This book is a systematic and concise resource useful to anyone involved with or looking to move into aquaculture and fisheries. A guide for individuals and families. Emerg Infect Dis 2006 Jan;12(1):66-72 [Full text], Luke TC, Kilbane EM, Jackson JL, et al. On April 17, 2009, the CDC determined, through a sentinel surveillance program, that two unrelated children in California had infections with a swine-origin influenza H1N1 virus. The document could serve as a beginning template for local agencies that have not begun the difficult discussions around public health continuity. Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007 [Full text], Cheung CL, Rayner JM, Smith GJD, et al. Respiratory route; ... could be a new "shift" pandemic variant. The authors of the report predicted that annual pandemic vaccine production capacity will rise to somewhere between 5 billion and 14.5 billion doses over the next 5 years. In the US military, death rates ranged from 5% to 10% (, A recent study examined cross-protection between successive waves of the 1918-1919 pandemic by looking at hospitalization data for repeated illnesses and mortality rates (. 26 Antigenic Variation in Influenza Virus: II II. Aerosol-generating procedures (eg, intubation, bronchoscopy, nebulizer treatments) theoretically could promote dissemination of droplet nuclei from infected patients, although this has not been studied for influenza. The epidemiologic potential of a virus tends to unfold in waves. Caring for someone with the flu. Existing antivirals are effective against influenza viruses with genes from the 1918 pandemic virus. Serologic tests are used to retrospectively diagnose infection. Nonpharmaceutical interventions implemented during the 1918-1919 influenza pandemic. In addition, the Roche supply chain is fully operational in the US, with an annual production capacity of 80 million treatment courses (Roche 2006: U.S.-based supply chain for Tamiflu fully operational). The idea of achieving herd immunity by simply stepping back and allowing a virus free rein to infect everyone wouldn’t work, either. This shift in the influenza virus is called antigenic shift. This part of the plan was updated in October 2006 with release of the document "Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Health Care Settings during an Influenza Pandemic" (HHS 2006). The virus and last month’s deadly insurrection are only going to make the tightness tighter, permanently. Most of the world's influenza vaccine is produced in a few countries. Science 2008;320:340- 346. Chest 2008 May;133(5 suppl):51S-66S [Abstract], Dowdle WR. Acambis enters flu vaccine arena with launch of flu vaccine development programme. Relatively few lineages of influenza A are circulating among humans at any one time, which reduces the likelihood of significant genetic reassortments. Instructions on making various home kits [Full text]WHO. Note: Estimates are rounded to the closest 50,000. J Immunol 1946;52:145-65 [Abstract], HHS.Federal guidance to assist states in improving state-level pandemic influenza operating plans. CDC says "take 3" steps to fight the flu. The severity level is initially based on CFR, a single criterion that will likely be known even early in a pandemic when small clusters and outbreaks are occurring. In February 2007, HHS released the "pandemic severity index," or PSI, as a way to grade pandemics (CDC/HHS 2007). © 2014 by the President and Fellows of Harvard College | Harvard Home | Trademark Notice | Privacy Statement, Not all changes are created equal (antigenic drift), How reassortment creates an entirely new virus. WHORapid advice guidelines for pharmacological management of sporadic human infection with avian influenza A (H5N1) virus. Moreover, the US plan does not address the issue of distributing vaccine to other countries. In February 2007, the CDC and HHS released a document on nonpharmaceutical interventions (CDC/HHS 2007). In the post-pandemic period, influenza disease activity will have returned to levels normally seen for seasonal influenza. In the influenza virus, the two relevant antigens are the surface proteins, hemagglutinin and neuraminidase. Respirator use should be in the context of a complete respiratory protection program in accordance with OSHA regulations. Driven to Discover. In 6 weeks it afflicted all of Europe. More than 10% of swine workers tested had antibodies to the novel influenza strain. Mobilize resources for the implementation of seasonal influenza vaccination programs. "The flu virus can undergo what we call antigenic drift, which is where a strain of virus slowly accumulates viral mutation during a season," she says. Antigenic Drift Antigenic Shift (Intrasubtypic 1990 1994 1998 2002 Reassortment) H3 HA gene 1992 1996 2000. Survey of hospital healthcare personnel response during a potential avian influenza pandemic: will they come to work? Sep 14, 2006 [Press release], Sanofi Pasteur. Emerg Infect Dis 2006;12(12) Dec:1961-4 [Full text], McKimm-Breschkin J, Trivedi T, et al. When space and chair availability permit, coughing persons should be encouraged to sit at least 3 feet away from others in common waiting areas. While antigenic drift or shift is often cited as the core obstacles to influenza vaccines, another stark challenge is the phenomenon of imprinting. Antigenic sites A and G have been shown to be immunodominant (17, 36), while antigenic sites D and E have been shown to be involved in antigenic differences and regulating HBGA binding (53, 54). If an AIR is unavailable, contact the healthcare facility engineer to assist or use portable HEPA filters to augment the number of ACH. Such rooms should have monitored negative air pressure in relation to corridor, with 6-12 ACH, and exhaust air directly outside or have recirculated air filtered by a HEPA filter. Jan 14, 2006, CDC. Institute of Medicine. Influenza A pandemics of the 20th century with special reference to 1918: virology, pathology and epidemiology. These are briefly addressed below. Pandemic influenza draft protocol for rapid response and containment. HHS now recommends that National Institute for Occupational Safety and Health (NIOSH)–certified N-95 respirators or higher be used when caring for patients with confirmed or suspected pandemic influenza during activities that have a high likelihood of generating infectious respiratory aerosols, including the following high-risk situations: Two documents related to use of masks and respirators can be found on the HHS Pandemic Influenza Web site: "Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Health Care Settings During an Influenza Pandemic" (HHS) and "Interim Public Health Guidance for the Use of Facemasks and Respirators in Non-Occupational Community Settings During an Influenza Pandemic" (HHS). Pandemic influenza 1700-1900, a study in historical epidemiology. Antimicrob Agents Chemother 2003 Jul;47(7):2264-72 [Full text], McKimm-Breschkin JL, Selleck PW, Usman TB, et al. Studies in mice also suggest the possibility of airborne transmission of influenza viruses. The pandemic spread to the Southern Hemisphere during the summer of 1957 and reached the United States in June 1957 (Glezen 1996). In the winters of 1919-1920 and 1920-1921, the Spanish flu made a comeback, but it had now morphed into a less virulent virus, whose symptoms were almost identical to a seasonal flu. Basic disaster supplies kit [Full text]Schwanberg SL, Renville MR. Pandemic flu home care: a detailed guide for caring for the ill at home. Earlier studies in mice using genetically engineered influenza strains similar to the H1N1 1918 pandemic strain suggest that macrophage activation with high levels of cytokine production may have been a key factor in lung damage caused by the pandemic strain (Kobasa 2004). Contain and dispose of solid waste (medical and nonmedical) in accordance with facility procedures and/or local or state regulations; wear gloves when handling waste and waste containers; perform hand hygiene. A face mask (ie, a disposable mask that covers the nose and mouth, such as a surgical mask) is recommended when exposure in a crowded setting (such as a bus or subway) occurs with persons not known to be ill. A face mask also is recommended for use by ill persons when they must be in close contact with others. Dec 2006 [Full text], Toner E, Waldhorn R. What hospitals should do to prepare for an influenza pandemic. Enveloped virions are 80 to 120 nm in diameter, are 200 to 300 nm long, and may be filamentous. CVD. This has forced frequent updates of vaccine antigens to ensure that the somewhat narrowly focused vaccine-induced immune responses defend against circulating strains. Although antibodies to NA antigen do not prevent infection, they may modify the severity of disease (Glezen 1996). Viral Ecology defines and explains the ecology of viruses by examining their interactions with their hosting species, including the types of transmission cycles that have evolved, encompassing principal and alternate hosts, vehicles, and ... Same with 1968, then again in 2009, at least here. Of more relevance to this year’s experience is the phenomenon of antigenic drift. Evidences suggest that before 1918, the major strain of influenza was H3N8. ... (H3N2) and 2009 (H1N1) and experts agree that it is not a matter of if, but when, the next pandemic will strike. Surveillance for pandemic influenza. [Full text], Department of Homeland Security. Below we look at two special cases in viral evolution: how evolution occurs in influenza viruses and in the human immunodeficiency virus (HIV… Explores pandemic outbreaks through news stories and everyday applications to explain the science behind them. Clinical review: allocating ventilators during large-scale disasters: problems, planning, and process. Apart from the inherent lethality of the virus, its capacity to cause severe disease in non-traditional age groups, namely young adults, is a major determinant of a pandemic's overall impact. The proportion of influenza virus transmission caused by direct or indirect contact remains unknown; however, transmission by these routes can occur. A meta-analysis of studies on influenza patients during the 1918 pandemic found that patients with Spanish influenza pneumonia who received influenza-convalescent human blood products may have had a decreased risk of death (Luke 2006: Meta-analysis: convalescent blood products for Spanish influenza pneumonia). First pre-pandemic vaccine approved to help protect against pandemic influenza. Type A viruses undergo both kinds of changes; influenza type B viruses change only by the more gradual process of antigenic drift and therefore do not cause pandemics. Describes new phase criteria [, Avian Influenza (Bird Flu): Implications for Human Disease, Guidance for Using Antiviral Agents During and Influenza Pandemic, White House announces $3.2 billion toward antivirals, Pre-COVID surge analysis shows lack of hospital pandemic planning, Emerging flu virus in Chinese pigs has pandemic potential, researchers say, 'Great Influenza' author talks COVID-19, 1918 flu, "Protect Iowa Health" communications campaign advocates preparedness for everyone, Pandemic Influenza Planning Kit for Schools, Prioritization of public health services for pandemic influenza, Caring for the sick at home when it's the only option, Allocating Influenza Vaccines in Minnesota, Office of the Vice President for Research. : Animal strains such as H5N1 avian influenza are not considered human pandemic strains unless the above criteria are met, but they have significant potential to evolve into new human pandemic strains through the process of genetic reassortment (see below) or through gradual adaptation to the human host. 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