Low Pathogenic Strains vs. Highly Pathogenic Strains.
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Transcript of Low Pathogenic Strains vs. Highly Pathogenic Strains.
Low Pathogenic Strains vs. Highly Pathogenic Strains
H5N1 Infection in Cats
Study looked at 500 blood samples taken from stray cats taken from poultry markets in Java. Of these cats, 20% had antibodies to H5N1. Unusually high numbers of dead cats have been found near many of the outbreaks. Unlike humans, cats shed virus in high titers and pass it to each other.
Human Cases: Summary of Current Situation
Since January, 2004 WHO has reported human cases of avian influenza A (H5N1) in the following countries:
•East Asia and the Pacific: •Cambodia
•China •Indonesia •Thailand •Vietnam
•Europe & Eurasia: •Azerbaijan
•Turkey •Near East:
•EgyptIraq
For additional information about these reports, visit the
World Health Organization Web Site.
Updated January 2007
Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO March 14, 2007
Country
2003 2004 2005 2006 2007 Total
cases deaths cases deaths cases deaths cases deaths cases deaths cases deaths
Azerbaijan 0 0 0 0 0 0 8 5 0 0 8 5
Cambodia 0 0 0 0 4 4 2 2 0 0 6 6
China 1 1 0 0 8 5 13 8 0 0 23 14
Djibouti 0 0 0 0 0 0 1 0 0 0 1 0
Egypt 0 0 0 0 0 0 18 10 1 1 24 13
Indonesia 0 0 0 0 19 12 56 46 7 6 83 65
Iraq 0 0 0 0 0 0 3 2 0 0 3 2
Nigeria 0 0 0 0 0 0 0 0 1 1 1 1
Thailand 0 0 17 12 5 2 3 3 0 0 25 17
Turkey 0 0 0 0 0 0 12 4 0 0 12 4
Viet Nam 3 3 29 20 61 19 0 0 0 0 93 42
Total 4 4 46 32 97 42 116 80 8 7 280 170
Responding to the Avian Influenza Pandemic Threat
Recommended Strategic Actions
World Health Organization 2005
WHO Proposals
1. Reduce opportunities for human infection - education
2. Strengthen the early warning system
3. Contain or delay spread at source - drugs, quarantine
4. Reduce morbidity, mortality and social disruption
5. Conduct research to guide response measures
Problems With Early Warning Systems
most outbreaks are occurring in poor countries
no funds to pay farmers for culled flocks(10 billion $$ to date)
no funds for information systems or labs
home slaughter of sick chickens
poor or no health care services
New WHO Pandemic PhasesInterpandemic Period
Phase 1 – No new influenza subtypes in humans, subtype that has caused human infection may be present in animals
Phase 2 – As above, but circulating animal subtype poses substantial risk of human disease
Pandemic Alert PeriodPhase 3 – Human infection with new subtype, no human-to-human
(HTH) spreadPhase 4 – Small clusters with limited HTH transmission, highly
localized spread, suggesting the virus is not well adapted to humans
Phase 5 – Larger clusters, but HTH spread is still localized, virus is increasingly better adapted to humans, but not yet fully transmissible
Pandemic Period – Increased and sustained transmission in general population
Current WHO phase of pandemic alert
Pandemic Vaccine Supply
Assumptions Imported vaccine will not be available
Two doses will be needed for protection
4-8 months until first vaccine doses are available
U.S Manufacturing CapacityOnly Sanofi has a completely domestic supplychain
Estimated production sufficient to deliver 5 millionmonovalent doses per week
Implication – less than 1% of the population may be protectedper week
Health Care and Emergency Response
Address hospital surge capacity issues
Address roles of triage centers, volunteers, home care
Develop hospital employee health guidance
Develop infection control guidelines
Address mass mortality issues
Develop system for tracking hospital resources
CDC PANDEMIC RANKINGFebruary 1, 2007
Category 1 Pandemic 90,000 additional deaths
Isolate the sick at home, reduce visitors
Category 3 Pandemic 90,000 – 450,000 additional deaths
consider closing schools for no more than a month
Category 5 Pandemic >900,000 additional deaths
Close schools (including universities) for up to 3 months, avoid gatherings and encourage people to work from home
“What we all learned from Katrina is that sometimes we have to think very clearly about the unthinkable, because the unthinkable often happens.”
Michael Leavitt
Health and Human Services Secretary
http://pandemicflu.gov
http://www.pandemicflu.state.pa.us
http://pandemicflu.gov/plan/pdf/CIKRpandemicInfluenzaGuide.pdf
http://www.pandemicflu.gov
HMC PANDEMIC PLAN
http://emergencyhomepreparation.org/
http://www.influenzareport.com/influenzareport2006.pdf
Birdflubook.com
“We’re all holding our breaths. H5N1 is the most important threat the world is facing.”
“People who fail to prepare for a flu pandemic are going to be tragically mistaken.”
Julie Gerberding, Head of the CDC