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A systematic analytic approach to pandemic influenza preparedness planning.

Barnett DJ, Balicer RD, Lucey DR, Everly GS, Omer SB, Steinhoff MC, Grotto I - PLoS Med. (2005)

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins Center for Public Health Preparedness, Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America. dbarnett@jhsph.edu

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As pathogenic avian influenza A (H5N1) strains (Figure 1) continue to spread in East Asia, with recently reported expansion to Siberia and westward regions in Russia as well as to migratory birds, the risk for reassortment of avian and human strains increases... Research suggesting that cats could host or transmit the H5N1 infection adds to a worrisome picture of multispecies transmission that can elevate the risk of reassortment... Indeed, Haddon himself used his analytic matrix to describe an outbreak of polio, and this matrix has been recently applied to other public-health emergency preparedness challenges such as SARS... Comprehensive public health emergency preparedness and response efforts require effective pre-event (preventive), event (mitigation), and post-event (consequence management) strategies... Thailand has been reported recently to have approved funding for the future purchase of up to 100,000 treatments of oseltamivir... An in-place culling policy played a significant role... Efforts are ongoing to closely link public health and animal health responses to H5N1... Stockpiled antivirals and antibiotics are important to Israel's preparedness... The Israeli Ministry of Health has successfully used cost-benefit analyses to persuade decision makers to invest the funds necessary for the rapid creation of a national antiviral stockpile, and several strategies for the use of these drugs during the pandemic are considered... The antiviral oseltamivir was found to be effective in mice against the newest strains of avian influenza currently sweeping through East Asia, suggesting that higher doses and prolonged courses of this drug may be required... The Haddon matrix has limitations that must be recognized to ensure appropriate implementation... Importantly, the matrix is not a stand-alone planning tool; rather, the results of any Haddon-matrix–based analysis must be operationalized in the form of policies and procedures to achieve their desired effects on the factors included in the matrix... The known potential for an avian influenza pandemic offers not only challenges but also unprecedented opportunities for advance planning at all levels of public health in the international community... This planning window may be rapidly closing, however... As an efficient yet comprehensive analytic approach, the Haddon matrix lends itself to the types of rapid and complex decision making necessary to plan for and respond more effectively to an urgent pandemic health threat.

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Emergency Hospital during 1918 Influenza Epidemic, Camp Funston, Kansas, United States(Photo: Image “NCP 1603,” National Museum of Health and Medicine, Armed Forces Institute of Pathology, Washington, D.C.)
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pmed-0020359-g002: Emergency Hospital during 1918 Influenza Epidemic, Camp Funston, Kansas, United States(Photo: Image “NCP 1603,” National Museum of Health and Medicine, Armed Forces Institute of Pathology, Washington, D.C.)

Mentions: Influenza pandemics can have devastating impacts. The Spanish flu of 1918 was particularly destructive (Figures 2 and 3), resulting in a higher death total in less than two years than in all of World War I [13]. Although earlier accounts suggested the mortality from the 1918 pandemic was 20 million to 40 million, more recent assessments including new estimates from Africa and Asia suggest that a more realistic figure is 50–100 million [14]. The high rates of infection with the pandemic virus meant that even an average case fatality rate lower than 3% resulted in this large number of deaths [13,15]. A 1918-type influenza pandemic today is projected to cause 180–360 million deaths globally (including 1.7 million deaths in the United States) [1], with transmission of the disease lasting at least two years [16].


A systematic analytic approach to pandemic influenza preparedness planning.

Barnett DJ, Balicer RD, Lucey DR, Everly GS, Omer SB, Steinhoff MC, Grotto I - PLoS Med. (2005)

Emergency Hospital during 1918 Influenza Epidemic, Camp Funston, Kansas, United States(Photo: Image “NCP 1603,” National Museum of Health and Medicine, Armed Forces Institute of Pathology, Washington, D.C.)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC1274283&req=5

pmed-0020359-g002: Emergency Hospital during 1918 Influenza Epidemic, Camp Funston, Kansas, United States(Photo: Image “NCP 1603,” National Museum of Health and Medicine, Armed Forces Institute of Pathology, Washington, D.C.)
Mentions: Influenza pandemics can have devastating impacts. The Spanish flu of 1918 was particularly destructive (Figures 2 and 3), resulting in a higher death total in less than two years than in all of World War I [13]. Although earlier accounts suggested the mortality from the 1918 pandemic was 20 million to 40 million, more recent assessments including new estimates from Africa and Asia suggest that a more realistic figure is 50–100 million [14]. The high rates of infection with the pandemic virus meant that even an average case fatality rate lower than 3% resulted in this large number of deaths [13,15]. A 1918-type influenza pandemic today is projected to cause 180–360 million deaths globally (including 1.7 million deaths in the United States) [1], with transmission of the disease lasting at least two years [16].

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins Center for Public Health Preparedness, Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America. dbarnett@jhsph.edu

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

As pathogenic avian influenza A (H5N1) strains (Figure 1) continue to spread in East Asia, with recently reported expansion to Siberia and westward regions in Russia as well as to migratory birds, the risk for reassortment of avian and human strains increases... Research suggesting that cats could host or transmit the H5N1 infection adds to a worrisome picture of multispecies transmission that can elevate the risk of reassortment... Indeed, Haddon himself used his analytic matrix to describe an outbreak of polio, and this matrix has been recently applied to other public-health emergency preparedness challenges such as SARS... Comprehensive public health emergency preparedness and response efforts require effective pre-event (preventive), event (mitigation), and post-event (consequence management) strategies... Thailand has been reported recently to have approved funding for the future purchase of up to 100,000 treatments of oseltamivir... An in-place culling policy played a significant role... Efforts are ongoing to closely link public health and animal health responses to H5N1... Stockpiled antivirals and antibiotics are important to Israel's preparedness... The Israeli Ministry of Health has successfully used cost-benefit analyses to persuade decision makers to invest the funds necessary for the rapid creation of a national antiviral stockpile, and several strategies for the use of these drugs during the pandemic are considered... The antiviral oseltamivir was found to be effective in mice against the newest strains of avian influenza currently sweeping through East Asia, suggesting that higher doses and prolonged courses of this drug may be required... The Haddon matrix has limitations that must be recognized to ensure appropriate implementation... Importantly, the matrix is not a stand-alone planning tool; rather, the results of any Haddon-matrix–based analysis must be operationalized in the form of policies and procedures to achieve their desired effects on the factors included in the matrix... The known potential for an avian influenza pandemic offers not only challenges but also unprecedented opportunities for advance planning at all levels of public health in the international community... This planning window may be rapidly closing, however... As an efficient yet comprehensive analytic approach, the Haddon matrix lends itself to the types of rapid and complex decision making necessary to plan for and respond more effectively to an urgent pandemic health threat.

Show MeSH
Related in: MedlinePlus