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Pandemic. From Greek=pan (=all)+demos (=people) WHO=a pandemic is a global epidemic of an infectious disease. Seasonal flu is not considered pandemic. Pandemics in history. Small pox (vaccine) Cholera (clean water) Plague (hygiene,general health) Syphilis (attenuation,antibiotics) Flu
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Pandemic From Greek=pan (=all)+demos (=people) WHO=a pandemic is a global epidemic of an infectious disease. Seasonal flu is not considered pandemic
Pandemics in history Small pox (vaccine) Cholera (clean water) Plague (hygiene,general health) Syphilis (attenuation,antibiotics) Flu Recent HIV
Pandemics today + Political awareness (HIV major inducer) Rapid diagnosis (SARS,weeks;HIV,years) Promising drug development. Vaccines + or - development - Rapid spread. Less robust societies (lean)
New pathogens all the time • 10 pathogenic viruses last 10 years • 4 of these lethal for man • SARS,epidemi 2003,10-70% lethality • Nipah,12 epidemies,>50% lethality • Hendra,40% lethality • H5N1,avian flu,present lethality 1-5%?
Economy of the SARS scare • GDP growth rate in China 2003 reduced by more than 1%. • Four months epidemic in Hong Kong, average reduction of 60% of air passengers • Global cost of epidemic with some 700 mortalities >35 billion USD. • 50 million USD cost/individual death.
Influenza virus subtypes: unpredictability of a pandemic threat Group 1 Group 2
Increasing flu pandemics? ”Pandemic” strains may be generated= 1.directly but mutated straight from a foreign animal species (Spanish). 2.exchange genes with flu from other species (pig,bird). In China 1968 2008 Increase Pigs 5 million 1.3 billion x260 Poultry 12 million 13 billion x1050
China not the source of H5N1? Robert G. Wallace, HoangMinh HoDac, Richard H. Lathrop, and Walter M. Fitch A statistical phylogeography of influenza A H5N1 PNAS 2007 104: 4473-4478 Foto Reuters
Speed/volume of global spread via human travel What took months to travel some hundred years ago may now take hours. International flight passengers =soon 1 billion/year. =>30 humans arrive from foreign countries every second.
Flu pandemics Ten A flu pandemics in last 300 years ”Spanish”,H1N1,1918-9 ”Asian”,H2N2,1957 ”HongKong”1968 ”?”,?,? ”Spanish” like avian flu,Asian and HongKong added avian flu genes
Handling pandemic threats • Educate politicians/mass media • Be open about disease information (SARS,MCD) • Make rational precautions • Reduce anxiety
Swine flu August 21,2009 Price of pork in USA down 72 % Rumours in Swedish press that flu vaccine is a)contaminated with squalene b)will induce neural paralysis In Stockholm suggestions that one person in Ministry of Health may be infected caused Ministry of Finance officials to give walk-over in budget discussions. All Swedes expected to be vaccinated=18 million doses ordered,500 million USD cost Reality=”Swine” flu is somewhat more aggressive at present compared to seasonal flu.