We should not be complacent about our population-based public health response to the first influenza pandemic of the 21stcentury
Identifieur interne : 000F38 ( Ncbi/Checkpoint ); précédent : 000F37; suivant : 000F39We should not be complacent about our population-based public health response to the first influenza pandemic of the 21stcentury
Auteurs : Heath A. Kelly [Australie] ; Patricia C. Priest [Nouvelle-Zélande] ; Geoffry N. Mercer [Australie] ; Gary K. Dowse [Australie]Source :
- BMC Public Health [ 1471-2458 ] ; 2011.
Descripteurs français
- KwdFr :
- Adolescent, Australie (épidémiologie), Dépistage systématique, Enfant, Enfant d'âge préscolaire, Grippe humaine (), Grippe humaine (diagnostic), Grippe humaine (histoire), Grippe humaine (traitement médicamenteux), Grippe humaine (épidémiologie), Histoire du 21ème siècle, Humains, Pandémies, Politique publique, Santé publique (), Sialidase (pharmacologie), Sialidase (usage thérapeutique), Sous-type H1N1 du virus de la grippe A (), Sous-type H1N1 du virus de la grippe A (isolement et purification), Établissements scolaires (organisation et administration).
- MESH :
- diagnostic : Grippe humaine.
- histoire : Grippe humaine.
- isolement et purification : Sous-type H1N1 du virus de la grippe A.
- organisation et administration : Établissements scolaires.
- pharmacologie : Sialidase.
- traitement médicamenteux : Grippe humaine.
- usage thérapeutique : Sialidase.
- épidémiologie : Australie, Grippe humaine.
- Adolescent, Dépistage systématique, Enfant, Enfant d'âge préscolaire, Grippe humaine, Histoire du 21ème siècle, Humains, Pandémies, Politique publique, Santé publique, Sous-type H1N1 du virus de la grippe A.
- Wicri :
- geographic : Australie.
English descriptors
- KwdEn :
- Adolescent, Australia (epidemiology), Child, Child, Preschool, History, 21st Century, Humans, Influenza A Virus, H1N1 Subtype (drug effects), Influenza A Virus, H1N1 Subtype (isolation & purification), Influenza, Human (diagnosis), Influenza, Human (drug therapy), Influenza, Human (epidemiology), Influenza, Human (history), Influenza, Human (prevention & control), Mass Screening, Neuraminidase (pharmacology), Neuraminidase (therapeutic use), Pandemics, Public Health (methods), Public Policy, Schools (organization & administration).
- MESH :
- chemical , pharmacology : Neuraminidase.
- geographic , epidemiology : Australia.
- diagnosis : Influenza, Human.
- drug effects : Influenza A Virus, H1N1 Subtype.
- drug therapy : Influenza, Human.
- epidemiology : Influenza, Human.
- history : Influenza, Human.
- isolation & purification : Influenza A Virus, H1N1 Subtype.
- methods : Public Health.
- organization & administration : Schools.
- prevention & control : Influenza, Human.
- chemical , therapeutic use : Neuraminidase.
- Adolescent, Child, Child, Preschool, History, 21st Century, Humans, Mass Screening, Pandemics, Public Policy.
Abstract
More than a year after an influenza pandemic was declared in June 2009, the World Health Organization declared the pandemic to be over. Evaluations of the pandemic response are beginning to appear in the public domain.
We argue that, despite the enormous effort made to control the pandemic, it is now time to acknowledge that many of the population-based public health interventions may not have been well considered. Prior to the pandemic, there was limited scientific evidence to support border control measures. In particular no border screening measures would have detected prodromal or asymptomatic infections, and asymptomatic infections with pandemic influenza were common. School closures, when they were partial or of short duration, would not have interrupted spread of the virus in school-aged children, the group with the highest rate of infection worldwide. In most countries where they were available, neuraminidase inhibitors were not distributed quickly enough to have had an effect at the population level, although they will have benefited individuals, and prophylaxis within closed communities will have been effective. A pandemic specific vaccine will have protected the people who received it, although in most countries only a small minority was vaccinated, and often a small minority of those most at risk. The pandemic vaccine was generally not available early enough to have influenced the shape of the first pandemic wave and it is likely that any future pandemic vaccine manufactured using current technology will also be available too late, at least in one hemisphere.
Border screening, school closure, widespread anti-viral prophylaxis and a pandemic-specific vaccine were unlikely to have been effective during a pandemic which was less severe than anticipated in the pandemic plans of many countries. These were cornerstones of the population-based public health response. Similar responses would be even less likely to be effective in a more severe pandemic. We agree with the recommendation from the World Health Organisation that pandemic preparedness plans need review.
Url:
DOI: 10.1186/1471-2458-11-78
PubMed: 21291568
PubMed Central: 3048535
Affiliations:
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PMC:3048535Le document en format XML
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>More than a year after an influenza pandemic was declared in June 2009, the World Health Organization declared the pandemic to be over. Evaluations of the pandemic response are beginning to appear in the public domain.</p>
</sec>
<sec><title>Discussion</title>
<p>We argue that, despite the enormous effort made to control the pandemic, it is now time to acknowledge that many of the population-based public health interventions may not have been well considered. Prior to the pandemic, there was limited scientific evidence to support border control measures. In particular no border screening measures would have detected prodromal or asymptomatic infections, and asymptomatic infections with pandemic influenza were common. School closures, when they were partial or of short duration, would not have interrupted spread of the virus in school-aged children, the group with the highest rate of infection worldwide. In most countries where they were available, neuraminidase inhibitors were not distributed quickly enough to have had an effect at the population level, although they will have benefited individuals, and prophylaxis within closed communities will have been effective. A pandemic specific vaccine will have protected the people who received it, although in most countries only a small minority was vaccinated, and often a small minority of those most at risk. The pandemic vaccine was generally not available early enough to have influenced the shape of the first pandemic wave and it is likely that any future pandemic vaccine manufactured using current technology will also be available too late, at least in one hemisphere.</p>
</sec>
<sec><title>Summary</title>
<p>Border screening, school closure, widespread anti-viral prophylaxis and a pandemic-specific vaccine were unlikely to have been effective during a pandemic which was less severe than anticipated in the pandemic plans of many countries. These were cornerstones of the population-based public health response. Similar responses would be even less likely to be effective in a more severe pandemic. We agree with the recommendation from the World Health Organisation that pandemic preparedness plans need review.</p>
</sec>
</div>
</front>
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<author><name sortKey="Jenkins, C" uniqKey="Jenkins C">C Jenkins</name>
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<author><name sortKey="Kelly, Pm" uniqKey="Kelly P">PM Kelly</name>
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<author><name sortKey="Cheng, A" uniqKey="Cheng A">A Cheng</name>
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<author><name sortKey="Hancox, Rj" uniqKey="Hancox R">RJ Hancox</name>
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<author><name sortKey="Holmes, M" uniqKey="Holmes M">M Holmes</name>
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<author><name sortKey="Wood Baker, R" uniqKey="Wood Baker R">R Wood-Baker</name>
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<author><name sortKey="Bowler, S" uniqKey="Bowler S">S Bowler</name>
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<author><name sortKey="Irving, L" uniqKey="Irving L">L Irving</name>
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<author><name sortKey="Thompson, P" uniqKey="Thompson P">P Thompson</name>
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<affiliations><list><country><li>Australie</li>
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<country name="Nouvelle-Zélande"><noRegion><name sortKey="Priest, Patricia C" sort="Priest, Patricia C" uniqKey="Priest P" first="Patricia C" last="Priest">Patricia C. Priest</name>
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