Marking the 1918 influenza pandemic centennial: addressing regional influenza threats through the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies
Identifieur interne : 000482 ( Pmc/Corpus ); précédent : 000481; suivant : 000483Marking the 1918 influenza pandemic centennial: addressing regional influenza threats through the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies
Auteurs : Erica Dueger ; Lisa Peters ; Li AilanSource :
- Western Pacific Surveillance and Response Journal : WPSAR [ 2094-7321 ] ; 2019.
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DOI: 10.5365/wpsar.2018.9.5.000
PubMed: 31832245
PubMed Central: 6902656
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Marking the 1918 influenza pandemic centennial: addressing regional influenza threats through the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies</title><author><name sortKey="Dueger, Erica" sort="Dueger, Erica" uniqKey="Dueger E" first="Erica" last="Dueger">Erica Dueger</name><affiliation><nlm:aff id="aff1">WHO Health Emergencies Programme,<institution>WHO Regional Office for the Western Pacific</institution>,<addr-line>Manila</addr-line>,<country>Philippines</country>.</nlm:aff></affiliation></author><author><name sortKey="Peters, Lisa" sort="Peters, Lisa" uniqKey="Peters L" first="Lisa" last="Peters">Lisa Peters</name><affiliation><nlm:aff id="aff1">WHO Health Emergencies Programme,<institution>WHO Regional Office for the Western Pacific</institution>,<addr-line>Manila</addr-line>,<country>Philippines</country>.</nlm:aff></affiliation></author><author><name sortKey="Ailan, Li" sort="Ailan, Li" uniqKey="Ailan L" first="Li" last="Ailan">Li Ailan</name><affiliation><nlm:aff id="aff1">WHO Health Emergencies Programme,<institution>WHO Regional Office for the Western Pacific</institution>,<addr-line>Manila</addr-line>,<country>Philippines</country>.</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">31832245</idno><idno type="pmc">6902656</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6902656</idno><idno type="RBID">PMC:6902656</idno><idno type="doi">10.5365/wpsar.2018.9.5.000</idno><date when="2019">2019</date><idno type="wicri:Area/Pmc/Corpus">000482</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000482</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Marking the 1918 influenza pandemic centennial: addressing regional influenza threats through the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies</title><author><name sortKey="Dueger, Erica" sort="Dueger, Erica" uniqKey="Dueger E" first="Erica" last="Dueger">Erica Dueger</name><affiliation><nlm:aff id="aff1">WHO Health Emergencies Programme,<institution>WHO Regional Office for the Western Pacific</institution>,<addr-line>Manila</addr-line>,<country>Philippines</country>.</nlm:aff></affiliation></author><author><name sortKey="Peters, Lisa" sort="Peters, Lisa" uniqKey="Peters L" first="Lisa" last="Peters">Lisa Peters</name><affiliation><nlm:aff id="aff1">WHO Health Emergencies Programme,<institution>WHO Regional Office for the Western Pacific</institution>,<addr-line>Manila</addr-line>,<country>Philippines</country>.</nlm:aff></affiliation></author><author><name sortKey="Ailan, Li" sort="Ailan, Li" uniqKey="Ailan L" first="Li" last="Ailan">Li Ailan</name><affiliation><nlm:aff id="aff1">WHO Health Emergencies Programme,<institution>WHO Regional Office for the Western Pacific</institution>,<addr-line>Manila</addr-line>,<country>Philippines</country>.</nlm:aff></affiliation></author></analytic><series><title level="j">Western Pacific Surveillance and Response Journal : WPSAR</title><idno type="ISSN">2094-7321</idno><idno type="eISSN">2094-7313</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="editorial"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Western Pac Surveill Response J</journal-id><journal-id journal-id-type="iso-abbrev">Western Pac Surveill Response J</journal-id><journal-id journal-id-type="publisher-id">WPSAR</journal-id><journal-title-group><journal-title>Western Pacific Surveillance and Response Journal : WPSAR</journal-title></journal-title-group><issn pub-type="ppub">2094-7321</issn><issn pub-type="epub">2094-7313</issn><publisher><publisher-name>World Health Organization</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">31832245</article-id><article-id pub-id-type="pmc">6902656</article-id><article-id pub-id-type="publisher-id">wpsar.2018.9.5-001</article-id><article-id pub-id-type="doi">10.5365/wpsar.2018.9.5.000</article-id><article-categories><subj-group subj-group-type="heading"><subject>Non Theme Issue</subject><subj-group subj-group-type="article-subtype"><subject>Editorial</subject></subj-group></subj-group></article-categories><title-group><article-title>Marking the 1918 influenza pandemic centennial: addressing regional influenza threats through the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Dueger</surname><given-names>Erica</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Peters</surname><given-names>Lisa</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Ailan</surname><given-names>Li</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><aff id="aff1"><label>a</label>WHO Health Emergencies Programme,<institution>WHO Regional Office for the Western Pacific</institution>,<addr-line>Manila</addr-line>,<country>Philippines</country>.</aff><aff id="aff2"><label>b</label><institution>Centers for Disease Control and Prevention</institution>,<addr-line>Atlanta, Georgia</addr-line>,<country>USA</country>.</aff></contrib-group><author-notes><corresp id="cor1">Correspondence to Erica Dueger (email: <email xlink:href="wpsar@who.int">wpsar@who.int</email>)</corresp></author-notes><pub-date pub-type="collection"><season>Winter</season><year>2018</year></pub-date><pub-date pub-type="epub"><day>19</day><month>11</month><year>2019</year></pub-date><volume>9</volume><issue>5 Suppl 1</issue><fpage>1</fpage><lpage>4</lpage><permissions><copyright-statement>(c) 2019 The authors; licensee World Health Organization.</copyright-statement><copyright-year>2019</copyright-year><license license-type="open-access"><license-p>This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/3.0/igo/legalcode">http://creativecommons.org/licenses/by/3.0/igo/legalcode</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.</license-p></license></permissions></article-meta></front><body><p>In 1918, near the close of the First World War, pandemic influenza swept across the world. Spread by the movement of troops and fueled by dense military-camp living quarters, the virus caused unusually high mortality rates in people 20–40 years old. An estimated 500 million people were infected, and up to 50 million died. Since then, pandemics caused by newly emerging influenza viruses have occurred every 10–40 years, with each of the pandemics in 1957, 1968 and 1977 taking the lives of roughly one million people. (<xref rid="R1" ref-type="bibr"><italic>1</italic></xref>) More recently, the 2009 H1N1 influenza pandemic resulted in an estimated half a million deaths and raised concerns about how prepared the global community was to cope with future public health events. (<xref rid="R2" ref-type="bibr"><italic>2</italic></xref>) Past pandemics can teach us important lessons about preventing and responding to emerging global health threats. This special issue highlights significant achievements across the Western Pacific Region in global pandemic preparedness and response.</p><p>The World Health Organization (WHO) Western Pacific Region is a hotspot for significant emerging infectious disease events, including human infections with avian influenza viruses. (<xref rid="R3" ref-type="bibr"><italic>3</italic></xref>) Home to nearly 1.9 billion people and 6 billion poultry, avian influenza viruses that pass from animals to humans living in close proximity could mutate and rapidly spread through the Region and the world. Since 2003, the Western Pacific Region has experienced the emergence of influenza A(H1N1)pdm09, A(H5N1), A(H5N6), A(H6N1), A(H7N4), A(H7N9), A(H9N2) and A(H10N8) viruses. (<xref rid="R4" ref-type="bibr"><italic>4</italic></xref>) Member States’ abilities to quickly identify emerging infections, determine the pandemic potential of the causative viruses, assess public health risk and event severity, and, when needed, mobilize a public health response is critical to better protecting people from emerging threats in the Region and around the world.</p><p>For more than a decade, the <italic>Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies</italic> (APSED III) and its earlier versions in 2005 and 2010 have driven joint efforts to build and strengthen national core capacities as required under the International Health Regulations or IHR (2005). (<xref rid="R5" ref-type="bibr"><italic>5</italic></xref>, <xref rid="R6" ref-type="bibr"><italic>6</italic></xref>) APSED III envisions a region able to prepare for, detect and respond to public health emergencies through improved regional connectivity and collective responsibility for managing health security. Importantly, APSED III builds on the foundations of the earlier versions to address emerging disease threats and public health emergencies (<bold>Fig. 1</bold>). APSED III provides critical elements for developing public health systems capable of identifying and responding to emerging infectious diseases, events and public health emergencies, including the next influenza pandemic (<bold>Fig. 2</bold>).</p><fig id="F1" fig-type="figure" orientation="portrait" position="float"><label>Figure 1</label><caption><p><bold>APSED development and priorities from 2005 to 2016 and beyond</bold></p></caption><p>[<bold>insert</bold><xref ref-type="fig" rid="F1">Figure 1</xref>]</p><graphic xlink:href="wpsar.2018.9.5-002-F1"></graphic></fig><fig id="F2" fig-type="figure" orientation="portrait" position="float"><label>Figure 2</label><caption><p><bold>APSED III provides a framework for public health emergency preparedness in the Western Pacific Region, including preparedness for future pandemic influenza</bold></p></caption><p>[<bold>insert</bold><xref ref-type="fig" rid="F2">Figure 2</xref>]</p><graphic xlink:href="wpsar.2018.9.5-002-F2"></graphic></fig><p>Over the last decade, Member States in the Western Pacific Region have substantially strengthened national virological and epidemiological surveillance for influenza. (<xref rid="R7" ref-type="bibr"><italic>7</italic></xref>) Through these improved capacities, the Region contributes to the continuous global monitoring of seasonal and emerging influenza viruses through the Global Influenza Surveillance and Response System. (<xref rid="R8" ref-type="bibr"><italic>8</italic></xref>) Event-based surveillance became a regional priority as part of the implementation of IHR (2005) and, through APSED III, is now well established in the Western Pacific Region. Outpatient influenza-like illness surveillance across the Asia-Pacific is used to evaluate seasonal severity (<xref rid="R9" ref-type="bibr"><italic>9</italic></xref>) of influenza and provides isolates to support seasonal influenza vaccine development. (<xref rid="R10" ref-type="bibr"><italic>10</italic></xref>) These activities are helping countries detect, conduct risk assessments of and respond to influenza outbreaks as well as contribute to biannual recommendations for vaccine composition.</p><p>The importance of coordinating pandemic preparedness and response efforts with the animal and environmental sectors cannot be overstated. Zoonotic influenza virus mutations have been associated with pandemics over the last century, and their significance was recognized broadly in 1997, when the first human cases of A(H5N1) were detected in Hong Kong Special Administrative Region SAR (China). As outlined in the perspective by Peters et al. (<xref rid="R11" ref-type="bibr"><italic>11</italic></xref>) and overview by Hamid et al., (<xref rid="R4" ref-type="bibr"><italic>4</italic></xref>) infected animals and contaminated environments are often the source of human infection. Close monitoring of domestic animals and wildlife, and any associated human populations, is important for identifying newly emerging influenza viruses. Sharing these data in a timely manner allows policy-makers and public health officials to quickly identify and respond to such emerging threats. In response to this need, the WHO Regional Office for the Western Pacific has developed a set of online interactive influenza dashboards (<xref rid="R12" ref-type="bibr"><italic>12</italic></xref>) that provide both baseline seasonal and avian influenza data and real-time surveillance information for risk assessments. In addition, the WHO Regional Office has supported national pandemic containment exercises that encourage multisectoral collaboration and improve national pandemic preparedness plans. (<xref rid="R13" ref-type="bibr"><italic>13</italic></xref>)</p><p>Risk communication is essential to moblize an effective public health response to influenza. The 2009 H1N1 influenza pandemic highlighted the importance of comprehensive risk communication strategies; the lessons learnt were applied for timely and transparent risk communication after discovery of the first human case of influenza A(H7N9) in China. (<xref rid="R14" ref-type="bibr"><italic>14</italic></xref>) Although significant progress has been made in risk communication over the last decade, there is still room for improvement. Efforts under way in Australia highlight improvements in risk communication for in Australian Aboriginal communities (<xref rid="R15" ref-type="bibr"><italic>15</italic></xref>) and secondary school students. (<xref rid="R16" ref-type="bibr"><italic>16</italic></xref>)</p><p>Lessons learnt from the 2009 pandemic mobilized the World Health Assembly to adopt the Pandemic Influenza Preparedness (PIP) framework in 2011, enabling efficient and equitable access to vaccines and medicines during future pandemics. (<xref rid="R17" ref-type="bibr"><italic>17</italic></xref>) Critical to these efforts is utilization of national surveillance data to support Member State policies and systems for seasonal influenza vaccination of high-risk groups. Determination of national disease burden, as described in detail for recent efforts in Cambodia (<xref rid="R18" ref-type="bibr"><italic>18</italic></xref>) and China, (<xref rid="R19" ref-type="bibr"><italic>19</italic></xref>) is imperative for obtaining national funding to support vaccination of high-risk groups and for influenza vaccination systems that can be scaled up quickly in the face of a pandemic. Collaborative efforts of PIP and the Partnership for Influenza Vaccine Introduction continue to support increased pandemic readiness through the expansion of national seasonal influenza vaccination programmes in low- and middle-income countries. (<xref rid="R10" ref-type="bibr"><italic>10</italic></xref>)</p><p>WHO has been working with partners to ensure strong regional systems are in place to support the rapid detection, identification, reporting and risk assessment of any events with pandemic potential in the Western Pacific Region. As reflected in published influenza profiles (<xref rid="R20" ref-type="bibr"><italic>20</italic></xref>) of the laboratory, surveillance and vaccination capacities for 37 countries and areas, influenza preparedness is well documented across the Region, including for surveillance and vaccination of high-risk groups. Under the guidance of APSED III, Member States have prioritized regional and global health security, learning from the past, engaging in the present and preparing for the future. This special issue highlights the Region’s collective journey in pandemic influenza preparedness and its significant progress over the last decade to improve health security in the Region and the world.</p></body><back><ref-list><title>References</title><ref id="R1"><label>1</label><mixed-citation publication-type="journal"><string-name><surname>Kilbourne</surname><given-names>ED</given-names></string-name>. <article-title>Influenza pandemics of the 20th century.</article-title><source>Emerg Infect Dis</source>. <year>2006</year><month>1</month>;<volume>12</volume>(<issue>1</issue>):<fpage>9</fpage>–<lpage>14</lpage>. <pub-id pub-id-type="doi">10.3201/eid1201.051254</pub-id><pub-id pub-id-type="pmid">16494710</pub-id></mixed-citation></ref><ref id="R2"><label>2</label><mixed-citation publication-type="journal"><string-name><surname>Viboud</surname><given-names>C</given-names></string-name>, <string-name><surname>Simonsen</surname><given-names>L</given-names></string-name>. <article-title>Global mortality of 2009 pandemic influenza A H1N1.</article-title><source>Lancet Infect Dis</source>. <year>2012</year><month>9</month>;<volume>12</volume>(<issue>9</issue>):<fpage>651</fpage>–<lpage>3</lpage>. <pub-id pub-id-type="doi">10.1016/S1473-3099(12)70152-4</pub-id><pub-id pub-id-type="pmid">22738892</pub-id></mixed-citation></ref><ref id="R3"><label>3</label><mixed-citation publication-type="web">Avian influenza. 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