CURRENTLY: (*Indicates a change since the last Pandemic Update)
WHY A PANDEMIC UPDATE?
A pandemic is a global disease outbreak. A flu pandemic occurs when a new influenza virus emerges for which people have little or no immunity, and for which there is no vaccine. The disease spreads easily person-to-person, it causes serious illness, and can sweep across the country and around the world in a very short time. It is difficult to predict when the next influenza pandemic will occur or how severe it will be. Wherever and whenever a pandemic starts, everyone around the world is at risk. Countries might, through measures such as border closures and travel restrictions, delay arrival of the virus, but cannot stop it.
Health professionals are concerned that the continued spread of a highly pathogenic avian H5N1 virus across eastern Asia and other countries represents a significant threat to human health. Influenza A (H5N1) virus has raised concerns about a potential human pandemic because it is especially virulent;
H5N1 virus does not usually infect people, but infections with these viruses have occurred in humans. Most of these cases have resulted from people having direct or close contact with H5N1-infected poultry or H5N1-contaminated surfaces. Of the few avian influenza viruses that have crossed the species barrier to infect humans, H5N1 has caused the largest number of detected cases of severe disease and death in humans. However, it is possible that those cases in the most severely ill people are more likely to be diagnosed and reported, while milder cases go unreported.
Mar 12, 2007 (CIDRAP News) – The accumulation of human cases of H5N1 avian influenza continued with the reporting of one case each in
Officials in
The boy, who fell ill Mar 7 and was hospitalized the next day, was in stable condition, the WHO said. A health ministry official said the boy caught the virus from birds raised by his family, according to AFP.
In
By the WHO's count,
With the new case in Egypt, the WHO's global tally of human cases reported since H5N1 began spreading widely in late 2003 reached 278 cases with 168 deaths.
In other developments,
The disease erupted on a breeding farm in Cheonan, 56 miles south of
By Jodi S. Cohen
March 11, 2007
Before she eats a meal, goes to sleep at night or even kisses her boyfriend, she first has to slip off the blue surgical mask that covers her nose and mouth and hooks around her ears.
Didn't freshmen already have enough pressure to fit in?
"People do kind of look at you weird," said Rowe, 18, the outline of her mouth moving behind the cotton mask.
Around the
"I felt it was a worthy cause to participate in," said Rowe, who plans to go to medical school.
The $2 million study, funded by the U.S. Centers for Disease Control and Prevention, is one of several worldwide intended to evaluate the feasibility and effectiveness of non-pharmaceutical measures in containing the next deadly flu pandemic.
Scientists have been saying the world is due for the next flu epidemic, one that health experts fear could mutate from the H5N1 strain of bird flu.
In the case of such a pandemic, federal officials have said a vaccine may not be available until six months after an outbreak, making it more important to know the effectiveness of other measures, such as masks and hand washing, in controlling the disease.
But the first year of the CDC study, which ends this week, may reveal as much about slacker students as it does about science. Though 187 residents in one dorm had enrolled in the project, students this past week said they rarely saw anyone wearing the masks anymore.
"It was inconvenient," said Meghan McMahon, 19.
"It's hard to breathe with them on," said her friend Kelly Patrick, 18.
Even sophomore Asman Butt, 19, among the more loyal participants in the beginning of the trial, didn't wear his mask to the cafeteria last week. "It started to bother me," he said.
Stigma in the
Study co-investigator Allison Aiello, assistant professor of epidemiology at the university's
She said students have been filling out online weekly surveys about their health, the amount of time spent wearing the masks and the reasons for not wearing them, including embarrassment and discomfort. Observers also are stationed in the dorms and cafeterias to watch how many students are wearing the masks.
Researchers said the project will be valuable even if some of the students don't wear the protection. The study may find that while masks help prevent the spread of respiratory illnesses, they may not be a viable option because people won't use them.
"There seems to be good acceptance of mask-wearing in many Asian countries, but there needs to be more research on the stigma associated with it here in the
"That is the aim here, to get some better information on whether these sorts of things will make a difference," said Dr. Stephen Waterman, a medical epidemiologist at the CDC.
Tomas Aragon, director of the Center for Infectious Disease Preparedness at the University of California, Berkeley, School of Public Health, said it's hard to study disease prevention using healthy subjects because they may not feel threatened enough to change their behavior.
"It might well be that in the real world . . . people are unwilling to wear a mask until maybe there is a real threat right upon them," Aragon said.
And even among those who wear them, how soon will they take them off?
"How good is a mask when you throw a large pizza in the middle of the table in the dorm?" asked Dr. Steven Wolinsky, chief of infectious diseases at
That's what
Study coordinators lured participants with money and the chance to win iPODs.
$100 for wearing a mask
The mask wearers will get $100 at the end of the study, while those in the control group will get $40.
Students who feel ill and get their throat swabbed to check for the influenza virus get an additional $25.
But for many, the temptation of cash wasn't enough, and recruiters fell short of their goal of 2,250 participants. It also has been a mild flu season, which could affect the project.
The study will be repeated during next winter's flu season, and Aiello said she expects greater participation because there will be more time to recruit. The CDC didn't announce funding for the project until October, leaving little time to enroll students before the first flu cases were confirmed in the dorms in late January.
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Steps to take to avoid the flu
Increase your chance of staying healthy by:
- Getting immunized each year.
- Washing your hands often.
- Keeping your hands away from your nose, eyes and mouth.
- Eating a healthy, balanced diet.
- Getting regular exercise.
- Not smoking because it irritates the lining of your nose, sinuses and lungs, making you susceptible to complications of the flu.
Source: Webmd.com
THE ASSOCIATED PRESS
Congress responded to the 2001 strikes and anthrax-tainted letters sent to lawmakers by putting much more money toward emergency preparedness. State health departments typically get tens of millions of dollars a year to prepare for bioterrorism; it was in the hundreds of thousands before 9/11.
The money came with a catch:
Can't show accountability
"We're not able to demonstrate accountability," said Craig Thomas, chief of the CDC office that evaluates and monitors public health departments.
"It's not just accountability to the CDC. It's accountability to your community. It's accountability to your local stakeholders and the people who fund you as well."
Thomas was speaking to public-health leaders at a recent conference in
"The difficulty comes down to, how do you measure (improvement), how do you quantify that, so you have something you can track over time, something you can use to identify gaps that have to be filled," said the CDC's Dr. Richard Besser. He oversees the Office for Terrorism Preparedness and Emergency Response.
The government began awarding money for bioterrorism preparedness in 1999, sending $40.7 million to the states. In 2002, the total jumped to $950 million. That is about one-quarter of what the
The government also has increased spending on research at the National Institutes of Health and for improving the capabilities of hospitals and first responders.
Health departments used federal grants to stock up on antivirals, buy needles and syringes, and hire more doctors and nurses. One of the most important upgrades came in disease surveillance.
In
"Sometimes it's nothing. Sometimes the Super Bowl happened and you had more headaches the next day. Sometimes it's worth looking into and they can discover a new outbreak," said Dr. JoLynn Montgomery, director of the Center for Public Health Preparedness at the
Measuring improvements
The challenge for the CDC is how to measure
An initial list of 100 benchmarks, drafted in 2003, has shrunk to the 23 that were used last year.
States are asked such things as how long it takes:
● To get a "knowledgeable public-health professional" to respond to an urgent call.
● To ship a specimen to a laboratory.
● To begin an epidemiological investigation of an event that may be of urgent health consequences.
CDC officials point to two reasons for the lag in developing the measures.
For one, the CDC is a scientific organization. It makes recommendations based on scientific data, but such data does not exist when it comes to showing which steps taken by health officials would bring about the best result during a particular emergency.
Also, the agency had difficulty getting health departments to agree about what the government should measure.
"Every health department is different, so where one may have strengths and they feel very confident in measuring something, another may have that as a weakness and feel less confident," said Donna Knutson, a senior adviser at the CDC.
State officials who attended the health officials' conference say many measurements are still unclear.
"I don't think they're asking things that are measurable," Kimberly Allan of the Virginia Department of Health said. "The right questions are not being asked."