1 / 9

“Science” of Pandemic Influenza

“Science” of Pandemic Influenza. Stephen C. Schoenbaum, MD, MPH Executive Vice President for Programs June 15, 2006 www.cmwf.org. Limitations of Our Knowledge. Direct or inferential virologic knowledge only about 1889, 1918, 1957, 1968, 1977 Direct virus isolation only for the latter 3

aimee
Download Presentation

“Science” of Pandemic Influenza

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. “Science” of Pandemic Influenza Stephen C. Schoenbaum, MD, MPH Executive Vice President for Programs June 15, 2006 www.cmwf.org

  2. Limitations of Our Knowledge • Direct or inferential virologic knowledge only about 1889, 1918, 1957, 1968, 1977 • Direct virus isolation only for the latter 3 • Virus reconstruction for 1918 • Direct pandemic experience with only H1,2,3; N1,2 • i.e., 3/16 hemagglutinin types; 2/9 neuraminidase types

  3. Avian Flu (H5N1) • Emerging pandemic among birds • A unique observation (I believe); hence difficult to estimate the probability of its being a prelude to a human pandemic • Some, but few, instances of spread to humans • Hopeful, but not an absolute protection • Has occurred with other strains (e.g., H7) • Possibly a few instances of spread between humans • Again, a concern; but this has occurred with other strains without causing a pandemic (e.g., Hsw1N1 =H1N1 at Fort Dix, NJ in 1976

  4. Policy-Relevant Information About Pandemics • Pandemics occur irregularly over time • It is likely there will be another some time • Pandemics vary in “size” • All are important; but not all have the impact of 1918 • Disproportionate effect on younger people than interpandemic epidemics • Policies for control need to be population-wide • Can/do cause societal disruption • Need contingency plans for vital societal functions • Usually associated with a second, even third, wave

  5. Policy Options for Preventing or Ameliorating Pandemic Spread • Global surveillance for novel strains • Occurring • Leading to control of influenza in flocks of birds • Hard to know if this can have an impact on prevention or amelioration of pandemic spread

  6. Policy Options for Preventing or Ameliorating Pandemic Spread • Developing methods for crash production of vaccines once a pandemic has been detected • Stockpiling prototype vaccines for each of the influenza A hemagglutinins • Prior immunization with prototypes of the influenza A hemagglutinins • Immediate production/use of vaccines to ameliorate second/third waves

  7. Policy Options for Preventing or Ameliorating Pandemic Spread • Stockpiling antivirals and using them with emergence of a new strain • Increasing routine use of antivirals • Research to develop new antivirals • Increased/repeat pneumococcal vaccination at time of emergence of a new influenza A strain • Statins - ?other novel/general methods of reducing the lethality of bacteremia or of viral infections

  8. Policy Options for Preventing or Ameliorating Pandemic Spread • “Social Distancing” • 1968: school closures (Xmas vacation) • 1918: Quarantine of Australia • Bottom line: could buy “some” time • Ability to enhance ICU/treatment capacity • Respirators – how many are really needed? • Cross-trained staff – will they show up? • Antibiotics – can we deal with resistance? • Bottom line guess: could probably handle a 1957-size pandemic

  9. Visit the Fundwww.cmwf.org

More Related