An evaluation of the Public Health Grid (PHGrid) technology during the 2009H1N1 influenza pandemic could enhance the capabilities of epidemiologists and disease-control agencies when the next emergent disease appears, according to a study published in the International Journal of Grid and Utility Computing***. …
…During the 2009 H1N1 pandemic, however, the Public Health Informatics and Technology Program Office at the CDC together with various partners used simulated data to explore how a decentralized information architecture run on the Public Health Grid (PHGrid) might be used to acquire relevant data quickly, securely and to effectively model the spread of disease. The main advantage of building the system on the PHGrid is that it allows for disparate, distributed data and services to be used by the public health community and so avoids the obstacles seen with repurposing specialized surveillance systems.
“The speed with which public health officials can identify, respond, and deploy interventions in response to public health events has the potential to change the course or impact of a disease,” the team explains. The PHGrid framework could be used to address specific surveillance needs such as those related to novel pandemic influenza in 2009. By using advances made by the “grid” community in health and other fields, PHGrid was able to focus on specific issues without having to re-invent and re-evaluate the information technology needed by using established data tools and formats. Such an approach also avoided the need to find ways to circumvent bugs and problems that would have arisen had new technology been developed at the time for the specific purpose. …
- Mexican flu pandemic study supports social distancing (eurekalert.org)
- WHO: Swine Flu Pandemic Is Over (zocdoc.com)
- Characterizing the Epidemiology of the 2009 Influenza A/H1N1 Pandemic in Mexico (veilleprosp.wordpress.com)
This bar-headed goose (Anser indicus) was marked with a satellite transmitter at Qinghai Lake, China, in an effort to understand the role that wild birds play in avian influenza. (Credit: Diann Prosser, USGS)
ScienceDaily (Mar. 25, 2011) — Wild migratory birds may indeed play a role in the spread of bird flu, also known as highly pathogenic avian influenza H5N1.
A study by the U.S. Geological Survey,[free full text at this link] the United Nations Food and Agriculture Organization and the Chinese Academy of Sciences used satellites, outbreak data and genetics to uncover an unknown link in Tibet among wild birds, poultry and the movement of the often-deadly virus.
Researchers attached GPS satellite transmitters to 29 bar-headed geese — a wild species that migrates across most of Asia and that died in the thousands in the 2005 bird flu outbreak in Qinghai Lake, China. GPS data showed that wild geese tagged at Qinghai Lake spend their winters in a region outside of Lhasa, the capitol of Tibet, near farms where H5N1 outbreaks have occurred in domestic geese and chickens….
- Chickens bred to thwart bird flu spread (cbc.ca)
- First step at breeding bird-flu resistant chickens (sfgate.com)
- Miyazaki bird flu epidemic spreads (search.japantimes.co.jp)
- “European Scientists Develop Genetically Engineered Chickens Unable To Spread Bird Flu” and related posts (topnews.us)
Another reason to get a flu shot (especially young adults)…….
On November 19, Jason Martin returned to the Medical Intensive Care Unit (MICU) at Vanderbilt University Medical Center for the first time since he nearly died there during last year’s H1N1 flu pandemic. The tall and burly Warren County, TN, ambulance worker – a 30-year-old, father of three young children – broke down and hugged some of the nurses he recognized.
“I got sick on September 12 and didn’t come out of it for the next 20 days. I am just so grateful I came through,” Martin said, wiping his eyes.
Martin was among the first wave of critically ill middle Tennesseans, hit hard by the H1N1 flu pandemic in late 2009. A hallmark of pandemic flu throughout history, including the H1N1 pandemic, has been its ability to make healthy young and middle-aged adults seriously ill and even kill this population in disproportionate numbers.
In a paper published Dec. 5 in Nature Medicine, Fernando Polack, M.D., the Cesar Milstein Associate Professor of Pediatrics at Vanderbilt, and colleagues in Argentina and Nashville provide a possible explanation for this alarming phenomenon of pandemic flu. The study’s findings suggest people are made critically ill, or even killed, by their own immune response…
“We have seen this before. Where non-protective antibody responses are associated with an immune-based disease in the lung,” Polack said.
Polack has previously published evidence that a first-line immune response, primed by an imperfect antibody, can overreact in a violent and uncontrolled fashion. Patients die from lung damage inflicted by their own immune system. A molecule called C4d, a product of this biochemical cascade (the complement system), is a marker for the strength of the response.
In adults who died during the 2009 H1N1 pandemic, high levels of C4d in lung tissues suggest a massive, potentially fatal activation of the complement system.
Pulmonary and critical care physician, Todd Rice, M.D., assistant professor of Medicine at VUMC, has seen people killed by the “exuberant” and uncontrolled response of the immune system in other diseases – like sepsis….
While many questions remain, one thing is clear: the H1N1 vaccine offers protection. Patients who died were overwhelmingly unvaccinated. Many fell ill before a vaccine was even available. [Editor Flahiff’s empahsis]
Hospital Preparedness Checklist for Pandemic Influenza (with a 2009 focus) aims to help “enhance the readiness of the health facilities to cope with the challenges of an epidemic, a pandemic or any other emergency or disaster, hospital managers need to ensure the initiation of relevant generic priority action. [The document] aims to provide a checklist of the key action to carry out in the context of a continuous hospital emergency preparedness process.”
This 32 page PDF document includes checklists in the areas of incident command, communication, continuity of essential services, surge capacity, human resources, logistics, and supply management (including pharmaceuticals), infection prevention and control, case management, surveillance, and laboratory services.
By Maggie Fox, Health and Science Editor
WASHINGTON (Reuters) – The H1N1 swine flu virus may be starting to mutate, and a slightly new form has begun to predominate in Australia, New Zealand and Singapore, researchers reported on Thursday.
More study is needed to tell whether the new strain is more likely to kill patients and whether the current vaccine can protect against it completely, said Ian Barr of the World Health Organization Collaborating Center for Reference and Research on Influenza in Melbourne, Australia and colleagues.
“However, it may represent the start of more dramatic antigenic drift of the pandemic influenza A(H1N1) viruses that may require a vaccine update sooner than might have been expected,” they wrote in the online publication Eurosurveillance.
It is possible it is both more deadly and also able to infect people who have been vaccinated, they said.
Flu viruses mutate constantly — this is why people need a fresh flu vaccine every year. Since it broke out in March 2009 and spread globally, the H1N1 swine flu virus has been very stable with almost no mutation….
“The virus has changed little since it emerged in 2009, however, in this report we describe several genetically distinct changes in the pandemic H1N1 influenza virus,” Barr’s team wrote in the report, available at http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19692.
“These variants were first detected in Singapore in early 2010 and have subsequently spread through Australia and New Zealand.”
The changes are not significant yet, they said. But there have been some cases of people who were vaccinated also becoming infected, and also some deaths.
“Already this variant virus has been associated with several vaccine breakthroughs in teenagers and adults vaccinated in 2010 with monovalent pandemic influenza vaccine (protecting against only H1N1) as well as a number of fatal cases from whom the variant virus was isolated,” they wrote.
But there is not enough information to tell whether there may have been other factors making the patients more vulnerable, they stressed.
“It remains to be seen whether this variant will continue to predominate for the rest of the influenza season in Oceania and in other parts of the southern hemisphere and then spread to the northern hemisphere or merely die out,” they wrote.
A few good resources to keep up with H1N1 news
- Flu.gov is a “comprehensive government-wide information on seasonal, H1N1 (swine), H5N1 (bird) and pandemic influenza for the general public, health and emergency preparedness professionals, policy makers, government and business leaders, school systems, and local communities”
Flu.gov includes an option for email updates, printable fact sheets and other printable resources, news articles, FAQs, and much more
- Influenza (World Health Organization)
From a Health Day News item
By Randy Dotinga
Monday, October 18, 2010
MONDAY, Oct. 18 (HealthDay News) — Canadian researchers say they do not expect the H1N1 virus — the so-called swine flu — to be very severe this year, although they are recommending that everyone over the age of 50, especially those with chronic health conditions, get immunized this fall.
Researchers in British Columbia examined the results of blood tests given to 1,127 people in the province both before and after the 2009 pandemic. Before the pandemic, less than 10 percent of children showed signs of antibodies, which are the “soldiers” in the immune system that develop resistance to specific germs. By contrast, more than three-quarters of people over the age of 80 had the antibodies, suggesting they’d been exposed to the virus before.
This helps explain why children were so severely affected by H1N1 compared to older people, the study authors noted.
“The higher percentage with seroprotection [antibodies in blood] we observed in the young may have resulted from higher pandemic H1N1 infection rates and earlier prioritization of pandemic H1N1 vaccine to young children,” said study co-author Dr. Danuta Skowronski, of the BC Centre for Disease Control and University of British Columbia, in a news release from the journal’s publisher.
The researchers wrote that enough people appear to be protected that “these findings reassure against the likelihood of a substantial third pandemic H1N1 wave during the 2010-2011 season, unless there is a significant waning of antibody or change in the virus.”
They also found that “adults 50 to 79 years exhibited the lowest seroprotection and also remain at higher risk of severe outcomes if infected. Our findings support a shift from the prioritized immunization of the young that occurred in fall 2009 to prioritized immunization of older adults for the coming 2010-2011 influenza season to protect against severe outcomes due to both pandemic and seasonal influenza.”
Dr. Peter Katona, associate professor of clinical medicine at the University of California at Los Angeles, cautioned, however, that it’s impossible to know for sure what the flu will do. “Flu is unpredictable regardless of what the models say and what the early surveillance says,” he said in an interview. “It can go in different directions for complicated reasons that you can’t figure out in advance.”
“The U.S. government proposed major changes on Thursday to the way it works with companies to fight new disease threats such as flu, including reform at the Food and Drug Administration and setting up centers to make vaccines quickly.”
The HHS news release may be found here.
The full report (along with a fact sheet and other related material) may be found here.
Health and Human Services (HHS) officials have recently looked at a new model of school-based immunization clinics. They believe it is an efficient way to deliver the pandemic vaccine to children. However, most schools would need more resources to hold future clinics.
The news report includes the following:
“They found that sites vaccinated an average of 28% of enrolled students during 1-day programs, which federal officials said compares favorably with state and national vaccination rates. For example, the average vaccination rate for the six states included in the study is 37%, which reflects a child vaccination period of about 3 months at multiple sites such as doctor’s offices, pharmacies, and community clinics. Most of the 38 locations said the school-based clinics were a useful vaccination method but said they would not hold them in the future without additional resources.
About 42% of the children vaccinated at the sites received the nasal mist form of the vaccine, and 59% received the injection. Reviewers noted that three of the six localities reported decreased demand for the nasal mist version, due to parent and staff misconceptions about its safety, which were driven by incorrect media messages that the nasal mist was riskier because it contained a live attenuated virus.”
More news on swine flu (H1N1) may be found here.
The human body makes rare antibodies effective against all flu viruses and these might be boosted to design a better universal flu treatment, researchers reported on Monday.