Biodefense Threat Analysis & Communications Center
Pandemic Influenza: Contingency Planning Discussion
Contact: Stephen M. Apatow,
Research and Development, Humanitarian University
Medicine and Law.
following topic has been opened for discussion with the IVPHC Working Group.
|ProMED: 24 January 2007, Archive 20070124.0323
| December 19, 2006 | vol. 103 | no. 51 | 19368-19373
the global spread of H5N1 avian influenza A: *Consortium for
Conservation Medicine, New York, NY 10001; Royal Society for the
Protection of Birds, Sandy,
Bedfordshire SG19 2DL, United Kingdom; and National Museum of Natural
and Smithsonian Migratory Bird Center, National Zoological Park,
Institution, Washington, DC 20008
The spread of highly pathogenic H5N1 avian influenza into Asia, Europe,
and Africa has resulted in enormous impacts on the poultry industry and
presents an important threat to human health. The pathways by which the
and will spread between countries
have been debated extensively, but have yet to be analyzed
comprehensively and quantitatively. We integrated data on phylogenetic
virus isolates, migratory bird movements, and trade in poultry and wild
birds to determine the
pathway for 52 individual introduction events into countries and
predict future spread. We show that 9 of 21 of H5N1 introductions to
countries in Asia were most likely through poultry, and 3 of 21 were
most likely through migrating birds. In contrast, spread to most
(20/23) countries in Europe was most likely through migratory birds.
Spread in Africa was likely partly by poultry (2/8 introductions) and
migrating birds (3/8). Our analyses predict that H5N1 is more likely to
introduced into the Western Hemisphere through infected poultry and
the mainland United States by subsequent movement of migrating birds
neighboring countries, rather than from eastern Siberia. These results
the potential synergism between trade and wild animal movement in the
emergence and pandemic spread of pathogens and demonstrate the value of
models for disease control.
- Avian influenza, human (140): atypical infections:
CDC, NEJM references indicate that atypical infections (encephalitis,
diarrheal, gastrointestinal illness) are a serious concern associated
with outbreaks of avian influenza A subtype H5N1 worldwide. -- ProMED,
5 September 2006.
- Co-Infection Influenza A - Methicillin Resistant
Staphylococcus Aureus (MRSA): MRSA, endemic in many hospitals, one
of the leading causes of nosocomial pneumonia and surgical site
infection and the second leading cause of nosocomial blood stream
infections. Prevention Methods for Airborne transmission of
- Influenza A/MRSA/Toxic Shock Syndrome (TSS):
Discussion papers, related information.
- CBN Report: Antibiotics to Treat Pneumonia: An
Overlooked Essential Element of Pandemic Preparedness: Clinicians Biosecurity Network,
Center for Biosecurity, 1 September 2006.
- International Health Regulations (Revisions
Approved): ProMED 22 May 2005. See also:
new International Health Regulations, Agreement must be
reached to protect the global village from pandemic
BMJ 2005;330:321-322 (12 February),
Pandemic Flu: We Are Not Prepared: "Pandemic flu
an enemy that we know will return. Indeed, of the 12 disaster scenarios
recently assessed by the US Department of Homeland Security, it is the
most likely and
perhaps the most deadly.
Our surveillance and countermeasures abroad are inadequate,
and current response plans won't do much to slow a pandemic once it is
under way. The United States, and the world, must meet this enemy with
the seriousness, the
investment, and the urgency that it demands. -- Medscape General Medicine, 15
- Halvorsen: contingency
planning for pandemic influenza: Discussion
on Vaccine Development, 27 October 2004
Influenza: International Contingency Planning
- Low Dose Interferon, Immune Modulation and Emergency
Influenza Prophylaxis: , Joseph M. Cummins, DVM, PhD, Chad
G. Thompson, BA, December 2004. See also "Systemic effects of interferons after oral
administration in animals and humans," AJVR, Vol 66, No. 1, January 2005.
In December 2003, Highly Pathogenic Avian
Influenza (HPAI) was confirmed about 80 kilometres south-east of
the capital, Seoul (December 2003), it was noted that if the outbreak
moved beyond the borders of Korea to countries in the East
Asian-Australasian Flyway via migratory bird patterns, could we be
looking at a widespread international multi-country outbreak (such as West
Nile Virus throughout North America).
Asian-Australasian Flyway stretches from within the Arctic Circle in
Siberia and western Alaska, through North and South East Asia to
Australia and Aotearoa/New Zealand. It covers twenty countries
Russia, Japan, China, Taiwan, Korea, Malaysia, Thailand, Vietnam,
Philippines, Indonesia, Mongolia, Alaska, Cambodia, Myanmar,
East Timor, Brunei, Singapore and Papua New Guinea, as well as
and Aotearoa/New Zealand.
On 25 October
2004 (Bird Flu Found in Migrant
Birds in Siberia), MosNews
"The bird flu virus has
in migrant birds living in Novosibirsk region. Ducks and geese are
thought to have brought the virus from South East Asia, the
head of a local zoogenous infections laboratory, Alexander Shestopalov,
was quoted by Interfax news agency as saying."
As the World
Health Organization redefined international law during the SARS
outbreak, we were fortunate that 90% of patients recovered without
hospitalization (SARS coronavirus: a new challenge for prevention and
therapy), while from a biodefense standpoint the
viral strain presented a new challenge:
"The genes of SARS-CoV were compared with the
corresponding genes of known coronaviruses of humans, pigs, cattle,
dogs, cats, mice, rats, chickens, and turkeys. Each gene of SARS-CoV
has only 70% or less identity with the corresponding gene of the known
coronaviruses. Thus, SARS-CoV is only dis-tantly related to the known
coronaviruses of humans and animals. Phylogenetic analysis suggests
that SARS-CoV does not fit within any of the three groups that contain
all other known coronaviruses."
Today, a global
population of approximately
6.4 billion, must be considered
plans for containment and control of a pandemic influenza
- Avian Influenza: Dave
Halvorson, College Of Veterinary Medicine, University
- Influenza: Biodefense and Epidemiological
Tracking, Humanitarian Resource Institute.
- West Nile Virus: Biodefense and Epidemiological
Tracking, Humanitarian Resource Institute.