of communicating the risks posed by pandemic influenza. The population of San Patricio County is socially vulnerable to a variety of disasters, including influenza pandemics due to the unique demographic profile of the county as well as its location on the Gulf Coast. The goals of this study were to help with pandemic planning efforts and to provide recommendations that could serve as a foundation for building more resilient communities within San Patricio County. Clearly the various governmental levels must work together to assist communities prepare for pandemic preparedness but broad, inclusive community participation is also necessary to strengthen community resilience. PMID:24350552

Kiltz, Linda; Fonseca, Diana; Rodriguez, Christina; Munoz, Paola

2013-01-01

188

What Are the Symptoms of the Flu?  

MedlinePLUS Videos and Cool Tools

... Vaccine Program Office, U.S. Department of Health and Human Services, talks about the symptoms of the flu ... website managed by the U.S. Department of Health & Human Services 200 Independence Avenue, S.W. - Washington, D.C. ...

189

How Do I Treat the Flu?  

MedlinePLUS Videos and Cool Tools

... Vaccine Program Office, U.S. Department of Health and Human Services, talks about treating seasonal flu. 0:25 ... website managed by the U.S. Department of Health & Human Services 200 Independence Avenue, S.W. - Washington, D.C. ...

190

A Case of American Education Flu.  

ERIC Educational Resources Information Center

Proposes that the American educational system's penchant for testing may be likened to an educational flu. Notes that teachers feel increasing pressure to abandon techniques that are engaging if they are not specifically aimed at performance on test day. Contends that the American educational system needs to keep pace with international…

Gross, Steven Jay

2002-01-01

191

Younger Adults Hit Hardest This Flu Season  

MedlinePLUS

... on this page, please enable JavaScript. Younger Adults Hit Hardest This Flu Season Although H1N1 strain predominates, ... aren't yet available. As in 2009, H1N1 hit younger adults harder than the elderly. Of the ...

192

Flu Hits Unvaccinated Hardest, Study Finds  

MedlinePLUS

... preventive steps include washing your hands or using hand sanitizer, and staying away from people who might have the flu. If you're the one who's sick, stay home to prevent spreading the infection to others. Wolfe suggested keeping your hands out of your eyes, nose and mouth as ...

193

VereFlu™: an integrated multiplex RT-PCR and microarray assay for rapid detection and identification of human influenza A and B viruses using lab-on-chip technology  

Microsoft Academic Search

Threatening sporadic outbreaks of avian influenza and the H1N1 pandemic of 2009 highlight the need for rapid and accurate\\u000a detection and typing of influenza viruses. In this paper, we describe the validation of the VereFlu™ Lab-on-Chip Influenza\\u000a Assay, which is based on the integration of two technologies: multiplex reverse transcription (RT)-PCR followed by microarray\\u000a amplicon detection. This assay simultaneously detects

Jeanette TeoPatrizia; Patrizia Di Pietro; Floriana San Biagio; Monica Capozzoli; Yi-Mo Deng; Ian Barr; Natalie Caldwell; Kian-Leong Ong; Mitsuharu Sato; Rosemary Tan; Raymond Lin

2011-01-01

194

Getting the "Edge" on the Next Flu Pandemic: We Should'a "Node" Better  

NSDL National Science Digital Library

Curricular materials designed to teach computational modeling to undergraduate or graduate students in science and other STEM disciplines. The module teaches the construction of a graphical network-based model of epidemiology and social networks using Mathematica.

Shiflet, Angela B.; Shiflet, George W.

195

Knowledge about pandemic influenza and compliance with containment measures among Australians  

PubMed Central

Abstract Objective To examine the level of stated compliance with public health pandemic influenza control measures and explore factors influencing cooperation for pandemic influenza control in Australia. Methods A computer-assisted telephone interview survey was conducted by professional interviewers to collect information on the Australian public’s knowledge of pandemic influenza and willingness to comply with public health control measures. The sample was randomly selected using an electronic database and printed telephone directories to ensure sample representativeness from all Australian states and territories. After we described pandemic influenza to the respondents to ensure they understood the significance of the issue, the questions on compliance were repeated and changes in responses were analysed with McNemar’s test for paired data. Findings Only 23% of the 1166 respondents demonstrated a clear understanding of the term “pandemic influenza”. Of those interviewed, 94.1% reported being willing to comply with home quarantine; 94.2%, to avoid public events; and 90.7%, to postpone social gatherings. After we explained the meaning of “pandemic” to interviewees, stated compliance increased significantly (to 97.5%, 98.3% and 97.2% respectively). Those who reported being unfamiliar with the term “pandemic influenza,” male respondents and employed people not able to work from home were less willing to comply. Conclusion In Australia, should the threat arise, compliance with containment measures against pandemic influenza is likely to be high, yet it could be further enhanced through a public education programme conveying just a few key messages. A basic understanding of pandemic influenza is associated with stated willingness to comply with containment measures. Investing now in promoting measures to prepare for a pandemic or other health emergency will have considerable value.

Durrheim, David; Francis, J Lynn; d'Espaignet, Edouard Tursan; Duncan, Sarah; Islam, Fakhrul; Speare, Rick

2009-01-01

196

Factors Affecting Acceptance and Intention to Receive Pandemic Influenza A H1N1 Vaccine among Primary School Children: A Cross-Sectional Study in Birmingham, UK  

PubMed Central

UK pandemic influenza strategy focused on vaccination of high risk groups, although evidence shows that school-age children have the highest infection rates. Vaccination of children might be an additional strategy. We undertook a cross-sectional study amongst 149 parents of primary school children aged 4–7 years in Birmingham, UK to quantify intention to accept pandemic influenza vaccine and identify factors affecting uptake. Ninety-one (61.1%, 95% CI 52.8, 68.9) had or would accept vaccine for their child. The most common reasons for declining vaccine were concerns about safety (58.6% reported this), side effects (55.2%), or believing their child had already had swine flu (12.1%). Parents of nonwhite ethnicity (OR 2.4 (1.1, 5.0)) and with asthmatic children (OR 6.6 (1.4, 32.1)) were significantly more likely to accept pandemic vaccine, as were those whose children had ever received seasonal vaccine and those who believed swine flu to be a serious threat (OR 4.2 (1.9, 9.1)). Parents would be more likely to accept vaccination if they received a letter of invite, if the government strongly encouraged them, if it were administered at school, and if it were more thoroughly tested. Accurate media portrayal of safety of the vaccine during future pandemics will be essential.

Janks, Michaela; Cooke, Sara; Odedra, Aimee; Kang, Harkeet; Bellman, Michelle; Jordan, Rachel E.

2012-01-01

197

Factors Affecting Acceptance and Intention to Receive Pandemic Influenza A H1N1 Vaccine among Primary School Children: A Cross-Sectional Study in Birmingham, UK.  

PubMed

UK pandemic influenza strategy focused on vaccination of high risk groups, although evidence shows that school-age children have the highest infection rates. Vaccination of children might be an additional strategy. We undertook a cross-sectional study amongst 149 parents of primary school children aged 4-7 years in Birmingham, UK to quantify intention to accept pandemic influenza vaccine and identify factors affecting uptake. Ninety-one (61.1%, 95% CI 52.8, 68.9) had or would accept vaccine for their child. The most common reasons for declining vaccine were concerns about safety (58.6% reported this), side effects (55.2%), or believing their child had already had swine flu (12.1%). Parents of nonwhite ethnicity (OR 2.4 (1.1, 5.0)) and with asthmatic children (OR 6.6 (1.4, 32.1)) were significantly more likely to accept pandemic vaccine, as were those whose children had ever received seasonal vaccine and those who believed swine flu to be a serious threat (OR 4.2 (1.9, 9.1)). Parents would be more likely to accept vaccination if they received a letter of invite, if the government strongly encouraged them, if it were administered at school, and if it were more thoroughly tested. Accurate media portrayal of safety of the vaccine during future pandemics will be essential. PMID:23150815

Janks, Michaela; Cooke, Sara; Odedra, Aimee; Kang, Harkeet; Bellman, Michelle; Jordan, Rachel E

2012-01-01

198

Storms and Water Usage; Swine Flu  

ERIC Educational Resources Information Center

This article offers a contemporary, authentic application of quantitative reasoning based on media clips. Students analyze items from the media to answer mathematical questions related to the article. Volumes, economics, and growth rates of a pandemic are featured in the two clips presented. (Contains 4 figures and 1 table.)

Edwards, C. C.; Muttiah, Daniel

2009-01-01

199

A study to identify winning strategies for the business community during the next pandemic.  

PubMed

This study examines the relationship between the healthcare system and the corporate sector to answer the following research question: how does the healthcare system best prepare small to medium-sized businesses for the next pandemic influenza? Data were collected and collated through a literature review, electronic survey and semi-structured follow-up telephone interviews. The participants were businesses with membership in the Alberta Chambers of Commerce, a provincial lobby group in Alberta, Canada. The findings indicate strategies that were effective in minimising impact to the business community during the H1N1 pandemic and suggest areas for the business community to improve in preparation for the next pandemic influenza. Recommendations focus on establishing new links for communication between the business community and the healthcare sector and improving strategies to increase the resilience of small to medium-sized businesses for the next pandemic influenza. PMID:23835426

Spriggs, Martin

2013-01-01

200

Antibody Recognition of the Pandemic H1N1 Influenza Virus Hemagglutinin Receptor Binding Site  

PubMed Central

Influenza virus is a global health concern due to its unpredictable pandemic potential. This potential threat was realized in 2009 when an H1N1 virus emerged that resembled the 1918 virus in antigenicity but fortunately was not nearly as deadly. 5J8 is a human antibody that potently neutralizes a broad spectrum of H1N1 viruses, including the 1918 and 2009 pandemic viruses. Here, we present the crystal structure of 5J8 Fab in complex with a bacterially expressed and refolded globular head domain from the hemagglutinin (HA) of the A/California/07/2009 (H1N1) pandemic virus. 5J8 recognizes a conserved epitope in and around the receptor binding site (RBS), and its HCDR3 closely mimics interactions of the sialic acid receptor. Electron microscopy (EM) reconstructions of 5J8 Fab in complex with an HA trimer from a 1986 H1 strain and with an engineered stabilized HA trimer from the 2009 H1 pandemic virus showed a similar mode of binding. As for other characterized RBS-targeted antibodies, 5J8 uses avidity to extend its breadth and affinity against divergent H1 strains. 5J8 selectively interacts with HA insertion residue 133a, which is conserved in pandemic H1 strains and has precluded binding of other RBS-targeted antibodies. Thus, the RBS of divergent HAs is targeted by 5J8 and adds to the growing arsenal of common recognition motifs for design of therapeutics and vaccines. Moreover, consistent with previous studies, the bacterially expressed H1 HA properly refolds, retaining its antigenic structure, and presents a low-cost and rapid alternative for engineering and manufacturing candidate flu vaccines.

Hong, Minsun; Lee, Peter S.; Hoffman, Ryan M. B.; Zhu, Xueyong; Krause, Jens C.; Laursen, Nick S.; Yoon, Sung-il; Song, Langzhou; Tussey, Lynda; Crowe, James E.; Ward, Andrew B.

2013-01-01

201

Antibody recognition of the pandemic H1N1 Influenza virus hemagglutinin receptor binding site.  

PubMed

Influenza virus is a global health concern due to its unpredictable pandemic potential. This potential threat was realized in 2009 when an H1N1 virus emerged that resembled the 1918 virus in antigenicity but fortunately was not nearly as deadly. 5J8 is a human antibody that potently neutralizes a broad spectrum of H1N1 viruses, including the 1918 and 2009 pandemic viruses. Here, we present the crystal structure of 5J8 Fab in complex with a bacterially expressed and refolded globular head domain from the hemagglutinin (HA) of the A/California/07/2009 (H1N1) pandemic virus. 5J8 recognizes a conserved epitope in and around the receptor binding site (RBS), and its HCDR3 closely mimics interactions of the sialic acid receptor. Electron microscopy (EM) reconstructions of 5J8 Fab in complex with an HA trimer from a 1986 H1 strain and with an engineered stabilized HA trimer from the 2009 H1 pandemic virus showed a similar mode of binding. As for other characterized RBS-targeted antibodies, 5J8 uses avidity to extend its breadth and affinity against divergent H1 strains. 5J8 selectively interacts with HA insertion residue 133a, which is conserved in pandemic H1 strains and has precluded binding of other RBS-targeted antibodies. Thus, the RBS of divergent HAs is targeted by 5J8 and adds to the growing arsenal of common recognition motifs for design of therapeutics and vaccines. Moreover, consistent with previous studies, the bacterially expressed H1 HA properly refolds, retaining its antigenic structure, and presents a low-cost and rapid alternative for engineering and manufacturing candidate flu vaccines. PMID:24027321

Hong, Minsun; Lee, Peter S; Hoffman, Ryan M B; Zhu, Xueyong; Krause, Jens C; Laursen, Nick S; Yoon, Sung-Il; Song, Langzhou; Tussey, Lynda; Crowe, James E; Ward, Andrew B; Wilson, Ian A

2013-11-01

202

Flu: A Guide for Parents of Children or Adolescents with Chronic Health Conditions  

MedlinePLUS

... Issues Listen Flu: A Guide for Parents of Children or Adolescents with Chronic Health Conditions Article Body Influenza (flu) ... each year. How do I know if my child is at greater risk for flu-related complications? ...

203

The 1957 pandemic of influenza in India  

PubMed Central

Asian influenza appears to have reached India via Madras in May 1957. The main pandemic wave swept through the subcontinent within the next 12 weeks; cases occurring thereafter represent the permanent infiltration of the new virus into the population. Between 19 May 1957 and 8 February 1958 there were reported 4 451 758 cases, with 1098 deaths. The author discusses the attack-rates by age-group, by occupational group, by State and in closed communities such as schools. The disease, in India as elsewhere, seems generally to have run a mild course, although nausea and vomiting and symptoms related to the nervous system were relatively frequently seen. A number of A/Asia/57 virus strains were isolated; their antigenic and biological characteristics are discussed in some detail. In view of the rapid spread of the pandemic, it proved impossible to prepare sufficient vaccine from the new strains in time for adequate field trials or mass immunization of the population. The author reports briefly on the results obtained with iodine in the prevention and treatment of influenza.

Menon, I. G. K.

1959-01-01

204

Monitoring influenza activity in Europe with Google Flu Trends: comparison with the findings of sentinel physician networks - results for 2009-10.  

PubMed

The number of Internet searches has recently been used by Google to estimate the influenza incidence in the United States. We examined the correlation between the Google Flu Trends tool and sentinel networks estimates in several European countries during the 2009 influenza A(H1N1) pandemic and found a good correlation between estimates and peak incidence timing, with the highest peaks in countries where Internet is most frequently used for health-related searching. Although somehow limited, Google could be a valuable tool for syndromic surveillance. PMID:20667303

Valdivia, A; Lopez-Alcalde, J; Vicente, M; Pichiule, M; Ruiz, M; Ordobas, M

2010-01-01

205

Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza  

SciTech Connect

The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

HCTT-CHE

2011-04-14

206

A Comprehensive Laboratory Animal Facility Pandemic Response Plan  

PubMed Central

The potential of a severe influenza pandemic necessitates the development of an organized, rational plan for continued laboratory animal facility operation without compromise of the welfare of animals. A comprehensive laboratory animal program pandemic response plan was integrated into a university-wide plan. Preparation involved input from all levels of organizational hierarchy including the IACUC. Many contingencies and operational scenarios were considered based on the severity and duration of the influenza pandemic. Trigger points for systematic action steps were based on the World Health Organization's phase alert criteria. One extreme scenario requires hibernation of research operations and maintenance of reduced numbers of laboratory animal colonies for a period of up to 6 mo. This plan includes active recruitment and cross-training of volunteers for essential personnel positions, protective measures for employee and family health, logistical arrangements for delivery and storage of food and bedding, the removal of waste, and the potential for euthanasia. Strategies such as encouraging and subsidizing cryopreservation of unique strains were undertaken to protect valuable research assets and intellectual property. Elements of this plan were put into practice after escalation of the pandemic alerts due to influenza A (H1N1) in April 2009.

Roble, Gordon S; Lingenhol, Naomi M; Baker, Bryan; Wilkerson, Amy; Tolwani, Ravi J

2010-01-01

207

Medical Students and Pandemic Influenza  

PubMed Central

To assess knowledge of pandemic influenza, we administered a questionnaire to all medical students at the University of Alberta; 354 (69%) of 510 students responded. Data from questionnaires such as this could help determine the role of medical students during a public health emergency.

Herman, Benjamin; Rosychuk, Rhonda J.; Bailey, Tracey; Lake, Robert; Yonge, Olive

2007-01-01

208

Structural Characterization of the Hemagglutinin Receptor Specificity from the 2009 H1N1 Influenza Pandemic  

PubMed Central

Influenza virus hemagglutinin (HA) is the viral envelope protein that mediates viral attachment to host cells and elicits membrane fusion. The HA receptor-binding specificity is a key determinant for the host range and transmissibility of influenza viruses. In human pandemics of the 20th century, the HA normally has acquired specificity for human-like receptors before widespread infection. Crystal structures of the H1 HA from the 2009 human pandemic (A/California/04/2009 [CA04]) in complex with human and avian receptor analogs reveal conserved recognition of the terminal sialic acid of the glycan ligands. However, favorable interactions beyond the sialic acid are found only for ?2-6-linked glycans and are mediated by Asp190 and Asp225, which hydrogen bond with Gal-2 and GlcNAc-3. For ?2-3-linked glycan receptors, no specific interactions beyond the terminal sialic acid are observed. Our structural and glycan microarray analyses, in the context of other high-resolution HA structures with ?2-6- and ?2-3-linked glycans, now elucidate the structural basis of receptor-binding specificity for H1 HAs in human and avian viruses and provide a structural explanation for the preference for ?2-6 siaylated glycan receptors for the 2009 pandemic swine flu virus.

Xu, Rui; McBride, Ryan; Nycholat, Corwin M.; Paulson, James C.

2012-01-01

209

42 CFR 410.57 - Pneumococcal vaccine and flu vaccine.  

Code of Federal Regulations, 2010 CFR

...2009-10-01 2009-10-01 false Pneumococcal vaccine and flu vaccine. 410.57 Section 410.57 Public Health ...Other Health Services § 410.57 Pneumococcal vaccine and flu vaccine. (a) Medicare Part B pays for pneumococcal...

2009-10-01

210

42 CFR 410.57 - Pneumococcal vaccine and flu vaccine.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 2010-10-01 false Pneumococcal vaccine and flu vaccine. 410.57 Section 410.57 Public Health ...Other Health Services § 410.57 Pneumococcal vaccine and flu vaccine. (a) Medicare Part B pays for pneumococcal...

2010-10-01

211

Vaccine Against Bird Flu Readied, Just in Case  

MedlinePLUS

... this page, please enable JavaScript. Vaccine Against Bird Flu Readied, Just in Case U.S. officials want to ... Wednesday, April 30, 2014 Related MedlinePlus Pages Bird Flu Immunization WEDNESDAY, April 30, 2014 (HealthDay News) -- A ...

212

42 CFR 410.57 - Pneumococcal vaccine and flu vaccine.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 2013-10-01 false Pneumococcal vaccine and flu vaccine. 410.57 Section 410.57 Public Health ...Other Health Services § 410.57 Pneumococcal vaccine and flu vaccine. (a) Medicare Part B pays for pneumococcal...

2013-10-01

213

The macroeconomic impact of pandemic influenza: estimates from models of the United Kingdom, France, Belgium and The Netherlands.  

PubMed

The 2003 outbreak of severe acute respiratory syndrome (SARS) showed that infectious disease outbreaks can have notable macroeconomic impacts. The current H1N1 and potential H5N1 flu pandemics could have a much greater impact. Using a multi-sector single country computable general equilibrium model of the United Kingdom, France, Belgium and The Netherlands, together with disease scenarios of varying severity, we examine the potential economic cost of a modern pandemic. Policies of school closure, vaccination and antivirals, together with prophylactic absence from work are evaluated and their cost impacts are estimated. Results suggest GDP losses from the disease of approximately 0.5-2% but school closure and prophylactic absenteeism more than triples these effects. Increasing school closures from 4 weeks at the peak to entire pandemic closure almost doubles the economic cost, but antivirals and vaccinations seem worthwhile. Careful planning is therefore important to ensure expensive policies to mitigate the pandemic are effective in minimising illness and deaths. PMID:19997956

Keogh-Brown, Marcus Richard; Smith, Richard D; Edmunds, John W; Beutels, Philippe

2010-12-01

214

Primary care physicians and pandemic influenza: an appraisal of the 1918 experience and an assessment of contemporary planning.  

PubMed

This multidisciplinary research project examined the role of primary care physicians in past pandemic flu responses and current planning efforts. Project researchers gathered and synthesized historical research, state and federal planning documents, and interview-based data. The 1918 influenza pandemic presented one model from which to understand the role played by physicians during a large-scale disease outbreak, and the challenges they faced. Contemporary planning documents were assessed for their inclusion of primary care physicians. Literature reviews and interviews comprised the principal sources of information. Findings included the following: (1) primary care physicians do not have the time to engage fully in pandemic planning activities; (2) physicians are willing to serve during a pandemic; however, government support and the availability of resources will affect their level of involvement; (3) communities should develop plans for coordinating local physicians who will allow alternative care sites to be functionally staffed; and (4) full coordination of physicians is not possible under the US healthcare system. PMID:18552650

Lauer, Jacob; Kastner, Justin; Nutsch, Abbey

2008-01-01

215

2009 H1N1 and Seasonal Flu: What to Do If You Get Sick  

MedlinePLUS

2009 H1N1 and Seasonal Flu: What To Do If You Get Sick This flu season CDC expects the new 2009 H1N1 flu to cause illness, hospital stays, and deaths in the United States along with seasonal flu. This flyer has information about what to do ...

216

Time to Get Your Annual Flu Shot | NIH MedlinePlus the Magazine  

MedlinePLUS

... of this page please turn Javascript on. Feature: Flu Shot Time to Get Your Annual Flu Shot Past Issues / Fall 2012 Table of Contents Give ... Option For those who do not receive a "flu-shot," a nasal-spray flu vaccine is available. Photo: ...

217

Pandemic Potential of a Strain of Influenza A (H1N1): Early Findings  

PubMed Central

A novel influenza A (H1N1) virus has spread rapidly across the globe. Judging its pandemic potential is difficult with limited data, but nevertheless essential to inform appropriate health responses. By analyzing the outbreak in Mexico, early data on international spread, and viral genetic diversity, we make an early assessment of transmissibility and severity. Our estimates suggest that 23,000 (range 6000 to 32,000) individuals had been infected in Mexico by late April, giving an estimated case fatality ratio (CFR) of 0.4% (range: 0.3 to 1.8%) based on confirmed and suspected deaths reported to that time. In a community outbreak in the small community of La Gloria, Veracruz, no deaths were attributed to infection, giving an upper 95% bound on CFR of 0.6%. Thus, although substantial uncertainty remains, clinical severity appears less than that seen in the 1918 influenza pandemic but comparable with that seen in the 1957 pandemic. Clinical attack rates in children in La Gloria were twice that in adults (<15 years of age: 61%; ?15 years: 29%). Three different epidemiological analyses gave basic reproduction number (R0) estimates in the range of 1.4 to 1.6, whereas a genetic analysis gave a central estimate of 1.2. This range of values is consistent with 14 to 73 generations of human-to-human transmission having occurred in Mexico to late April. Transmissibility is therefore substantially higher than that of seasonal flu, and comparable with lower estimates of R0 obtained from previous influenza pandemics.

Fraser, Christophe; Donnelly, Christl A.; Cauchemez, Simon; Hanage, William P.; Van Kerkhove, Maria D.; Hollingsworth, T. Deirdre; Griffin, Jamie; Baggaley, Rebecca F.; Jenkins, Helen E.; Lyons, Emily J.; Jombart, Thibaut; Hinsley, Wes R.; Grassly, Nicholas C.; Balloux, Francois; Ghani, Azra C.; Ferguson, Neil M.; Rambaut, Andrew; Pybus, Oliver G.; Lopez-Gatell, Hugo; Alpuche-Aranda, Celia M.; Chapela, Ietza Bojorquez; Zavala, Ethel Palacios; Guevara, Dulce Ma. Espejo; Checchi, Francesco; Garcia, Erika; Hugonnet, Stephane; Roth, Cathy

2013-01-01

218

Two Years after Pandemic Influenza A/2009/H1N1: What Have We Learned?  

PubMed Central

Summary: The world had been anticipating another influenza pandemic since the last one in 1968. The pandemic influenza A H1N1 2009 virus (A/2009/H1N1) finally arrived, causing the first pandemic influenza of the new millennium, which has affected over 214 countries and caused over 18,449 deaths. Because of the persistent threat from the A/H5N1 virus since 1997 and the outbreak of the severe acute respiratory syndrome (SARS) coronavirus in 2003, medical and scientific communities have been more prepared in mindset and infrastructure. This preparedness has allowed for rapid and effective research on the epidemiological, clinical, pathological, immunological, virological, and other basic scientific aspects of the disease, with impacts on its control. A PubMed search using the keywords “pandemic influenza virus H1N1 2009” yielded over 2,500 publications, which markedly exceeded the number published on previous pandemics. Only representative works with relevance to clinical microbiology and infectious diseases are reviewed in this article. A significant increase in the understanding of this virus and the disease within such a short amount of time has allowed for the timely development of diagnostic tests, treatments, and preventive measures. These findings could prove useful for future randomized controlled clinical trials and the epidemiological control of future pandemics.

Cheng, Vincent C. C.; To, Kelvin K. W.; Tse, Herman; Hung, Ivan F. N.

2012-01-01

219

Comparison of the NOW Influenza A & B, NOW Flu A, NOW Flu B, and Directigen Flu A+B assays, and immunofluorescence with viral culture for the detection of influenza A and B viruses  

Microsoft Academic Search

To evaluate the Binax NOW Influenza A & B combination assay, we tested upper respiratory tract samples in parallel with the Binax NOW Flu A and Binax NOW Flu B assays, the Becton–Dickinson Directigen Flu A+B assay, and immunofluorescence, and the results were compared with viral culture. Of the 521 samples tested, influenza A was cultured from 113 and influenza

Marita Smit; Kirsten A. Beynon; David R. Murdoch; Lance C. Jennings

2007-01-01

220

Low Clinical Burden of 2009 Pandemic Influenza A (H1N1) Infection during Pregnancy on the Island of La R?union  

PubMed Central

Background Pregnant women have been identified as a group at risk, both for respiratory complications than for the admissions to the Intensive Care Unit (ICU) during the 2009 H1N1 influenza pandemic (pdm). The purpose of this prospective register-based cohort-study was to characterize the clinical virulence of the pdm (H1N1/09)v during pregnancy in La Réunion. Methods/Principal Findings Over a twelve-week pdm wave (13 July to 3 October 2009), 294 pregnant women presented with an influenza-like illness (ILI) to one of the three maternity departments of the South Reunion area, Indian Ocean. Out of these, 278 were checked by RT-PCR for influenza viruses (157 positive and 121 negative, of whom, 141 with pdm flu and 132 with ILIs of non pdm origin, 5 untyped). The median body temperature was higher in women experiencing pdm flu than in those with non pdm ILI (38.9°C versus 38.3°C, P<0.0001), without evidence linked to circulating viremia. Oseltamivir was given for 86% of pdm flu cases in a median time inferior than 48 hrs (range 0–7 days). The hospitalization rate for pdm flu was of 60% and not associated with underlying conditions. Six viral pneumonia and fourteen asthma attacks were observed among 84 hospitalized pdm flu cases, of whom, only one led to the ICU for an acute lung injury. No maternal death occurred during the pdm wave. None adverse pregnancy outcome was associated with pdm flu. No congenital birth defect, nor early-onset neonatal influenza infection was attributable to pdm flu exposure. Conclusions/Significance This report mitigates substantially the presumed severity of pandemic H1N1/09 influenza infection during pregnancy. The reasons for which the clinical burden of H1N1/09 influenza virus may differ worldwide raise questions about a differential local viral-strain effect and public health preparedness, notably in timely access to special care and antiviral treatments.

Gerardin, Patrick; El Amrani, Rachid; Cyrille, Beatrice; Gabriele, Marc; Guillermin, Philippe; Boukerrou, Malik; Boumahni, Brahim; Randrianaivo, Hanitra; Winer, Arnaud; Rouanet, Jean-Fabien; Bohrer, Michel; Jaffar-Bandjee, Marie-Christine; Robillard, Pierre-Yves; Barau, Georges; Michault, Alain

2010-01-01

221

Pathology Case Study: Flu-Like Symptoms  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology which presents a "37-year-old white female who was in excellent health until three years prior, when she developed flu-like symptoms." Visitors are given an extensive patient history along with pathologic findings, including images, and are given the opportunity to diagnose the patient. A "Final Diagnosis" section provides a discussion of the findings as well as references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in cardiovascular pathology.

Klionsky, Bernard; Molina, J. T.; Nichols, Larry

2008-04-21

222

Pandemic Planning Guide for Alberta School Authorities  

ERIC Educational Resources Information Center

A crisis always seems like something that happens somewhere else - that is, until it arrives on your doorstep. Although other issues and challenges scream for your attention, School Authorities should not postpone developing an influenza pandemic plan. The "Pandemic Planning Guide for Alberta School Authorities" (the "Guide") is designed to assist…

Alberta Education, 2008

2008-01-01

223

Pandemic Influenza Pediatric Office Plan Template  

SciTech Connect

This is a planning tool developed by pediatric stakeholders that is intended to assist pediatric medical offices that have no pandemic influenza plan in place, but may experience an increase in patient calls/visits or workload due to pandemic influenza.

HCTT CHE

2010-01-01

224

Almost only women: Canadian volunteer response to the 1918-1920 pandemic.  

PubMed

When pandemic influenza arrived from the United States in 1918-1920 to strike Canada with devastating force, the health system was overwhelmed. Although emergency hospitals were established in public buildings including schools and universities, many sick remained in their homes. Because of the war, many physicians and nurses were overseas. Many of those who were in Canada became flu victims. The result was a massive call for volunteers. Although a few men responded, most volunteers were women. These women, many of whom had little or no training, risked their lives by acting as nurses in existing and emergency hospitals and by assisting sick families in their homes. Many became ill and some died. The result is an incredible portrait of volunteer response to a major medical emergency. PMID:20104726

Scanlon, Joseph; Casey, Hurrell; McMahon, Terry

2009-01-01

225

Thimerosal and 2013-2014 Seasonal Flu Vaccines  

MedlinePLUS

... and rigorous scientific research does not support the argument that thimerosal-containing vaccines are harmful. However, CDC ... page CDC on Facebook CDC Flu on Twitter Get email updates Subscribe to RSS Listen to audio/ ...

226

State Flu Shot Rule for Preschoolers Curbs Kids' Hospitalizations: CDC  

MedlinePLUS

... JavaScript. State Flu Shot Rule for Preschoolers Curbs Kids' Hospitalizations: CDC When vaccination rates rose in Connecticut, ... for easy spread of influenza," Hadler said. "The kids get it, they give it to each other, ...

227

Mechanisms of symptoms of common cold and flu  

Microsoft Academic Search

It is the familiar symptoms of sore throat, runny nose, sneezing, and nasal congestion, muscle aches, chilliness and fever,\\u000a etc., that define the common cold and flu syndromes as self-diagnosed illnesses. Although there is much information about\\u000a the molecular biology of the viruses that cause the common cold and flu syndromes, there is relatively little research on\\u000a the immunological, physiological

Ronald Eccles

228

Scientific triumphalism and learning from facts: bacteriology and the "Spanish flu" challenge of 1918.  

PubMed

The devastating influenza pandemic known as 'Spanish flu', which killed at least 20 million people all over the world in 1918, was responsible for the first bitter blow inflicted on triumphant bacteriology, fortified by the series of resounding successes achieved in identifying the pathogenic agents of terrible diseases such as anthrax, cholera, tuberculosis, plague, and syphilis. Over-confidence and the idea, born of the Pasteur revolution, that every infectious disease was caused by a bacterium, had led the scientific community to accept the theory put forward by the German bacteriologist, Richard Pfeiffer, who, in 1892, believed he had identified the pathogenic influenza agent in a bacterium, Haemophilus influenzae. But, while the most appalling epidemic ever to sweep through the world since the 'Black Death' of the 1300s was still raging, the scientific community had to admit that influenza originated not from a microbe, but from a virus. This article aims to reconstruct the enlightening and little-known cultured/scientific events and issues of the dramatic crisis that bacteriology experienced in the autumn of 1918, with the consequent simultaneous collapse of both the 'Pfeiffer doctrine' on the microbial origin of influenza and the illusion of a world free of infectious diseases. This was an illusion destined to surface again at the end of the century and collapse with the advent of AIDS. PMID:14598819

Tognotti, Eugenia

2003-04-01

229

Effective Detection of the 2009 H1N1 Influenza Pandemic in U.S. Veterans Affairs Medical Centers Using a National Electronic Biosurveillance System  

PubMed Central

Background The 2008–09 influenza season was the time in which the Department of Veterans Affairs (VA) utilized an electronic biosurveillance system for tracking and monitoring of influenza trends. The system, known as ESSENCE or Electronic Surveillance System for the Early Notification of Community-based Epidemics, was monitored for the influenza season as well as for a rise in influenza cases at the start of the H1N1 2009 influenza pandemic. We also describe trends noted in influenza-like illness (ILI) outpatient encounter data in VA medical centers during the 2008–09 influenza season, before and after the recognition of pandemic H1N1 2009 influenza virus. Methodology/Principal Findings We determined prevalence of ILI coded visits using VA's ESSENCE for 2008–09 seasonal influenza (Sept. 28, 2008–April 25, 2009 corresponding to CDC 2008–2009 flu season weeks 40–16) and the early period of pandemic H1N1 2009 (April 26, 2009–July 31, 2009 corresponding to CDC 2008–2009 flu season weeks 17–30). Differences in diagnostic ICD-9-CM code frequencies were analyzed using Chi-square and odds ratios. There were 649,574 ILI encounters captured representing 633,893 patients. The prevalence of VA ILI visits mirrored the CDC's Outpatient ILI Surveillance Network (ILINet) data with peaks in late December, early February, and late April/early May, mirroring the ILINet data; however, the peaks seen in the VA were smaller. Of 31 ILI codes, 6 decreased and 11 increased significantly during the early period of pandemic H1N1 2009. The ILI codes that significantly increased were more likely to be symptom codes. Although influenza with respiratory manifestation (487.1) was the most common code used among 150 confirmed pandemic H1N1 2009 cases, overall it significantly decreased since the start of the pandemic. Conclusions/Significance VA ESSENCE effectively detected and tracked changing ILI trends during pandemic H1N1 2009 and represents an important temporal alerting system for monitoring health events in VA facilities.

Schirmer, Patricia; Lucero, Cynthia; Oda, Gina; Lopez, Jessica; Holodniy, Mark

2010-01-01

230

Stockpiling Supplies for the Next Influenza Pandemic  

PubMed Central

Faced with increasing concerns about the likelihood of an influenza pandemic, healthcare systems have been challenged to determine what specific medical supplies that should be procured and stockpiled as a component of preparedness. Despite publication of numerous pandemic planning recommendations, little or no specific guidance about the types of items and quantities of supplies needed has been available. The primary purpose of this report is to detail the approach of 1 healthcare system in building a cache of supplies to be used for patient care during the next influenza pandemic. These concepts may help guide the actions of other healthcare systems.

Magalian, Paul D.; Hollingsworth, Mary Kay; Baracco, Gio

2009-01-01

231

Determinants of Refusal of A/H1N1 Pandemic Vaccination in a High Risk Population: A Qualitative Approach  

PubMed Central

Background Our study analyses the main determinants of refusal or acceptance of the 2009 A/H1N1 vaccine in patients with cystic fibrosis, a high-risk population for severe flu infection, usually very compliant for seasonal flu vaccine. Methodology/Principal Findings We conducted a qualitative study based on semi-structured interviews in 3 cystic fibrosis referral centres in Paris, France. The study included 42 patients with cystic fibrosis: 24 who refused the vaccine and 18 who were vaccinated. The two groups differed quite substantially in their perceptions of vaccine- and disease-related risks. Those who refused the vaccine were motivated mainly by the fears it aroused and did not explicitly consider the 2009 A/H1N1 flu a potentially severe disease. People who were vaccinated explained their choice, first and foremost, as intended to prevent the flu's potential consequences on respiratory cystic fibrosis disease. Moreover, they considered vaccination to be an indirect collective prevention tool. Patients who refused the vaccine mentioned multiple, contradictory information sources and did not appear to consider the recommendation of their local health care provider as predominant. On the contrary, those who were vaccinated stated that they had based their decision solely on the clear and unequivocal advice of their health care provider. Conclusions/Significance These results of our survey led us to formulate three main recommendations for improving adhesion to new pandemic vaccines. (1) it appears necessary to reinforce patient education about the disease and its specific risks, but also general population information about community immunity. (2) it is essential to disseminate a clear and effective message about the safety of novel vaccines. (3) this message should be conveyed by local health care providers, who should be involved in implementing immunization.

d'Alessandro, Eugenie; Hubert, Dominique; Launay, Odile; Bassinet, Laurence; Lortholary, Olivier; Jaffre, Yannick; Sermet-Gaudelus, Isabelle

2012-01-01

232

Pandemic influenza A H1N1 in Swine and other animals.  

PubMed

Influenza A virus infection has been reported in a variety of mammalian and avian species. Wild waterfowl such as ducks and geese are considered the principal reservoir of many influenza A viruses. On May 2, 2009, the first confirmed case of pandemic 2009 H1N1 (pH1N1) in animals was reported in a small swine herd in Canada. A public health investigation concluded that transmission from people to pigs was the likely source of infection. Subsequently the pH1N1 virus has been reported in turkeys, cats, dogs, ferrets, and several wildlife species. Human to animal transmission has been confirmed or suspected in a number of cases. The naming of the virus as "swine flu" in the international media led to a drop in the demand for pork and subsequently a reduction in the price of pork paid to farmers. Estimates of losses to pork producers in North America run into hundreds of millions of dollars. Increased surveillance of swine populations for influenza viruses has been suggested as a control measure against the development of future pandemic viruses. In order to be successful, future surveillance and reporting policies must include provisions to protect the livelihoods of farmers. PMID:23254339

Keenliside, Julia

2013-01-01

233

Reasons for Low Pandemic H1N1 2009 Vaccine Acceptance within a College Sample  

PubMed Central

This study examined health beliefs associated with novel influenza A (H1N1) immunization among US college undergraduates during the 2009-2010 pandemic. Undergraduates (ages 18–24 years) from a large Midwestern University were invited to complete an online survey during March, 2010, five months after H1N1 vaccines became available. Survey items measured H1N1 vaccine history and H1N1-related attitudes based on the health belief literature. Logistic regression was used to identify attitudes associated with having received an H1N1 vaccine, and thematic analysis of student comments was conducted to further understand influences on vaccine decisions. Among the 296 students who participated in the survey, 15.2% reported having received an H1N1 vaccine. In regression analysis, H1N1 immunization was associated with seasonal flu vaccine history, perceived vaccine effectiveness, perceived obstacles to vaccination, and vaccine safety concerns. Qualitative results illustrate the relationship of beliefs to vaccine decisions, particularly in demonstrating that students often held concerns that vaccine could cause H1N1 or side effects. Vaccine safety, efficacy, and obstacles to immunization were major considerations in deciding whether to accept the H1N1 pandemic vaccine. Therefore, focusing on those aspects might be especially useful in future vaccine efforts within the college population.

Ravert, Russell D.; Fu, Linda Y.; Zimet, Gregory D.

2012-01-01

234

Effectiveness of pandemic and seasonal influenza vaccines in preventing pandemic influenza-associated hospitalization.  

PubMed

Vaccines are leading pharmacological measures for limiting the impact of pandemic influenza in the community. The objective of this study was to investigate the effectiveness of influenza (pandemic and seasonal) vaccines in preventing pandemic influenza-associated hospitalization. We conducted a multicenter matched case-control study in 36 Spanish hospitals. Patients hospitalized with confirmed pandemic influenza between November 2009 and February 2010 and two hospitalized controls per case, matched according to age, date of hospitalization and province of residence, were selected. Multivariate analysis was performed using conditional logistic regression. Subjects were considered vaccinated if they had received the vaccine >14 days (seasonal influenza vaccine) or >7 days (pandemic influenza vaccine) before the onset of symptoms (cases) or the onset of symptoms of the matched case (controls). For the pandemic influenza vaccine, vaccination effectiveness (VE) was estimated taking into account only patients recruited from November 23, 2009, seven days after the beginning of the pandemic influenza vaccination campaign. 638 cases and 1250 controls were included. The adjusted VE of the pandemic vaccine in the ?18 years age group was 74.2% (95% CI, 29-90) and that of the influenza seasonal vaccine 15.0% (-34 to 43). The recommendation of influenza vaccination should be reinforced as a regular measure to reduce influenza-associated hospitalization during pandemics and seasonal epidemics. PMID:22796136

Domínguez, Angela; Castilla, Jesús; Godoy, Pere; Delgado-Rodríguez, Miguel; Martín, Vicente; Saez, Marc; Soldevila, Núria; Quintana, José María; Mayoral, José María; Astray, Jenaro; González-Candelas, Fernando; Cantón, Rafael; Tamames, Sonia; Castro, Ady; Baricot, Maretva; Alonso, Jordi; Pumarola, Tomás

2012-08-17

235

Avian influenza pandemic preparedness: developing prepandemic and pandemic vaccines against a moving target  

PubMed Central

The unprecedented global spread of highly pathogenic avian H5N1 influenza viruses within the past ten years and their extreme lethality to poultry and humans has underscored their potential to cause an influenza pandemic. Combating the threat of an impending H5N1 influenza pandemic will require a combination of pharmaceutical and nonpharmaceutical intervention strategies. The emergence of the H1N1 pandemic in 2009 emphasised the unpredictable nature of a pandemic influenza. Undoubtedly, vaccines offer the most viable means to combat a pandemic threat. Current egg-based influenza vaccine manufacturing strategies are unlikely to be able to cater to the huge, rapid global demand because of the anticipated scarcity of embryonated eggs in an avian influenza pandemic and other factors associated with the vaccine production process. Therefore, alternative, egg-independent vaccine manufacturing strategies should be evaluated to supplement the traditional egg-derived influenza vaccine manufacturing. Furthermore, evaluation of dose-sparing strategies that offer protection with a reduced antigen dose will be critical for pandemic influenza preparedness. Development of new antiviral therapeutics and other, nonpharmaceutical intervention strategies will further supplement pandemic preparedness. This review highlights the current status of egg-dependent and egg-independent strategies against an avian influenza pandemic.

Singh, Neetu; Pandey, Aseem; Mittal, Suresh K.

2010-01-01

236

The Swine Flu Episode and the Fog of Epidemics1  

PubMed Central

The 1918 influenza pandemic has shaped research and public health for nearly a century. In 1976, the specter of 1918 loomed large when a pandemic threatened the country again. Public health officials initiated a mass vaccination campaign, but the anticipated pandemic failed to occur. An examination of the available data in 1976 and the decision to vaccinate, as well as lessons learned from the HIV/AIDS epidemic in the early 1980s, may help shape an appropriate public health response to future threats from avian influenza or other infectious diseases.

2006-01-01

237

Emergence of pandemic 2009 influenza A H1N1, India  

PubMed Central

Background & objectives: Pandemic H1N1 caused deluge of cases from 74 countries and prompted World Health Organization to raise warning to phase 6. The present study was conducted on throat and nasal swab samples received and tested at National Centre for Disease Control, Delhi, India during 2009-2010 to collect epidemiological and clinical information on positive cases. Methods: Throat and nasopharyngeal swabs from category C influenza A H1N1 patients during May 2009-September 2010 along with their clinico-epidemiological details were collected from identified hospitals from Delhi and other States. Samples were tested by Real time reverse transcriptase PCR using primers and probes developed at CDC, Atlanta for four influenza target genes. Results: A total of 33,751 samples, both throat and nasal swab samples from each patient were tested for H1N1 influenza virus, of which, 7943 (23.5%) were positive for pandemic influenza A H1N1 and 3759 (11.1%) were positive for influenza A (seasonal flu). Maximum number of positive cases (N=2792, 35.1%) were from 20-39 yr age group, comprising 1790 (22.5%) males and 1182 (14.8%) females. Only 2620 (33%) positive cases were close contact of influenza A H1N1 positive patient. Majority cases presented (N=2792, 35.1%) with fever 7005 (88.1%), followed by 6133 cases (77.2%) exhibiting fever and cough, 377 (4.7%) complained of fever, cough, nasal catarrh and 362 (4.5%) cases had fever with shortness of breath. Interpretation & conclusions: The study showed a peak of cases of pandemic influenza A H1N1 in December 2009 and indicated predominance of H1N1 positive cases among 20-39 yr age group and among males compared to females.

Choudhry, Archana; Singh, Supriya; Khare, Shashi; Rai, Arvind; Rawat, D.S.; Aggarwal, R.K.; Chauhan, L.S.

2012-01-01

238

Removing barriers to global pandemic influenza vaccination.  

PubMed

This article clarifies the regulatory issues surrounding influenza pandemic vaccine for the larger policy community and describes the need for regulatory harmonization. Vaccination would save lives in an influenza pandemic, but a lack of global manufacturing capacity will leave most of the world without access to vaccine. Capacity can be expanded if governments harmonize their regulatory policies. This article details the regulatory approaches taken by the United States, the European Union, and Japan for pandemic vaccine development, three regions that produce the majority of the world's seasonal influenza vaccine. They should quickly converge on regulatory requirements, intellectual property considerations, the use of recombinant DNA techniques for vaccine production, and technical issues about the composition of pandemic vaccine. PMID:16792484

Gronvall, Gigi Kwik; Borio, Luciana L

2006-01-01

239

Determinants of Receiving the Pandemic (H1N1) 2009 Vaccine and Intention to Receive the Seasonal Influenza Vaccine in Taiwan  

PubMed Central

Objectives The paper examines the factors associated with both receiving pandemic (H1N1) 2009 vaccines and individuals’ intentions to get the next seasonal influenza vaccine in Taiwan. Methods We conducted a representative nationwide survey with in-person household interviews during April–July 2010. Multivariate logistic regression incorporated socio-demographic background, household characteristics, health status, behaviors, and perceptions of influenza and vaccination. Results We completed interviews with 1,954 respondents. Among those, 548 (28.0%) received the pandemic (H1N1) 2009 vaccination, and 469 (24.0%) intended to get the next seasonal influenza vaccine. Receipt of the H1N1 vaccine was more prevalent among schoolchildren, the elderly, those who had contact with more people in their daily lives, and those who had received influenza vaccinations in previous years. In comparison, the intention to receive the next seasonal influenza vaccine tended to be stronger among children, the elderly, and those who reported less healthy status or lived with children, who received a seasonal influenza vaccination before, and who worried more about a possible new pandemic. Conclusions Children, the elderly, and those who had gotten seasonal flu shots before in Taiwan were more likely to both receive a pandemic H1N1 vaccination and intend to receive a seasonal influenza vaccine.

Chan, Ta-Chien; Fu, Yang-chih; Wang, Da-Wei; Chuang, Jen-Hsiang

2014-01-01

240

Development of a triage protocol for critical care during an influenza pandemic  

PubMed Central

Background The recent outbreaks of avian influenza (H5N1) have placed a renewed emphasis on preparing for an influenza pandemic in humans. Of particular concern in this planning is the allocation of resources, such as ventilators and antiviral medications, which will likely become scarce during a pandemic. Methods We applied a collaborative process using best evidence, expert panels, stakeholder consultations and ethical principles to develop a triage protocol for prioritizing access to critical care resources, including mechanical ventilation, during a pandemic. Results The triage protocol uses the Sequential Organ Failure Assessment score and has 4 main components: inclusion criteria, exclusion criteria, minimum qualifications for survival and a prioritization tool. Interpretation This protocol is intended to provide guidance for making triage decisions during the initial days to weeks of an influenza pandemic if the critical care system becomes overwhelmed. Although we designed this protocol for use during an influenza pandemic, the triage protocol would apply to patients both with and without influenza, since all patients must share a single pool of critical care resources.

Christian, Michael D.; Hawryluck, Laura; Wax, Randy S.; Cook, Tim; Lazar, Neil M.; Herridge, Margaret S.; Muller, Matthew P.; Gowans, Douglas R.; Fortier, Wendy; Burkle, Frederick M.

2006-01-01

241

Alberta family physicians' willingness to work during an influenza pandemic: a cross-sectional study  

PubMed Central

Objective Effective pandemic responses rely on frontline healthcare workers continuing to work despite increased risk to themselves. Our objective was to investigate Alberta family physicians willingness to work during an influenza pandemic. Design: Cross-sectional survey. Setting: Alberta prior to the fall wave of the H1N1 epidemic. Participants: 192 participants from a random sample of 1000 Alberta family physicians stratified by region. Main Outcome Measures: Willingness to work through difficult scenarios created by an influenza epidemic. Results The corrected response rate was 22%. The most physicians who responded were willing to continue working through some scenarios caused by a pandemic, but in other circumstances less than 50% would continue. Men were more willing to continue working than women. In some situations South African and British trained physicians were more willing to continue working than other groups. Conclusions Although many physicians intend to maintain their practices in the event of a pandemic, in some circumstances fewer are willing to work. Pandemic preparation requires ensuring a workforce is available. Healthcare systems must provide frontline healthcare workers with the support and resources they need to enable them to continue providing care.

2013-01-01

242

The Global Economic Effects of Pandemic Influenza  

Microsoft Academic Search

We analyse the global economic effects of two influenza pandemics that represent extremes along the virulence-infectiousness continuum of possible pandemics: a high virulence-low infectiousness event and a low virulence-high infectiousness event. We do this by applying results from a susceptible-infected-recovered epidemiological model to a detailed, quarterly computable general equilibrium model. Our findings indicate that global economic activity will be more

George Verikios; Maura Sullivan; Pane Stojanovski; James Giesecke; Gordon Woo

2011-01-01

243

HealthLines - Plan to Get Your Flu Shot | NIH MedlinePlus the Magazine  

MedlinePLUS

... 2010 Table of Contents Plan to Get Your Flu Shot The U.S. Food and Drug Administration (FDA) has ... is why people are advised to get a flu shot every year. The Centers for Disease Control and ...

244

Space-Time Dynamic Analysis of Global Bird Flu Based on Internet and GIS  

Microsoft Academic Search

Based on the information about bird flu collected from Internet, this paper analyzed the space-time change of global bird flu with the application of geographic information system (GIS) and discovered the principles of the inter-years periodicity of global bird flu attacks in recent 100 years, its within-year change since 2003 and the originating areas of global bird flu, thus finding

Lixin Yu

2010-01-01

245

I Don't Need a Flu Shot!  

NSDL National Science Digital Library

In this “clicker case,” Ryan, a college student, receives an email from the campus health education office urging students to get a flu shot. Ryan thinks it is too late since he just had the stomach flu, and besides, even if he did catch it, he would just take antibiotics. Fortunately, his girlfriend Ashley is able to correct these and other commonly held misconceptions. In learning about the dangers of flu and how to prevent becoming sick, students also learn about viral mutations (antigenic drift) and viral recombination (genetic shift). The case was written for a large introductory biology course for both science majors and non-majors that makes use of personal response systems (“clickers”). In class, the instructor presents the case using a PowerPoint presentation (~1.6 MB) punctuated by multiple choice questions that students answer with their clickers. The case could be adapted for use without these technologies.

Rogers, William D.

2010-01-01

246

New health risks and sociocultural contexts: bird flu impacts on consumers and poultry businesses in Lao PDR.  

PubMed

Avian flu has been identified as one of the most challenging new risks, global in impact due to the "highly interconnected and integrated world economy along with other unpredictable events such as the Asian financial crisis and global terrorism." We have chosen the case of Lao PDR to shed light on an area in which local people consume chicken as one of their staple foods. Our research analyzes consumer behavior, poultry business modification patterns in a high-risk country, and government reaction for business resilience. The geographic choice is motivated by the 2006 EIU report on Catastrophe Risk Management that indicated that Asian-Pacific companies are better prepared for such risks as bird flu than European business is, despite the many cases found in both regions. PMID:18304102

Suder, Gabriele; Inthavong, Saynakhone

2008-02-01

247

Economic analysis of pandemic influenza mitigation strategies for five pandemic severity categories  

PubMed Central

Background The threat of emergence of a human-to-human transmissible strain of highly pathogenic influenza A(H5N1) is very real, and is reinforced by recent results showing that genetically modified A(H5N1) may be readily transmitted between ferrets. Public health authorities are hesitant in introducing social distancing interventions due to societal disruption and productivity losses. This study estimates the effectiveness and total cost (from a societal perspective, with a lifespan time horizon) of a comprehensive range of social distancing and antiviral drug strategies, under a range of pandemic severity categories. Methods An economic analysis was conducted using a simulation model of a community of ~30,000 in Australia. Data from the 2009 pandemic was used to derive relationships between the Case Fatality Rate (CFR) and hospitalization rates for each of five pandemic severity categories, with CFR ranging from 0.1% to 2.5%. Results For a pandemic with basic reproduction number R0?=?1.8, adopting no interventions resulted in total costs ranging from $441 per person for a pandemic at category 1 (CFR 0.1%) to $8,550 per person at category 5 (CFR 2.5%). For severe pandemics of category 3 (CFR 0.75%) and greater, a strategy combining antiviral treatment and prophylaxis, extended school closure and community contact reduction resulted in the lowest total cost of any strategy, costing $1,584 per person at category 5. This strategy was highly effective, reducing the attack rate to 5%. With low severity pandemics costs are dominated by productivity losses due to illness and social distancing interventions, whereas higher severity pandemic costs are dominated by healthcare costs and costs arising from productivity losses due to death. Conclusions For pandemics in high severity categories the strategies with the lowest total cost to society involve rigorous, sustained social distancing, which are considered unacceptable for low severity pandemics due to societal disruption and cost.

2013-01-01

248

Pandemic and post-pandemic Influenza A (H1N1) infection in critically ill patients  

PubMed Central

Background There is a vast amount of information published regarding the impact of 2009 pandemic Influenza A (pH1N1) virus infection. However, a comparison of risk factors and outcome during the 2010-2011 post-pandemic period has not been described. Methods A prospective, observational, multi-center study was carried out to evaluate the clinical characteristics and demographics of patients with positive RT-PCR for H1N1 admitted to 148 Spanish intensive care units (ICUs). Data were obtained from the 2009 pandemic and compared to the 2010-2011 post-pandemic period. Results Nine hundred and ninety-seven patients with confirmed An/H1N1 infection were included. Six hundred and forty-eight patients affected by 2009 (pH1N1) virus infection and 349 patients affected by the post-pandemic Influenza (H1N1)v infection period were analyzed. Patients during the post-pandemic period were older, had more chronic comorbid conditions and presented with higher severity scores (Acute Physiology And Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA)) on ICU admission. Patients from the post-pandemic Influenza (H1N1)v infection period received empiric antiviral treatment less frequently and with delayed administration. Mortality was significantly higher in the post-pandemic period. Multivariate analysis confirmed that haematological disease, invasive mechanical ventilation and continuous renal replacement therapy were factors independently associated with worse outcome in the two periods. HIV was the only new variable independently associated with higher ICU mortality during the post-pandemic Influenza (H1N1)v infection period. Conclusion Patients from the post-pandemic Influenza (H1N1)v infection period had an unexpectedly higher mortality rate and showed a trend towards affecting a more vulnerable population, in keeping with more typical seasonal viral infection.

2011-01-01

249

The zombie thermographer apocalypse preparedness 101: zombie thermographer pandemic  

NASA Astrophysics Data System (ADS)

Fact: The U.S Government Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response, rather remarkably has dedicated part of their web site to" Zombie Preparedness". See: http://www.cdc.gov/phpr/zombies.htm for more information. This is a tongue-incheek campaign with messages to engage audiences with the hazards of unpreparedness. The CDC director, U.S. Assistant Surgeon General Ali S. Khan (RET), MD, MPH notes, "If you are generally well equipped to deal with a zombie apocalypse you will be prepared for a hurricane, pandemic, earthquake, or terrorist attack. Make a plan, and be prepared!" (CDC Website, April 26th, 2013). Today we can make an easy comparison between the humor that the CDC is bringing to light, and what is actually happening in the Thermographic Industry. It must be acknowledge there are "Zombie Thermographers" out there. At times, it can be observed from the sidelines as a pandemic apocalypse attacking the credibility and legitimacy of the science and the industry that so many have been working to advance for over 30 years. This paper outlines and explores the trends currently taking place, the very real risks to facility plant, property, and human life as a result, and the strategies to overcome these problems.

Colbert, Fred

2013-05-01

250

Flu, risks, and videotape: escalating fear and avoidance.  

PubMed

While extensive risk perception research has focused on emotions, cognitions, and behavior at static points in time, less attention has been paid to how these variables might change over time. This study assesses how negative affect, threat beliefs, perceived risk, and intended avoidance behavior change over the course of an escalating biological disaster. A scenario simulation methodology was used that presents respondents with a video simulation of a 15-day series of local news reports to immerse respondents in the developing details of the disaster. Systemic manipulation of the virus's causal origin (terrorist attack, medical lab accident, unknown) and the respondent's proximity to the virus (local vs. opposite coast) allowed us to investigate the dynamics of public response. The unfolding scenario was presented in discrete episodes, allowing responses to be tracked over the episodes. The sample includes 600 respondents equally split by sex and by location, with half in the Washington, DC area, and half in the Los Angeles area. The results showed respondents' reactions to the flu epidemic increased as the disaster escalated. More importantly, there was considerable consistency across respondents' emotional, cognitive, and behavioral responses to the epidemic over the episodes. In addition, the reactions of respondents proximally closer to the epidemic increased more rapidly and with greater intensity than their distant counterparts. Finally, as the flu epidemic escalated, both terrorist and accidental flu releases were perceived as being less risky and were less likely to lead to avoidance behavior compared to the unknown flu release. PMID:22332702

Rosoff, Heather; John, Richard S; Prager, Fynnwin

2012-04-01

251

Guidance for Schools on the Recent Flu Outbreak  

ERIC Educational Resources Information Center

The document provides a transcript of a conference call moderated by Bill Modzeleski, Director of the Office of Safe and Drug-Free Schools. The focus of the call was the recent outbreak of swine flu in Mexico and the United States. Centers for Disease Control (CDC) actions and recommendations to the education community were discussed. A comparison…

US Department of Education, 2009

2009-01-01

252

FLU: A negative regulator of chlorophyll biosynthesis in Arabidopsis thaliana  

PubMed Central

Tetrapyrroles such as chlorophylls and bacteriochlorophylls play a fundamental role in the energy absorption and transduction activities of photosynthetic organisms. Because of these molecules, however, photosynthetic organisms are also prone to photooxidative damage. They had to evolve highly efficient strategies to control tetrapyrrole biosynthesis and to prevent the accumulation of free intermediates that potentially are extremely destructive when illuminated. In higher plants, the metabolic flow of tetrapyrrole biosynthesis is regulated at the step of ?-aminolevulinic acid synthesis. This regulation previously has been attributed to feedback control of Glu tRNA reductase, the first enzyme committed to tetrapyrrole biosynthesis, by heme. With the recent discovery of chlorophyll intermediates acting as signals that control both nuclear gene activities and tetrapyrrole biosynthesis, it seems likely that heme is not the only regulator of this pathway. A genetic approach was used to identify additional factors involved in the control of tetrapyrrole biosynthesis. In Arabidopsis thaliana, we have found a negative regulator of tetrapyrrole biosynthesis, FLU, which operates independently of heme and seems to selectively affect only the Mg2+ branch of tetrapyrrole biosynthesis. The identity of this protein was established by map-based cloning and sequencing the FLU gene. FLU is a nuclear-encoded plastid protein that, after import and processing, becomes tightly associated with plastid membranes. It is unrelated to any of the enzymes known to be involved in tetrapyrrole biosynthesis. Its predicted features suggest that FLU mediates its regulatory effect through interaction with enzymes involved in chlorophyll synthesis.

Meskauskiene, Rasa; Nater, Mena; Goslings, David; Kessler, Felix; op den Camp, Roel; Apel, Klaus

2001-01-01

253

Flu Shots, Mammogram, and the Perception of Probabilities  

Microsoft Academic Search

We study individuals’ decisions to decline or accept preventive health care interventions such as flu shots and mammograms. In particular, we analyze the role of perceptions of the effectiveness of the intervention, by eliciting individuals' subjective probabilities of sickness and survival, with and without the interventions. Respondents appear to be aware of some of the qualitative relationships between risk factors

K. G. Carman; P. Kooreman

2010-01-01

254

Flu Shots, Mammograms, and the Perception of Probabilities  

Microsoft Academic Search

We study individuals' decisions to decline or accept preventive health care interventions such as flu shots and mammograms. In particular, we analyze the role of perceptions of the effectiveness of the intervention, by eliciting individuals' subjective probabilities of sickness and survival, with and without the interventions. Respondents appear to be aware of some of the qualitative relationships between risk factors

Katherine Grace Carman; Peter Kooreman

2011-01-01

255

mHealth for Influenza Pandemic Surveillance in Developing Countries  

Microsoft Academic Search

Influenza pandemics caused millions of deaths and massive economic losses worldwide in the last century. The impact of any future pandemic is likely to be greatest in developing countries as a result of their limited surveillance and healthcare resources. eHealth facilitates the detection and reporting of potential pandemic strains by using digital data transmitted, sorted and retrieved electronically both at

JunHua Li; Nathan Moore; Shahriar Akter; Steven Bleisten; Pradeep Ray

2010-01-01

256

Dynamic modelling of costs and health consequences of school closure during an influenza pandemic  

PubMed Central

Background The purpose of this article is to evaluate the cost-effectiveness of school closure during a potential influenza pandemic and to examine the trade-off between costs and health benefits for school closure involving different target groups and different closure durations. Methods We developed two models: a dynamic disease model capturing the spread of influenza and an economic model capturing the costs and benefits of school closure. Decisions were based on quality-adjusted life years gained using incremental cost-effectiveness ratios. The disease model is an age-structured SEIR compartmental model based on the population of Oslo. We studied the costs and benefits of school closure by varying the age targets (kindergarten, primary school, secondary school) and closure durations (1–10 weeks), given pandemics with basic reproductive number of 1.5, 2.0 or 2.5. Results The cost-effectiveness of school closure varies depending on the target group, duration and whether indirect costs are considered. Using a case fatality rate (CFR) of 0.1-0.2% and with current cost-effectiveness threshold for Norway, closing secondary school is the only cost-effective strategy, when indirect costs are included. The most cost-effective strategies would be closing secondary schools for 8 weeks if R0=1.5, 6 weeks if R0=2.0, and 4 weeks if R0= 2.5. For severe pandemics with case fatality rates of 1-2%, similar to the Spanish flu, or when indirect costs are disregarded, the optimal strategy is closing kindergarten, primary and secondary school for extended periods of time. For a pandemic with 2009 H1N1 characteristics (mild severity and low transmissibility), closing schools would not be cost-effective, regardless of the age target of school children. Conclusions School closure has moderate impact on the epidemic’s scope, but the resulting disruption to society imposes a potentially great cost in terms of lost productivity from parents’ work absenteeism.

2012-01-01

257

PRIORITIZATION OF DELAYED VACCINATION FOR PANDEMIC INFLUENZA  

PubMed Central

Limited production capacity and delays in vaccine development are major obstacles to vaccination programs that are designed to mitigate a pandemic influenza. In order to evaluate and compare the impact of various vaccination strategies during a pandemic influenza, we developed an age/risk-structured model of influenza transmission, and parameterized it with epidemiological data from the 2009 H1N1 influenza A pandemic. Our model predicts that the impact of vaccination would be considerably diminished by delays in vaccination and staggered vaccine supply. Nonetheless, prioritizing limited H1N1 vaccine to individuals with a high risk of complications, followed by school-age children, and then preschool-age children, would minimize an over-all attack rate as well as hospitalizations and deaths. This vaccination scheme would maximize the benefits of vaccination by protecting the high-risk people directly, and generating indirect protection by vaccinating children who are most likely to transmit the disease.

Shim, Eunha

2013-01-01

258

"Will they just pack up and leave?" - attitudes and intended behaviour of hospital health care workers during an influenza pandemic  

PubMed Central

Background There is a general consensus that another influenza pandemic is inevitable. Although health care workers (HCWs) are essential to the health system response, there are few studies exploring HCW attitudes to pandemic influenza. The aim of this study was to explore HCWs knowledge, attitudes and intended behaviour towards pandemic influenza. Methods Cross-sectional investigation of a convenience sample of clinical and non-clinical HCWs from two tertiary-referral teaching hospitals in Sydney, Australia was conducted between June 4 and October 19, 2007. The self-administered questionnaire was distributed to hospital personal from 40 different wards and departments. The main outcome measures were intentions regarding work attendance and quarantine, antiviral use and perceived preparation. Results Respondents were categorized into four main groups by occupation: Nursing (47.5%), Medical (26.0%), Allied (15.3%) and Ancillary (11.2%). Our study found that most HCWs perceived pandemic influenza to be very serious (80.9%, n = 873) but less than half were able to correctly define it (43.9%, n = 473). Only 24.8% of respondents believed their department to be prepared for a pandemic, but nonetheless most were willing to work during a pandemic if a patient or colleague had influenza. The main determinants of variation in our study were occupational factors, demographics and health beliefs. Non-clinical staff were significantly most likely to be unsure of their intentions (OR 1.43, p < 0.001). Only 42.5% (n = 459) of respondents considered that neuraminidase inhibitor antiviral medications (oseltamivir/zanamivir) would protect them against pandemic influenza, whereas 77.5% (n = 836) believed that vaccination would be of benefit. Conclusion We identified two issues that could undermine the best of pandemic plans – the first, a low level of confidence in antivirals as an effective measure; secondly, that non-clinical workers are an overlooked group whose lack of knowledge and awareness could undermine pandemic plans. Other issues included a high level of confidence in dietary measures to protect against influenza, and a belief among ancillary workers that antibiotics would be protective. All health care worker strategies should include non clinical and ancillary staff to ensure adequate business continuity for hospitals. HCW education, psychosocial support and staff communication could improve knowledge of appropriate pandemic interventions and confidence in antivirals.

Seale, Holly; Leask, Julie; Po, Kieren; MacIntyre, C Raina

2009-01-01

259

How has the flu virus infected the Web? 2010 influenza and vaccine information available on the Internet  

PubMed Central

Background The 2009–10 influenza pandemic was a major public health concern. Vaccination was recommended by the health authorities, but compliance was not optimal and perception of the presumed associated risks was high among the public. The Internet is increasingly being used as a source of health information and advice. The aim of the study was to investigate the characteristics of websites providing information about flu vaccine and the quality of the information provided. Methods Website selection was performed in autumn 2010 by entering eight keywords in two of the most commonly used search engines (Google.com and Yahoo.com). The first three result pages were analysed for each search, giving a total of 480 occurrences. Page rank was evaluated to assess visibility. Websites based on Web 2.0 philosophy, websites merely displaying popular news/articles and single files were excluded from the subsequent analysis. We analysed the selected websites (using WHO criteria) as well as the information provided, using a codebook for pro/neutral websites and a qualitative approach for the adverse ones. Results Of the 89 websites selected, 54 dealt with seasonal vaccination, three with anti-H1N1 vaccination and 32 with both. Rank analysis showed that only classic websites (ones not falling in any other category) and one social network were provided on the first pages by Yahoo; 21 classic websites, six displaying popular news/articles and one blog by Google. Analysis of the selected websites revealed that the majority of them (88.8%) had a positive/neutral attitude to flu vaccination. Pro/neutral websites distinguished themselves from the adverse ones by some revealing features like greater transparency, credibility and privacy protection. Conclusions We found that the majority of the websites providing information on flu vaccination were pro/neutral and gave sufficient information. We suggest that antivaccinationist information may have been spread by a different route, such as via Web 2.0 tools, which may be more prone to the dissemination of “viral” information. The page ranking analysis revealed the crucial role of search engines regarding access to information on the Internet.

2013-01-01

260

The limitations of point of care testing for pandemic influenza: what clinicians and public health professionals need to know.  

PubMed

As the world prepares for the next influenza pandemic, governments have made significant funding commitments to vaccine development and antiviral stockpiling. While these are essential components to pandemic response, rapid and accurate diagnostic testing remains an often neglected cornerstone of pandemic influenza preparedness. Clinicians and Public Health Practitioners need to understand the benefits and drawbacks of different influenza tests in both seasonal and pandemic settings. Culture has been the traditional gold standard for influenza diagnosis but requires from 1-10 days to generate a positive result, compared to nucleic acid detection methods such as real time reverse transcriptase polymerase chain reaction (RT-PCR). Although the currently available rapid antigen detection kits can generate results in less than 30 minutes, their sensitivity is suboptimal and they are not recommended for the detection of novel influenza viruses. Until point-of-care (POC) tests are improved, PILPN recommends that the best option for pandemic influenza preparation is the enhancement of nucleic acid-based testing capabilities across Canada. PMID:19507723

Hatchette, Todd F; Bastien, Nathalie; Berry, Jody; Booth, Tim F; Chernesky, Max; Couillard, Michel; Drews, Steven; Ebsworth, Anthony; Fearon, Margaret; Fonseca, Kevin; Fox, Julie; Gagnon, Jean-Nicolas; Guercio, Steven; Horsman, Greg; Jorowski, Cathy; Kuschak, Theodore; Li, Yan; Majury, Anna; Petric, Martin; Ratnam, Sam; Smieja, Marek; Van Caeseele, Paul

2009-01-01

261

Protecting public health and global freight transportation systems during an influenza pandemic.  

PubMed

The H5N1 influenza threat is resulting in global preparations for the next influenza pandemic. Pandemic influenza planners are prioritizing scarce vaccine, antivirals, and public health support for different segments of society. The freight, bulk goods, and energy transportation network comprise the maritime, rail, air, and trucking industries. It relies on small numbers of specialized workers who cannot be rapidly replaced if lost due to death, illness, or voluntary absenteeism. Because transportation networks link economies, provide critical infrastructures with working material, and supply citizens with necessary commodities, disrupted transportation systems can lead to cascading failures in social and economic systems. However, some pandemic influenza plans have assigned transportation workers a low priority for public health support, vaccine, and antivirals. The science of Transportation Geography demonstrates that transportation networks and workers are concentrated at, or funnel through, a small number of chokepoints and corridors. Chokepoints should be used to rapidly and efficiently vaccinate and prophylax the transportation worker cohort and to implement transmission prevention measures and thereby protect the ability to move goods. Nations, states, the transportation industry and unions, businesses, and other stakeholders must plan, resource, and exercise, and then conduct a transportation health assurance and security campaign for an influenza pandemic. PMID:18522251

Luke, Thomas C; Rodrigue, Jean-Paul

2008-01-01

262

Colleges and Universities Pandemic Influenza Planning Checklist  

ERIC Educational Resources Information Center

In the event of an influenza pandemic, colleges and universities will play an integral role in protecting the health and safety of students, employees and their families. The Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) have developed this checklist as a framework to assist colleges and…

Centers for Disease Control and Prevention, 2006

2006-01-01

263

Business Contingency Plan for Pandemic Avian Influenza  

Microsoft Academic Search

Grand Ballroom It has been generally agreed by most experts that a pandemic avian influenza is very likely to strike soon. It is just the matter of at what degree. The United Nations has recently highlighted the rapid escalation in the spread of avian influenza. There were confirmed cases in 15 countries in the past two and one-half years. Now

Rama Gardens Hotel

2006-01-01

264

Pandemic lineages of extraintestinal pathogenic Escherichia coli.  

PubMed

Pathogenic Escherichia coli strains cause a wide variety of intestinal and extraintestinal infections. The widespread geographical clonal dissemination of intestinal pathogenic E. coli strains, such as E. coli O157:H7, is well recognized, and its spread is most often attributed to contaminated food products. On the other hand, the clonal dissemination of extraintestinal pathogenic E. coli (ExPEC) strains is also recognized, but the mechanism of their spread is not well explained. Here, I describe major pandemic clonal lineages of ExPEC based on multilocus sequence typing (MLST), and discuss possible reasons for their global dissemination. These lineages include sequence type (ST)131, ST393, ST69, ST95, and ST73, which are all associated with both community-onset and healthcare-associated infections, in particular urinary tract infections and bloodstream infections. As with many other types of drug-resistant Gram-negative and Gram-positive bacterial infections, drug-resistant ExPEC infections are recognized to be caused by a limited set of clonal lineages. However, reported observations on these major pandemic lineages suggest that the resistance phenotype is not necessarily the determinant of their clonal dissemination. Both epidemiological factors and their intrinsic biological 'fitness' are likely to contribute. An important public health and clinical concern is that pandemicity itself may be a determinant of progressive drug resistance acquisition by clonal lineages. New research is urgently needed to better understand the epidemiological and biological causes of ExPEC pandemicity. PMID:24766445

Riley, L W

2014-05-01

265

Vaccines for seasonal and pandemic influenza.  

PubMed

Seasonal influenza continues to have a huge annual impact in the United States, accounting for tens of millions of illnesses, hundreds of thousands of excess hospitalizations, and tens of thousands of excess deaths. Vaccination remains the mainstay for the prevention of influenza. In the United States, 2 types of influenza vaccine are currently licensed: trivalent inactivated influenza vaccine and live attenuated influenza vaccine. Both are safe and effective in the populations for which they are approved for use. Children, adults <65 years of age, and the elderly all receive substantial health benefits from vaccination. In addition, vaccination appears to be cost-effective, if not cost saving, across the age spectrum. Despite long-standing recommendations for the routine vaccination of persons in high-priority groups, US vaccination rates remain too low across all age groups. Important issues to be addressed include improving vaccine delivery to current and expanded target groups, ensuring timely availability of adequate vaccine supply, and development of even more effective vaccines. Development of a vaccine against potentially pandemic strains is an essential part of the strategy to control and prevent a pandemic outbreak. The use of existing technologies for influenza vaccine production would be the most straightforward approach, because these technologies are commercially available and licensing would be relatively simple. Approaches currently being tested include subvirion inactivated vaccines and cold-adapted, live attenuated vaccines. Preliminary results have suggested that, for some pandemic antigens, particularly H5, subvirion inactivated vaccines are poorly immunogenic, for reasons that are not clear. Data from evaluation of live pandemic vaccines are pending. Second-generation approaches designed to provide improved immune responses at lower doses have focused on adjuvants such as alum and MF59, which are currently licensed for influenza or other vaccines. Additional experimental approaches are required to achieve the ultimate goal for seasonal and pandemic influenza prevention--namely, the ability to generate broadly cross-reactive and durable protection in humans. PMID:17163383

Nichol, Kristin L; Treanor, John J

2006-11-01

266

Comparison of efficacy and safety of oseltamivir and zanamivir in pandemic influenza treatment  

PubMed Central

Aim: In 2009, a flu pandemic caused panic worldwide. Oseltamivir and zanamivir were widely used in this pandemic. Currently, there are a limited number of studies comparing the efficacy and tolerability of these two drugs. This study aimed to compare the efficacy and tolerability of these two drugs in the treatment of influenza. Materials and Methods: Patients diagnosed with influenza at our infectious disease outpatient clinic during the influenza season between October 1, 2009 and February 1, 2010 were included in the study. Study data were obtained retrospectively from files for consecutive patients. A total of 136 subjects were selected. After exclusion criteria were applied, 56 subjects were discarded. The information for 80 patients in whom oseltamivir or zanamivir therapy was initiated (40 for each therapy) was compiled, and the efficacy and tolerability of the drugs were compared. Results: There was no significant difference in efficacy for the two drugs (P > 0.05). Temperature normalization was significantly faster in patients taking zanamivir (P = 0.0157). Drowsiness was the most frequent adverse event for both drugs (38% for the oseltamivir group, and 22% for the zanamivir group). Respiratory distress was observed in five patients in the zanamivir group, whereas it was not observed in patients in the oseltamivir group (P < 0.05). One patient had to discontinue therapy in the zanamivir group due to respiratory distress. Conclusion: Efficacy (in terms of symptom relief and duration to resumption of work) and adverse events were similar for zanamivir and oseltamivir, but temperature normalization was much more rapid in patients using zanamivir. Patients using zanamivir should be monitored for respiratory distress.

Tuna, Nazan; Karabay, Oguz; Yahyaoglu, Mehmet

2012-01-01

267

Hyperimmune intravenous immunoglobulin containing high titers of pandemic H1N1 hemagglutinin and neuraminidase antibodies provides dose-dependent protection against lethal virus challenge in SCID mice  

PubMed Central

Background Convalescent plasma and fractionated immunoglobulins have been suggested as prophylactic or therapeutic interventions during an influenza pandemic. Findings Intravenous immunoglobulin (IVIG) preparations manufactured from human plasma collected before the 2009 H1N1 influenza pandemic, and post-pandemic hyperimmune (H)-IVIG preparations were characterized with respect to hemagglutination inhibition (HI), microneutralization (MN) and neuraminidase-inhibiting (NAi) antibody titers against pandemic H1N1 (pH1N1) and seasonal H1N1 (sH1N1) viruses. The protective efficacy of the IVIG and H-IVIG preparations was evaluated in a SCID mouse challenge model. Substantial levels of HI, MN and NAi antibodies against pH1N1 (GMTs 1:45, 1:204 and 1: 727, respectively) and sH1N1 (GMTs 1:688, 1:4,946 and 1:312, respectively) were present in pre-pandemic IVIG preparations. In post-pandemic H-IVIG preparations, HI, MN and NAi antibody GMTs against pH1N1 were 1:1,280, 1:11,404 and 1:2,488 (28-, 56- and 3.4-fold enriched), respectively, compared to pre-pandemic IVIG preparations (p?pandemic H-IVIG (HI titer 1:1,280) provided complete protection from lethality of SCID mice against pH1N1 challenge (100% of mice survived for 29 days post-challenge). Pre-pandemic IVIG (HI titer 1:70) did not provide significant protection against pH1N1 challenge (50% of mice survived 29 days post-challenge compared to 40% survival in the buffer control group). There was a highly significant correlation between circulating in vivo HI and MN antibody titers and survival (p?pandemic influenza for immunocompromised patients and other risk groups.

2014-01-01

268

Swine flu in Buenos Aires: beyond the principle of resilience  

Microsoft Academic Search

Purpose – Throughout April\\/May of 2009 a new type of virus surfaced in Mexico and the USA, denominated H1N1 or swine flu, that has been immediately disseminated worldwide. Even though the mortality of this virus has been slow, comparing with other antecedents, the mass-media articulated a troublesome discourse that put the world in tenterhooks waiting for the evolution of the

Maximiliano E. Korstanje

2011-01-01

269

Avirulent Avian Influenza Virus as a Vaccine Strain against a Potential Human Pandemic  

Microsoft Academic Search

In the influenza H5N1 virus incident in Hong Kong in 1997, viruses that are closely related to H5N1 viruses initially isolated in a severe outbreak of avian influenza in chickens were isolated from humans, signaling the possibility of an incipient pandemic. However, it was not possible to prepare a vaccine against the virus in the conventional embryonated egg system because

AYATO TAKADA; NORITAKA KUBOKI; KATSUNORI OKAZAKI; AI NINOMIYA; HIROKO TANAKA; HIROICHI OZAKI; SHIGEYUKI ITAMURA; HIDEKAZU NISHIMURA; MASAYOSHI ENAMI; MASATO TASHIRO; KENNEDY F. SHORTRIDGE; HIROSHI KIDA

1999-01-01

270

Viral double-stranded RNA, cytokines, and the flu.  

PubMed

The symptoms of the flu, such as fever, drowsiness, and malaise, are the sole means by which this common clinical syndrome is defined. The syndrome is usually the first clinical manifestation of both acute bacterial and viral infections. In the case of acute bacterial infections, several proinflammatory cytokines induced by bacterial products have been implicated as the causative agents of the flu syndrome. Viruses induce similar cytokines to bacteria, plus substantial amounts of interferon-alpha (IFN-alpha), although the direct association of these cytokines with the viral flu syndrome is less clear. Furthermore, the viral inducer(s) of cytokines has not been defined. The best candidate cytokine inducer associated with a majority of viral infections is virus-associated double-stranded RNA (dsRNA). This review examines the essential physical properties of toxic dsRNA, the cytokines induced by it, its viral and cellular sources, evidence for its presence in infected cells, its quantities in normal and infected cells, its cytotoxic mechanisms, and its cell-penetration properties. Toxic effects of viruses and dsRNA are compared. Energetics and extraction artifact issues are also discussed. Whereas most research on dsRNA toxicity has employed synthetic dsRNA, studies with virus-associated dsRNA are featured when available. Finally, a model for how viral dsRNA might initiate systemic disease is presented. PMID:10762073

Majde, J A

2000-03-01

271

Factors affecting nurses' decision to get the flu vaccine.  

PubMed

The objective of this study was to identify factors that influence the decision whether or not to get the influenza (flu) vaccine among nurses in Israel by using the health belief model (HBM). A questionnaire distributed among 299 nurses in Israel in winter 2005/2006 included (1) socio-demographic information; (2) variables based on the HBM, including susceptibility, seriousness, benefits, barriers and cues to action; and (3) knowledge about influenza and the vaccine, and health motivation. A probit model was used to analyze the data. In Israel, the significant HBM categories affecting nurses' decision to get a flu shot are the perceived benefits from vaccination and cues to action. In addition, nurses who are vaccinated have higher levels of (1) knowledge regarding the vaccine and influenza, (2) perceived seriousness of the illness, (3) perceived susceptibility, and (4) health motivation than do those who do not get the vaccine. Immunization of healthcare workers may reduce the risk of flu outbreaks in all types of healthcare facilities and reduce morbidity and mortality among high-risk patients. In order to increase vaccination rates among nurses, efforts should be made to educate them regarding the benefits of vaccination and the potential health consequences of influenza for their patients, and themselves. PMID:18781347

Shahrabani, Shosh; Benzion, Uri; Yom Din, Gregory

2009-05-01

272

Mini medical record application: annual register for flu shot vaccinations.  

PubMed

This application is an Intranet-based system. A database has been established utilizing patient information on the basis of age, medical diagnosis and employment history. If a health care provider or support staff states that a patient is over 65 years of age or has been diagnosed with a chronic disease and this limits the patient's ability to fight off infection, the need for preventive care is activated. In this situation the preventive care is the administration of an annual flu shot. For anyone over 65 years of age or with a chronic illness, a bulk mail of reminder cards with the dates of availability of injection is generated and mailed. All health care workers are notified at work of vaccination sites that they can use. In addition, should a patient have an appointment with a provider and a preventive flu injection is indicated, a reminder appears on the registration form. This reminder indicates a flu shot is needed as well as other preventive intervention. PMID:16050078

Hatcher, Myron; Heetebry, Irene; Tabriziani, Hossein

2005-06-01

273

Protecting Against the Flu: Advice for Caregivers of Children Less than 6 Months Old. Fact Sheet  

ERIC Educational Resources Information Center

Research has shown that children less than 5 years of age are at high risk of serious flu-related complications. It is estimated that more than 20,000 children less than 5 years old are hospitalized due to flu each year in the U.S. Many more have to go to a doctor, an urgent care center, or the emergency room because of flu. Complications from the…

Centers for Disease Control and Prevention, 2007

2007-01-01

274

Pandemic influenza A (H1N1) vaccination among libyan health care personnel: A cross-sectional retrospective study  

PubMed Central

Context: Vaccination rate among health-care personnel's (HCPs) are not promising notwithstanding the World Health Organization campaigns over three decades resulting in compromising patient safety. The H1N1 virus, which caused a world-wide pandemic earlier has now transformed into a seasonal flu virus. Aims: The aim of this study was to analyze the incidence of 2009-10 pandemic influenza A (H1N1) vaccination among Libyan HCPs in four hospitals of Al-Zawia, Libya. Materials and Methods: A questionnaire, which listed eight sections of parameters distributed among 310 HCPs to assess the vaccination rate and resulting adverse effects. Statistical Analysis: The data were analyzed using descriptive statistics, Pearson's ?2-test and Student's t-test where appropriate. Results: The overall pandemic A (H1N1) vaccination among all HCPs was only 107 (39.9%) out of 268 respondents. The distribution of respondents based on physicians, other staff and sex were found significant (P < 0.05). The common barriers of H1N1 vaccination being lack of awareness fear of adverse effects, allergies and religious beliefs. The major adverse effect observed was erythema in 95.56% of physicians and 87.1% in other staff. About 2% of HCPs have reported arthralgia. No significant differences existed between the responses of general variables and adverse effects. The glycoprotein 120 and squalene were found responsible for the reported adverse effects. 37 (82.22%) vaccinated medical HCPs have advised their patients to get vaccinated. Conclusions: Due to recurrence of H1N1 influenza in recent times, vaccination campaigns should be promoted immediately to address the knowledge gap of HCPs for intervention by regulatory and health organizations in Libya. The health belief model could be applied to improve vaccination among HCPs.

Hwisa, Nagiat Tayeb; Katakam, Prakash; Chandu, Babu Rao; Ismael, Mraa Hazim; Bader, Abdalwahab

2014-01-01

275

The novel influenza A (H1N1) virus pandemic: An update  

PubMed Central

In the 4 months since it was first recognized, the pandemic strain of a novel influenza A (H1N1) virus has spread to all continents and, after documentation of human-to-human transmission of the virus in at least three countries in two separate World Health Organization (WHO) regions, the pandemic alert was raised to level 6. The agent responsible for this pandemic, a swine-origin influenza A (H1N1) virus (S-OIV), is characterized by a unique combination of gene segments that has not previously been identified among human or swine influenza A viruses. As of 31th July 2009, 168 countries and overseas territories/communities have each reported at least one laboratory-confirmed case of pandemic H1N1 infection. There have been a total of 162,380 reported cases and 1154 associated deaths. Influenza epidemics usually take off in autumn, and it is important to prepare for an earlier start this season. Estimates from Europe indicate that 230 millions Europe inhabitants will have clinical signs and symptoms of S-OIV this autumn, and 7–35% of the clinical cases will have a fatal outcome, which means that there will be 160,000–750,000 H1N1-related deaths. A vaccine against H1N1 is expected to be the most effective tool for controlling influenza A (H1N1) infection in terms of reducing morbidity and mortality and limiting diffusion. However, there are several issues with regard to vaccine manufacture and approval, as well as production capacity, that remain unsettled. We searched the literature indexed in PubMed as well as the websites of major international health agencies to obtain the material presented in this update on the current S-OIV pandemic.

Petrosillo, N.; Di Bella, S.; Drapeau, C. M.; Grilli, E.

2009-01-01

276

Narcolepsy, 2009 A(H1N1) pandemic influenza, and pandemic influenza vaccinations: what is known and unknown about the neurological disorder, the role for autoimmunity, and vaccine adjuvants.  

PubMed

The vaccine safety surveillance system effectively detected a very rare adverse event, narcolepsy, in subjects receiving AS03-adjuvanted A(H1N1) pandemic vaccine made using the European inactivation/purification protocol. The reports of increased cases of narcolepsy in non-vaccinated subjects infected with wild A(H1N1) pandemic influenza virus suggest a role for the viral antigen(s) in disease development. However, additional investigations are needed to better understand what factor(s) in wild influenza infection trigger(s) narcolepsy in susceptible hosts. An estimated 31 million doses of European AS03-adjuvanted A(H1N1) pandemic vaccine were used in more than 47 countries. The Canadian AS03-adjuvanted A(H1N1) pandemic vaccine was used with high coverage in Canada where an estimated 12 million doses were administered. As no similar narcolepsy association has been reported to date with the AS03-adjuvanted A(H1N1) pandemic vaccine made using the Canadian inactivation/purification protocol, this suggests that the AS03 adjuvant alone may not be responsible for the narcolepsy association. To date, no narcolepsy association has been reported with the MF59®-adjuvanted A(H1N1) pandemic vaccine. This review article provides a brief background on narcolepsy, outlines the different types of vaccine preparations including the ones for influenza, reviews the accumulated evidence for the safety of adjuvants, and explores the association between autoimmune diseases and natural infections. It concludes by assimilating the historical observations and recent clinical studies to formulate a feasible hypothesis on why vaccine-associated narcolepsy may not be solely linked to the AS03 adjuvant but more likely be linked to how the specific influenza antigen component of the European AS03-adjuvanted pandemic vaccine was prepared. Careful and long-term epidemiological studies of subjects who developed narcolepsy in association with AS03-adjuvanted A(H1N1) pandemic vaccine prepared with the European inactivation/purification protocol are needed. PMID:24559657

Ahmed, S Sohail; Schur, Peter H; MacDonald, Noni E; Steinman, Lawrence

2014-05-01

277

76 FR 58466 - Request for Comments on World Health Organization Pandemic Influenza Preparedness Framework  

Federal Register 2010, 2011, 2012, 2013

...Administration Request for Comments on World Health Organization Pandemic Influenza...response, including implementation of the World Health Organization Pandemic Influenza...sought in light of the approval of the World Health Organization (WHO) Pandemic...

2011-09-21

278

Capacity of Thailand to Contain an Emerging Influenza Pandemic  

PubMed Central

Southeast Asia will likely be the epicenter of the next influenza pandemic. To determine whether health system resources in Thailand are sufficient to contain an emerging pandemic, we mapped health system resources in 76 provinces. We used 3 prepandemic scenarios of clustered cases and determined resource needs, availability, and gaps. We extended this analysis to a scenario of a modest pandemic and assumed that the same standards of clinical care would be required. We found that gaps exist in many resource categories, even under scenarios in which few cases occur. Such gaps are likely to be profound if a severe pandemic occurs. These gaps exist in infrastructure, personnel and materials, and surveillance capacity. Policy makers must determine whether such resource gaps can realistically be closed, ideally before a pandemic occurs. Alternatively, explicit assumptions must be made regarding allocation of scarce resources, standards of care, and priority setting during a pandemic.

Putthasri, Weerasak; Lertiendumrong, Jongkol; Chompook, Pornthip; Tangcharoensathien, Viroj

2009-01-01

279

Nonpharmaceutical Interventions for Pandemic Influenza, National and Community Measures  

PubMed Central

The World Health Organization's recommended pandemic influenza interventions, based on limited data, vary by transmission pattern, pandemic phase, and illness severity and extent. In the pandemic alert period, recommendations include isolation of patients and quarantine of contacts, accompanied by antiviral therapy. During the pandemic period, the focus shifts to delaying spread and reducing effects through population-based measures. Ill persons should remain home when they first become symptomatic, but forced isolation and quarantine are ineffective and impractical. If the pandemic is severe, social distancing measures such as school closures should be considered. Nonessential domestic travel to affected areas should be deferred. Hand and respiratory hygiene should be routine; mask use should be based on setting and risk, and contaminated household surfaces should be disinfected. Additional research and field assessments during pandemics are essential to update recommendations. Legal authority and procedures for implementing interventions should be understood in advance and should respect cultural differences and human rights.

2006-01-01

280

Ethics, pandemics, and the duty to treat.  

PubMed

Numerous grounds have been offered for the view that healthcare workers have a duty to treat, including expressed consent, implied consent, special training, reciprocity (also called the social contract view), and professional oaths and codes. Quite often, however, these grounds are simply asserted without being adequately defended or without the defenses being critically evaluated. This essay aims to help remedy that problem by providing a critical examination of the strengths and weaknesses of each of these five grounds for asserting that healthcare workers have a duty to treat, especially as that duty would arise in the context of an infectious disease pandemic. Ultimately, it argues that none of the defenses is currently sufficient to ground the kind of duty that would be needed in a pandemic. It concludes by sketching some practical recommendations in that regard. PMID:18802849

Malm, Heidi; May, Thomas; Francis, Leslie P; Omer, Saad B; Salmon, Daniel A; Hood, Robert

2008-08-01

281

VAST 2010 Challenge: Arms Dealings and Pandemics  

SciTech Connect

The 5th VAST Challenge consisted of three mini-challenges that involved both intelligence analysis and bioinformatics. Teams could solve one, two or all three mini-challenges and assess the overall situation to enter the Grand Challenge. Mini-challenge one involved text reports about people and events giving information about arms dealers, situations in various countries and linkages between different countries. Mini-challenge two involved hospital admission and death records from various countries providing information about the spread of a world wide pandemic. Mini-challenge three involved genetic data to be used to identify the origin of the pandemic and the most dangerous viral mutations. The Grand Challenge was to determine how these various mini-challenges were connected. As always the goal was to analyze the data and provide novel interactive visualizations useful in the analytic process. We received 58 submissions in total and gave 15 awards.

Grinstein, Georges; Konecni, Shawn; Plaisant, Catherine; Scholtz, Jean; Whiting, Mark A.

2010-10-23

282

Microdroplet Sandwich Real-Time RT-PCR for Detection of Pandemic and Seasonal Influenza Subtypes  

PubMed Central

As demonstrated by the recent 2012/2013 flu epidemic, the continual emergence of new viral strains highlights the need for accurate medical diagnostics in multiple community settings. If rapid, robust, and sensitive diagnostics for influenza subtyping were available, it would help identify epidemics, facilitate appropriate antiviral usage, decrease inappropriate antibiotic usage, and eliminate the extra cost of unnecessary laboratory testing and treatment. Here, we describe a droplet sandwich platform that can detect influenza subtypes using real-time reverse-transcription polymerase chain reaction (rtRT-PCR). Using clinical samples collected during the 2010/11 season, we effectively differentiate between H1N1p (swine pandemic), H1N1s (seasonal), and H3N2 with an overall assay sensitivity was 96%, with 100% specificity for each subtype. Additionally, we demonstrate the ability to detect viral loads as low as 104 copies/mL, which is two orders of magnitude lower than viral loads in typical infected patients. This platform performs diagnostics in a miniaturized format without sacrificing any sensitivity, and can thus be easily developed into devices which are ideal for small clinics and pharmacies.

Angione, Stephanie L.; Inde, Zintis; Beck, Christina M.; Artenstein, Andrew W.; Opal, Steven M.; Tripathi, Anubhav

2013-01-01

283

Containing Pandemic Influenza at the Source  

Microsoft Academic Search

Highly pathogenic avian influenza A (subtype H5N1) is threatening to cause a human pandemic of potentially devastating proportions. We used a stochastic influenza simulation model for rural Southeast Asia to investigate the effectiveness of targeted antiviral prophylaxis, quarantine, and pre-vaccination in containing an emerging influenza strain at the source. If the basic reproductive number (R0) was below 1.60, our simulations

Ira M. Longini; Azhar Nizam; Shufu Xu; Kumnuan Ungchusak; Wanna Hanshaoworakul; Derek A. T. Cummings; M. Elizabeth Halloran

2005-01-01

284

Simulation of strategies for containing pandemic influenza  

Microsoft Academic Search

We use a stochastic simulation model of pandemic influenza to investigate realistic intervention strategies that can be used in reaction to developing outbreaks. The model is constructed to represent a typical mid-sized North American city. Our model predicts average illness attack rates and economic costs for various intervention scenarios, e.g., in the case when low-coverage reactive vaccination and limited antiviral

Sigrún Andradóttir; Wenchi Chiu; David Goldsman; Mi Lim Lee; Kwok-Leung Tsui; David N. Fisman; Beate Sander; Azhar Nizam

2010-01-01

285

Prevalence of seroprotection against the pandemic (H1N1) virus after the 2009 pandemic  

PubMed Central

Background Before pandemic (H1N1) 2009, less than 10% of serum samples collected from all age groups in the Lower Mainland of British Columbia, Canada, showed seroprotection against the pandemic (H1N1) 2009 virus, except those from very elderly people. We reassessed this profile of seroprotection by age in the same region six months after the fall 2009 pandemic and vaccination campaign. Methods We evaluated 100 anonymized serum samples per 10-year age group based on convenience sampling. We measured levels of antibody against the pandemic virus by hemagglutination inhibition and microneutralization assays. We assessed geometric mean titres and the proportion of people with seroprotective antibody levels (hemagglutination inhibition titre ? 40). We performed sensitivity analyses to evaluate titre thresholds of 80, 20 and 10. Results Serum samples from 1127 people aged 9 months to 101 years were obtained. The overall age-standardized proportion of people with seroprotective antibody levels was 46%. A U-shaped age distribution was identified regardless of assay or titre threshold applied. Among those less than 20 years old and those 80 years and older, the prevalence of seroprotection was comparably high at about 70%. Seroprotection was 44% among those aged 20–49 and 30% among those 50–79 years. It was lowest among people aged 70–79 years (21%) and highest among those 90 years and older (88%). Interpretation We measured much higher levels of seroprotection after the 2009 pandemic compared than before the pandemic, with a U-shaped age distribution now evident. These findings, particularly the low levels of seroprotection among people aged 50–79 years, should be confirmed in other settings and closer to the influenza season.

Skowronski, Danuta M.; Hottes, Travis S.; Janjua, Naveed Z.; Purych, Dale; Sabaiduc, Suzana; Chan, Tracy; De Serres, Gaston; Gardy, Jennifer; McElhaney, Janet E.; Patrick, David M.; Petric, Martin

2010-01-01

286

Preparing  

Microsoft Academic Search

Anthocyanins are found in the flowers and fruits of natural plants. Since their color depends on pH, they are sometines used as a pH indicator. Since these sequences are reversible, they are also useful in demonstrating chemical equilibrium in the repetitive color changes of anthocyanins from flowers by controlling pH conditions. We prepared the polysaccharide beads conatining water extracts of

Naoki Kanda; Takayuki Asano; Toshiyuki Itoh; Makoto Onoda

1995-01-01

287

The H1N1 influenza pandemic: need for solutions to ethical problems.  

PubMed

The rapid spread of the novel influenza virus of H1N1 swine origin led to widespread fear, panic and unrest among the public and healthcare personnel. The pandemic not only tested the world's health preparedness, but also brought up new ethical issues which need to be addressed as soon as possible. This article highlights these issues and suggests ethical answers to the same. The main areas that require attention are the distribution of scarce resources, prioritisation of antiviral drugs and vaccines, obligations of healthcare workers, and adequate dissemination and proper communication of information related to the pandemic. It is of great importance to plan in advance how to confront these issues in an ethical manner. This is possible only if a comprehensive contingency plan is prepared with the involvement of and in consultation with all the stakeholders concerned. PMID:24152353

Bhatia, Prateek

2013-01-01

288

Influenza (“Bird Flu”), inflammation and anti-inflammatory\\/analgesic drugs  

Microsoft Academic Search

.  The spectre of an influenza pandemic is being widely mooted. Most of the strategies explored to date for controlling or treating\\u000a the condition have centred on controlling the spread of the infection, the use of vaccines or anti-viral agents. There has\\u000a been relatively little discussion about treating the lung and systemic inflammatory reactions that occur during influenza\\u000a infection. In this

K. D. Rainsford

2006-01-01

289

Intranasal Flu Vaccine Protective against Seasonal and H5N1 Avian Influenza Infections  

Microsoft Academic Search

BackgroundInfluenza A (flu) virus causes significant morbidity and mortality worldwide, and current vaccines require annual updating to protect against the rapidly arising antigenic variations due to antigenic shift and drift. In fact, current subunit or split flu vaccines rely exclusively on antibody responses for protection and do not induce cytotoxic T (Tc) cell responses, which are broadly cross-reactive between virus

Mohammed Alsharifi; Yoichi Furuya; Timothy R. Bowden; Mario Lobigs; Aulikki Koskinen; Matthias Regner; Lee Trinidad; David B. Boyle; Arno Müllbacher; Derya Unutmaz

2009-01-01

290

Conceptual Representations of Flu and Microbial Illness Held by Students, Teachers, and Medical Professionals  

ERIC Educational Resources Information Center

This study describes 5th, 8th, and 11th-grade students', teachers', and medical professionals' conceptions of flu and microbial illness. Participants constructed a concept map on "flu" and participated in a semi-structured interview. The results showed that these groups of students, teachers and medical professionals held and structured their…

Jones, M. Gail; Rua, Melissa J.

2008-01-01

291

Who Takes Advantage of Free Flu Shots? Examining the Effects of an Expansion in Coverage  

Microsoft Academic Search

Because of the high risk of costly complications (including death) and the externalities of contagious diseases, many countries provide free flu shots to certain populations free of charge. This paper examines the expansion of the free flu shot program in the Netherlands. This program expanded in 2008 to cover all individuals over the age of 60, instead of 65. We

K. G. Carman; I. Mosca

2011-01-01

292

The Effects of Framing and Action Instructions on Whether Older Adults Obtain Flu Shots  

Microsoft Academic Search

The authors tested the effects of cues to action—messages intended to increase flu immunizations. North Dakota counties were randomly assigned to reminder letters, action letters, or no letters. Within the reminder-letter counties, Medicare recipients received either (a) a reminder from the state peer review organization (PRO) to obtain a flu shot or (b) a reminder from the PRO, framed either

Kevin D. McCaul; Rebecca J. Johnson; Alexander J. Rothman

2002-01-01

293

Study: half of people at high risk unaware they need a flu shot.  

PubMed

Many people at high risk of flu infection mistakenly believe they're in a low-risk group and, as a result, are much less likely to get a flu shot, according to a researcher from the University of North Carolina (UNC) at Chapel Hill School of Public Health. PMID:17342835

2007-01-01

294

Help make your school a flu-free zone.  

PubMed

Schools are a particular "hot spot" for influenza because children can spread the disease a day or two before they show symptoms and can continue to spread the virus for at least a week after symptoms have subsided. School-age children have also been identified as key transmitters in communitywide outbreaks. The best way to prevent influenza outbreaks in schools and communities is through vaccination. Communities are encouraged to join efforts to vaccinate increasing numbers of children and youth. School nurses play an important role in helping to not only promote this national effort but also model it by receiving an annual flu shot. PMID:22165485

Baker, Carol J

2011-11-01

295

Interaction of FLU, a negative regulator of tetrapyrrole biosynthesis, with the glutamyl-tRNA reductase requires the tetratricopeptide repeat domain of FLU  

Microsoft Academic Search

Regulation of tetrapyrrole biosynthesis in plants has been attributed to feedback control of glutamyl-tRNA reductase (GLU-TR) by heme. Recently, another negative regulator, the FLU protein, has been discovered that operates independently of heme. A truncated form of FLU that contains two domains implicated in protein–protein interaction was co-expressed in yeast with either GLU-TR or glutamate-1-semialdehyde-2-1-aminotransferase (GSA-AT), the second enzyme involved

Rasa Meskauskiene; Klaus Apel

2002-01-01

296

Development and evaluation of candidate influenza a vaccines for pandemic preparedness  

Microsoft Academic Search

Pandemic vaccine seed viruses for H5N1, H5N2 and H9N2 subtypes were prepared and evaluated. Formalin-inactivated reassortant vaccines using A\\/Puerto Rico\\/8\\/34 (PR8) as a donor of internal genes with surface glycoprotein genes, hemagglutinin (HA) and neuraminidase (NA), of H5N2 and H9N2 subtypes, were generated by conventional reassortment. A reassortant virus for the highly pathogenic H5N1 subtype was prepared using reverse genetics

Yumiko Matsuoka; Kanta Subbarao; Hualan Chen; Christine Warnes; Melanie Altholtz; Samadhan Jadhao; David Swayne; Nancy Cox

2004-01-01

297

North American Plan for Animal and Pandemic Influenza.  

National Technical Information Service (NTIS)

Pandemic (H1N1) 2009 was the first public health emergency of international concern (PHEIC) declared under the International Health Regulations (2005) (IHR (2005)) and the first influenza pandemic in more than 40 years. Canada, Mexico, and the United Stat...

2012-01-01

298

Characterization of the Reconstructed 1918 Spanish Influenza Pandemic Virus  

Microsoft Academic Search

The pandemic influenza virus of 1918-1919 killed an estimated 20 to 50 million people worldwide. With the recent availability of the complete 1918 influenza virus coding sequence, we used reverse genetics to generate an influenza virus bearing all eight gene segments of the pandemic virus to study the properties associated with its extraordinary virulence. In stark contrast to contemporary human

Terrence M. Tumpey; Christopher F. Basler; Patricia V. Aguilar; Hui Zeng; Alicia Solórzano; David E. Swayne; Nancy J. Cox; Jacqueline M. Katz; Jeffery K. Taubenberger; Peter Palese; Adolfo García-Sastre

2005-01-01

299

Applications of E-Health for pandemic management  

Microsoft Academic Search

During the last century, influenza pandemics caused hundreds of thousands of deaths, millions of hospitalizations, social disruption, and massive economic losses worldwide. With the increase in global transport and communications, as well as urbanization and overcrowding conditions, any novel influenza strain would be likely to spread quickly, and as a result the impact of an influenza pandemic can be even

JunHua Li; P. Ray

2010-01-01

300

Pandemic (H1N1) 2009 Encephalitis in Woman, Taiwan  

PubMed Central

We report an unusual case of pandemic (H1N1) 2009–related encephalitis in an immunocompetent woman. Although rare cases of pandemic (H1N1) 2009 associated with encephalitis have been reported previously, in this patient, direct viral invasion of the central nervous system was shown by simultaneous detection of viral RNA and pleocytosis.

Cheng, Aristine; Kuo, Kuei-Hong

2011-01-01

301

The 1918-1920 influenza pandemic in Peru  

PubMed Central

Background Increasing our knowledge of past influenza pandemic patterns in different regions of the world is crucial to guide preparedness plans against future influenza pandemics. Here, we undertook extensive archival collection efforts from 3 representative cities of Peru (Lima in the central coast, Iquitos in the northeastern Amazon region, Ica in the southern coast) to characterize the age and geographic patterns of the 1918–1920 influenza pandemic in this country. Materials and Methods We analyzed historical documents describing the 1918–1920 influenza pandemic in Peru and retrieved individual mortality records from local provincial archives for quantitative analysis. We applied seasonal excess mortality models to daily and monthly respiratory mortality rates for 1917–1920 and quantified transmissibility estimates based on the daily growth rate in respiratory deaths. Results A total of 52,739 individual mortality records were inspected from local provincial archives. We found evidence for an initial mild pandemic wave during July-September 1918 in Lima, identified a synchronized severe pandemic wave of respiratory mortality in all three locations in Peru during November 1918-February 1919, and a severe pandemic wave during January 1920- March 1920 in Lima and July-October 1920 in Ica. There was no recrudescent pandemic wave in 1920 in Iquitos. Remarkably, Lima experienced the brunt of the 1918–20 excess mortality impact during the 1920 recrudescent wave, with all age groups experiencing an increase in all cause excess mortality from 1918–19 to 1920. Middle age groups experienced the highest excess mortality impact, relative to baseline levels, in the 1918–19 and 1920 pandemic waves. Cumulative excess mortality rates for the 1918–20 pandemic period were higher in Iquitos (2.9%) than Lima (1.6%). The mean reproduction number for Lima was estimated in the range 1.3–1.5. Conclusions We identified synchronized pandemic waves of intense excess respiratory mortality during November 1918-February 1919 in Lima, Iquitos, Ica, followed by asynchronous recrudescent waves in 1920. Cumulative data from quantitative studies of the 1918 influenza pandemic in Latin American settings have confirmed the high mortality impact associated with this pandemic. Further historical studies in lesser-studied regions of Latin America, Africa, and Asia are warranted for a full understanding of the global impact of the 1918 pandemic virus.

Chowell, G.; Viboud, C.; Simonsen, L.; Miller, M.A.; Hurtado, J.; Soto, G.; Vargas, R.; Guzman, M.A.; Ulloa, M.; Munayco, C.V.

2011-01-01

302

Persuasiveness of online flu-vaccination promotional banners.  

PubMed

Young people appear to have relatively little motivation to participate in flu-vaccination programs. This study assessed the effectiveness of online banners in efforts to persuade young people to get vaccinated. Specifically, a 2 x 3 between-subjects factorial design was used to examine the effects of message framing (gain vs loss) and color configuration (white text on a red background, black text on a yellow background, and white text on a blue background) on 180 college students' perceptions of the persuasiveness of flu-vaccination promotional banners. Each participant completed a four-item questionnaire, and the results of an analysis of variance showed that persuasiveness scores were higher among participants exposed to a loss-framed than to a gain-framed message, but only when the loss-framed message was presented in white text on a red background. The theoretical and practical implications of manipulating these two factors in the development of effective health-promotion materials are discussed. PMID:23833868

Chien, Yu-Hung

2013-04-01

303

Using model-based evidence in the governance of pandemics.  

PubMed

Pandemic preparedness planning relies on techniques to extend epidemiological inference beyond the bounds of direct observation. Mathematical modelling and simulation techniques are used to predict the course of an outbreak or test various mitigation strategies in pre-pandemic preparedness planning. This reflects an increasing reliance on quantifiable objects and establishing regulatory and governing practices by developing numerical assessment methods. This process has been described in terms of techne; the emergence of technologies and practices of calculation in the context of governance. This article develops a narrative framework to study how modelling methods are used in the governance of pandemic outbreaks by analysing both pre-pandemic modelling practices and model-based evidence used in pandemic risk assessment at the European Disease Control Centre. It examines how the modelling methods form techne through which the efforts of governance are organised. It concludes with a critical reflection on the limits of modelling methods by studying how they accommodate uncertainties. PMID:23278437

Mansnerus, Erika

2013-02-01

304

Response to the 2009-H1N1 influenza pandemic in the Mekong Basin: surveys of country health leaders  

PubMed Central

Background Soon after the 2009-H1N1 virus emerged as the first influenza pandemic in 41 years, countries had an early opportunity to test their preparedness plans, protocols and procedures, including their cooperation with other countries in responding to the global pandemic threat. The Mekong Basin Disease Surveillance cooperation (MBDS) comprises six countries - Cambodia, China (Yunnan and Guangxi Provinces), Lao People's Democratic Republic, Myanmar, Thailand and Vietnam - that formally organized themselves in 2001 to cooperate in disease surveillance and control. The pandemic presented an opportunity to assess their responses in light of their individual and joint planning. We conducted two surveys of the MBDS leadership from each country, early during the pandemic and shortly after it ended. Results On average, participants rated their country's pandemic response performance as good in both 2009 and 2010. Post-pandemic (2010), perceived performance quality was best for facility-based interventions (overall mean of 4.2 on a scale from 1 = poor to 5 = excellent), followed by surveillance and information sharing (4.1), risk communications (3.9) and disease prevention and control in communities (3.7). Performance was consistently rated as good or excellent for use of hotlines for case reporting (2010 mean of 4.4) and of selected facility-based interventions (each with a 2010 mean of 4.4): using hospital admission criteria, preparing or using isolation areas, using PPE for healthcare workers and using antiviral drugs for treatment. In at least half the countries, the post-pandemic ratings were lower than initial 2009 assessments for performance related to surveillance, facility-based interventions and risk communications. Conclusions MBDS health leaders perceived their pandemic responses effective in areas previously considered problematic. Most felt that MBDS cooperation helped drive and thus added value to their efforts. Surveillance capacity within countries and surveillance information sharing across countries, longstanding MBDS focus areas, were cited as particular strengths. Several areas needing further improvement are already core strategies in the 2011-2016 MBDS Action Plan. Self-organized sub-regional cooperation in disease surveillance is increasingly recognized as an important new element in global disease prevention and control. Our findings suggest that more research is needed to understand the characteristics of networking that will result in the best shared outcomes.

2011-01-01

305

Development of a Quick Look Pandemic Influenza Modeling and Visualization Tool  

SciTech Connect

Federal, State, and local decision makers and public health officials must prepare and exercise complex plans to contend with a variety of possible mass casualty events, such as pandemic influenza. Through the provision of quick look tools (QLTs) focused on mass casualty events, such planning can be done with higher accuracy and more realism through the combination of interactive simulation and visualization in these tools. If an event happens, the QLTs can then be employed to rapidly assess and execute alternative mitigation strategies, and thereby minimize casualties. This can be achieved by conducting numerous 'what-if' assessments prior to any event in order to assess potential health impacts (e.g., number of sick individuals), required community resources (e.g., vaccinations and hospital beds), and optimal mitigative decision strategies (e.g., school closures) during the course of a pandemic. In this presentation, we overview and demonstrate a pandemic influenza QLT, discuss some of the modeling methods and construct and visual analytic components and interface, and outline additional development concepts. These include the incorporation of a user selectable infectious disease palette, simultaneous visualization of decision alternatives, additional resource elements associated with emergency response (e.g., first responders and medical professionals), and provisions for other potential disaster events.

Brigantic, Robert T.; Ebert, David S.; Corley, Courtney D.; Maciejewski, Ross; Muller, George; Taylor, Aimee E.

2010-05-30

306

Early observational research and registries during the 2009-2010 influenza A pandemic.  

PubMed

As a critical care community, we have an obligation to provide not only clinical care but also the research that guides initial and subsequent clinical responses during a pandemic. There are many challenges to conducting such research. The first is speed of response. However, given the near inevitability of certain events, for example, viral respiratory illness such as the 2009 pandemic, geographically circumscribed natural disasters, or acts of terror, many study and trial designs should be preplanned and modified quickly when specific events occur. Template case report forms should be available for modification and web entry; centralized research ethics boards and funders should have the opportunity to preview and advise on such research beforehand; and national and international research groups should be prepared to work together on common studies and trials for common challenges. We describe the early international critical care research response to the influenza A 2009 (H1N1) pandemic, including specifics of observational study case report form, registry, and clinical trial design, cooperation of international critical care research organizations, and the early results of these collaborations. PMID:20101176

Fowler, Robert A; Webb, Steven A R; Rowan, Kathy M; Sprung, Charles L; Thompson, B Taylor; Randolph, Adrienne G; Jouvet, Philippe; Lapinsky, Stephen; Rubinson, Lewis; Rello, Jordi; Cobb, J Perren; Rice, Todd W; Uyeki, Tim; Marshall, John C

2010-04-01

307

Early observational research and registries during the 2009-2010 influenza A pandemic  

PubMed Central

As a critical care community, we have an obligation to provide not only clinical care but also the research that guides initial and subsequent clinical responses during a pandemic. There are many challenges to conducting such research. The first is speed of response. However, given the near inevitability of certain events, for example, viral respiratory illness such as the 2009 pandemic, geographically circumscribed natural disasters, or acts of terror, many study and trial designs should be preplanned and modified quickly when specific events occur. Template case report forms should be available for modification and web entry; centralized research ethics boards and funders should have the opportunity to preview and advise on such research beforehand; and national and international research groups should be prepared to work together on common studies and trials for common challenges. We describe the early international critical care research response to the influenza A 2009 (H1N1) pandemic, including specifics of observational study case report form, registry, and clinical trial design, cooperation of international critical care research organizations, and the early results of these collaborations.

Fowler, Robert A.; Webb, Steven A. R.; Rowan, Kathy M.; Sprung, Charles L.; Thompson, B. Taylor; Randolph, Adrienne G.; Jouvet, Philippe; Lapinsky, Stephen; Rubinson, Lewis; Rello, Jordi; Cobb, J. Perren; Rice, Todd W.; Uyeki, Tim; Marshall, John C.

2013-01-01

308

Avian influenza and pandemic influenza preparedness in Hong Kong.  

PubMed

Avian influenza A H5N1 continues to be a major threat to global public health as it is a likely candidate for the next influenza pandemic. To protect public health and avert potential disruption to the economy, the Hong Kong Special Administrative Region Government has committed substantial effort in preparedness for avian and pandemic influenza. Public health infrastructures for emerging infectious diseases have been developed to enhance command, control and coordination of emergency response. Strategies against avian and pandemic influenza are formulated to reduce opportunities for human infection, detect pandemic influenza timely, and enhance emergency preparedness and response capacity. Key components of the pandemic response include strengthening disease surveillance systems, updating legislation on infectious disease prevention and control, enhancing traveller health measures, building surge capacity, maintaining adequate pharmaceutical stockpiles, and ensuring business continuity during crisis. Challenges from avian and pandemic influenza are not to be underestimated. Implementing quarantine and social distancing measures to contain or mitigate the spread of pandemic influenza is problematic in a highly urbanised city like Hong Kong as they involved complex operational and ethical issues. Sustaining effective risk communication campaigns during interpandemic times is another challenge. Being a member of the global village, Hong Kong is committed to contributing its share of efforts and collaborating with health authorities internationally in combating our common public health enemy. PMID:18618061

Lam, Ping Yan

2008-06-01

309

Attending to social vulnerability when rationing pandemic resources.  

PubMed

Pandemic plans are increasingly attending to groups experiencing health disparities and other social vulnerabilities. Although some pandemic guidance is silent on the issue, guidance that attends to socially vulnerable groups ranges widely, some procedural (often calling for public engagement), and some substantive. Public engagement objectives vary from merely educational to seeking reflective input into the ethical commitments that should guide pandemic planning and response. Some plans that concern rationing during a severe pandemic recommend ways to protect socially vulnerable groups without prioritizing access to scarce resources based on social vulnerability per se. The Minnesota Pandemic Ethics Project (MPEP), a public engagement project on rationing scarce health resources during a severe influenza pandemic, agrees and recommends an integrated set of ways to attend to the needs of socially vulnerable people and avoid exacerbation of health disparities during a severe influenza pandemic. Among other things, MPEP recommends: 1. Engaging socially vulnerable populations to clarify unique needs and effective strategies; 2. Engaging socially vulnerable populations to elicit ethical values and perspectives on rationing; 3. Rejecting rationing based on race, socioeconomic class, citizenship, quality of life, length of life-extension and first-come, first-served; 4. Prioritizing those in the general population for access to resources based on combinations of risk (of death or severe complications from influenza, exposure to influenza, transmitting influenza to vulnerable groups) and the likelihood of responding well to the resource in question. 5. Protecting critical infrastructures on which vulnerable populations and the general public rely; 6. Identifying and removing access barriers during pandemic planning and response; and 7. Collecting and promptly analyzing data during the pandemic to identify groups at disproportionate risk of influenza-related mortality and serious morbidity and to optimize the distribution of resources. PMID:21595354

Vawter, Dorothy E; Garrett, J Eline; Gervais, Karen G; Prehn, Angela Witt; DeBruin, Debra A

2011-01-01

310

Lifelines Episode 13: Is Quercetin a Flu Fighter?  

NSDL National Science Digital Library

This is a free audio podcast from the American Physiological Society. Discussion quetsions, related research, and other teaching resources are available by clicking "collections" tab in the left hand column. J. Mark Davis (Starts at 3:55) of the University of South Carolina on stressful exercise, the flu and quercetin. Rick Lieber (Starts at 12:56) of the University of California San Diego and The VA Medical Center San Diego talks on elite athletes and muscles. Physiology in the News gives a quick look on a study that finds a possible link between your genes and activity level. Another looks at a benefit of hydrogen sulfide gas. We also talk to APS member Jim Hicks (Starts at 2:45) of the University of California Irvine about his involvement with the film, Wall-E.

APS Communications Office (American Physiological Society Communications Office); Rick Lieber (UCSD); James W Hicks (UC-Irvine Comparative and Evolutionary Physiology); PhD J Mark Davis (University of South Carolina Exercise Science)

2008-09-01

311

Potential Impact of Antiviral Drug Use during Influenza Pandemic  

PubMed Central

The recent spread of highly pathogenic strains of avian influenza has highlighted the threat posed by pandemic influenza. In the early phases of a pandemic, the only treatment available would be neuraminidase inhibitors, which many countries are considering stockpiling for pandemic use. We estimate the effect on hospitalization rates of using different antiviral stockpile sizes to treat infection. We estimate that stockpiles that cover 20%–25% of the population would be sufficient to treat most of the clinical cases and could lead to 50% to 77% reductions in hospitalizations. Substantial reductions in hospitalization could be achieved with smaller antiviral stockpiles if drugs are reserved for persons at high risk.

Hughes, Helen; Fleming, Douglas; Griffin, Thomas; Medlock, Jolyon; Leach, Steve

2005-01-01

312

Swine influenza (H1N1) pandemic: developing countries' perspective.  

PubMed

Since the first case of the current pandemic (H1N1) 2009 virus reported to WHO on 24 April 2009 on the American continent, the virus has spread in 160 countries and territories. By mid-2009, there were 135,000 cases and 816 deaths recorded. Pandemic preparedness is not advanced in most developing countries. Effective and essential measures include heightened surveillance, early detection and appropriate medical care. The use of local resources and capacity building with the assistance of developed nations will reduce the impact of this pandemic in the developing world. PMID:19681650

Khan, S I; Akbar, S M F; Hossain, S T; Mahtab, M A

2009-01-01

313

Public preparedness guidance for a severe influenza pandemic in different countries: a qualitative assessment and critical overview  

PubMed Central

During a severe influenza pandemic individuals and families can, by following well-directed and scientifically-based measures, not only benefit themselves but also play an effective role in reducing transmission rates and the burden on public services. Such guidelines should be provided as clearly and comprehensively as possible by official sources. Here we examine the official recommendations issued by 10 countries to prepare their citizens for a severe pandemic. We have found the presence of hazardous guidelines – as the advice to personally visit a health center at the earliest symptoms – and shortage of practical advices for home isolation, business preparation and treatment to be widespread. Our review shows that, while many positive recommendations were provided, the set of recommendations issued by most countries was not comprehensive enough for severe influenza scenarios. This is a situation that needs revision

Alonso, Wladimir J.; Schuck-Paim, Cynthia

2010-01-01

314

Epidemiological aspects of influenza A related to climatic conditions during and after a pandemic period in the city of Salvador, northeastern Brazil  

PubMed Central

During the influenza pandemic of 2009, the A(H1N1)pdm09, A/H3N2 seasonal and influenza B viruses were observed to be co-circulating with other respiratory viruses. To observe the epidemiological pattern of the influenza virus between May 2009-August 2011, 467 nasopharyngeal aspirates were collected from children less than five years of age in the city of Salvador. In addition, data on weather conditions were obtained. Indirect immunofluorescence, real-time transcription reverse polymerase chain reaction (RT-PCR), and sequencing assays were performed for influenza virus detection. Of all 467 samples, 34 (7%) specimens were positive for influenza A and of these, viral characterisation identified Flu A/H3N2 in 25/34 (74%) and A(H1N1)pdm09 in 9/34 (26%). Influenza B accounted for a small proportion (0.8%) and the other respiratory viruses for 27.2% (127/467). No deaths were registered and no pattern of seasonality or expected climatic conditions could be established. These observations are important for predicting the evolution of epidemics and in implementing future anti-pandemic measures.

Silva, Rosangela de Castro; Siqueira, Marilda Agudo Mendonca; Netto, Eduardo Martins; Bastos, Jacione Silva; Nascimento-Carvalho, Cristiana Maria; Vilas-Boas, Ana Luisa; Bouzas, Maiara Lana; Motta, Fernando do Couto; Brites, Carlos

2014-01-01

315

Knowledge, Attitudes, and Practices Regarding Pandemic H1N1 Influenza Among Medical and Dental Residents and Fellowships in Shiraz, Iran  

PubMed Central

Background: Influenza disease is one of the oldest medical problems that can cause severe illness and high mortality rates, worldwide. In flu pandemics, medical and dental students’ knowledge, attitudes, and practices (KAP) is critical to save patients life. The aim of this study was to determine the score of KAP toward the Pandemic H1N1 and their predictor factors among the medical and dental residents and fellowships of Shiraz University of Medical Sciences, Iran. Methods: In 2009, 125 participants were recruited in a convenient sampling cross-sectional survey. Self-reported questionnaire were used and results were analyzed applying appropriate statistical tests. Results: The mean score of participants’ knowledge, attitude and practice were 22.6, 21.1 and 26.5 respectively. Participants practice had significant linear positive correlation with knowledge and attitude. Also, their age was significantly and directly correlated to knowledge and practice. The educational major, age, and sex were significant predictors of responder's knowledge score and age was the only significant predictor of both attitude and practice scores. Conclusions: High knowledge is not sufficient lonely for improve attitude and practices. It seems that traditional educational models are not efficient and governments should emphasize to advanced and motivational education methods including health belief model and motivational interview at postgraduate levels. Perhaps younger students, dentists and males have less motivation to change their attitude and behavior, so we can focuses our interventions in these groups.

Askarian, Mehrdad; Danaei, Mina; Vakili, Veda

2013-01-01

316

Immunization with high epitope density of M2e derived from 2009 pandemic H1N1 elicits protective immunity in mice.  

PubMed

As highly conserved amongst human influenza A strains, the extracellular domain of influenza M2 protein (M2e) is considered and proved as a promising candidate for a universal influenza vaccine. However, there are four amino acid variations in the M2e sequence of the 2009 pandemic H1N1 (referred to as "swine flu M2e, SFM2e") compared with the conventional M2e consensus sequence. Whether the sequence variation alters the immunogenicity and protection of SFM2e epitope remains unclear. In our present study, we synthesized SFM2e peptide and constructed a series of GST fusion proteins containing various copies of the SFM2e epitope and immunized mice to evaluate their immunogenicity and protective activity. We found that although the amino acid variations have weakened the immunogenicity of the SFM2e peptide, the SFM2e fusion proteins with high epitope densities induced intense and diverse antibody response as well as T cell response. Moreover, mice immunized with high epitope density of SFM2e were nearly fully protected against a lethal challenge by the mouse-adapted influenza virus A/Porto Rico/8/34. Our study could provide new available data to improve the epitope vaccine strategy against influenza pandemic. PMID:22446634

Zhou, Chang; Zhou, Leilei; Chen, Ying-Hua

2012-05-14

317

Factors associated with post-seasonal serological titer and risk factors for infection with the pandemic A/H1N1 virus in the French general population.  

PubMed

The CoPanFlu-France cohort of households was set up in 2009 to study the risk factors for infection by the pandemic influenza virus (H1N1pdm) in the French general population. The authors developed an integrative data-driven approach to identify individual, collective and environmental factors associated with the post-seasonal serological H1N1pdm geometric mean titer, and derived a nested case-control analysis to identify risk factors for infection during the first season. This analysis included 1377 subjects (601 households). The GMT for the general population was 47.1 (95% confidence interval (CI): 45.1, 49.2). According to a multivariable analysis, pandemic vaccination, seasonal vaccination in 2009, recent history of influenza-like illness, asthma, chronic obstructive pulmonary disease, social contacts at school and use of public transports by the local population were associated with a higher GMT, whereas history of smoking was associated with a lower GMT. Additionally, young age at inclusion and risk perception of exposure to the virus at work were identified as possible risk factors, whereas presence of an air humidifier in the living room was a possible protective factor. These findings will be interpreted in light of the longitudinal analyses of this ongoing cohort. PMID:23613718

Lapidus, Nathanael; de Lamballerie, Xavier; Salez, Nicolas; Setbon, Michel; Delabre, Rosemary M; Ferrari, Pascal; Moyen, Nanikaly; Gougeon, Marie-Lise; Vely, Frédéric; Leruez-Ville, Marianne; Andreoletti, Laurent; Cauchemez, Simon; Boëlle, Pierre-Yves; Vivier, Eric; Abel, Laurent; Schwarzinger, Michaël; Legeas, Michèle; Le Cann, Pierre; Flahault, Antoine; Carrat, Fabrice

2013-01-01

318

Combining estimates from two surveys: an example from monitoring 2009 influenza A (H1N1) pandemic vaccination.  

PubMed

During the 2009 influenza A (H1N1) pandemic, there was an ongoing need to monitor 2009 H1N1 vaccination coverage at the national and state level to evaluate the vaccination campaign; thus, precise vaccination coverage estimates were needed in a timely fashion. The current objective is to describe and evaluate the methodology used to combine 2009 H1N1 vaccination coverage estimates from the Behavioral Risk Factor Surveillance System (BRFSS) and the National 2009 H1N1 Flu Survey (NHFS). H1N1 state level vaccination coverage estimates were combined by taking weighted averages of the BRFSS and NHFS estimates, with more weight given to the estimate with the larger effective sample size (sample size/design effect). The impact of the choice of weights was evaluated by comparing estimates when the design effect was removed from the weights. Combined vaccination coverage estimates for children generally fell midway between NHFS and BRFSS estimates because of larger NHFS sample sizes but smaller BRFSS design effects. Adult estimates were more closely weighted to BRFSS estimates because of larger BRFSS sample sizes. Combined standard errors were smaller than the survey-specific standard errors. When removing the design effect from the weights, the child combined estimates were more closely weighted to those from NHFS, resulting in larger standard errors. Adult combined estimates were similar regardless of choice of weight because of similar design effects across the two surveys. Combining estimates by weighting by the effective sample size allowed timely release of more precise estimates in all states during the 2009 H1N1 pandemic. PMID:22859268

Furlow-Parmley, Carolyn; Singleton, James A; Bardenheier, Barbara; Bryan, Leah

2012-11-30

319

A novel system of artificial antigen-presenting cells efficiently stimulates Flu peptide-specific cytotoxic T cells in vitro  

SciTech Connect

Highlights: {yields} Adoptive immunotherapy depends on relevant numbers of cytolytic T lymphocytes. {yields} An ideal artificial APCs system was successfully prepared in vivo. {yields} Controlled release of IL-2 leads to much more T-cell expansion. {yields} This system is better than general cellular APCs on T-cell expansion. -- Abstract: Therapeutic numbers of antigen-specific cytotoxic T lymphocytes (CTLs) are key effectors in successful adoptive immunotherapy. However, efficient and reproducible methods to meet the qualification remain poor. To address this issue, we designed the artificial antigen-presenting cell (aAPC) system based on poly(lactic-co-glycolic acid) (PLGA). A modified emulsion method was used for the preparation of PLGA particles encapsulating interleukin-2 (IL-2). Biotinylated molecular ligands for recognition and co-stimulation of T cells were attached to the particle surface through the binding of avidin-biotin. These formed the aAPC system. The function of aAPCs in the proliferation of specific CTLs against human Flu antigen was detected by enzyme-linked immunospot assay (ELISPOT) and MTT staining methods. Finally, we successfully prepared this suitable aAPC system. The results show that IL-2 is released from aAPCs in a sustained manner over 30 days. This dramatically improves the stimulatory capacity of this system as compared to the effect of exogenous addition of cytokine. In addition, our aAPCs promote the proliferation of Flu antigen-specific CTLs more effectively than the autologous cellular APCs. Here, this aAPC platform is proved to be suitable for expansion of human antigen-specific T cells.

Han, Hui [Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044 (China)] [Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044 (China); Peng, Ji-Run, E-mail: pengjr@medmail.com.cn [Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044 (China)] [Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044 (China); Chen, Peng-Cheng; Gong, Lei [Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044 (China)] [Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044 (China); Qiao, Shi-Shi [Department of Hepatobiliary Surgery, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052 (China)] [Department of Hepatobiliary Surgery, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052 (China); Wang, Wen-Zhen; Cui, Zhu-Qingqing; Yu, Xin; Wei, Yu-Hua [Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044 (China)] [Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044 (China); Leng, Xi-Sheng, E-mail: lengxs2003@yahoo.com.cn [Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044 (China)] [Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044 (China)

2011-08-05

320

Pandemic preparedness: perceptions of vulnerable migrants in Thailand towards WHO-recommended non-pharmaceutical interventions: a cross-sectional study  

PubMed Central

Background Non-pharmaceutical interventions (NPIs) constituted the principal public health response to the previous influenza A (H1N1) 2009 pandemic and are one key area of ongoing preparation for future pandemics. Thailand is an important point of focus in terms of global pandemic preparedness and response due to its role as the major transportation hub for Southeast Asia, the endemic presence of multiple types of influenza, and its role as a major receiving country for migrants. Our aim was to collect information about vulnerable migrants’ perceptions of and ability to implement NPIs proposed by the WHO. We hope that this information will help us to gauge the capacity of this population to engage in pandemic preparedness and response efforts, and to identify potential barriers to NPI effectiveness. Methods A cross-sectional survey was performed. The study was conducted during the influenza H1N1 2009 pandemic and included 801 migrant participants living in border areas thought to be high risk by the Thailand Ministry of Public Health. Data were collected by Migrant Community Health Workers using a 201-item interviewer-assisted questionnaire. Univariate descriptive analyses were conducted. Results With the exception of border measures, to which nearly all participants reported they would be adherent, attitudes towards recommended NPIs were generally negative or uncertain. Other potential barriers to NPI implementation include limited experience applying these interventions (e.g., using a thermometer, wearing a face mask) and inadequate hand washing and household disinfection practices. Conclusions Negative or ambivalent attitudes towards NPIs combined with other barriers identified suggest that vulnerable migrants in Thailand have a limited capacity to participate in pandemic preparedness efforts. This limited capacity likely puts migrants at risk of propagating the spread of a pandemic virus. Coordinated risk communication and public education are potential strategies that may reduce barriers to individual NPI implementation.

2014-01-01

321

Capacity Building in Response to Pandemic Influenza Threats: Lao PDR Case Study  

PubMed Central

The Lao People's Democratic Republic (PDR) committed to pandemic detection and response preparations when faced with the threat of avian influenza. Since 2006, the National Center for Laboratory and Epidemiology of Lao PDR has developed credible laboratory, surveillance, and epidemiological (human) capacity and as a result was designated a World Health Organization National Influenza Center in 2010. The Lao PDR experience in building influenza capacities provides a case study of the considerable crossover effect of such investments to augment the capacity to combat emerging and re-emerging diseases other than influenza.

Phommasack, Bounlay; Moen, Ann; Vongphrachanh, Phengta; Tsuyuoka, Reiko; Cox, Nancy; Khamphaphongphanh, Bouaphanh; Phonekeo, Darouny; Kasai, Takeshi; Ketmayoon, Pakapak; Lewis, Hannah; Kounnavong, Bounheuang; Khanthamaly, Viengphone; Corwin, Andrew

2012-01-01

322

ClassyFlu: classification of influenza A viruses with Discriminatively trained profile-HMMs.  

PubMed

Accurate and rapid characterization of influenza A virus (IAV) hemagglutinin (HA) and neuraminidase (NA) sequences with respect to subtype and clade is at the basis of extended diagnostic services and implicit to molecular epidemiologic studies. ClassyFlu is a new tool and web service for the classification of IAV sequences of the HA and NA gene into subtypes and phylogenetic clades using discriminatively trained profile hidden Markov models (HMMs), one for each subtype or clade. ClassyFlu merely requires as input unaligned, full-length or partial HA or NA DNA sequences. It enables rapid and highly accurate assignment of HA sequences to subtypes H1-H17 but particularly focusses on the finer grained assignment of sequences of highly pathogenic avian influenza viruses of subtype H5N1 according to the cladistics proposed by the H5N1 Evolution Working Group. NA sequences are classified into subtypes N1-N10. ClassyFlu was compared to semiautomatic classification approaches using BLAST and phylogenetics and additionally for H5 sequences to the new "Highly Pathogenic H5N1 Clade Classification Tool" (IRD-CT) proposed by the Influenza Research Database. Our results show that both web tools (ClassyFlu and IRD-CT), although based on different methods, are nearly equivalent in performance and both are more accurate and faster than semiautomatic classification. A retraining of ClassyFlu to altered cladistics as well as an extension of ClassyFlu to other IAV genome segments or fragments thereof is undemanding. This is exemplified by unambiguous assignment to a distinct cluster within subtype H7 of sequences of H7N9 viruses which emerged in China early in 2013 and caused more than 130 human infections. http://bioinf.uni-greifswald.de/ClassyFlu is a free web service. For local execution, the ClassyFlu source code in PERL is freely available. PMID:24404173

Van der Auwera, Sandra; Bulla, Ingo; Ziller, Mario; Pohlmann, Anne; Harder, Timm; Stanke, Mario

2014-01-01

323

Learning to EXHALE: don't catch the flu this season!  

PubMed

Decrease your chances of getting the flu by first, getting your flu shot, and second, by adopting this three-step technique to help prevent the spread of influenza as well as other viral respiratory illnesses. Like cough etiquette (ie, covering your nose and mouth when coughing or sneezing) and hand washing, this easily implemented, noninvasive technique should be an additional component of respiratory hygiene. The three steps are exhale, look away, and walk away. PMID:18828647

Sherman, Fredrick T

2008-10-01

324

Tennessee Department of Health Influenza Pandemic Response Plan.  

National Technical Information Service (NTIS)

Pandemic Influenza Preparedness Planning will be integrated with bioterrorism activities. The Tennessee Department of Health (TDH) is responsible for smallpox vaccination planning as part of its overall bioterrorism planning activities. The Department wor...

2003-01-01

325

Evaluation of three live attenuated H2 pandemic influenza vaccine candidates in mice and ferrets.  

PubMed

H2 influenza viruses have not circulated in humans since 1968, and therefore a significant portion of the population would be susceptible to infection should H2 influenza viruses reemerge. H2 influenza viruses continue to circulate in avian reservoirs worldwide, and these reservoirs are a potential source from which these viruses could emerge. Three reassortant cold-adapted (ca) H2 pandemic influenza vaccine candidates with hemagglutinin (HA) and neuraminidase (NA) genes derived from the wild-type A/Japan/305/1957 (H2N2) (Jap/57), A/mallard/6750/1978 (H2N2) (mal/78), or A/swine/MO/4296424/2006 (H2N3) (sw/06) viruses and the internal protein gene segments from the A/Ann Arbor/6/60 ca virus were generated by plasmid-based reverse genetics (Jap/57 ca, mal/78 ca, and sw/06 ca, respectively). The vaccine candidates exhibited the in vitro phenotypes of temperature sensitivity and cold adaptation and were restricted in replication in the respiratory tract of ferrets. In mice and ferrets, the vaccines elicited neutralizing antibodies and conferred protection against homologous wild-type virus challenge. Of the three candidates, the sw/06 ca vaccine elicited cross-reactive antibodies and provided significant protection against the greatest number of heterologous viruses. These observations suggest that the sw/06 ca vaccine should be further evaluated in a clinical trial as an H2 pandemic influenza vaccine candidate. Importance: Influenza pandemics arise when novel influenza viruses are introduced into a population with little prior immunity to the new virus and often result in higher rates of illness and death than annual seasonal influenza epidemics. An influenza H2 subtype virus caused a pandemic in 1957, and H2 viruses circulated in humans till 1968. H2 influenza viruses continue to circulate in birds, and the development of an H2 influenza vaccine candidate is therefore considered a priority in preparing for future pandemics. However, we cannot predict whether a human H2 virus will reemerge or a novel avian H2 virus will emerge. We identified three viruses as suitable candidates for further evaluation as vaccines to protect against H2 influenza viruses and evaluated the immune responses and protection that these three vaccines provided in mice and ferrets. PMID:24371061

Chen, Grace L; Lamirande, Elaine W; Cheng, Xing; Torres-Velez, Fernando; Orandle, Marlene; Jin, Hong; Kemble, George; Subbarao, Kanta

2014-03-01

326

Mitigation strategies for pandemic influenza in the United States  

Microsoft Academic Search

Recent human deaths due to infection by highly pathogenic (H5N1) avian influenza A virus have raised the specter of a devastating pandemic like that of 1917-1918, should this avian virus evolve to become readily transmissible among humans. We introduce and use a large-scale stochastic simulation model to investigate the spread of a pandemic strain of influenza virus through the U.S.

Timothy C. Germann; Kai Kadau; Ira M. Longini; Catherine A. Macken

2006-01-01

327

2009 Pandemic influenza H1N1: paediatric perspectives.  

PubMed

Children, especially those younger than 5 years of age and those with chronic medical conditions, such as respiratory diseases, neurological diseases, immunosuppression, receiving longterm aspirin therapy, obesity or co-infection with bacteria, are at an increased risk of pandemic H1N1 infection-related complications. This paper reviews the underlying medical conditions associated with death or complications of pandemic H1N1 infection in children. PMID:20473461

Lee, Hao Yuan; Wu, Chang Teng; Lin, Tzou Yien; Chiu, Cheng Hsun

2010-04-01

328

Capacity and Adaptations of General Practice during an Influenza Pandemic  

PubMed Central

Background GPs play a major role in influenza epidemics, and most patients with influenza-like-illness (ILI) are treated in general practice or by primary care doctors on duty in out-of-hours services (OOH). Little is known about the surge capacity in primary care services during an influenza pandemic, and how the relationship between them changes. Aim To investigate how general practice and OOH services were used by patients during the 2009 pandemic in Norway and the impact of the pandemic on primary care services in comparison to a normal influenza season. Materials Data from electronic remuneration claims from all OOH doctors and regular GPs for 2009. Methods We conducted a registry-based study of all ILI consultations in the 2009 pandemic with the 2008/09 influenza season (normal season) as baseline for comparison. Results The majority (82.2%) of ILI consultations during the 2009 pandemic took place in general practice. The corresponding number in the 2008/09 season was 89.3%. Compared with general practice, the adjusted odds ratio for ILI with all other diagnoses as reference in OOH services was 1.23 (95% CI, 1.18, 1.27) for the 2008/2009 season and 1.87 (95% CI, 1.84, 1.91) for the pandemic influenza season. In total there was a 3.3-fold increase in ILI consultations during the pandemic compared to the 2008/09 season. A 5.5-fold increase of ILI consultations were observed in OOH services in comparison to the 2008/09 season. Children and young adults with ILI were the most frequent users of OOH services during influenza periods. Conclusions The autumn pandemic wave resulted in a significantly increased demand on primary care services. However, GPs in primary care services in Norway showed the ability to increase capacity in a situation with increased patient demand.

Simonsen, Kristian A.; Hunskaar, Steinar; Sandvik, Hogne; Rortveit, Guri

2013-01-01

329

Experimental infection with a Thai reassortant swine influenza virus of pandemic H1N1 origin induced disease  

PubMed Central

Background Following the emergence of the pandemic H1N1 influenza A virus in 2009 in humans, this novel virus spread into the swine population. Pigs represent a potential host for this virus and can serve as a mixing vessel for genetic mutations of the influenza virus. Reassortant viruses eventually emerged from the 2009 pandemic and were reported in swine populations worldwide including Thailand. As a result of the discovery of this emergent disease, pathogenesis studies of this novel virus were conducted in order that future disease protection and control measures in swine and human populations could be enacted. Methods The pandemic H1N1 2009 virus (pH1N1) and its reassortant virus (rH1N1) isolated from pigs in Thailand were inoculated into 2 separate cohorts of 9, 3-week-old pigs. Cohorts were consisted of one group experimentally infected with pH1N1 and one group with rH1N1. A negative control group consisting of 3 pigs was also included. Clinical signs, viral shedding and pathological lesions were investigated and compared. Later, 3 pigs from viral inoculated groups and 1 pig from the control group were necropsied at 2, 4, and 12 days post inoculation (DPI). Results The results indicated that pigs infected with both viruses demonstrated typical flu-like clinical signs and histopathological lesions of varying severity. Influenza infected-pigs of both groups had mild to moderate pulmonary signs on 1-4 DPI. Interestingly, pigs in both groups demonstrated viral RNA detection in the nasal swabs until the end of the experiment (12 DPI). Conclusion The present study demonstrated that both the pH1N1 and rH1N1 influenza viruses, isolated from naturally infected pigs, induced acute respiratory disease in experimentally inoculated nursery pigs. Although animals in the rH1N1-infected cohort demonstrated more severe clinical signs, had higher numbers of pigs shedding the virus, were noted to have increased histopathological severity of lung lesions and increased viral antigen in lung tissue, the findings were not statistically significant in comparison with the pH1N1-infected group. Interestingly, viral genetic material of both viruses could be detected from the nasal swabs until the end of the experiment. Similar to other swine influenza viruses, the clinical signs and pathological lesions in both rH1N1 and pH1N1 were limited to the respiratory tract.

2013-01-01

330

H1N1 Influenza Pandemic of 2009 Compared With Other Influenza Pandemics: Epidemiology, Diagnosis, Management, Pulmonary Complications, and Outcomes  

Microsoft Academic Search

Influenza pandemics are complex events that have occurred frequently throughout human history, three during the past century\\u000a alone. Now the world is facing the first 21st century pandemic, and the comparison among them is essential to identify common\\u000a epidemiologic patterns, clinical characteristics, and outcomes. The evolution of medicine, including diagnostic and treatment\\u000a options, the critical care advances, and global responses

Guillermo Domínguez-Cherit; Silvio A. Ñamendys-Silva; Alethse de la Torre; Alejandro E. Macias; Jose Angel Cordova-Villalobos

2010-01-01

331

Insufficient preparedness of primary care practices for pandemic influenza and the effect of a preparedness plan in Japan: a prefecture-wide cross-sectional study  

PubMed Central

Background Cases of emerging infectious diseases, including H5N1 influenza, H7N9 influenza, and Middle East Respiratory Syndrome, have been reported in recent years, and the threat of pandemic outbreaks persists. In Japan, primary care is the frontline against emerging infectious diseases in communities. Although the importance of pandemic preparedness in primary care has been highlighted previously, few studies have thus far investigated the preparedness among primary care practices (PCPs) or differences in the preparedness of different institutional settings. We examined PCP preparedness and response to the 2009 influenza pandemic in Japan, and explored the role of a pandemic preparedness plan during the pandemic. Methods We used a survey questionnaire to assess how well individual PCPs in Okinawa, Japan, were prepared for the 2009 influenza pandemic. The questionnaire was mailed to all eligible PCPs (N?=?465) in Okinawa, regardless of their institutional setting. In addition, we assessed the differences in the preparedness of clinics and hospitals and determined whether the national preparedness plan affected individual preparedness and response. Data were analyzed using descriptive and logistic regression analyses. Results A total of 174 (37.4%) PCPs responded to our survey. In general, high-level personal protective equipment (PPE) such as N95 masks (45.4%), gowns (30.5%), and eye protection (21.3%) was stocked at a low rate. Clinic-based PCPs were significantly less prepared than hospital-based PCPs to provide N95 masks (OR 0.34), gowns (OR 0.15), and eye protection (OR 0.18). In addition, only 32.8% of PCPs adopted an adequate business continuity plan (BCP). After controlling for institutional setting, reading the national preparedness plan was significantly associated with establishment of a BCP (OR 5.86), and with knowledge of how to transfer a swab specimen to a local medical laboratory (OR 5.60). Conclusions With regard to PPE availability, PCPs (especially clinic-based PCPs) were not adequately prepared for the influenza pandemic. Awareness of the national pandemic preparedness plan is likely to promote prefecture-wide implementation of BCPs and surveillance activity.

2013-01-01

332

Structure, Receptor Binding, and Antigenicity of Influenza Virus Hemagglutinins from the 1957 H2N2 Pandemic  

SciTech Connect

The hemagglutinin (HA) envelope protein of influenza viruses mediates essential viral functions, including receptor binding and membrane fusion, and is the major viral antigen for antibody neutralization. The 1957 H2N2 subtype (Asian flu) was one of the three great influenza pandemics of the last century and caused 1 million deaths globally from 1957 to 1968. Three crystal structures of 1957 H2 HAs have been determined at 1.60 to 1.75 {angstrom} resolutions to investigate the structural basis for their antigenicity and evolution from avian to human binding specificity that contributed to its introduction into the human population. These structures, which represent the highest resolutions yet recorded for a complete ectodomain of a glycosylated viral surface antigen, along with the results of glycan microarray binding analysis, suggest that a hydrophobicity switch at residue 226 and elongation of receptor-binding sites were both critical for avian H2 HA to acquire human receptor specificity. H2 influenza viruses continue to circulate in birds and pigs and, therefore, remain a substantial threat for transmission to humans. The H2 HA structure also reveals a highly conserved epitope that could be harnessed in the design of a broader and more universal influenza A virus vaccine.

Xu, Rui; McBride, Ryan; Paulson, James C.; Basler, Christopher F.; Wilson, Ian A. (Sinai); (Scripps)

2010-03-04

333

Developing proactive communication strategies for a potential pandemic  

Microsoft Academic Search

Communication through the Australian media during a potential avian influenza epidemic could act to inform the public OR misinform, contributing to unnecessary public panic and undesirable responses. This project is part of ongoing research to assess Australians’ knowledge and perceptions of bird flu which will allow the development of public service advertising messages for use by the Australian government in

Sandra C. Jones; D. Iverson; L. Waters; I. Bevins; R. Hayes; O. Holland

2007-01-01

334

Skip the Trip: Air Travelers' Behavioral Responses to Pandemic Influenza  

PubMed Central

Theory suggests that human behavior has implications for disease spread. We examine the hypothesis that individuals engage in voluntary defensive behavior during an epidemic. We estimate the number of passengers missing previously purchased flights as a function of concern for swine flu or A/H1N1 influenza using 1.7 million detailed flight records, Google Trends, and the World Health Organization's FluNet data. We estimate that concern over “swine flu,” as measured by Google Trends, accounted for 0.34% of missed flights during the epidemic. The Google Trends data correlates strongly with media attention, but poorly (at times negatively) with reported cases in FluNet. Passengers show no response to reported cases. Passengers skipping their purchased trips forwent at least $50 M in travel related benefits. Responding to actual cases would have cut this estimate in half. Thus, people appear to respond to an epidemic by voluntarily engaging in self-protection behavior, but this behavior may not be responsive to objective measures of risk. Clearer risk communication could substantially reduce epidemic costs. People undertaking costly risk reduction behavior, for example, forgoing nonrefundable flights, suggests they may also make less costly behavior adjustments to avoid infection. Accounting for defensive behaviors may be important for forecasting epidemics, but linking behavior with epidemics likely requires consideration of risk communication.

Fenichel, Eli P.; Kuminoff, Nicolai V.; Chowell, Gerardo

2013-01-01

335

Modeling the Worldwide Spread of Pandemic Influenza: Baseline Case and Containment Interventions  

PubMed Central

Background The highly pathogenic H5N1 avian influenza virus, which is now widespread in Southeast Asia and which diffused recently in some areas of the Balkans region and Western Europe, has raised a public alert toward the potential occurrence of a new severe influenza pandemic. Here we study the worldwide spread of a pandemic and its possible containment at a global level taking into account all available information on air travel. Methods and Findings We studied a metapopulation stochastic epidemic model on a global scale that considers airline travel flow data among urban areas. We provided a temporal and spatial evolution of the pandemic with a sensitivity analysis of different levels of infectiousness of the virus and initial outbreak conditions (both geographical and seasonal). For each spreading scenario we provided the timeline and the geographical impact of the pandemic in 3,100 urban areas, located in 220 different countries. We compared the baseline cases with different containment strategies, including travel restrictions and the therapeutic use of antiviral (AV) drugs. We investigated the effect of the use of AV drugs in the event that therapeutic protocols can be carried out with maximal coverage for the populations in all countries. In view of the wide diversity of AV stockpiles in different regions of the world, we also studied scenarios in which only a limited number of countries are prepared (i.e., have considerable AV supplies). In particular, we compared different plans in which, on the one hand, only prepared and wealthy countries benefit from large AV resources, with, on the other hand, cooperative containment scenarios in which countries with large AV stockpiles make a small portion of their supplies available worldwide. Conclusions We show that the inclusion of air transportation is crucial in the assessment of the occurrence probability of global outbreaks. The large-scale therapeutic usage of AV drugs in all hit countries would be able to mitigate a pandemic effect with a reproductive rate as high as 1.9 during the first year; with AV supply use sufficient to treat approximately 2% to 6% of the population, in conjunction with efficient case detection and timely drug distribution. For highly contagious viruses (i.e., a reproductive rate as high as 2.3), even the unrealistic use of supplies corresponding to the treatment of approximately 20% of the population leaves 30%–50% of the population infected. In the case of limited AV supplies and pandemics with a reproductive rate as high as 1.9, we demonstrate that the more cooperative the strategy, the more effective are the containment results in all regions of the world, including those countries that made part of their resources available for global use.

Colizza, Vittoria; Barrat, Alain; Barthelemy, Marc; Valleron, Alain-Jacques; Vespignani, Alessandro

2007-01-01

336

Interatrial Block: A Virtual Pandemic Requiring Attention  

PubMed Central

Interatrial block (IAB) denotes a conduction delay between the two atria (P-wave duration ?110 ms). Depending on the severity of the block, IAB can be partial or advanced. Even though several studies have reported a high prevalence of IAB, it still remains a diagnosis many neglect without any follow-up. The crisis in IAB is undramatic until predictable complications appear. Nevertheless, the danger in IAB is real because of the major associations with multiple medical conditions, including atrial fibrillation, myocardial ischemia, left atrial enlargement, and systemic emboli. There are different treatment options for IAB to eliminate its consequences, including pacing and medical management with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Pacing has been shown to give promising results and could potentially prevent conditions related to cardiovascular disease such as hypertension or diabetes mellitus. Given the high prevalence of IAB, together with its potentially serious consequences, and yet being largely ignored, we stress attention to this potentially dangerous pandemic and raise consideration for further investigations.

Mehrzad, Raman; Spodick, David H.

2014-01-01

337

The AIDS pandemic in historic perspective.  

PubMed

Potent antiretroviral drugs (ART) have changed the nature of AIDS, a once deadly disease, into a manageable illness and offer the promise of reducing the spread of HIV. But the pandemic continues to expand and cause significant morbidity and devastation to families and nations as ART cannot be distributed worldwide to all who need the drugs to treat their infections, prevent HIV transmission, or serve as prophylaxis. Furthermore, conventional behavioral prevention efforts based on theories that individuals can be taught to modify risky behaviors if they have the knowledge to do so have been ineffective. Noting behavioral strategies targeting individuals fail to address broader social and political structures that create environments vulnerable to HIV spread, social scientists and public health officials insist that HIV policies must be comprehensive and also target a variety of structures at the population and environmental level. Nineteenth-century public health programs that targeted environmental susceptibility are the historical analogues to today's comprehensive biomedical and structural strategies to handle AIDS. Current AIDS policies underscore that those fighting HIV using scientific advances in virology and molecular biology cannot isolate HIV from its broader environment and social context any more than their nineteenth-century predecessors who were driven by the filth theory of disease. PMID:23090980

Kazanjian, Powel

2014-07-01

338

The pandemic potential of Nipah virus.  

PubMed

Nipah virus, a paramyxovirus whose wildlife reservoir is Pteropus bats, was first discovered in a large outbreak of acute encephalitis in Malaysia in 1998 among persons who had contact with sick pigs. Apparently, one or more pigs was infected from bats, and the virus then spread efficiently from pig to pig, then from pigs to people. Nipah virus outbreaks have been recognized nearly every year in Bangladesh since 2001 and occasionally in neighboring India. Outbreaks in Bangladesh and India have been characterized by frequent person-to-person transmission and the death of over 70% of infected people. Characteristics of Nipah virus that increase its risk of becoming a global pandemic include: humans are already susceptible; many strains are capable of limited person-to-person transmission; as an RNA virus, it has an exceptionally high rate of mutation: and that if a human-adapted strain were to infect communities in South Asia, high population densities and global interconnectedness would rapidly spread the infection. Appropriate steps to estimate and manage this risk include studies to explore the molecular and genetic basis of respiratory transmission of henipaviruses, improved surveillance for human infections, support from high-income countries to reduce the risk of person-to-person transmission of infectious agents in low-income health care settings, and consideration of vaccination in communities at ongoing risk of exposure to the secretions and excretions of Pteropus bats. PMID:23911335

Luby, Stephen P

2013-10-01

339

Pneumococcal immunizations at flu clinics: the impact of community-wide outreach.  

PubMed

This study examined the effectiveness of a community-wide outreach campaign to promote the use of pneumococcal vaccine at public flu immunization clinics, and assessed whether this intervention was more effective than simply making pneumococcal vaccination available at such clinics. In 1997, a community-wide outreach campaign promoting pneumococcal and influenza immunizations was launched in a 17 zip code area of Dutchess County, NY. The campaign was aimed at 7,961 Medicare beneficiaries urging them to obtain pneumococcal immunization from local flu clinics. Medicare reimbursement data were used to assess the countywide pneumococcal vaccination rate, and to analyze differences between rates for beneficiaries in the target area and elsewhere in the county. Between 1996 and 1997 there was a 94% increase in pneumococcal vaccination billed to Medicare beneficiaries in Dutchess County. The 1997 annual rate of pneumococcal immunization in the target area reached 16.3% versus 12.2% elsewhere in the county (p < 0.001), with an increase over the previous year of 8.7% and 5.6%, respectively. Nearly all of the increase is accounted for by pneumococcal vaccination delivered at flu clinics. It is possible to significantly increase the use of pneumococcal immunization by linking its delivery to community-based flu clinics and by developing local outreach strategies. The outreach campaign has a significant additive effect over simply making PPV available at flu shot clinics. Additional community-wide outreach can further improve pneumococcal immunization utilization rates. PMID:11478565

Shenson, D; Quinley, J; DiMartino, D; Stumpf, P; Caldwell, M; Lee, T

2001-06-01

340

An avian live attenuated master backbone for potential use in epidemic and pandemic influenza vaccines.  

PubMed

The unprecedented emergence in Asia of multiple avian influenza virus (AIV) subtypes with a broad host range poses a major challenge in the design of vaccination strategies that are both effective and available in a timely manner. The present study focused on the protective effects of a genetically modified AIV as a source for the preparation of vaccines for epidemic and pandemic influenza. It has previously been demonstrated that a live attenuated AIV based on the internal backbone of influenza A/Guinea fowl/Hong Kong/WF10/99 (H9N2), called WF10att, is effective at protecting poultry species against low- and high-pathogenicity influenza strains. More importantly, this live attenuated virus provided effective protection when administered in ovo. In order to characterize the WF10att backbone further for use in epidemic and pandemic influenza vaccines, this study evaluated its protective effects in mice. Intranasal inoculation of modified attenuated viruses in mice provided adequate protective immunity against homologous lethal challenges with both the wild-type influenza A/WSN/33 (H1N1) and A/Vietnam/1203/04 (H5N1) viruses. Adequate heterotypic immunity was also observed in mice vaccinated with modified attenuated viruses carrying H7N2 surface proteins. The results presented in this report suggest that the internal genes of a genetically modified AIV confer similar protection in a mouse model and thus could be used as a master donor strain for the generation of live attenuated vaccines for epidemic and pandemic influenza. PMID:18931063

Hickman, Danielle; Hossain, Md Jaber; Song, Haichen; Araya, Yonas; Solórzano, Alicia; Perez, Daniel R

2008-11-01

341

Public health intelligence and the detection of potential pandemics.  

PubMed

This article considers contemporary developments in public health intelligence (PHI), especially their focus on health events of pandemic potential. It argues that the sociological study of PHI can yield important insights for the sociology of pandemics. PHI aims to detect health events as (or even before) they unfold. Whilst its apparatuses envelope traditional public health activities, such as epidemiological surveillance, they increasingly extend to non-traditional public health activities such as data-mining in electronically mediated social networks. With a focus on non-traditional PHI activities, the article first situates the study of PHI in relation to the sociology of public health. It then discusses the conceptualisation and actualisation of pandemics, reflecting on how public health professionals and organisations must equip themselves with diverse allies in order to realise the claims they make about pandemic phenomena. Finally, using the analytic tools of actor-network theory, sites for future empirical research that can contribute to the sociology of pandemics are suggested. PMID:23278393

French, Martin; Mykhalovskiy, Eric

2013-02-01

342

Prediction and prevention of the next pandemic zoonosis  

PubMed Central

Most pandemics—eg, HIV/AIDS, severe acute respiratory syndrome, pandemic influenza—originate in animals, are caused by viruses, and are driven to emerge by ecological, behavioural, or socioeconomic changes. Despite their substantial effects on global public health and growing understanding of the process by which they emerge, no pandemic has been predicted before infecting human beings. We review what is known about the pathogens that emerge, the hosts that they originate in, and the factors that drive their emergence. We discuss challenges to their control and new efforts to predict pandemics, target surveillance to the most crucial interfaces, and identify prevention strategies. New mathematical modelling, diagnostic, communications, and informatics technologies can identify and report hitherto unknown microbes in other species, and thus new risk assessment approaches are needed to identify microbes most likely to cause human disease. We lay out a series of research and surveillance opportunities and goals that could help to overcome these challenges and move the global pandemic strategy from response to pre-emption.

Morse, Stephen S; Mazet, Jonna A K; Woolhouse, Mark; Parrish, Colin R; Carroll, Dennis; Karesh, William B; Zambrana-Torrelio, Carlos; Lipkin, W Ian; Daszak, Peter

2013-01-01

343

Efficacy of live attenuated vaccines against 2009 pandemic H1N1 influenza in ferrets  

Microsoft Academic Search

The advent of the H1N1 influenza pandemic (pH1N1) in 2009 triggered the rapid production of pandemic influenza vaccines, since seasonal influenza vaccines were expected and demonstrated not to provide significant cross-protection against the newly emerged pandemic virus. To increase vaccine production capacity and further evaluate the effectiveness of different candidate pandemic influenza vaccines, the World Health Organization stimulated the evaluation

Koert J. Stittelaar; Edwin J. B. Veldhuis Kroeze; Larisa Rudenko; Rajeev Dhere; Sit Thirapakpoomanunt; Marie Paule Kieny; Albert D. M. E. Osterhaus

2011-01-01

344

Annual Flu Shot Rates among Persons 18 and Older in the U.S. Civilian Noninstitutionalized Population, 2003. Statistical Brief Number 114.  

National Technical Information Service (NTIS)

Influenza is a contagious viral infection of the nose, throat, and lungs. Flu complications can include bacterial pneumonia, dehy-dration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes. Flu season can b...

A. Soni

2006-01-01

345

Adaptation of the FLU-FOBT Program for a Primary Care Clinic Serving a Low-Income Chinese American Community: New Evidence of Effectiveness  

Microsoft Academic Search

:Introduction. We sought to adapt and evaluate the FLU-FOBT Program for a primary care clinic serving a low-income Chinese American community. Methods. We compared colorectal cancer screening (CRCS) rate changes for patients who received flu shots versus those who did not receive flu shots during the FLU-FOBT Program. Analysis of data from the year prior to the intervention was used

Stephen J. McPhee; Ginny Gildengorin; Albert Y. Yu; Kit Chan; Michael B. Potter; Lawrence W. Green; Judith M. E. Walsh; Tina M. Yu

2011-01-01

346

Adaptation of the FLU-FOBT Program for a Primary Care Clinic Serving a Low-Income Chinese American Community: New Evidence of Effectiveness  

Microsoft Academic Search

Introduction. We sought to adapt and evaluate the FLU-FOBT Program for a primary care clinic serving a low-income Chinese American community. Methods. We compared colorectal cancer screening (CRCS) rate changes for patients who received flu shots versus those who did not receive flu shots during the FLU-FOBT Program. Analysis of data from the year prior to the intervention was used

Stephen J. McPhee; Ginny Gildengorin; Albert Y. Yu; Kit Chan; Michael B. Potter; Lawrence W. Green; Judith M. E. Walsh; Tina M. Yu

2011-01-01

347

Molecular-level simulation of pandemic influenza glycoproteins.  

PubMed

Computational simulation of pandemic diseases provides important insight into many disease features that may benefit public health. This is especially true for the influenza virus, a continuing global pandemic threat. Molecular or atomic-level investigation of influenza has predominantly focused on the two major virus glycoproteins, neuraminidase (NA) and hemagglutinin (HA). In this chapter, we walk the readers through major considerations for studying pandemic influenza glycoproteins, from choosing the most useful choice of system(s) to avoiding common pitfalls in experimental design and execution. While a brief discussion of several potential simulation and docking techniques is presented, we emphasize molecular dynamics (MD) and Brownian dynamics (BD) simulation techniques and molecular docking, within the context of biologically outstanding questions in influenza research. PMID:22183559

Amaro, Rommie E; Li, Wilfred W

2012-01-01

348

Influenza pandemics in Singapore, a tropical, globally connected city.  

PubMed

Tropical cities such as Singapore do not have well-defined influenza seasons but have not been spared from influenza pandemics. The 1918 epidemic in Singapore, which was then already a major global trading hub, occurred in 2 waves, June-July, and October-November, and resulted in > or = 2,870 deaths. The excess mortality rate was higher than that for industrialized nations in the Northern Hemisphere but lower than that for less industrialized countries in Asia and Africa. The 1957 epidemic occurred in May and resulted in widespread illness. The 1968 epidemic occurred in August and lasted a few weeks, again with widespread illness. Tropical cities may be affected early in a pandemic and have higher mortality rates. With the increase in travel and trade, a future pandemic may reach a globally connected city early and spread worldwide. Preparedness and surveillance plans must be developed to include the megacities of the tropical world. PMID:18214178

Lee, Vernon J; Chen, Mark I; Chan, Slew Pang; Wong, Chia Siong; Cutter, Jeffery; Goh, Kee Tai; Tambyah, Paul Anath

2007-07-01

349

Changing Perceptions: of Pandemic Influenza and Public Health Responses  

PubMed Central

According to the latest World Bank estimates, over the past decade some US?$4.3 billion has been pledged by governments to combat the threat of pandemic influenza. Presidents, prime ministers, and even dictators the world over have been keen to demonstrate their commitment to tackling this disease, but this has not always been the case. Indeed, government-led intervention in responding to the threat of pandemic influenza is a relatively recent phenomenon. I explore how human understandings of influenza have altered over the past 500 years and how public policy responses have shifted accordingly. I trace the progress in human understanding of causation from meteorological conditions to the microscopic, and how this has prompted changes in public policy to mitigate the disease's impact. I also examine the latest trend of viewing pandemic influenza as a security threat and how this has changed contemporary governance structures and power dynamics.

2012-01-01

350

Center for Disease Control and Prevention: H1N1 Flu  

NSDL National Science Digital Library

The Centers for Disease Control and Prevention (CDC) has created this uniformly excellent site to help the general public learn about the H1N1 flu. The homepage is well-organized, and it contains helpful social networking buttons, along with direct links to email updates, and their RSS feed. Here, visitors can also read the "Situation Update" section, which includes a map of the United States showing the weekly flu activity estimate maps and a number of other charts and tables. The site is chock-full of other helpful resources, including a section dedicated to "General Info" about the flu, information about vaccinations for individuals and public health officials, and a "What's New" area. The site is rounded out by a selection of podcasts and video clips.

351

The effects of framing and action instructions on whether older adults obtain flu shots.  

PubMed

The authors tested the effects of cues to action--messages intended to increase flu immunizations. North Dakota counties were randomly assigned to reminder letters, action letters, or no letters. Within the reminder-letter counties, Medicare recipients received either (a) a reminder from the state peer review organization (PRO) to obtain a flu shot or (b) a reminder from the PRO, framed either in terms of the loss associated with failing to get a shot or (c) the benefits associated with getting a shot. Within the action-letter counties, Medicare recipients leaned where and when to receive a flu shot. Reminder type failed to differentially affect the immunization rate (overall M = 24.5%). However, the action messages worked better (28.2%) than no message (19.6%). PMID:12433017

McCaul, Kevin D; Johnson, Rebecca J; Rothman, Alexander J

2002-11-01

352

Assessing the Ecotoxicologic Hazards of a Pandemic Influenza Medical Response  

PubMed Central

Background: The global public health community has closely monitored the unfolding of the 2009 H1N1 influenza pandemic to best mitigate its impact on society. However, little attention has been given to the impact of this response on the environment. Antivirals and antibiotics prescribed to treat influenza are excreted into wastewater in a biologically active form, which presents a new and potentially significant ecotoxicologic challenge to microorganisms responsible for wastewater nutrient removal in wastewater treatment plants (WWTPs) and receiving rivers. Objectives: We assessed the ecotoxicologic risks of a pandemic influenza medical response. Methods: To evaluate this risk, we coupled a global spatially structured epidemic model that simulates the quantities of antivirals and antibiotics used during an influenza pandemic of varying severity and a water quality model applied to the Thames catchment to determine predicted environmental concentrations. An additional model was then used to assess the effects of antibiotics on microorganisms in WWTPs and rivers. Results: Consistent with expectations, our model projected a mild pandemic to exhibit a negligible ecotoxicologic hazard. In a moderate and severe pandemic, we projected WWTP toxicity to vary between 0–14% and 5–32% potentially affected fraction (PAF), respectively, and river toxicity to vary between 0–14% and 0–30% PAF, respectively, where PAF is the fraction of microbial species predicted to be growth inhibited (lower and upper 95% reference range). Conclusions: The current medical response to pandemic influenza might result in the discharge of insufficiently treated wastewater into receiving rivers, thereby increasing the risk of eutrophication and contamination of drinking water abstraction points. Widespread drugs in the environment could hasten the generation of drug resistance. Our results highlight the need for empirical data on the effects of antibiotics and antiviral medications on WWTPs and freshwater ecotoxicity.

Colizza, Vittoria; Schmitt, Heike; Andrews, Johanna; Balcan, Duygu; Huang, Wei E.; Keller, Virginie D.J.; Vespignani, Alessandro; Williams, Richard J.

2011-01-01

353

Comparative Epidemiology of Pandemic and Seasonal Influenza A in Households  

PubMed Central

BACKGROUND There are few data on the comparative epidemiology and virology of the pandemic 2009 influenza A (H1N1) virus and cocirculating seasonal influenza A viruses in community settings. METHODS We recruited 348 index patients with acute respiratory illness from 14 outpatient clinics in Hong Kong in July and August 2009. We then prospectively followed household members of 99 patients who tested positive for influenza A virus on rapid diagnostic testing. We collected nasal and throat swabs from all household members at three home visits within 7 days for testing by means of quantitative reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay and viral culture. Using hemagglutination-inhibition and viral-neutralization assays, we tested baseline and convalescent serum samples from a subgroup of patients for antibody responses to the pandemic and seasonal influenza A viruses. RESULTS Secondary attack rates (as confirmed on RT-PCR assay) among household contacts of index patients were similar for the pandemic influenza virus (8%; 95% confidence interval [CI], 3 to 14) and seasonal influenza viruses (9%; 95% CI, 5 to 15). The patterns of viral shedding and the course of illness among index patients were also similar for the pandemic and seasonal influenza viruses. In a subgroup of patients for whom baseline and convalescent serum samples were available, 36% of household contacts who had serologic evidence of pandemic influenza virus infection did not shed detectable virus or report illness. CONCLUSIONS Pandemic 2009 H1N1 virus has characteristics that are broadly similar to those of seasonal influenza A viruses in terms of rates of viral shedding, clinical illness, and transmissibility in the household setting.

Cowling, Benjamin J.; Chan, Kwok Hung; Fang, Vicky J.; Lau, Lincoln L.H.; So, Hau Chi; Fung, Rita O.P.; Ma, Edward S.K.; Kwong, Alfred S.K.; Chan, Chi-Wai; Tsui, Wendy W.S.; Ngai, Ho-Yin; Chu, Daniel W.S.; Lee, Paco W.Y.; Chiu, Ming-Chee

2014-01-01

354

Adaptation of High-Growth Influenza H5N1 Vaccine Virus in Vero Cells: Implications for Pandemic Preparedness  

PubMed Central

Current egg-based influenza vaccine production technology can't promptly meet the global demand during an influenza pandemic as shown in the 2009 H1N1 pandemic. Moreover, its manufacturing capacity would be vulnerable during pandemics caused by highly pathogenic avian influenza viruses. Therefore, vaccine production using mammalian cell technology is becoming attractive. Current influenza H5N1 vaccine strain (NIBRG-14), a reassortant virus between A/Vietnam/1194/2004 (H5N1) virus and egg-adapted high-growth A/PR/8/1934 virus, could grow efficiently in eggs and MDCK cells but not Vero cells which is the most popular cell line for manufacturing human vaccines. After serial passages and plaque purifications of the NIBRG-14 vaccine virus in Vero cells, one high-growth virus strain (Vero-15) was generated and can grow over 108 TCID50/ml. In conclusion, one high-growth H5N1 vaccine virus was generated in Vero cells, which can be used to manufacture influenza H5N1 vaccines and prepare reassortant vaccine viruses for other influenza A subtypes.

Huang, Mei-Liang; Yeh, Wei-Zhou; Weng, Tsai-Chuan; Chen, Yu-Shuan; Chong, Pele; Lee, Min-Shi

2011-01-01

355

Effectiveness of Non-Adjuvanted Pandemic Influenza A Vaccines for Preventing Pandemic Influenza Acute Respiratory Illness Visits in 4 U.S. Communities  

Microsoft Academic Search

We estimated the effectiveness of four monovalent pandemic influenza A (H1N1) vaccines (three unadjuvanted inactivated, one live attenuated) available in the U.S. during the pandemic. Patients with acute respiratory illness presenting to inpatient and outpatient facilities affiliated with four collaborating institutions were prospectively recruited, consented, and tested for influenza. Analyses were restricted to October 2009 through April 2010, when pandemic

Marie R. Griffin; Arnold S. Monto; Edward A. Belongia; John J. Treanor; Qingxia Chen; Jufu Chen; H. Keipp Talbot; Suzanne E. Ohmit; Laura A. Coleman; Gerry Lofthus; Joshua G. Petrie; Jennifer K. Meece; Caroline Breese Hall; John V. Williams; Paul Gargiullo; LaShondra Berman; David K. Shay

2011-01-01

356

Longitudinal Investigation of Public Trust in Institutions Relative to the 2009 H1N1 Pandemic in Switzerland  

PubMed Central

Background The 2009 H1N1 pandemic left a legacy of mistrust in the public relative to how outbreaks of emerging infectious diseases are managed. To prepare for future outbreaks, it is crucial to explore the phenomenon of public trust in the institutions responsible for managing disease outbreaks. We investigated the evolution of public trust in institutions during and after the 2009 pandemic in Switzerland. We also explored respondents’ perceptions of the prevention campaign and the roles of the government and media. Methodology/Principal Findings A two-wave longitudinal survey was mailed to 2,400 members of the Swiss public. Wave 1 was in Spring 2009. Wave 2 was in Spring 2010. Six hundred and two participants responded in both waves. Participants indicated moderate to high levels of trust in medical organizations, the WHO, the Swiss government, the pharmaceutical industry, and the EU. On the other hand, trust in the media was low. Moreover, trust in almost all institutions decreased over time. Participants were satisfied with the amount of information received and indicated having followed official recommendations, but widespread concerns about the vaccine were evident. A large majority of participants agreed the vaccine might have unknown or undesirable side effects. Perceptions of the government’s and the media’s role in handling the outbreak were characterized by a substantial degree of skepticism and mistrust. Conclusions/Significance Results show clear patterns of skepticism and mistrust on the part of the public relative to various institutions and their actions. Results underscore the importance of systematically investigating trust of the public relative to epidemics. Moreover, studies investigating the evolution of the public’s memories of the pandemic over the coming years may be important to understand reactions to future pandemics. A systematic research program on trust can inform public health communication campaigns, enabling tailored communication initiatives.

Bangerter, Adrian; Krings, Franciska; Mouton, Audrey; Gilles, Ingrid; Green, Eva G. T.; Clemence, Alain

2012-01-01

357

Preparation and application of magnetic fluid with magnetite (I).  

National Technical Information Service (NTIS)

Magnetite should be larger than 1 mm in order to supply as the raw materials of iron making industries. In Synemi mine, more than 40 % of the magnetite has not been utilized too fine as iron source. The objects of this study are preparing the magnetic flu...

H. S. Lee D. J. Kim Y. Hwang

1996-01-01

358

Polymeric nanocarriers for magnetic targeted drug delivery: preparation, characterization, and in vitro and in vivo evaluation.  

PubMed

In this paper the preparation of magnetic nanocarriers (MNCs), containing superparamagnetic domains, is reported, useful as potential magnetically targeted drug delivery systems. The preparation of MNCs was performed by using the PHEA-IB-p(BMA) graft copolymer as coating material through the homogenization-solvent evaporation method. Magnetic and nonmagnetic nanocarriers containing flutamide (FLU-MNCs) were prepared. The prepared nanocarriers have been exhaustively characterized by dynamic light scattering (DLS), transmission electron microscopy (TEM), and magnetic measurements. Biological evaluation was performed by in vitro cytotoxicity and cell uptake tests and in vivo biodistribution studies. Magnetic nanocarriers showed dimensions of about 300 nm with a narrow size distribution, an amount of loaded FLU of 20% (w/w), and a superparamagnetic behavior. Cell culture experiments performed on prostate cancer cell line LNCaP demonstrated the cytotoxic effect of FLU-MNCs. In vivo biodistribution studies carried out by the application of an external magnetic field in rats demonstrated the effect of the external magnet on modifying the biodistribution of FLU-MNCs. FLU-MNCs resulted efficiently internalized by tumor cells and susceptible to magnetic targeting by application of an external magnetic field. The proposed nanocarriers can represent a very promising approach to obtain an efficient magnetically targeted anticancer drug delivery system. PMID:24168360

Licciardi, Mariano; Scialabba, Cinzia; Fiorica, Calogero; Cavallaro, Gennara; Cassata, Giovanni; Giammona, Gaetano

2013-12-01

359

Influenza ("Bird Flu"), inflammation and anti-inflammatory/analgesic drugs.  

PubMed

The spectre of an influenza pandemic is being widely mooted. Most of the strategies explored to date for controlling or treating the condition have centred on controlling the spread of the infection, the use of vaccines or anti-viral agents. There has been relatively little discussion about treating the lung and systemic inflammatory reactions that occur during influenza infection. In this review a range of therapeutic agents are proposed to treat the inflammatory reactions, principally in the lung as well as the systemic cytokine-mediated immuno-inflammatory reactions that may be a major cause of the morbidity and mortality associated with influenza infections. Among these are pentoxifylline, the statins, the macrolide antibiotics (e.g. azithromycin, clarithromycin, erythromycin), resveratrol (a component of wine and fruits with inhibitory effects on influenza virus replication) and nutraceuticals (including those that contain flavonoids, the marine oils eicosapentanoic and docosanoic acids or the green-lipped mussel extract, Liprinol which may by virtue of the inhibitory effects on the production or actions of pro-inflammatory cytokines, be useful for their anti-inflammatory actions. The efficacy, mode of actions and side effects of non-steroidal anti-inflammatory drugs (NSAIDs) are considered. There are a number of issues relating to their use in treating the inflammatory reactions in the respiratory tract. Among these are the development of gastro-intestinal ulcers and bleeding and hepato-renal reactions in patients that may because of severe systemic inflammation be prone to the development of these adverse reactions. There are also theoretical issues concerning the impact of COX-1 mediating reduction in prostaglandin and increased cytokine production that might have some negative consequences for respiratory inflammation.In conclusion, further consideration should be given to exploring the actions of these anti-inflammatory agents to control the respiratory inflammatory in influenza infections which can have serious consequences for the outcome of the infection. PMID:16835706

Rainsford, K D

2006-03-01

360

Molecular evolution of the seventh-pandemic clone of Vibrio cholerae and its relationship to other pandemic and epidemic V. cholerae isolates.  

PubMed Central

Genetic variation and molecular evolution within the seventh-pandemic clone of Vibrio cholerae O1 and its relationship to other V. cholerae isolates were examined by studying 58 clinical isolates that were epidemiologically unassociated and isolated from patients in different countries over 62 years (1931 to 1993). The sample consisted of 45 isolates from the seventh cholera pandemic (1961 to the present), 3 from the sixth pandemic, 3 from sporadic El Tor outbreaks prior to the seventh pandemic, 2 from the U.S. Gulf Coast, and 5 O139 Bengal isolates. Ribotyping detected 11 polymorphic restriction sites within the seventh-pandemic isolates and showed major differences in ribotypes in comparison with sixth- and pre-seventh-pandemic isolates. O139 isolates were very similar to isolates from the start of the seventh pandemic, differing at only two sites. The majority of seventh-pandemic isolates fall into two groups, the first present from 1961 to the present and found only in Asia and the second arising in 1966 and spreading worldwide. Both groups underwent change over time, allowing a provisional estimate for the nucleotide substitution rate within the seventh pandemic clone. Images

Karaolis, D K; Lan, R; Reeves, P R

1994-01-01

361

Pandemics in the Age of Twitter: Content Analysis of Tweets during the 2009 H1N1 Outbreak  

PubMed Central

Background Surveys are popular methods to measure public perceptions in emergencies but can be costly and time consuming. We suggest and evaluate a complementary “infoveillance” approach using Twitter during the 2009 H1N1 pandemic. Our study aimed to: 1) monitor the use of the terms “H1N1” versus “swine flu” over time; 2) conduct a content analysis of “tweets”; and 3) validate Twitter as a real-time content, sentiment, and public attention trend-tracking tool. Methodology/Principal Findings Between May 1 and December 31, 2009, we archived over 2 million Twitter posts containing keywords “swine flu,” “swineflu,” and/or “H1N1.” using Infovigil, an infoveillance system. Tweets using “H1N1” increased from 8.8% to 40.5% (R2?=?.788; p<.001), indicating a gradual adoption of World Health Organization-recommended terminology. 5,395 tweets were randomly selected from 9 days, 4 weeks apart and coded using a tri-axial coding scheme. To track tweet content and to test the feasibility of automated coding, we created database queries for keywords and correlated these results with manual coding. Content analysis indicated resource-related posts were most commonly shared (52.6%). 4.5% of cases were identified as misinformation. News websites were the most popular sources (23.2%), while government and health agencies were linked only 1.5% of the time. 7/10 automated queries correlated with manual coding. Several Twitter activity peaks coincided with major news stories. Our results correlated well with H1N1 incidence data. Conclusions This study illustrates the potential of using social media to conduct “infodemiology” studies for public health. 2009 H1N1-related tweets were primarily used to disseminate information from credible sources, but were also a source of opinions and experiences. Tweets can be used for real-time content analysis and knowledge translation research, allowing health authorities to respond to public concerns.

Chew, Cynthia; Eysenbach, Gunther

2010-01-01

362

Applying the lessons of SARS to pandemic influenza: an evidence-based approach to mitigating the stress experienced by healthcare workers.  

PubMed

We describe an evidence-based approach to enhancing the resilience of healthcare workers in preparation for an influenza pandemic, based on evidence about the stress associated with working in healthcare during the SARS outbreak. SARS was associated with significant long-term stress in healthcare workers, but not with increased mental illness. Reducing pandemic-related stress may best be accomplished through interventions designed to enhance resilience in psychologically healthy people. Applicable models to improve adaptation in individuals include Folkman and Greer's framework for stress appraisal and coping along with psychological first aid. Resilience is supported at an organizational level by effective training and support, development of material and relational reserves, effective leadership, the effects of the characteristics of "magnet hospitals," and a culture of organizational justice. Evidence supports the goal of developing and maintaining an organizational culture of resilience in order to reduce the expected stress of an influenza pandemic on healthcare workers. This recommendation goes well beyond the provision of adequate training and counseling. Although the severity of a pandemic is unpredictable, this effort is not likely to be wasted because it will also support the health of both patients and staff in normal times. PMID:19149392

Maunder, Robert G; Leszcz, Molyn; Savage, Diane; Adam, Mary Anne; Peladeau, Nathalie; Romano, Donna; Rose, Marci; Schulman, Bernard

2008-01-01

363

Assessing Healthcare Utilization for Influenza-like Illness at an Emergency Department and a Student Health Service during the 2009-2010 H1N1 Pandemic  

PubMed Central

Estimates of healthcare utilization during an influenza pandemic are needed in order to plan for the allocation of staff and resources. The aim of this study was to assess the number, age, and arrival time of patients with influenza-like-illness (ILI), and associations between their symptoms during the 2009–2010 H1N1 pandemic. We conducted a cross-sectional analysis of electronic health records from the student health service (SHS) and an emergency department (ED) in Morgantown, West Virginia, between January 2009 and December 2010. During the 2009–2010 H1N1 pandemic, patient arrivals at SHS and ED varied over the week. SHS patients arrived early in the week and primarily in the afternoon. ED patient arrivals were more evenly distributed, with busier evenings and weekends. Those with fever were more likely to experience cough, sore throat, vomiting/nausea, chills, congestion, headache, and body-ache. These results can assist health professionals in preparing for an influenza pandemic.

Bhandari, Ruchi; Hartley, Tara A.; Lindsley, William G.; Fisher, Melanie A.; Palmer, Jan E.

2013-01-01

364

North American Plan for Avian and Pandemic Influenza.  

National Technical Information Service (NTIS)

Canada, Mexico and the United States face a growing threat posed by the spread of avian influenza and the potential emergence of a human influenza pandemic. The highly pathogenic (HPAI) H5N1 avian influenza virus, which re- emerged in Asia in late 2003, h...

2007-01-01

365

Pandemic influenza planning, United States, 1978-2008.  

PubMed

During the past century, 4 influenza pandemics occurred. After the emergence of a novel influenza virus of swine origin in 1976, national, state, and local US public health authorities began planning efforts to respond to future pandemics. Several events have since stimulated progress in public health emergency planning: the 1997 avian influenza A(H5N1) outbreak in Hong Kong, China; the 2001 anthrax attacks in the United States; the 2003 outbreak of severe acute respiratory syndrome; and the 2003 reemergence of influenza A(H5N1) virus infection in humans. We outline the evolution of US pandemic planning since the late 1970s, summarize planning accomplishments, and explain their ongoing importance. The public health community's response to the 2009 influenza A(H1N1)pdm09 pandemic demonstrated the value of planning and provided insights into improving future plans and response efforts. Preparedness planning will enhance the collective, multilevel response to future public health crises. PMID:23731839

Iskander, John; Strikas, Raymond A; Gensheimer, Kathleen F; Cox, Nancy J; Redd, Stephen C

2013-06-01

366

New Approaches to Confronting an Imminent Influenza Pandemic  

PubMed Central

Scientists and health officials are concerned that an H5N1 influenza pandemic could be both imminent and catastrophic. Managing it will be difficult. Supplies of antiviral agents will be limited and expensive. Clinical development of adjuvant-combined, antigen-sparing, inactivated vaccines has been slow; the vaccines will take several months to produce and the global capacity to produce them will remain limited for several years. People who live in countries without vaccine companies — more than 85% of humankind — will have little prospect for being immunized. Thus, new approaches are needed to confront an imminent pandemic. The interventions must be scientifically promising and already licensed or near licensure. Moreover, the global industrial capacity to produce them must be large and already in place. Three interventions meet these criteria. Within a few months, several billion doses of live-attenuated H5N1 vaccines could be produced in existing egg-based or cell culture production facilities and several billion doses of an H5 recombinant hemagglutinin (rHA) vaccine could be produced in existing pharmaceutical bioreactors. In addition, generic medications such as statins might be able to moderate the aberrant innate immune response that characterizes human cases of H5N1 influenza. Statins would be affordable and available worldwide on the first day of the pandemic. Given the limitations of current efforts to develop and produce antivirals and conventional vaccines, urgent attention must be given these promising new approaches to pandemic control.

Fedson, David S; Dunnill, Peter

2007-01-01

367

Genetic reassortment in pandemic and interpandemic influenza viruses  

Microsoft Academic Search

The human influenza pandemics of 1957 and 1968 were caused by reassortant viruses that possessed internal gene segments from avian and human strains. Whether genetic reassortment of human and avian influenza viruses occurs during interpandemic periods and how often humans are infected with such reassortants is not known. To provide this information, we used dot-blot hybridization, partial nucleotide sequencing and

L. P. Shu; G. B. Sharp; Y. P. Lin; E. C. J. Claas; S. L. Krauss; K. F. Shortridge; R. G. Webster

1996-01-01

368

Gender and Monitoring the Response to HIV\\/AIDS Pandemic  

Microsoft Academic Search

The mechanisms, techniques, and data sources used to monitor and evaluate global AIDS prevention and treat- ment services may vary according to gender. The Joint United Nations Programme on HIV\\/AIDS has been charged with tracking the response to the pandemic by using a set of indicators developed as part of the Declaration of Commitment endorsed at the U.N. General Assembly

Paul DeLay

2004-01-01

369

Review Clinical review: Influenza pandemic - physicians and their  

Microsoft Academic Search

An influenza pandemic threatens to be the most lethal public health crisis to confront the world. Physicians will have critical roles in diagnosis, containment and treatment of influenza, and their commitment to treat despite increased personal risks is essential for a successful public health response. The obligations of the medical profession stem from the unique skills of its practitioners, who

Devanand Anantham; Wendy McHugh; Stephen O'Neill; Lachlan Forrow

370

Clinical review: Influenza pandemic – physicians and their obligations  

Microsoft Academic Search

An influenza pandemic threatens to be the most lethal public health crisis to confront the world. Physicians will have critical roles in diagnosis, containment and treatment of influenza, and their commitment to treat despite increased personal risks is essential for a successful public health response. The obligations of the medical profession stem from the unique skills of its practitioners, who

Devanand Anantham; Wendy McHugh; Stephen O'Neill; Lachlan Forrow

2008-01-01

371

Cost-Benefit of Stockpiling Drugs for Influenza Pandemic  

PubMed Central

We analyzed strategies for the use of stockpiled antiviral drugs in the context of a future influenza pandemic and estimated cost-benefit ratios. Current stockpiling of oseltamivir appears to be cost-saving to the economy under several treatment strategies, including therapeutic treatment of patients and postexposure prophylactic treatment of patients' close contacts.

Huerta, Michael; Davidovitch, Nadav; Grotto, Itamar

2005-01-01

372

Genome plasticity of Vibrio parahaemolyticus: microevolution of the 'pandemic group'  

Microsoft Academic Search

BACKGROUND: Outbreak of V. parahaemolyticus infections occurred since 1996 was linked to a proposed clonal complex, the pandemic group. The whole genome sequence provides an unprecedented opportunity for dissecting genome plasticity and phylogeny of the populations of V. parahaemolyticus. In the present work, a whole-genome cDNA microarray was constructed to compare the genomic contents of a collection of 174 strains

Haihong Han; Hin-chung Wong; Biao Kan; Zhaobiao Guo; Xiaotao Zeng; Shengjun Yin; Xiumei Liu; Ruifu Yang; Dongsheng Zhou

2008-01-01

373

Influenza: lessons from past pandemics, warnings from current incidents  

Microsoft Academic Search

Recent outbreaks of highly pathogenic avian influenza A virus infections (H5 and H7 subtypes) in poultry and in humans (through direct contact with infected birds) have had important economic repercussions and have raised concerns that a new influenza pandemic will occur in the near future. The eradication of pathogenic avian influenza viruses seems to be the most effective way to

Taisuke Horimoto; Yoshihiro Kawaoka

2005-01-01

374

ECD and the HIV/AIDS Pandemic in Africa  

ERIC Educational Resources Information Center

An unprecedented number of young children in Sub-Saharan Africa are being adversely affected by the HIV/AIDS pandemic, yet programs specifically designed to meet the developmental needs of orphaned and vulnerable children (OVC) from birth to age 8 are rare. This article summarizes the daunting array of challenges facing young OVC in Sub-Saharan…

Jackson, Lynette; O'Gara, Chloe; Akinware, Margaret; Akomas, Olive; Nyesigomwe, Lydia; Sabaa, Susan

2004-01-01

375

Two resource distribution strategies for dynamic mitigation of influenza pandemics  

PubMed Central

As recently pointed out by the Institute of Medicine, the existing pandemic containment and mitigation models lack the dynamic decision support capabilities. We present two simulation-based optimization models for developing dynamic predictive resource distribution strategies for cross-regional pandemic outbreaks. In both models, the underlying simulation mimics the disease and population dynamics of the affected regions. The quantity-based optimization model generates a progressive allocation of limited quantities of mitigation resources, including vaccines, antiviral, administration capacities, and social distancing enforcement resources. The budget-based optimization model strives instead allocating a total resource budget. Both models seek to minimize the impact of ongoing outbreaks and the expected impact of potential outbreaks. The models incorporate measures of morbidity, mortality, and social distancing, translated into the societal and economic costs of lost productivity and medical expenses. The models were calibrated using historic pandemic data and implemented on a sample outbreak in Florida, with over four million inhabitants. The quantity-based model was found to be inferior to the budget-based model, which was advantageous in its ability to balance the varying relative cost and effectiveness of individual resources. The models are intended to assist public health policy makers in developing effective distribution policies for mitigation of influenza pandemics.

Uribe-Sanchez, Andres; Savachkin, Alex

2010-01-01

376

Mortality Associated with Influenza in Tropics, State of S?o Paulo, Brazil, from 2002 to 2011: The Pre-Pandemic, Pandemic, and Post-Pandemic Periods  

PubMed Central

The impact of the seasonal influenza and 2009 AH1N1 pandemic influenza on mortality is not yet completely understood, particularly in tropical and subtropical countries. The trends of influenza related mortality rate in different age groups and different outcomes on a area in tropical and subtropical climate with more than 41 million people (State of São Paulo, Brazil), were studied from 2002 to 2011 were studied. Serfling-type regression analysis was performed using weekly mortality registries and virological data obtained from sentinel surveillance. The prepandemic years presented a well-defined seasonality during winter and a clear relationship between activity of AH3N2 and increase of mortality in all ages, especially in individuals older than 60 years. The mortality due to pneumonia and influenza and respiratory causes associated with 2009 pandemic influenza in the age groups 0–4 years and older than 60 was lower than the previous years. Among people aged 5–19 and 20–59 years the mortality was 2.6 and 4.4 times higher than that in previous periods, respectively. The mortality in all ages was higher than the average of the previous years but was equal mortality in epidemics of AH3N2. The 2009 pandemic influenza mortality showed significant differences compared to other years, especially considering the age groups most affected.

Freitas, Andre Ricardo Ribas; Francisco, Priscila M. S. Bergamo; Donalisio, Maria Rita

2013-01-01

377

Flu vaccine shortage places premium on infection control and surge capacity.  

PubMed

There are several steps you can take today to lessen the impact of flu season on your ED. Combine public education, inoculation, and good hygiene to optimize infection control. Improve surge capacity through targeted cohorting of patients with symptoms of airborne diseases and canceling elective admissions. Put an immediate ban on boarding admitted patients in your hallways. PMID:15605897

2004-12-01

378

Swine-Flu Scare Offers Lessons for Study-Abroad Programs  

ERIC Educational Resources Information Center

Reports of swine flu have led some colleges to pull students and faculty members out of Mexico, the epicenter of the outbreak, and to cancel study-abroad programs there. But even as the number of new cases appears to be falling, the health scare offers some lasting lessons for colleges, says Gary Rhodes, director of the Center for Global Education…

Fischer, Karin

2009-01-01

379

Assessing impacts of SARS and Avian Flu on international tourism demand to Asia  

Microsoft Academic Search

The purpose of this paper is to investigate the impacts of infectious diseases including Avian Flu and severe acute respiratory syndrome (hereafter SARS) on international tourist arrivals in Asian countries using both single datasets and panel data procedures. An autoregressive moving average model together with an exogenous variables (ARMAX) model are used to estimate the effects of these diseases in

Hsiao-I. Kuo; Chi-Chung Chen; Wei-Chun Tseng; Lan-Fen Ju; Bing-Wen Huang

2008-01-01

380

CAN FLU-LIKE ILLNESS BE AN INDICATION OF RECENT ORGANOPHOSPHATE PESTICIDE EXPOSURE IN PRESCHOOL CHILDREN?  

EPA Science Inventory

Can flu-like illness be an indication of recent organophosphate pesticide exposure in preschool children? P Mendola*, D Barr, D Walsh, S Hern, S Rhoney, L Needham, E Hilborn, M Gonzales, C Carty, G Robertson, J Creason (US EPA, ORD, NHEERL, Research Triangle Park, NC 27711) ...

381

It'll Only Hurt a Second? Microeconomic Determinants of Who Gets Flu Shots  

Microsoft Academic Search

Appreciating how propensities to be immunized against the flu depend on individual characteristics and environments is essential if policies regarding influenza control are to be sensibly formulated. Beyond epidemiology, there are some important economic issues that must be addressed if the determinants of this form of preventive care are to be comprehensively understood. One concerns the relationship between labor supply

John Mullahy

1998-01-01

382

Are Pink Slips Better Than Flu Shots? The Effects of Employment on Influenza Rates  

Microsoft Academic Search

The seasonal influenza virus afflicts between five and twenty percent of the U.S. population each year, imposing significant costs on those who fall ill, their families, employers, and the health care system. The flu is transmitted via droplet spread or close contact, and certain environments, such as schools or offices, promote transmission. In this paper, we examine whether increases in

Sara Markowitz; Erik Nesson; Joshua Robinson

2010-01-01

383

It'll only hurt a second? Microeconomic determinants of who gets flu shots  

Microsoft Academic Search

Appreciating how the propensity to be immunized against the flu depends on individual characteristics and environments is essential for policies regarding influenza control to be formulated sensibly. To this point, the literature has offered little documentation on the determinants of influenza immunization. Beyond epidemiology, there are important economic issues that must be addressed to understand this form of preventive care.

John Mullahy

1999-01-01

384

Spatial Transmission of 2009 Pandemic Influenza in the US.  

PubMed

The 2009 H1N1 influenza pandemic provides a unique opportunity for detailed examination of the spatial dynamics of an emerging pathogen. In the US, the pandemic was characterized by substantial geographical heterogeneity: the 2009 spring wave was limited mainly to northeastern cities while the larger fall wave affected the whole country. Here we use finely resolved spatial and temporal influenza disease data based on electronic medical claims to explore the spread of the fall pandemic wave across 271 US cities and associated suburban areas. We document a clear spatial pattern in the timing of onset of the fall wave, starting in southeastern cities and spreading outwards over a period of three months. We use mechanistic models to tease apart the external factors associated with the timing of the fall wave arrival: differential seeding events linked to demographic factors, school opening dates, absolute humidity, prior immunity from the spring wave, spatial diffusion, and their interactions. Although the onset of the fall wave was correlated with school openings as previously reported, models including spatial spread alone resulted in better fit. The best model had a combination of the two. Absolute humidity or prior exposure during the spring wave did not improve the fit and population size only played a weak role. In conclusion, the protracted spread of pandemic influenza in fall 2009 in the US was dominated by short-distance spatial spread partially catalysed by school openings rather than long-distance transmission events. This is in contrast to the rapid hierarchical transmission patterns previously described for seasonal influenza. The findings underline the critical role that school-age children play in facilitating the geographic spread of pandemic influenza and highlight the need for further information on the movement and mixing patterns of this age group. PMID:24921923

Gog, Julia R; Ballesteros, Sébastien; Viboud, Cécile; Simonsen, Lone; Bjornstad, Ottar N; Shaman, Jeffrey; Chao, Dennis L; Khan, Farid; Grenfell, Bryan T

2014-06-01

385

Acceptance of Vaccinations in Pandemic Outbreaks: A Discrete Choice Experiment  

PubMed Central

Background Preventive measures are essential to limit the spread of new viruses; their uptake is key to their success. However, the vaccination uptake in pandemic outbreaks is often low. We aim to elicit how disease and vaccination characteristics determine preferences of the general public for new pandemic vaccinations. Methods In an internet-based discrete choice experiment (DCE) a representative sample of 536 participants (49% participation rate) from the Dutch population was asked for their preference for vaccination programs in hypothetical communicable disease outbreaks. We used scenarios based on two disease characteristics (susceptibility to and severity of the disease) and five vaccination program characteristics (effectiveness, safety, advice regarding vaccination, media attention, and out-of-pocket costs). The DCE design was based on a literature review, expert interviews and focus group discussions. A panel latent class logit model was used to estimate which trade-offs individuals were willing to make. Results All above mentioned characteristics proved to influence respondents’ preferences for vaccination. Preference heterogeneity was substantial. Females who stated that they were never in favor of vaccination made different trade-offs than males who stated that they were (possibly) willing to get vaccinated. As expected, respondents preferred and were willing to pay more for more effective vaccines, especially if the outbreak was more serious (€6–€39 for a 10% more effective vaccine). Changes in effectiveness, out-of-pocket costs and in the body that advises the vaccine all substantially influenced the predicted uptake. Conclusions We conclude that various disease and vaccination program characteristics influence respondents’ preferences for pandemic vaccination programs. Agencies responsible for preventive measures during pandemics can use the knowledge that out-of-pocket costs and the way advice is given affect vaccination uptake to improve their plans for future pandemic outbreaks. The preference heterogeneity shows that information regarding vaccination needs to be targeted differently depending on gender and willingness to get vaccinated.

Determann, Domino; Korfage, Ida J.; Lambooij, Mattijs S.; Bliemer, Michiel; Richardus, Jan Hendrik; Steyerberg, Ewout W.; de Bekker-Grob, Esther W.

2014-01-01

386

Spatial Transmission of 2009 Pandemic Influenza in the US  

PubMed Central

The 2009 H1N1 influenza pandemic provides a unique opportunity for detailed examination of the spatial dynamics of an emerging pathogen. In the US, the pandemic was characterized by substantial geographical heterogeneity: the 2009 spring wave was limited mainly to northeastern cities while the larger fall wave affected the whole country. Here we use finely resolved spatial and temporal influenza disease data based on electronic medical claims to explore the spread of the fall pandemic wave across 271 US cities and associated suburban areas. We document a clear spatial pattern in the timing of onset of the fall wave, starting in southeastern cities and spreading outwards over a period of three months. We use mechanistic models to tease apart the external factors associated with the timing of the fall wave arrival: differential seeding events linked to demographic factors, school opening dates, absolute humidity, prior immunity from the spring wave, spatial diffusion, and their interactions. Although the onset of the fall wave was correlated with school openings as previously reported, models including spatial spread alone resulted in better fit. The best model had a combination of the two. Absolute humidity or prior exposure during the spring wave did not improve the fit and population size only played a weak role. In conclusion, the protracted spread of pandemic influenza in fall 2009 in the US was dominated by short-distance spatial spread partially catalysed by school openings rather than long-distance transmission events. This is in contrast to the rapid hierarchical transmission patterns previously described for seasonal influenza. The findings underline the critical role that school-age children play in facilitating the geographic spread of pandemic influenza and highlight the need for further information on the movement and mixing patterns of this age group.

Gog, Julia R.; Ballesteros, Sebastien; Viboud, Cecile; Simonsen, Lone; Bjornstad, Ottar N.; Shaman, Jeffrey; Chao, Dennis L.; Khan, Farid; Grenfell, Bryan T.

2014-01-01

387

Transmissibility and geographic spread of the 1889 influenza pandemic.  

PubMed

Until now, mortality and spreading mechanisms of influenza pandemics have been studied only for the 1918, 1957, and 1968 pandemics; none have concerned the 19th century. Herein, we examined the 1889 "Russian" pandemic. Clinical attack rates were retrieved for 408 geographic entities in 14 European countries and in the United States. Case fatality ratios were estimated from datasets in the French, British and German armies, and morbidity and mortality records of Swiss cities. Weekly all-cause mortality was analyzed in 96 European and American cities. The pandemic spread rapidly, taking only 4 months to circumnavigate the planet, peaking in the United States 70 days after the original peak in St. Petersburg. The median and interquartile range of clinical attack rates was 60% (45-70%). The case fatality ratios ranged from 0.1% to 0.28%, which is comparable to those of 1957 and 1968, and 10-fold lower than in 1918. The median basic reproduction number (R(0)) was 2.1, which is comparable to the values found for the other pandemics, despite the different viruses and contact networks. R(0) values varied widely from one city to another, and only a small minority of those values was within the range in which modelers' mitigation scenarios predicted effectiveness. The 1889 and 1918 R(0) correlated for the subset of cities for which both values were available. Social and geographic factors probably shape the local R(0) , and they could be identified to design optimal mitigation scenarios tailored to each city. PMID:20421481

Valleron, Alain-Jacques; Cori, Anne; Valtat, Sophie; Meurisse, Sofia; Carrat, Fabrice; Boëlle, Pierre-Yves

2010-05-11

388

The H1N1 pandemic: media frames, stigmatization and coping  

PubMed Central

Background Throughout history, people have soothed their fear of disease outbreaks by searching for someone to blame. Such was the case with the April 2009 H1N1 flu outbreak. Mexicans and other Latinos living in the US were quickly stigmatized by non-Latinos as carriers of the virus, partly because of news reports on the outbreak’s alleged origin in Mexican pig farms. Methods In this exploratory study we examined the psychological processes of cue convergence and associative priming, through which many people likely conflated news of the H1N1 outbreak with pre-existing cognitive scripts that blamed Latino immigrants for a variety of social problems. We also used a transactional model of stress and coping to analyze the transcripts from five focus groups, in order to examine the ways in which a diverse collection of New England residents appraised the threat of H1N1, processed information about stereotypes and stigmas, and devised personal strategies to cope with these stressors. Results Twelve themes emerged in the final wave of coding, with most of them appearing at distinctive points in the stress and coping trajectories of focus group participants. Primary and secondary appraisals were mostly stressful or negative, with participants born in the USA reporting more stressful responses than those who were not. Latino participants reported no stressful primary appraisals, but spoke much more often than Whites or Non-Hispanic Blacks about negative secondary appraisals. When interactions between participants dealt with stigmas regarding Latinos and H1N1, Latinos in our focus groups reported using far more negative coping strategies than Whites or Non-Hispanic Blacks. When discussions did not focus on stereotypes or stigmas, Latino participants spoke much more often about positive coping strategies compared to members of these same groups. Conclusions Participants in all five focus groups went through a similar process of stress and coping in response to the threat of H1N1, though individual responses varied by race and ethnicity. Stigmatization has often been common during pandemics, and public health and emergency preparedness practitioners can help to mitigate its impacts by developing interventions to address the social stressors that occur during outbreaks in highly-localized geographic regions.

2013-01-01

389

Th1 and Th17 hypercytokinemia as early host response signature in severe pandemic influenza  

PubMed Central

Introduction Human host immune response following infection with the new variant of A/H1N1 pandemic influenza virus (nvH1N1) is poorly understood. We utilize here systemic cytokine and antibody levels in evaluating differences in early immune response in both mild and severe patients infected with nvH1N1. Methods We profiled 29 cytokines and chemokines and evaluated the haemagglutination inhibition activity as quantitative and qualitative measurements of host immune responses in serum obtained during the first five days after symptoms onset, in two cohorts of nvH1N1 infected patients. Severe patients required hospitalization (n = 20), due to respiratory insufficiency (10 of them were admitted to the intensive care unit), while mild patients had exclusively flu-like symptoms (n = 15). A group of healthy donors was included as control (n = 15). Differences in levels of mediators between groups were assessed by using the non parametric U-Mann Whitney test. Association between variables was determined by calculating the Spearman correlation coefficient. Viral load was performed in serum by using real-time PCR targeting the neuraminidase gene. Results Increased levels of innate-immunity mediators (IP-10, MCP-1, MIP-1?), and the absence of anti-nvH1N1 antibodies, characterized the early response to nvH1N1 infection in both hospitalized and mild patients. High systemic levels of type-II interferon (IFN-?) and also of a group of mediators involved in the development of T-helper 17 (IL-8, IL-9, IL-17, IL-6) and T-helper 1 (TNF-?, IL-15, IL-12p70) responses were exclusively found in hospitalized patients. IL-15, IL-12p70, IL-6 constituted a hallmark of critical illness in our study. A significant inverse association was found between IL-6, IL-8 and PaO2 in critical patients. Conclusions While infection with the nvH1N1 induces a typical innate response in both mild and severe patients, severe disease with respiratory involvement is characterized by early secretion of Th17 and Th1 cytokines usually associated with cell mediated immunity but also commonly linked to the pathogenesis of autoimmune/inflammatory diseases. The exact role of Th1 and Th17 mediators in the evolution of nvH1N1 mild and severe disease merits further investigation as to the detrimental or beneficial role these cytokines play in severe illness.

2009-01-01

390

An Evaluation of Community Assessment Tools (CATs) in Predicting Use of Clinical Interventions and Severe Outcomes during the A(H1N1)pdm09 Pandemic  

PubMed Central

During severe influenza pandemics healthcare demand can exceed clinical capacity to provide normal standards of care. Community Assessment Tools (CATs) could provide a framework for triage decisions for hospital referral and admission. CATs have been developed based on evidence that supports the recognition of severe influenza and pneumonia in the community (including resource limited settings) for adults, children and infants, and serious feverish illness in children. CATs use six objective criteria and one subjective criterion, any one or more of which should prompt urgent referral and admission to hospital. A retrospective evaluation of the ability of CATs to predict use of hospital-based interventions and patient outcomes in a pandemic was made using the first recorded routine clinical assessment on or shortly after admission from 1520 unselected patients (800 female, 480 children <16 years) admitted with PCR confirmed A(H1N1)pdm09 infection (the FLU-CIN cohort). Outcome measures included: any use of supplemental oxygen; mechanical ventilation; intravenous antibiotics; length of stay; intensive or high dependency care; death; and “severe outcome” (combined: use of intensive or high dependency care or death during admission). Unadjusted and multivariable analyses were conducted for children (age <16 years) and adults. Each CATs criterion independently identified both use of clinical interventions that would in normal circumstances only be provided in hospital and patient outcome measures. “Peripheral oxygen saturation ?92% breathing air, or being on oxygen” performed well in predicting use of resources and outcomes for both adults and children; supporting routine measurement of peripheral oxygen saturation when assessing severity of disease. In multivariable analyses the single subjective criterion in CATs “other cause for clinical concern” independently predicted death in children and in adults predicted length of stay, mechanical ventilation and “severe outcome”; supporting the role of clinical acumen as an important independent predictor of serious illness.

Nicholson, Karl G.; Lim, Wei Shen; Read, Robert C.; Taylor, Bruce L.; Brett, Stephen J.; Openshaw, Peter J. M.; Enstone, Joanne E.; McMenamin, James; Bannister, Barbara; Nguyen-Van-Tam, Jonathan S.

2013-01-01

391

Occurrence of AH1N1 viral infection and clinical features in symptomatic patients who received medical care during the 2009 influenza pandemic in Central Mexico  

PubMed Central

Background In 2009 a new influenza serotype (AH1N1) was identified in Mexico that spread rapidly generating worldwide alarm. San Luis Potosi (SLP) was the third state with more cases reported in that year. The clinical identification of this flu posed a challenge to medical staff. This study aimed at estimating the AH1N1 infection, hospitalization and mortality rates, and at identifying related clinical features in persons who received medical care during the influenza pandemic. Methods Retrospective study with persons with flu-like illness who received public or private medical care in SLP from 15.03.09 to 30.10.09. Physicians purposely recorded many clinical variables. Samples from pharyngeal exudate or bronchoalveolar lavage were taken to diagnose AH1N1 using real-time PCR. Clinical predictors were identified using multivariate logistic regression with infection as a dependent variable. Odds ratios (OR) with 95% confidence intervals (CI) were computed. Analyses were stratified by age group based on the distribution of positive cases. Results From the 6922 persons with flu symptoms 6158 had available laboratory results from which 44.9% turned out to be positive for AH1N1. From those, 5.8% were hospitalized and 0.7% died. Most positive cases were aged 5–14 years and, in this subgroup, older age was positively associated with A H1N1 infection (95% CI 1.05-1.1); conversely, in patients aged 15 years or more, older age was negatively associated with the infection (95% CI 0.97-0.98). Fever was related in those aged 15 years or more (95% CI 1.4-3.5), and headache (95% CI 1.2-2.2) only in the 0–14 years group. Clear rhinorrhea and cough were positively related in both groups (p?

2012-01-01

392

The spatiotemporal association of non-prescription retail sales with cases during the 2009 influenza pandemic in Great Britain  

PubMed Central

Objective To assess whether retail sales of non-prescription products can be used for syndromic surveillance and whether it can detect influenza activity at different spatial scales. A secondary objective was to assess whether changes in purchasing behaviour were related to public health advice or levels of media or public interest. Setting The UK. Participants National and regional influenza case estimates and retail sales from a major British supermarket. Outcome measures Weekly, seasonally adjusted sales of over-the-counter symptom remedies and non-pharmaceutical products; recommended as part of the advice offered by public health agencies; were compared with weekly influenza case estimates. Comparisons were made at national and regional spatial resolutions. We also compared sales to national measures of contemporaneous media output and public interest (Internet search volume) related to the pandemic. Results At a national scale there was no significant correlation between retail sales of symptom remedies and cases for the whole pandemic period in 2009. At the regional scale, a minority of regions showed statistically significant positive correlations between cases and sales of adult ‘cold and flu’ remedies and cough remedies (3.2%, 5/156, 3.8%, 6/156), but a greater number of regions showed a significant positive correlation between cases and symptomatic remedies for children (35.6%, 55/156). Significant positive correlations between cases and sales of thermometers and antiviral hand gels/wash were seen at both spatial scales (Cor 0.477 (95% CI 0.171 to 0.699); 0.711 (95% CI 0.495 to 0.844)). We found no significant association between retail sales and media reporting or Internet search volume. Conclusions This study provides evidence that the British public responded appropriately to health messaging about hygiene. Non-prescription retail sales at a national level are not useful for the detection of cases. However, at finer spatial scales, in particular age-groups, retail sales may help augment existing surveillance and merit further study.

Todd, Stacy; Diggle, Peter J; White, Peter J; Fearne, Andrew; Read, Jonathan M

2014-01-01

393

Nationwide Surveillance of Influenza during the Pandemic (2009-10) and Post-Pandemic (2010-11) Periods in Taiwan  

PubMed Central

Introduction Although WHO declared the world moving into the post-pandemic period on August 10, 2010, influenza A(H1N1) 2009 virus continued to circulate globally. Its impact was expected to continue during the 2010–11 influenza season. This study describes the nationwide surveillance findings of the pandemic and post-pandemic influenza periods in Taiwan and assesses the impact of influenza A(H1N1) 2009 during the post-pandemic period. Methods The Influenza Laboratory Surveillance Network consisted of 12 contract laboratories for collecting and testing samples with acute respiratory tract infections. Surveillance of emergency room visits and outpatient department visits for influenza-like illness (ILI) were conducted using the Real-Time Outbreak and Disease Surveillance system and the National Health Insurance program data, respectively. Hospitalized cases with severe complications and deaths were reported to the National Notifiable Disease Surveillance System. Results During the 2009–10 influenza season, pandemic A(H1N1) 2009 was the predominant circulating strain and caused 44 deaths. However, the 2010–11 influenza season began with A(H3N2) being the predominant circulating strain, changing to A(H1N1) 2009 in December 2010. Emergency room and outpatient department ILI surveillance displayed similar trends. By March 31, 2011, there were 1,751 cases of influenza with severe complications; 50.1% reported underlying diseases. Of the reported cases, 128 deaths were associated with influenza. Among these, 93 (72.6%) were influenza A(H1N1) 2009 and 30 (23.4%) A(H3N2). Compared to the pandemic period, during the immediate post-pandemic period, increased number of hospitalizations and deaths were observed, and the patients were consistently older. Conclusions Reemergence of influenza A(H1N1) 2009 during the 2010–11 influenza season had an intense activity with age distribution shift. To further mitigate the impact of future influenza epidemics, Taiwan must continue its multifaceted influenza surveillance systems, remain flexible with antiviral use policies, and revise the vaccine policies to include the population most at risk.

Chuang, Jen-Hsiang; Huang, Angela S.; Huang, Wan-Ting; Liu, Ming-Tsan; Chou, Jih-Haw; Chang, Feng-Yee; Chiu, Wen-Ta

2012-01-01

394

Pandemic influenza - including a risk assessment of H5N1  

PubMed Central

Summary Influenza pandemics and epidemics have apparently occurred since at least the Middle Ages. When pandemics appear, 50% or more of an affected population can be infected in a single year, and the number of deaths caused by influenza can dramatically exceed what is normally expected. Since 1500, there appear to have been 13 or more influenza pandemics. In the past 120 years there were undoubted pandemics in 1889, 1918, 1957, 1968, and 1977. Although most experts believe we will face another influenza pandemic, it is impossible to predict when it will appear, where it will originate, or how severe it will be. Nor is there agreement about the subtype of influenza virus most likely to cause the next pandemic. The continuing spread of H5N1 highly pathogenic avian influenza viruses has heightened interest in pandemic prediction. Despite uncertainties in the historical record of the pre-virology era, study of previous pandemics may help guide future pandemic planning and lead to a better understanding of the complex ecobiology underlying the formation of pandemic strains of influenza A viruses.

Taubenberger, J.K.; Morens, D.M.

2009-01-01

395

Flu Preparations Underscore Schools' Key Role in Vaccinations: Research Confirms Exemptions Lead to Higher Disease Incidence  

ERIC Educational Resources Information Center

At the beginning of each school year, the school-nurse coordinator for the 3,000-student Ashland, Oregon, district plans a "parent's night" around the topic of vaccinations for the safety and health of children. That is only the beginning of the school-nurse coordinator's contact with parents who are skeptical about the necessity of immunizations,…

Samuels, Christina A.

2009-01-01

396

The impact of the 1918 Spanish flu epidemic on economic performance in Sweden: An investigation into the consequences of an extraordinary mortality shock.  

PubMed

We study the impact of the 1918 influenza pandemic on short- and medium-term economic performance in Sweden. The pandemic was one of the severest and deadliest pandemics in human history, but it has hitherto received only scant attention in the economic literature - despite representing an unparalleled labour supply shock. In this paper, we exploit seemingly exogenous variation in incidence rates between Swedish regions to estimate the impact of the pandemic. The pandemic led to a significant increase in poorhouse rates. There is also evidence that capital returns were negatively affected by the pandemic. However, contrary to predictions, we find no discernible effect on earnings. PMID:24721206

Karlsson, Martin; Nilsson, Therese; Pichler, Stefan

2014-07-01

397

Combined inhalational and oral supplementation of ascorbic acid may prevent influenza pandemic emergency: a hypothesis.  

PubMed

Occurrence of influenza pandemics is a worldwide phenomenon and a significant cause of mortality and morbidity throughout the globe. It is due to mutations in the influenza virus genetic material creating antigenic drift of pathogenic viral proteins resulting in emergence of new influenza virus strains. Therefore, the vaccines available for prevention of influenza offer no protection against influenza pandemics caused by new virus strains. Moreover, the existing drugs used to combat influenza may be ineffective to treat influenza pandemics due to the emergence of drug resistance in the pandemic virus strain. Therefore, a working strategy must be developed to combat influenza pandemics. In this review we have addressed this problem and reviewed the published studies on ascorbic acid in the common cold and influenza and laboratory studies on the effect of ascorbic acid on influenza virus. We have also correlated the clinical and laboratory studies and developed a hypothesis to prevent influenza pandemics. PMID:20005468

Banerjee, Dibyajyoti; Kaul, Deepak

2010-01-01

398

Age distribution of cases and deaths during the 1889 influenza pandemic.  

PubMed

Using historical data taken from archival records from five European countries and the United States, we evaluate the age distributions of influenza cases and deaths during the 1889 influenza pandemic. We found that the clinical attack rate in 1889 was relatively high and constant between the ages of 1 and 60 years, but was lower outside of the extremes of this age range. By contrast, age-specific influenza-related mortality rates were J-shaped and increased with age beyond 20 years. We conclude that the age-specific attack rates of the 1889 pandemic were most similar to those of the 1968 pandemic and that influenza-related mortality rates did not follow a W-shaped curve as was observed during the 1918 pandemic. Adding 1889 to the short catalogue of influenza pandemics previously studied makes the 1918 pandemic even more exceptional in terms of mortality burden and age distribution of deaths. PMID:21757106

Valtat, Sophie; Cori, Anne; Carrat, Fabrice; Valleron, Alain-Jacques

2011-07-22

399

Lessons from the NSW laboratory response to pandemic (H1N1) 2009 influenza.  

PubMed

Procedures undertaken by NSW Health in the laboratory response to pandemic (H1N1) 2009 influenza were reviewed to assist planning for a future infectious disease emergency. Laboratory plans developed prior to the pandemic sought rapid detection of pandemic virus in the early phases of the pandemic response until demonstration of widespread community transmission, followed then by limited testing when indicated clinically. As planned, the laboratory response was based on the Pandemic Influenza Management System with a web-based outbreak management tool, NetEpi, as the single public health database used for cases and test results. This was found to be effective for tracking specimens and results, and enhanced the public health response. The sustained large volume of community testing during this mild pandemic had an adverse effect on the timely delivery of priority results. PMID:20374693

Adamson, Sheena; Fizzell, Jan; Dwyer, Dominic E; Rawlinson, William; Armstrong, Paul K

2010-01-01

400

National Institute for Occupational Safety and Health (NIOSH) ALERT: Protecting Poultry Workers from Avian Influenza (Bird Flu).  

National Technical Information Service (NTIS)

The National Institute for Occupational Safety and Health (NIOSH) requests help in protecting poultry workers from infection with viruses that cause avian influenza (also known as bird flu). Although human infection with avian influenza viruses is rare, w...

G. Kullman, J. Decker, K. MacMahon, L. J. Delaney

2008-01-01

401

Low Acceptability of A/H1N1 Pandemic Vaccination in French Adult Population: Did Public Health Policy Fuel Public Dissonance?  

PubMed Central

Background In July 2009, French public health authorities embarked in a mass vaccination campaign against A/H1N1 2009 pandemic-influenza. We explored the attitudes and behaviors of the general population toward pandemic vaccination. Methodology/Principal Findings We conducted a cross-sectional online survey among 2,253 French representative adults aged 18 to 64 from November 17 to 25, 2009 (completion rate: 93.8%). The main outcome was the acceptability of A/H1N1 vaccination as defined by previous receipt or intention to get vaccinated (“Yes, certainly”, “Yes, probably”). Overall 17.0% (CI 95%, 15.5% to 18.7%) of respondents accepted A/H1N1 vaccination. Independent factors associated with acceptability included: male sex (p?=?.0001); older age (p?=?.002); highest or lowest level of education (p?=?.016); non-clerical occupation (p?=?.011); having only one child (p?=?.008); and having received seasonal flu vaccination in prior 3 years (p<.0001). Acceptability was also significantly higher among pregnant women (37.9%) and other at risk groups with chronic diseases (34.8%) (p?=?.002). Only 35.5% of respondents perceived A/H1N1 influenza illness as a severe disease and 12.7% had experienced A/H1N1 cases in their close relationships with higher acceptability (p<.0001 and p?=?.006, respectively). In comparison to 26.0% respondents who did not consult their primary care physician, acceptability was significantly higher among 8.0% respondents who were formally advised to get vaccinated, and lower among 63.7% respondents who were not advised to get vaccinated (respectively: 15.8%, 59.5% and 11.7%- p<.0001). Among respondents who refused vaccination, 71.2% expressed concerns about vaccine safety. Conclusions/Significance Our survey occurred one week before the peak of the pandemic in France. We found that alarming public health messages aiming at increasing the perception of risk severity were counteracted by daily personal experience which did not confirm the threat, while vaccine safety was a major issue. This dissonance may have been amplified by having not involved primary care physicians in the mass vaccination campaign.

Schwarzinger, Michael; Flicoteaux, Remi; Cortarenoda, Sebastien; Obadia, Yolande; Moatti, Jean-Paul

2010-01-01

402

Optimizing Tactics for use of the U.S. Antiviral Strategic National Stockpile for Pandemic (H1N1) Influenza, 2009  

PubMed Central

Public health agencies across the globe are working to mitigate the impact of the 2009 pandemic caused by swine-origin influenza A (H1N1) virus. Prior to the large-scale distribution of an effective vaccine, the primary modes of control have included careful surveillance, social distancing and hygiene measures, strategic school closures, other community measures, and the prudent use of antiviral medications to prevent infection (prophylaxis) or reduce the severity and duration of symptoms (treatment). Here, we use mathematical models to determine the optimal geo-temporal tactics for distributing the U.S. strategic national stockpile of antivirals for treatment of infected cases during the early stages of a pandemic, prior to the wide availability of vaccines. We present a versatile optimization method for efficiently searching large sets of public health intervention strategies, and apply it to evaluating tactics for distributing antiviral medications from the U.S. Strategic National Stockpile (SNS). We implemented the algorithm on a network model of H1N1 transmission within and among U.S. cities to project the epidemiological impacts of antiviral stockpile distribution schedules and priorities. The resulting optimized strategies critically depend on the rates of antiviral uptake and wastage (through misallocation or loss). And while a surprisingly simple pro rata distribution schedule is competitive with the optimized strategies across a wide range of uptake and wastage, other equally simple policies perform poorly. Even as vaccination campaigns get underway worldwide, antiviral medications continue to play a critical in reducing H1N1-associated morbidity and mortality. If efforts are made to increase the fraction of cases treated promptly with antivirals above current levels, our model suggests that optimal use of the antiviral component of the Strategic National Stockpile may appreciably slow the transmission of H1N1 during fall 2009, thereby improving the impact of targeted vaccination. A more aggressive optimized antiviral strategy of this type may prove critical to mitigating future flu pandemics, but may increase the risk of antiviral resistance.

Dimitrov, Nedialko; Goll, Sebastian; Meyers, Lauren Ancel; Pourbohloul, Babak; Hupert, Nathaniel

2009-01-01

403

Were Equatorial Regions Less Affected by the 2009 Influenza Pandemic? The Brazilian Experience  

PubMed Central

Although it is in the Tropics where nearly half of the world population lives and infectious disease burden is highest, little is known about the impact of influenza pandemics in this area. We investigated the mortality impact of the 2009 influenza pandemic relative to mortality rates from various outcomes in pre-pandemic years throughout a wide range of latitudes encompassing the entire tropical, and part of the subtropical, zone of the Southern Hemisphere (+5°N to ?35°S) by focusing on a country with relatively uniform health care, disease surveillance, immunization and mitigation policies: Brazil. To this end, we analyzed laboratory-confirmed deaths and vital statistics mortality beyond pre-pandemic levels for each Brazilian state. Pneumonia, influenza and respiratory mortality were significantly higher during the pandemic, affecting predominantly adults aged 25 to 65 years. Overall, there were 2,273 and 2,787 additional P&I- and respiratory deaths during the pandemic, corresponding to a 5.2% and 2.7% increase, respectively, over average pre-pandemic annual mortality. However, there was a marked spatial structure in mortality that was independent of socio-demographic indicators and inversely related with income: mortality was progressively lower towards equatorial regions, where low or no difference from pre-pandemic mortality levels was identified. Additionally, the onset of pandemic-associated mortality was progressively delayed in equatorial states. Unexpectedly, there was no additional mortality from circulatory causes. Comparing disease burden reliably across regions is critical in those areas marked by competing health priorities and limited resources. Our results suggest, however, that tropical regions of the Southern Hemisphere may have been disproportionally less affected by the pandemic, and that climate may have played a key role in this regard. These findings have a direct bearing on global estimates of pandemic burden and the assessment of the role of immunological, socioeconomic and environmental drivers of the transmissibility and severity of this pandemic.

Schuck-Paim, Cynthia; Viboud, Cecile; Simonsen, Lone; Miller, Mark A.; Moura, Fernanda E. A.; Fernandes, Roberto M.; Carvalho, Marcia L.; Alonso, Wladimir J.

2012-01-01

404

Seroepidemiology of pandemic influenza A (H1N1) 2009 virus infections in Pune, India  

Microsoft Academic Search

BACKGROUND: In India, Pune was one of the badly affected cities during the influenza A (H1N1) 2009 pandemic. We undertook serosurveys among the risk groups and general population to determine the extent of pandemic influenza A (H1N1) 2009 virus infections. METHODS: Pre-pandemic sera from the archives, collected during January 2005 to March 2009, were assayed for the determination of baseline

Babasaheb V Tandale; Shailesh D Pawar; Yogesh K Gurav; Mandeep S Chadha; Santosh S Koratkar; Vijay N Shelke; Akhilesh C Mishra

2010-01-01

405

Public perceptions, anxiety, and behaviour change in relation to the swine flu outbreak: cross sectional telephone survey  

Microsoft Academic Search

Objective To assess whether perceptions of the swine flu outbreak predicted changes in behaviour among members of the public in England, Scotland, and Wales.Design Cross sectional telephone survey using random digit dialling.Setting Interviews by telephone between 8 and 12 May.Participants 997 adults aged 18 or more who had heard of swine flu and spoke English.Main outcome measures Recommended change in

G James Rubin; Richard Amlôt; Lisa Page; Simon Wessely

2009-01-01

406

Monitoring Influenza Activity in the United States: A Comparison of Traditional Surveillance Systems with Google Flu Trends  

Microsoft Academic Search

BackgroundGoogle Flu Trends was developed to estimate US influenza-like illness (ILI) rates from internet searches; however ILI does not necessarily correlate with actual influenza virus infections.Methods and FindingsInfluenza activity data from 2003–04 through 2007–08 were obtained from three US surveillance systems: Google Flu Trends, CDC Outpatient ILI Surveillance Network (CDC ILI Surveillance), and US Influenza Virologic Surveillance System (CDC Virus

Justin R. Ortiz; Hong Zhou; David K. Shay; Kathleen M. Neuzil; Ashley L. Fowlkes; Christopher H. Goss; Vernon Lee

2011-01-01

407

The 2009 H1N1 Influenza Pandemic: the role of threat, coping, and media trust on vaccination intentions in Canada.  

PubMed

Swine flu (H1N1) reached pandemic proportions in 2009, yet ambivalence was met concerning intentions to be vaccinated. The present investigation determined predictors of perceived H1N1 contraction risk and vaccination intentions among Canadian adults (N = 1,027) responding to an online questionnaire. The relatively low rate of vaccination intent (30.12%, and 34.99% being unsure of their intent) was related to a sense of invulnerability regarding illness contraction and symptom severity. Most individuals were skeptical that H1N1 would be widespread, believing that less than 10% of the population would contract H1N1. Yet, they also indicated that their attitudes would change once a single person they knew contracted the illness. Also, worry regarding H1N1 was related to self-contraction risk and odds of individuals seeking vaccination. Moreover, vaccination intent was related to the perception that the threat was not particularly great, mistrust of the media to provide accurate information regarding H1N1, and whether individuals endorsed problem-focused versus avoidant coping strategies. Given the role media plays in public perceptions related to a health crisis, trust in this outlet and credibility regarding the threat are necessary for adherence to recommended measures to minimize health risk. PMID:23301849

Taha, Sheena Aislinn; Matheson, Kimberly; Anisman, Hymie

2013-01-01

408

Pandemic A(H1N1)2009 influenza vaccination in Lyon University Hospitals, France: perception and attitudes of hospital workers.  

PubMed

Health-care authorities encouraged A(H1N1)2009 influenza vaccination for all hospital workers because of their high risk of contracting and transmitting the virus. Six months after the vaccination campaign began, an electronic anonymous questionnaire was completed by 1630 among 14,000 hospital workers (11.6%). Vaccination rate was 54.3%. Independent predictors for vaccination acceptance were advanced age (OR=1.61-2.19), being a physician (OR=5.07), working in gynaecology-obstetrics or podiatry (OR=1.62), and having been informed about vaccination (OR=2.78). The main reasons for getting vaccinated were to avoid flu for relatives (82.4%), themselves (65.8%) and patients (57.1%). Arguments against vaccination were lack of sufficient studies of the vaccine (75.7%) and the perception of A(H1N1)2009 influenza as a benign disease (51.5%). Vaccination coverage would be insufficient to keep the health-care system operating at maximum capacity during a severe pandemic disease, and to avoid nosocomial transmission of influenza. These results suggest a better-targeted vaccination campaign. PMID:23219437

Valour, F; Bénet, T; Chidiac, C

2013-01-11

409

Strategies for containing an emerging influenza pandemic in Southeast Asia  

Microsoft Academic Search

Highly pathogenic H5N1 influenza A viruses are now endemic in avian populations in Southeast Asia, and human cases continue to accumulate. Although currently incapable of sustained human-to-human transmission, H5N1 represents a serious pandemic threat owing to the risk of a mutation or reassortment generating a virus with increased transmissibility. Identifying public health interventions that might be able to halt a

Neil M. Ferguson; Derek A. T. Cummings; Simon Cauchemez; Christophe Fraser; Steven Riley; Aronrag Meeyai; Sopon Iamsirithaworn; Donald S. Burke

2005-01-01

410

Quantifying the Routes of Transmission for Pandemic Influenza  

Microsoft Academic Search

Motivated by the desire to assess nonpharmaceutical interventions for pandemic influenza, we seek in this study to quantify\\u000a the routes of transmission for this disease. We construct a mathematical model of aerosol (i.e., droplet-nuclei) and contact\\u000a transmission of influenza within a household containing one infected. An analysis of this model in conjunction with influenza\\u000a and rhinovirus data suggests that aerosol

Michael P. Atkinsona; Lawrence M. Wein

2008-01-01

411

Economic Value of Seasonal and Pandemic Influenza Vaccination During Pregnancy  

PubMed Central

Background The cost-effectiveness of maternal influenza immunization against laboratory-confirmed influenza has never been studied. The current 2009 H1N1 influenza pandemic provides a timely opportunity to perform such analyses. The study objective was to evaluate the cost-effectiveness of maternal influenza vaccination using both single and two-dosing strategies against laboratory-confirmed influenza secondary to both seasonal epidemics and pandemic influenza outbreaks. Methods A cost-effectiveness decision analytic model construct using epidemic and pandemic influenza characteristics from both the societal and third-party payor perspectives. A comparison was made between vaccinating all pregnant women in the United States versus not vaccinating pregnant women. Probabilistic (Monte Carlo) sensitivity analyses were also performed. The main outcome measures were incremental cost-effectiveness ratios (ICERs). Results Maternal influenza vaccination using either the single or two-dose strategy is a cost-effective approach when influenza prevalence greater than or equal to 7.5% and influenza-attributable mortality is greater than or equal to 1.05% (consistent with epidemic strains). As the prevalence of influenza and/or the severity of the outbreak increases the incremental value of vaccination also increases. At a higher prevalence of influenza (?30%) the single-dose strategy demonstrates cost-savings while the two-dose strategy remains highly cost-effective (ICER ? $6,787.77 per quality adjusted life year). Conclusions Maternal influenza immunization is a highly cost-effective intervention at disease rates and severity that correspond to both seasonal influenza epidemics and occasional pandemics. These findings justify ongoing efforts to optimize influenza vaccination during pregnancy from an economic perspective.

Beigi, Richard H.; Wiringa, Ann E.; Bailey, Rachel; Assi, Tina-Marie; Lee, Bruce Y.

2010-01-01

412

H5N1 influenza: A protean pandemic threat  

Microsoft Academic Search

vian influenza viruses pose significant threats to animal and human health. They are a source of genetic diversity that permits the emergence of pandemic influenza by means of genetic reassortment with prevailing human influenza viruses (1). In recent years, purely avian influenza viruses of subtypes H5N1 and H7N7 have crossed the species barrier to directly cause fatal disease in humans

Y. Guan; L. L. M. Poon; C. Y. Cheung; T. M. Ellis; W. Lim; A. S. Lipatov; K. H. Chan; K. M. Sturm-Ramirez; C. L. Cheung; Y. H. C. Leung; K. Y. Yuen; R. G. Webster; J. S. M. Peiris

2004-01-01

413

Lessons learned from the 1918–1919 influenza pandemic  

Microsoft Academic Search

The 1918 influenza pandemic was one of the most virulent strains of influenza in history. Phylogenic evidence of the novel\\u000a H1N1 strain of influenza discovered in Mexico last spring (2009) links it to the 1918 influenza strain. With information gained\\u000a from analyzing viral genetics, public health records and advances in medical science we can confront the 2009 H1N1 influenza\\u000a on

James E. Hollenbeck

2009-01-01

414

The Emergence of 2009 H1N1 Pandemic Influenza  

Microsoft Academic Search

\\u000a The emergence of a novel H1N1 virus in Mexico and the USA in spring 2009 and its rapid spread around the globe has led the\\u000a World Health Organization to declare the first pandemic of the twenty-first century. Employing almost real-time sequencing\\u000a technologies and disseminating this information freely and widely has permitted the most intensive investigation of the origins\\u000a and evolution

Benjamin Greenbaum; Vladimir Trifonov; Hossein Khiabanian; Arnold Levine; Raul Rabadan

415

Crossing the species barrier: the threat of an avian influenza pandemic  

PubMed Central

Avian influenza (H5N1) has recently been recognized as a new emerging infectious disease that may pose a threat to international public health. Most recent developments lead to the belief that H5N1 could become the cause of the next influenza pandemic. This review discusses the characteristics of H5N1 avian influenza virus as an emerging infectious disease with the potential for pandemic development. In addition, the current pandemic influenza alert status and guidelines for pandemic preparedness, treatment, and prevention are discussed.

2006-01-01

416

Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza  

SciTech Connect

The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

ORAU's Oak Ridge Institute for Science Education (HCTT-CHE)

2011-04-14

417

Responses to Pandemic (H1N1) 2009, Australia  

PubMed Central

In 2007, adults in Australia were interviewed about their willingness to comply with potential health interventions during a hypothetical influenza outbreak. After the first wave of pandemic (H1N1) 2009 in Australia, many of the same respondents were interviewed about behavior and protection measures they actually adopted. Of the original 1,155 respondents, follow-up interviews were conducted for 830 (71.9%). Overall, 20.4% of respondents in 2009 had recently experienced influenza-like illness, 77.7% perceived pandemic (H1N1) 2009 to be mild, and 77.8% reported low anxiety. Only 14.5% could correctly answer 4 questions about influenza virus transmission, symptoms, and infection control. Some reported increasing handwashing (46.6%) and covering coughs and sneezes (27.8%) to reduce transmission. Compared with intentions reported in 2007, stated compliance with quarantine or isolation measures in 2009 remained high. However, only respondents who perceived pandemic (H1N1) 2009 as serious or who had attained higher educational levels expressed intention to comply with social distancing measures.

Durrheim, David N.; Butler, Michelle; Jones, Alison

2010-01-01

418

Nonpharmaceutical Interventions for Military Populations During Pandemic Influenza  

PubMed Central

Influenza causes substantial illness and loss of work days among young adults, and outbreaks can affect the preparedness of military units. In an influenza pandemic, people who live in confined settings have greater risk of infection. Military trainees are at particularly high risk. Because of likely unavailability of vaccines and antiviral drugs at the start of a pandemic and for many months thereafter, nonpharmaceutical interventions may be very important. During a pandemic, it seems prudent that military public health officials employ at least several nonpharmaceutical interventions. For example frequent handwashing and respiratory hygiene/cough etiquette should be strongly encouraged among soldiers. Head-to-toe sleeping, a “no-cost” intervention should be for crowded berthing areas. Isolation of patients with influenza and quarantine of their close contacts should be employed. Masks and alcohol-based hand rubs may be employed among those at highest risk. Finally, whenever possible military planners should, reduce crowding and limit the interaction of training cohorts to reduce risk of influenza virus transmission.

Kilic, Selim; Gray, Gregory C.

2008-01-01

419

Nonpharmaceutical Interventions for Military Populations During Pandemic Influenza.  

PubMed

Influenza causes substantial illness and loss of work days among young adults, and outbreaks can affect the preparedness of military units. In an influenza pandemic, people who live in confined settings have greater risk of infection. Military trainees are at particularly high risk. Because of likely unavailability of vaccines and antiviral drugs at the start of a pandemic and for many months thereafter, nonpharmaceutical interventions may be very important. During a pandemic, it seems prudent that military public health officials employ at least several nonpharmaceutical interventions. For example frequent handwashing and respiratory hygiene/cough etiquette should be strongly encouraged among soldiers. Head-to-toe sleeping, a "no-cost" intervention should be for crowded berthing areas. Isolation of patients with influenza and quarantine of their close contacts should be employed. Masks and alcohol-based hand rubs may be employed among those at highest risk. Finally, whenever possible military planners should, reduce crowding and limit the interaction of training cohorts to reduce risk of influenza virus transmission. PMID:18516249

Kiliç, Selim; Gray, Gregory C

2007-01-01

420

Increase Human Metapneumovirus Mediated Morbidity following Pandemic Influenza Infection  

PubMed Central

Human metapneumovirus (hMPV) is a recently discovered respiratory pathogen, infecting mainly young children. The infected patients suffer from influenza like symptoms (ILS). In Israel the virus is mainly circulating in February to March. Here we report on an increased rate of hMPV infection in the winter season of 2009–10. The 2009–10 infection had several unique characteristics when compared to previous seasons; it started around January and a large number of infants were infected by the virus. Genetic analysis based on the viral L and F genes of hMPV showed that only subtypes A2 and B2 circulated in Israel. Additionally, we have identified a novel variant of hMPV within subgroup A2b, which subdivide it into A2b1 and A2b2. Finally, we showed that the hMPV infection was detected in the country soon after the infection with the pandemic influenza virus had declined, that infection with the pandemic influenza virus was dominant and that it interfered with the infection of other respiratory viruses. Thus, we suggest that the unusual increase in hMPV infection observed in 2009–10 was due to the appearance of the pandemic influenza virus in the winter season prior to 2009–10.

Hindiyeh, Musa; Mendelson, Ella; Mandelboim, Michal

2012-01-01

421

Pandemic planning as risk management: how fared the Australian federation?  

PubMed

The role of law in managing public health challenges such as influenza pandemics poses special challenges. This article reviews Australian plans in the context of the H1N1 09 experience to assess whether risk management was facilitated or inhibited by the "number" of levels or phases of management, the degree of prescriptive detail for particular phases, the number of plans, the clarity of the relationship between them, and the role of the media. Despite differences in the content and form of the plans at the time of the H1N1 09 emerging pandemic, the article argues that in practice, the plans proved to be responsive and robust bases for managing pandemic risks. It is suggested that this was because the plans proved to be frameworks for coordination rather than prescriptive straitjackets, to be only one component of the regulatory response, and to offer the varied tool box of possible responses, as called for by the theory of responsive regulation. Consistent with the principle of subsidiarity, it is argued that the plans did not inhibit localised responses such as selective school closures or rapid responses to selected populations such as cruise ship passengers. PMID:22558906

Carney, Terry; Bailey, Richard; Bennett, Belinda

2012-03-01

422

Comparison of Xpert Flu rapid nucleic acid testing with rapid antigen testing for the diagnosis of influenza A and B  

PubMed Central

Influenza infections are associated with thousands of hospital admissions and deaths each year. Rapid detection of influenza is important for prompt initiation of antiviral therapy and appropriate patient triage. In this study the Cepheid Xpert Flu assay was compared with two rapid antigen tests, BinaxNOW Influenza A & B and BD Directigen EZ Flu A + B, as well as direct fluorescent antibody testing for the rapid detection of influenza A and B. Using real-time, hydrolysis probe-based, reverse transcriptase PCR as the reference method, influenza A sensitivity was 97.3% for Xpert Flu, 95.9% for direct fluorescent antibody testing, 62.2% for BinaxNOW, and 71.6% for BD Directigen. Influenza B sensitivity was 100% for Xpert Flu and direct fluorescent antibody testing, 54.5% for BinaxNOW, and 48.5% for BD Directigen. Specificity for influenza A was 100% for Xpert Flu, BinaxNOW, and BD Directigen, and 99.2% for direct fluorescent antibody testing. All methods demonstrated 100% specificity for influenza B. These findings support the use of the Xpert Flu assay in settings requiring urgent diagnosis of influenza A and B.

DiMaio, Michael A.; Sahoo, Malaya K.; Waggoner, Jesse; Pinsky, Benjamin A.

2014-01-01

423

Xpert Flu for point-of-care diagnosis of human influenza in industrialized countries.  

PubMed

Respiratory infections, particularly those caused by influenza viruses, represent the third-most important cause of death in the world due to infectious diseases. Nevertheless, despite the enormous publicity attracted by epidemics due to these viruses, laboratory diagnosis, documentation and recording of respiratory diseases is still unsatisfactory. Available diagnostic tests capable of providing results rapidly are either limited and insufficiently sensitive or highly sensitive and specific but insufficiently rapid. Considerable investment and research efforts have been made towards the development of new diagnostics for influenza A and B viruses and the Xpert(®) Flu assay (Cepheid(®), CA, USA) has emerged as one of the most promising. In this article, we review current knowledge of the Xpert Flu test, discuss its potential value as a point-of-care test and outline the potential leads for future development. PMID:24707995

Salez, Nicolas; Nougairede, Antoine; Ninove, Laetitia; Zandotti, Christine; de Lamballerie, Xavier; Charrel, Rémi N

2014-05-01

424

Transnational Quarantine Rhetorics: Public Mobilization in SARS and in H1N1 Flu.  

PubMed

This essay examines how Chinese governments, local communities, and overseas Chinese in North America responded to the perceived health risks of Severe Acute Respiratory Syndrome (SARS) and H1N1 flu through the use of public and participatory rhetoric about risk and quarantines. Focusing on modes of security and quarantine practices, I examine how globalization and the social crises surrounding SARS and H1N1 flu operated to regulate differently certain bodies and areas. I identify three types of quarantines (mandatory, voluntary, and coerced) and conduct a transnational comparative analysis to investigate the relationships among quarantines, rhetoric, and public communication. I argue that health authorities must openly acknowledge the legitimacy of public input and actively seek public support regarding health crises. Only by collaborating with concerned communities and citizens and by providing careful guidance for public participation can health institutions ensure the efficacy of quarantine orders during emerging epidemics. PMID:24729025

Ding, Huiling

2014-06-01

425

The flu shot study: using multiattribute utility theory to design a vaccination intervention.  

PubMed

Differences between the multiattribute utility (MAU) profiles of participants who had previously gotten flu shots and those who had not done so were used to design an informational brochure urging influenza vaccination. The effectiveness of the MAU brochure was evaluated in a VA ambulatory care clinic with a long-standing influenza vaccination program. The target population for the intervention was high-risk clinic patients who had not gotten a shot the previous year. Participants received either a letter urging them to get a flu shot, or a letter plus the informational brochure. A significantly larger proportion of the patients who received the brochure got shots; 36% versus 23% for the letter only. While a 13 percentage point increase is modest, influenza and related complications (preventable through vaccination) are the fourth-leading killers of older persons. Adding a MAU-based brochure to an ongoing vaccination program is inexpensive and may save additional lives. PMID:10279492

Carter, W B; Beach, L R; Inui, T S

1986-12-01

426

Evaluating Syndromic surveillance systems at institutions of higher education (IHEs): A retrospective analysis of the 2009 H1N1 influenza pandemic at two universities  

PubMed Central

Background Syndromic surveillance has been widely adopted as a real-time monitoring tool for timely response to disease outbreaks. During the second wave of the pH1N1 pandemic in Fall 2009, two major universities in Washington, DC collected data that were potentially indicative of influenza-like illness (ILI) cases in students and staff. In this study, our objectives were three-fold. The primary goal of this study was to characterize the impact of pH1N1 on the campuses as clearly as possible given the data available and their likely biases. In addition, we sought to evaluate the strengths and weaknesses of the data series themselves, in order to inform these two universities and other institutions of higher education (IHEs) about real-time surveillance systems that are likely to provide the most utility in future outbreaks (at least to the extent that it is possible to generalize from this analysis). Methods We collected a wide variety of data that covered both student ILI cases reported to medical and non-medical staff, employee absenteeism, and hygiene supply distribution records (from University A only). Communication data were retrieved from university broadcasts, university preparedness websites, and H1N1-related on campus media reports. Regional data based on the Centers for Disease Control and Prevention Outpatient Influenza-like Illness Surveillance Network (CDC ILINet) surveillance network, American College Health Association (ACHA) pandemic influenza surveillance data, and local Google Flu Trends were used as external data sets. We employed a "triangulation" approach for data analysis in which multiple contemporary data sources are compared to identify time patterns that are likely to reflect biases as well as those that are more likely to be indicative of actual infection rates. Results Medical personnel observed an early peak at both universities immediately after school began in early September and a second peak in early November; only the second peak corresponded to patterns in the community at large. Self-reported illness to university deans' offices was also relatively increased during mid-term exam weeks. The overall volume of pH1N1-related communication messages similarly peaked twice, corresponding to the two peaks of student ILI cases. Conclusions During the 2009 H1N1 pandemic, both University A and B experienced a peak number of ILI cases at the beginning of the Fall term. This pattern, seen in surveillance systems at these universities and to a lesser extent in data from other IHEs, most likely resulted from students bringing the virus back to campus from their home states coupled with a sudden increase in population density in dormitories and lecture halls. Through comparison of data from different syndromic surveillance data streams, paying attention to the likely biases in each over time, we have determined, at least in the case of the pH1N1 pandemic, that student health center data more accurately depicted disease transmission on campus at both universities during the Fall 2009 pandemic than other available data sources.

2011-01-01

427

Virus-like particle (VLP)-based vaccines for pandemic influenza: performance of a VLP vaccine during the 2009 influenza pandemic.  

PubMed

The influenza pandemic of 2009 demonstrated the inability of the established global capacity for egg-based vaccine production technology to provide sufficient vaccine for the population in a timely fashion. Several alternative technologies for developing influenza vaccines have been proposed, among which non-replicating virus-like particles (VLPs) represent an attractive option because of their safety and immunogenic characteristics. VLP vaccines against pandemic influenza have been developed in tobacco plant cells and in Sf9 insect cells infected with baculovirus that expresses protein genes from pandemic influenza strains. These technologies allow rapid and large-scale production of vaccines (3-12 weeks). The 2009 influenza outbreak provided an opportunity for clinical testing of a pandemic influenza VLP vaccine in the midst of the outbreak at its epicenter in Mexico. An influenza A(H1N1)2009 VLP pandemic vaccine (produced in insect cells) was tested in a phase II clinical trial involving 4,563 healthy adults. Results showed that the vaccine is safe and immunogenic despite high preexisting anti-A(H1N1)2009 antibody titers present in the population. The safety and immunogenicity profile presented by this pandemic VLP vaccine during the outbreak in Mexico suggests that VLP technology is a suitable alternative to current influenza vaccine technologies for producing pandemic and seasonal vaccines. PMID:22330956

López-Macías, Constantino

2012-03-01

428

New strategies to overcome the drawbacks of currently available flu vaccines.  

PubMed

Vaccination represents the most efficient tool to control morbidity and mortality resulting from influenza infections in humans. The currently licensed influenza vaccines provide good protection levels in healthy adults, whereas lower protection is generally achieved in ageing individuals who are at a higher risk of developing severe clinical manifestations. Future improvements in influenza vaccines should address the needs of high risk groups including the elderly, small children and chronic patients. Recently, due to the increased incidence of avian influenza pandemic outbreaks, the prevention of a potential human influenza pandemic turned into another crucial issue in the influenza vaccination field. The development and validation of manufacturing processes for efficient and safe pandemic vaccines became one of the top priorities of health, regulatory and funding agencies all over the world. In the pandemic context, the development of novel vaccines administered via the mucosal route may play a significant role by reducing virus shedding from infected individuals. This chapter provides insights in the limitations of existing manufacturing processes, new approaches to overcome limitation in vaccine production, mechanisms of action of current vaccines and discuss potential strategies to improve the immunogenicity and efficacy of influenza vaccines. PMID:20047044

Fichera, Epifanio; Felnerova, Diana; Mischler, Robert; Viret, Jean-François; Glueck, Reinhard

2009-01-01

429

Tracking Epidemics with Google Flu Trends Data and a State-Space SEIR Model  

Microsoft Academic Search

In this paper we use Google Flu Trends data together with a sequential surveillance model based on the state-space methodology, to track the evolution of an epidemic process over time. We embed a classical mathematical epidemiology model (a susceptible-exposed-infected-recovered (SEIR) model) within the state-space framework, thereby extending the SEIR dynamics to allow changes through time. The implementation of this model

Vanja Dukic; Hedibert F. Lopes; Nicholas G. Polson

2012-01-01

430

RESULTADOS PRELIMINARES DO BALANÇO DE ENERGIA SOBRE O OCEANO ATLÂNTICO TROPICAL (PROJETO FluTuA)  

Microsoft Academic Search

The observational campaign carried out on May 15-24, 2002, as part of the FluTuA Program, is described here. During 10 days, 5 minute averaged measurements of (i) solar radiation fluxes (incoming and outcoming) and long wave radiation fluxes (atmospheric and surface emission), at 6 m above the sea level; (ii) air temperature, relative humidity and horizontal wind components, at 11

Jacyra Soares; Amauri Pereira de Oliveira; Jacques Servain; Sarasvati de Araújo Bacellar

431

Effectiveness of non-adjuvanted pandemic influenza A vaccines for preventing pandemic influenza acute respiratory illness visits in 4 U.S. communities.  

PubMed

We estimated the effectiveness of four monovalent pandemic influenza A (H1N1) vaccines (three unadjuvanted inactivated, one live attenuated) available in the U.S. during the pandemic. Patients with acute respiratory illness presenting to inpatient and outpatient facilities affiliated with four collaborating institutions were prospectively recruited, consented, and tested for influenza. Analyses were restricted to October 2009 through April 2010, when pandemic vaccine was available. Patients testing positive for pandemic influenza by real-time RT-PCR were cases; those testing negative were controls. Vaccine effectiveness was estimated in logistic regression models adjusted for study community, patient age, timing of illness, insurance status, enrollment site, and presence of high-risk medical conditions. Pandemic virus was detected in 1,011 (15%) of 6,757 enrolled patients. Fifteen (1%) of 1,011 influenza positive cases and 1,042 (18%) of 5,746 test-negative controls had record-verified pandemic vaccination >14 days prior to illness onset. Adjusted effectiveness (95% confidence interval) for pandemic vaccines combined was 56% (23%, 75%). Adjusted effectiveness for inactivated vaccines alone (79% of total) was 62% (25%, 81%) overall and 32% (-92%, 76%), 89% (15%, 99%), and -6% (-231%, 66%) in those aged 0.5 to 9, 10 to 49, and 50+ years, respectively. Effectiveness for the live attenuated vaccine in those aged 2 to 49 years was only demonstrated if vaccination >7 rather than >14 days prior to illness onset was considered (61%? 12%, 82%). Inactivated non-adjuvanted pandemic vaccines offered significant protection against confirmed pandemic influenza-associated medical care visits in young adults. PMID:21857999

Griffin, Marie R; Monto, Arnold S; Belongia, Edward A; Treanor, John J; Chen, Qingxia; Chen, Jufu; Talbot, H Keipp; Ohmit, Suzanne E; Coleman, Laura A; Lofthus, Gerry; Petrie, Joshua G; Meece, Jennifer K; Hall, Caroline Breese; Williams, John V; Gargiullo, Paul; Berman, LaShondra; Shay, David K

2011-01-01

432

The aromatic fluctuation index (FLU): A new aromaticity index based on electron delocalization  

NASA Astrophysics Data System (ADS)

In this work, the aromatic fluctuation index (FLU) that describes the fluctuation of electronic charge between adjacent atoms in a given ring is introduced as a new aromaticity measure. This new electronic criterion of aromaticity is based on the fact that aromaticity is related to the cyclic delocalized circulation of ? electrons. It is defined not only considering the amount of electron sharing between contiguous atoms, which should be substantial in aromatic molecules, but also taking into account the similarity of electron sharing between adjacent atoms. For a series of rings in 15 planar polycyclic aromatic hydrocarbons, we have found that, in general, FLU is strongly correlated with other widely used indicators of local aromaticity, such as the harmonic-oscillator model of aromaticity, the nucleus independent chemical shift, and the para-delocalization index (PDI). In contrast to PDI, the FLU index can be applied to study the aromaticity of rings with any number of members and it can be used to analyze both the local and global aromatic character of rings and molecules.

Matito, Eduard; Duran, Miquel; Solà, Miquel

2005-01-01

433

The FLU-FOBT Program in community clinics: durable benefits of a randomized controlled trial  

PubMed Central

The objective of the study was to determine the extent to which the FLU-FOBT Program, a colorectal cancer screening (CRCS) intervention linking the provision of fecal occult blood tests (FOBT) to the time of annual influenza vaccination, resulted in practice changes in six primary care clinics 1 year after it was introduced in a randomized controlled trial (RCT). We assessed CRCS rate changes for influenza vaccine recipients, administered brief serial clinic staff surveys and interviewed clinic leaders 1 year after the RCT. CRCS rates for influenza vaccination recipients between the ages of 50 and 75 years were 42.5% before the RCT, 54.5% immediately after the RCT and 55.8% 1 year after the RCT (P?FLU-FOBT Program components were maintained in most clinics at 1-year follow-up. Only 63% of clinic staff survey respondents (26 of 41) continued offering FOBT with influenza vaccines, but 85% (35 of 41) continued to provide mailing kits with FOBT. Many patient education materials were maintained and staff satisfaction with the intervention remained high. Clinic leaders acknowledged barriers to maintenance but also observed several beneficial practice changes. Many components of the FLU-FOBT Program were maintained, with beneficial outcomes for participating practices.

Walsh, Judith M. E.; Gildengorin, Ginny; Green, Lawrence W.; Jenkins, Jason; Potter, Michael B.

2012-01-01

434

Long-term effect of the influenza A/H1N1 pandemic: attitudes and preventive behaviours one year after the pandemic.  

PubMed

This study aimed to describe changes in attitudes and behaviours regarding influenza A infection 1 year after the end of the pandemic. A cross-sectional study was performed based on two population-based telephone surveys including 1027 (February, 2010) and 1000 (February, 2011) participants in Spain. The percentages of the respondents who reported that they had adopted preventive measures to avoid Influenza infection declined 1 year after the pandemic. Influenza-related consultations decreased, whereas confidence in vaccination increased. Despite the decrease observed in adopting preventive measures, some behaviours were still being adopted long time after the pandemic in general population. PMID:23748851

Garcia-Continente, Xavier; Serral, Gemma; López, María José; Pérez, Anna; Nebot, Manel

2013-08-01

435

Establishment of multiple sublineages of H5N1 influenza virus in Asia: Implications for pandemic control  

Microsoft Academic Search

Preparedness for a possible influenza pandemic caused by highly pathogenic avian influenza A subtype H5N1 has become a global priority. The spread of the virus to Europe and continued human infection in Southeast Asia have heightened pandemic concern. It remains unknown from where the pandemic strain may emerge; current attention is directed at Vietnam, Thailand, and, more recently, Indonesia and

H. Chen; G. J. D. Smith; K. S. Li; J. Wang; X. H. Fan; J. M. Rayner; D. Vijaykrishna; J. X. Zhang; L. J. Zhang; C. T. Guo; C. L. Cheung; K. M. Xu; L. Duan; K. Huang; K. Qin; Y. H. C. Leung; W. L. Wu; H. R. Lu; Y. Chen; N. S. Xia; T. S. P. Naipospos; K. Y. Yuen; S. S. Hassan; S. Bahri; T. D. Nguyen; R. G. Webster; J. S. M. Peiris; Y. Guan

2006-01-01

436

From Press Release to News: Mapping the Framing of the 2009 H1N1 A Influenza Pandemic  

Microsoft Academic Search

Pandemics challenge conventional assumptions about health promotion, message development, community engagement, and the role of news media. To understand the use of press releases in news coverage of pandemics, this study traces the development of framing devices from a government public health agency's press releases to news stories about the 2009 H1N1 A influenza pandemic. The communication management of the

Seow Ting Lee; Iccha Basnyat

2012-01-01

437

Comparative genomic analysis of Vibrio cholerae: Genes that correlate with cholera endemic and pandemic disease  

Microsoft Academic Search

Historically, the first six recorded cholera pandemics occurred between 1817 and 1923 and were caused by Vibrio cholerae O1 serogroup strains of the classical biotype. Although strains of the El Tor biotype caused sporadic infections and cholera epidemics as early as 1910, it was not until 1961 that this biotype emerged to cause the 7th pandemic, eventually resulting in the

Michelle Dziejman; Emmy Balon; Dana Boyd; Clare M. Fraser; John F. Heidelberg; John J. Mekalanos

2002-01-01

438

Evidence for recombination between pandemic GII.4 norovirus strains New Orleans 2009 and Sydney 2012.  

PubMed

During 2012, a novel pandemic GII.4 norovirus variant, Sydney 2012, emerged worldwide. A signature of the variant was a GII.Pe ORF1, in association with GII.4 Apeldoorn 2008-like ORF2-ORF3 genes. We report the detection of recombinant GII.4 Sydney 2012 strains, possessing the ORF1 gene of the former pandemic variant New Orleans 2009. PMID:23966499

Martella, V; Medici, M C; De Grazia, S; Tummolo, F; Calderaro, A; Bonura, F; Saporito, L; Terio, V; Catella, C; Lanave, G; Buonavoglia, C; Giammanco, G M

2013-11-01

439

Oseltamivir-Resistant Pandemic (H1N1) 2009 Virus, Mexico  

PubMed Central

During May 2009–April 2010, we analyzed 692 samples of pandemic (H1N1) 2009 virus from patients in Mexico. We detected the H275Y substitution of the neuraminidase gene in a specimen from an infant with pandemic (H1N1) 2009 who was treated with oseltamivir. This virus was susceptible to zanamivir and resistant to adamantanes and oseltamivir.

Ramirez-Gonzalez, Jose Ernesto; Gonzalez-Duran, Elizabeth; Alcantara-Perez, Patricia; Wong-Arambula, Claudia; Olivera-Diaz, Hiram; Cortez-Ortiz, Iliana; Barrera-Badillo, Gisela; Nguyen, Ha; Gubareva, Larisa; Lopez-Martinez, Irma; Diaz-Quinonez, Jose Alberto; Lezana-Fernandez, Miguel Angel; Gatell-Ramirez, Hugo Lopez; Villalobos, Jose Angel Cordova; Hernandez-Avila, Mauricio

2011-01-01

440

Hospitalizations for Pandemic (H1N1) 2009 among Maori and Pacific Islanders, New Zealand  

PubMed Central

Community transmission of influenza A pandemic (H1N1) 2009 was followed by high rates of hospital admissions in the Wellington region of New Zealand, particularly among Maori and Pacific Islanders. These findings may help health authorities anticipate the effects of pandemic (H1N1) 2009 in other communities.

Verrall, Ayesha; Norton, Katherine; Rooker, Serena; Dee, Stephen; Olsen, Leeanne; Tan, Chor Ee; Paull, Sharon; Allen, Richard

2010-01-01

441

Healthcare workers' attitudes to working during pandemic influenza: a qualitative study  

Microsoft Academic Search

BACKGROUND: Healthcare workers (HCWs) will play a key role in any response to pandemic influenza, and the UK healthcare system's ability to cope during an influenza pandemic will depend, to a large extent, on the number of HCWs who are able and willing to work through the crisis. UK emergency planning will be improved if planners have a better understanding

Jonathan Ives; Sheila Greenfield; Jayne M Parry; Heather Draper; Christine Gratus; Judith I Petts; Tom Sorell; Sue Wilson

2009-01-01

442

Combination strategies for pandemic influenza response - a systematic review of mathematical modeling studies  

Microsoft Academic Search

BACKGROUND: Individual strategies in pandemic preparedness plans may not reduce the impact of an influenza pandemic. METHODS: We searched modeling publications through PubMed and associated references from 1990 to 30 September 2009. Inclusion criteria were modeling papers quantifying the effectiveness of combination strategies, both pharmaceutical and non-pharmaceutical. RESULTS: Nineteen modeling papers on combination strategies were selected. Four studies examined combination

Vernon J Lee; David C Lye; Annelies Wilder-Smith

2009-01-01

443

Effective, Robust Design of Community Mitigation for Pandemic Influenza: A Systematic Examination of Proposed US Guidance  

Microsoft Academic Search

BackgroundThe US government proposes pandemic influenza mitigation guidance that includes isolation and antiviral treatment of ill persons, voluntary household member quarantine and antiviral prophylaxis, social distancing of individuals, school closure, reduction of contacts at work, and prioritized vaccination. Is this the best strategy combination? Is choice of this strategy robust to pandemic uncertainties? What are critical enablers of community resilience?Methods

Victoria J. Davey; Robert J. Glass; H. Jason Min; Walter E. Beyeler; Laura M. Glass; Eshel Ben-Jacob

2008-01-01

444

Mortality from the influenza pandemic of 1918-19 in Indonesia  

PubMed Central

The influenza pandemic of 1918–19 was the single most lethal short-term epidemic of the twentieth century. For Indonesia, the world's fourth most populous country, the most widely used estimate of mortality from that pandemic is 1.5 million. We estimated mortality from the influenza pandemic in Java and Madura, home to the majority of Indonesia's population, using panel data methods and data from multiple quinquennial population counts and two decennial censuses. The new estimates suggest that, for Java alone, population loss was in the range of 4.26–4.37 million, or more than twice the established estimate for mortality for all of Indonesia. We conclude that the standing estimates of mortality from influenza in Java and Indonesia need to be revised upward significantly. We also present new findings on geographic patterns of population loss across Java, and pre-pandemic and post-pandemic population growth rates.

Chandra, Siddharth

2013-01-01

445

Pandemic influenza preparedness and response in Israel: a unique model of civilian-defense collaboration.  

PubMed

In April 2009, the World Health Organization announced the emergence of a novel influenza A(H1N1-09) virus and in June 2009 declared the outbreak a pandemic. The value of military structures in responding to pandemic influenza has become widely acknowledged in recent years. In 2005, the Israeli Government appointed the Ministry of Defense to be in charge of national preparedness and response for a severe pandemic influenza scenario. The Israeli case offers a unique example of civilian-defense partnership where the interface between the governmental, military and civilian spheres has formed a distinctive structure. The Israeli pandemic preparedness protocols represent an example of a collaboration in which aspects of an inherently medical problem can be managed by the defense sector. Although distinctive concepts of the model are not applicable to all countries, it offers a unique forum for governments and international agencies to evaluate this interface within the context of pandemic influenza. PMID:20535106

Kohn, Sivan; Barnett, Daniel J; Leventhal, Alex; Reznikovich, Shmuel; Oren, Meir; Laor, Danny; Grotto, Itamar; Balicer, Ran D

2010-07-01