A Poultry outbreak in Chile sparks new alarm
The detection of an H1N1 virus in turkeys in Chile raises concern that poultry farms elsewhere in the world may also become infected with the pandemic swine flu virus, according to the United Nations FAO (Food and Agriculture Organization). Chilean authorities last week reported that the pandemic H1N1 virus, had been detected in turkeys on two farms near Valparaiso.
The flu strain found in the poultry flocks is identical to the H1N1/2009 pandemic strain currently circulating among human populations around the world.
The FAO said the discovery of the virus did not pose any immediate threat to human health and turkey meat can still be sold commercially following veterinary inspection.
However, the FAO did say that it could theoretically become more dangerous if it combines with H5N1, commonly known as bird flu, which is far more deadly but harder to pass along among humans. [See an earlier post in this blog called “Swine Flu and Bird Flu - What If They Join Forces?” http://blog.binomial.com/2009/08/swine-flu-and-bird-flu-what-if-they.html
The report describes two cases of what is described as 'influenza A virus' in turkeys in the state of Valparaiso.
One case, starting on 29 July, is in Nogales. It involved illness in 12,248 breeding turkeys of a flock of almost 30,000. An abnormal decrease in the laying rate was observed but no respiratory signs or increased mortality.
Symptoms were observed on 23 July in another flock of breeding turkeys in Valparaiso. More than 24,000 birds out of another flock of 30,000 birds were affected. Egg production fell from around 70 per cent to 31 per cent, and shell quality deteriorated. Again, no respiratory signs or increased mortality were observed. Necroscopy of the affected birds showed salpingitis, peritonitis and an interruption of the follicular development. No other lesions were observed. Samples of embryonated eggs collected from the incubation building gave negative results with real time PCR. Twenty days after the beginning of the event, a recovery in the laying rate was observed.
The affected farms are turkey breeding premises belonging to the same company, vertically integrated, where appropriate biosecurity measures are applied.
Outbreak 1 was on a farm composed of five breeding premises. The outbreak started in premises no. 1 and through horizontal transmission, it reached three other premises. In outbreak 2, two of five sectors were affected.
Chile does not yet have H5N1 flu. In South-East Asia where there is a lot of the virus circulating in poultry, the introduction of H1N1 in these populations would be of a greater concern.
The FAO is encouraging better monitoring of animals to ensure that hygienic and good farming practice guidelines are followed.
Chile is now the fourth country that is investigating the spill-over of the H1N1/2009 virus from farm workers showing flu-like illness to animals, with swine becoming infected in Canada, Argentina and, most recently, Australia.
The emergence of new influenza virus strains capable of affecting humans and domestic animals remains a broader, more general concern that is being closely monitored by FAO, the World Organization for Animal Health and the WHO (World Health Organization).
The U.S Center for Disease Control and Prevention said it was theoretically possible for the viruses to combine. That hasn't been documented but is a concern."
Monday, August 31, 2009
Saturday, August 29, 2009
Preparing for the second wave: (H1N1)
This is a reprint of this very important article from the World Health Organization.
http://www.who.int/csr/disease/swineflu/notes/h1n1_second_wave_20090828/en/index.html
Preparing for the second wave: lessons from current outbreaks
Pandemic (H1N1) 2009 briefing note 9
28 AUGUST 2009 | GENEVA -- Monitoring of outbreaks from different parts of the world provides sufficient information to make some tentative conclusions about how the influenza pandemic might evolve in the coming months.
WHO is advising countries in the northern hemisphere to prepare for a second wave of pandemic spread. Countries with tropical climates, where the pandemic virus arrived later than elsewhere, also need to prepare for an increasing number of cases.
Countries in temperate parts of the southern hemisphere should remain vigilant. As experience has shown, localized “hot spots” of increasing transmission can continue to occur even when the pandemic has peaked at the national level.
H1N1 now the dominant virus strain
Evidence from multiple outbreak sites demonstrates that the H1N1 pandemic virus has rapidly established itself and is now the dominant influenza strain in most parts of the world. The pandemic will persist in the coming months as the virus continues to move through susceptible populations.
Close monitoring of viruses by a WHO network of laboratories shows that viruses from all outbreaks remain virtually identical. Studies have detected no signs that the virus has mutated to a more virulent or lethal form.
Likewise, the clinical picture of pandemic influenza is largely consistent across all countries. The overwhelming majority of patients continue to experience mild illness. Although the virus can cause very severe and fatal illness, also in young and healthy people, the number of such cases remains small.
Large populations susceptible to infection
While these trends are encouraging, large numbers of people in all countries remain susceptible to infection. Even if the current pattern of usually mild illness continues, the impact of the pandemic during the second wave could worsen as larger numbers of people become infected.
Larger numbers of severely ill patients requiring intensive care are likely to be the most urgent burden on health services, creating pressures that could overwhelm intensive care units and possibly disrupt the provision of care for other diseases.
Monitoring for drug resistance
At present, only a handful of pandemic viruses resistant to oseltamivir have been detected worldwide, despite the administration of many millions of treatment courses of antiviral drugs. All of these cases have been extensively investigated, and no instances of onward transmission of drug-resistant virus have been documented to date. Intense monitoring continues, also through the WHO network of laboratories.
Not the same as seasonal influenza
Current evidence points to some important differences between patterns of illness reported during the pandemic and those seen during seasonal epidemics of influenza.
The age groups affected by the pandemic are generally younger. This is true for those most frequently infected, and especially so for those experiencing severe or fatal illness.
To date, most severe cases and deaths have occurred in adults under the age of 50 years, with deaths in the elderly comparatively rare. This age distribution is in stark contrast with seasonal influenza, where around 90% of severe and fatal cases occur in people 65 years of age or older.
Severe respiratory failure
Perhaps most significantly, clinicians from around the world are reporting a very severe form of disease, also in young and otherwise healthy people, which is rarely seen during seasonal influenza infections. In these patients, the virus directly infects the lung, causing severe respiratory failure. Saving these lives depends on highly specialized and demanding care in intensive care units, usually with long and costly stays.
During the winter season in the southern hemisphere, several countries have viewed the need for intensive care as the greatest burden on health services. Some cities in these countries report that nearly 15 percent of hospitalized cases have required intensive care.
Preparedness measures need to anticipate this increased demand on intensive care units, which could be overwhelmed by a sudden surge in the number of severe cases.
Vulnerable groups
An increased risk during pregnancy is now consistently well-documented across countries. This risk takes on added significance for a virus, like this one, that preferentially infects younger people.
Data continue to show that certain medical conditions increase the risk of severe and fatal illness. These include respiratory disease, notably asthma, cardiovascular disease, diabetes and immunosuppression.
When anticipating the impact of the pandemic as more people become infected, health officials need to be aware that many of these predisposing conditions have become much more widespread in recent decades, thus increasing the pool of vulnerable people.
Obesity, which is frequently present in severe and fatal cases, is now a global epidemic. WHO estimates that, worldwide, more than 230 million people suffer from asthma, and more than 220 million people have diabetes.
Moreover, conditions such as asthma and diabetes are not usually considered killer diseases, especially in children and young adults. Young deaths from such conditions, precipitated by infection with the H1N1 virus, can be another dimension of the pandemic’s impact.
Higher risk of hospitalization and death
Several early studies show a higher risk of hospitalization and death among certain subgroups, including minority groups and indigenous populations. In some studies, the risk in these groups is four to five times higher than in the general population.
Although the reasons are not fully understood, possible explanations include lower standards of living and poor overall health status, including a high prevalence of conditions such as asthma, diabetes and hypertension.
Implications for the developing world
Such findings are likely to have growing relevance as the pandemic gains ground in the developing world, where many millions of people live under deprived conditions and have multiple health problems, with little access to basic health care.
As much current data about the pandemic come from wealthy and middle-income countries, the situation in developing countries will need to be very closely watched. The same virus that causes manageable disruption in affluent countries could have a devastating impact in many parts of the developing world.
Co-infection with HIV
The 2009 influenza pandemic is the first to occur since the emergence of HIV/AIDS. Early data from two countries suggest that people co-infected with H1N1 and HIV are not at increased risk of severe or fatal illness, provided these patients are receiving antiretroviral therapy. In most of these patients, illness caused by H1N1 has been mild, with full recovery.
If these preliminary findings are confirmed, this will be reassuring news for countries where infection with HIV is prevalent and treatment coverage with antiretroviral drugs is good.
On current estimates, around 33 million people are living with HIV/AIDS worldwide. Of these, WHO estimates that around 4 million were receiving antiretroviral therapy at the end of 2008.
http://www.who.int/csr/disease/swineflu/notes/h1n1_second_wave_20090828/en/index.html
Preparing for the second wave: lessons from current outbreaks
Pandemic (H1N1) 2009 briefing note 9
28 AUGUST 2009 | GENEVA -- Monitoring of outbreaks from different parts of the world provides sufficient information to make some tentative conclusions about how the influenza pandemic might evolve in the coming months.
WHO is advising countries in the northern hemisphere to prepare for a second wave of pandemic spread. Countries with tropical climates, where the pandemic virus arrived later than elsewhere, also need to prepare for an increasing number of cases.
Countries in temperate parts of the southern hemisphere should remain vigilant. As experience has shown, localized “hot spots” of increasing transmission can continue to occur even when the pandemic has peaked at the national level.
H1N1 now the dominant virus strain
Evidence from multiple outbreak sites demonstrates that the H1N1 pandemic virus has rapidly established itself and is now the dominant influenza strain in most parts of the world. The pandemic will persist in the coming months as the virus continues to move through susceptible populations.
Close monitoring of viruses by a WHO network of laboratories shows that viruses from all outbreaks remain virtually identical. Studies have detected no signs that the virus has mutated to a more virulent or lethal form.
Likewise, the clinical picture of pandemic influenza is largely consistent across all countries. The overwhelming majority of patients continue to experience mild illness. Although the virus can cause very severe and fatal illness, also in young and healthy people, the number of such cases remains small.
Large populations susceptible to infection
While these trends are encouraging, large numbers of people in all countries remain susceptible to infection. Even if the current pattern of usually mild illness continues, the impact of the pandemic during the second wave could worsen as larger numbers of people become infected.
Larger numbers of severely ill patients requiring intensive care are likely to be the most urgent burden on health services, creating pressures that could overwhelm intensive care units and possibly disrupt the provision of care for other diseases.
Monitoring for drug resistance
At present, only a handful of pandemic viruses resistant to oseltamivir have been detected worldwide, despite the administration of many millions of treatment courses of antiviral drugs. All of these cases have been extensively investigated, and no instances of onward transmission of drug-resistant virus have been documented to date. Intense monitoring continues, also through the WHO network of laboratories.
Not the same as seasonal influenza
Current evidence points to some important differences between patterns of illness reported during the pandemic and those seen during seasonal epidemics of influenza.
The age groups affected by the pandemic are generally younger. This is true for those most frequently infected, and especially so for those experiencing severe or fatal illness.
To date, most severe cases and deaths have occurred in adults under the age of 50 years, with deaths in the elderly comparatively rare. This age distribution is in stark contrast with seasonal influenza, where around 90% of severe and fatal cases occur in people 65 years of age or older.
Severe respiratory failure
Perhaps most significantly, clinicians from around the world are reporting a very severe form of disease, also in young and otherwise healthy people, which is rarely seen during seasonal influenza infections. In these patients, the virus directly infects the lung, causing severe respiratory failure. Saving these lives depends on highly specialized and demanding care in intensive care units, usually with long and costly stays.
During the winter season in the southern hemisphere, several countries have viewed the need for intensive care as the greatest burden on health services. Some cities in these countries report that nearly 15 percent of hospitalized cases have required intensive care.
Preparedness measures need to anticipate this increased demand on intensive care units, which could be overwhelmed by a sudden surge in the number of severe cases.
Vulnerable groups
An increased risk during pregnancy is now consistently well-documented across countries. This risk takes on added significance for a virus, like this one, that preferentially infects younger people.
Data continue to show that certain medical conditions increase the risk of severe and fatal illness. These include respiratory disease, notably asthma, cardiovascular disease, diabetes and immunosuppression.
When anticipating the impact of the pandemic as more people become infected, health officials need to be aware that many of these predisposing conditions have become much more widespread in recent decades, thus increasing the pool of vulnerable people.
Obesity, which is frequently present in severe and fatal cases, is now a global epidemic. WHO estimates that, worldwide, more than 230 million people suffer from asthma, and more than 220 million people have diabetes.
Moreover, conditions such as asthma and diabetes are not usually considered killer diseases, especially in children and young adults. Young deaths from such conditions, precipitated by infection with the H1N1 virus, can be another dimension of the pandemic’s impact.
Higher risk of hospitalization and death
Several early studies show a higher risk of hospitalization and death among certain subgroups, including minority groups and indigenous populations. In some studies, the risk in these groups is four to five times higher than in the general population.
Although the reasons are not fully understood, possible explanations include lower standards of living and poor overall health status, including a high prevalence of conditions such as asthma, diabetes and hypertension.
Implications for the developing world
Such findings are likely to have growing relevance as the pandemic gains ground in the developing world, where many millions of people live under deprived conditions and have multiple health problems, with little access to basic health care.
As much current data about the pandemic come from wealthy and middle-income countries, the situation in developing countries will need to be very closely watched. The same virus that causes manageable disruption in affluent countries could have a devastating impact in many parts of the developing world.
Co-infection with HIV
The 2009 influenza pandemic is the first to occur since the emergence of HIV/AIDS. Early data from two countries suggest that people co-infected with H1N1 and HIV are not at increased risk of severe or fatal illness, provided these patients are receiving antiretroviral therapy. In most of these patients, illness caused by H1N1 has been mild, with full recovery.
If these preliminary findings are confirmed, this will be reassuring news for countries where infection with HIV is prevalent and treatment coverage with antiretroviral drugs is good.
On current estimates, around 33 million people are living with HIV/AIDS worldwide. Of these, WHO estimates that around 4 million were receiving antiretroviral therapy at the end of 2008.
Monday, August 24, 2009
How to Communicate with Staff during a Pandemic
In case of an interruption to your workflow caused by the influenza outbreak, as with other outages, you will want to notify your staff as to what they should do.
You have several choices:
1. The simplest is the telephone number, which is communicated to all staff, that they can call before coming to work to get today's status in the workplace. The message would be updated, perhaps twice a day, by a management member and would inform the staff as to whether or not the workplace would be open for staff. This number would have to have sufficient capacity for many people to call at the same time. The capacity would be determined by the size of your staff. If you have 2000+ staff, you might need telephone capacity of 50. The message would be short and could be delivered quickly. This type of service could be provided by your local telephone utility.
2. The next choice using telephony would be to use a service that provides outgoing, pre-recorded telephone messages. The message would be recorded by one of your management members and would be broadcast to all staff members, to a number of their choice (home, mobile, etc.). There are several commercial services that provide this.
3. You could provide an updated message on your internal company website that staff could go to to check if the workplace will be open today or not. This would have to be updated frequently (a couple of times a day) and could provide messages tailored to various parts of your business.
4. If sufficient numbers of your staff have modern PDAs (smart phones, iPhones, Blackberries, etc.), you could provide a message directly onto their phone telling them of the status of the workplace. This is called ‘push techology’ and requires no action on their part but the message would have to be updated frequently.
You have several choices:
1. The simplest is the telephone number, which is communicated to all staff, that they can call before coming to work to get today's status in the workplace. The message would be updated, perhaps twice a day, by a management member and would inform the staff as to whether or not the workplace would be open for staff. This number would have to have sufficient capacity for many people to call at the same time. The capacity would be determined by the size of your staff. If you have 2000+ staff, you might need telephone capacity of 50. The message would be short and could be delivered quickly. This type of service could be provided by your local telephone utility.
2. The next choice using telephony would be to use a service that provides outgoing, pre-recorded telephone messages. The message would be recorded by one of your management members and would be broadcast to all staff members, to a number of their choice (home, mobile, etc.). There are several commercial services that provide this.
3. You could provide an updated message on your internal company website that staff could go to to check if the workplace will be open today or not. This would have to be updated frequently (a couple of times a day) and could provide messages tailored to various parts of your business.
4. If sufficient numbers of your staff have modern PDAs (smart phones, iPhones, Blackberries, etc.), you could provide a message directly onto their phone telling them of the status of the workplace. This is called ‘push techology’ and requires no action on their part but the message would have to be updated frequently.
H1N1 Statistics as of 11:18EDT August 24,2009
H1N1 Statistics:
USA(57283)
Canada(9799)
UK(116950)
Australia(32556)
New Zealand(3510)
from http://flutracker.rhizalabs.com/
USA(57283)
Canada(9799)
UK(116950)
Australia(32556)
New Zealand(3510)
from http://flutracker.rhizalabs.com/
Saturday, August 22, 2009
Google Flu Trends - FAQ Frequently asked questions
This information is copied from:
http://www.google.org/about/flutrends/faq.html
and is shown here so that you will know such a resource exists and to help to spread this information. Go to that site for all additional information and hyperlinks.
About Google Flu Trends
What information is provided by Google Flu Trends?
Google Flu Trends provides up-to-date estimates of flu activity in Australia, New Zealand, and the United States based on aggregated search queries. Data can be viewed on the Flu Trends website or downloaded as a CSV file for analysis.
What information is provided by Experimental Flu Trends for Mexico?
Experimental Flu Trends for Mexico provides up-to-date estimates of possible flu activity based on aggregated search queries. Unlike Google Flu Trends, these estimates have not been verified against historical Mexican flu data. This experimental data can be viewed on the website or downloaded as a CSV file for analysis.
I'm a public health official. How can I get Google Flu Trends for my country?
Thanks for your interest! If your country experiences seasonal influenza and has data on influenza-like illness (ILI), acute respiratory infection (ARI), and/or laboratory-confirmed influenza case counts from the past 3-5 years, we'd like to validate Google Flu Trends for your country. Please contact us for more information.
How does it work?
Google researchers have found a close relationship between how many people search for flu-related topics and how many people actually have flu symptoms. Some search queries tend to be popular exactly when flu season is happening, and are therefore good indicators of flu activity. By training models over multiple seasons we're able to filter and control for news driven terms that may be popular one year, but not the next. Google Flu Trends uses aggregated Google search data to estimate the current flu activity level in different countries around the world, providing a multi-national, up-to-date flu tracking system.
Unlike Google Flu Trends, Experimental Flu Trends for Mexico has not been validated against historic flu data. Read more about how Google Flu Trends works.
How are the flu activity levels determined?
For each country or region where we have access to historical flu data, Flu Trends compares the estimates based on search data against a historical baseline level of flu activity for that area. Depending on whether the current estimate is higher or lower than the baseline, Flu Trends reports the general activity level as Minimal, Low, Moderate, High, or Intense. Each category has a corresponding color that is displayed under the graph.
For Mexico, in the absence of data to provide a historic baseline of flu activity, Flu Trends uses the same scale based on a relative measure of search activity.
How accurate and up-to-date is the information provided by Google Flu Trends?
Historically, national and regional estimates have been very consistent with traditional surveillance data collected by health agencies. Estimates for individual states in the U.S. have not been compared against traditional surveillance data because such data is not publicly available. Because Flu Trends is still new, it's quite possible that future estimates may deviate from actual flu activity, but we're hoping to see similar correlations in the coming years. Flu Trends is still quite experimental for Mexico, as it has not been verified against historic flu data from Mexico.
How is Google Flu Trends useful for pandemic flu?
Google Flu Trends models are built based on historic flu surveillance data. When a new flu virus causes the same symptoms as seasonal flu, Google Flu Trends can detect if overall flu rates are significantly increasing. Some search queries tend to be popular exactly when flu is happening, and are therefore good indicators of flu activity.
How is information gathered to determine countries, regions and states?
Google Flu Trends uses IP address information from our server logs to make a best guess about where queries originated.
For which countries does Google Flu Trends provide estimates?
Anyone connected to the internet can access Google Flu Trends, but we currently have verified estimates for Australia, New Zealand and the United States, and unverified estimates for Mexico. We hope to produce estimates for other countries in the future.
What organizations provided flu data for each country?
* Australia: Data provided publicly by the Victorian Infectious Diseases Reference Laboratory.
* New Zealand: Data provided courtesy of the WHO National Influenza Centre at the Institute of Environmental Science and Research, funded by the New Zealand Ministry of Health.
* United States: Data provided publicly by the U.S. Centers for Disease Control.
Is there a way to export the data? How may the data be used?
Yes. The Download raw data page provides links to exported CSV files. Exported data may be used for any purpose, subject to the Google Terms of Service. If you choose to use the information, please make sure to appropriately attribute it to Google. If you're planning to publish using this data, please send a courtesy notification to flutrends-support@google.com. If possible, a representative will respond and answer additional questions you may have.
When are flu activity estimates revised?
Estimates for the current week are updated daily as new search query data is collected. However, once a week is over, the estimate for that week is final and not revised. Google Flu Trends weeks begin on Sunday and end on Saturday.
Understanding Flu Activity
What is an ILI percentage?
ILI stands for influenza-like illness. Public health agencies like the U.S Centers for Disease Control track the percentage of doctor visits each week which are related to ILI, gathering data from a network of sentinel healthcare providers. A high ILI percentage means that a large fraction of patients are experiencing influenza-like symptoms. These symptoms are often caused by seasonal influenza viruses, but other viruses can also cause influenza-like symptoms. A notable increase in ILI-related doctor visits may indicate a need for a public health inquiry to identify the pathogen or pathogens involved.
How do public health agencies use ILI percentages to monitor seasonal flu?
Traditional surveillance systems often rely on both virologic and clinical data. A network of sentinel laboratories may perform virologic testing by counting and classifying influenza viruses collected from patients, while a network of sentinel physicians will report the fraction of patients presenting with an influenza-like illness (ILI).
What is unique about Google's approach versus traditional collection mechanisms?
Google Flu Trends estimates flu activity for Australia, Mexico, New Zealand and the United States from aggregated search query data. The system provides users and health professionals with up-to-date estimates of flu activity in their region. Traditional surveillance reports come directly from doctors and other health service professionals, sometimes with a delay of up to 1-2 weeks.
When does flu season usually occur?
Flu is a seasonal disease in non-tropical countries, and flu season typically starts in late autumn. In the Northern hemisphere the flu season typically spans from November to March. In the Southern hemisphere the flu season typically spans from May to September. In tropical countries, a strong seasonal pattern may not exist.
How can I learn more about the flu?
To learn more about the flu, please consult the Ministry of Health, Centers for Disease Control, or flu surveillance network for your country.
What should I do if there are high levels of flu activity in my region?
According to U.S. CDC, the single best way to prevent seasonal flu is for individuals, especially people at high risk for serious complications from the flu, to get a vaccination. To learn more, see Key Facts about Flu Vaccine.
For information on H1N1, or swine flu please see the WHO site. Additional information can be found at the U.S. CDC site.
About Google.org
Is Google Flu Trends part of Google.org's work on preventing pandemics?
Google.org's Predict and Prevent initiative supports efforts to identify hotspots where new infectious diseases may emerge, detect new pathogens and outbreaks earlier, and respond quickly to prevent local threats from becoming global crises. The Google Flu Trends team worked closely with the Predict and Prevent team as the product was developed, and we continue to look for ways to use Google's tools and products to predict and prevent infectious disease outbreaks and other emerging threats. Read more about the Predict and Prevent initiative on the Google.org website.
Privacy and Terms of Use
When is it okay to use the information I find on Google Flu Trends?
You're free to use any of the information you find on Google Flu Trends, subject to the Google Terms of Service. If you choose to use the information, please make sure to appropriately attribute it to Google.
This tool makes search information public. What about my personal search data?
Your personal search data remains safe and private. Our graphs are based on aggregated data from millions of Google searches over time. Moreover, the results Google Flu Trends displays are produced by an automated system. See our Privacy Center for more about how we use search query data.
How is this related to Google Health? Is Flu Trends connected to my personal health records?
Google Flu Trends, like Google Health, supports Google's mission to organize the world's information and make it universally accessible and useful. Beyond that, there is no connection between the two products. We don't use personal health records or personally identifiable information to create our flu estimates. Only aggregated search queries are used to provide Google Flu Trends.
Can you tell more about what Google does with my personal search data?
Please read more at the Google Privacy FAQ.
http://www.google.org/about/flutrends/faq.html
and is shown here so that you will know such a resource exists and to help to spread this information. Go to that site for all additional information and hyperlinks.
About Google Flu Trends
What information is provided by Google Flu Trends?
Google Flu Trends provides up-to-date estimates of flu activity in Australia, New Zealand, and the United States based on aggregated search queries. Data can be viewed on the Flu Trends website or downloaded as a CSV file for analysis.
What information is provided by Experimental Flu Trends for Mexico?
Experimental Flu Trends for Mexico provides up-to-date estimates of possible flu activity based on aggregated search queries. Unlike Google Flu Trends, these estimates have not been verified against historical Mexican flu data. This experimental data can be viewed on the website or downloaded as a CSV file for analysis.
I'm a public health official. How can I get Google Flu Trends for my country?
Thanks for your interest! If your country experiences seasonal influenza and has data on influenza-like illness (ILI), acute respiratory infection (ARI), and/or laboratory-confirmed influenza case counts from the past 3-5 years, we'd like to validate Google Flu Trends for your country. Please contact us for more information.
How does it work?
Google researchers have found a close relationship between how many people search for flu-related topics and how many people actually have flu symptoms. Some search queries tend to be popular exactly when flu season is happening, and are therefore good indicators of flu activity. By training models over multiple seasons we're able to filter and control for news driven terms that may be popular one year, but not the next. Google Flu Trends uses aggregated Google search data to estimate the current flu activity level in different countries around the world, providing a multi-national, up-to-date flu tracking system.
Unlike Google Flu Trends, Experimental Flu Trends for Mexico has not been validated against historic flu data. Read more about how Google Flu Trends works.
How are the flu activity levels determined?
For each country or region where we have access to historical flu data, Flu Trends compares the estimates based on search data against a historical baseline level of flu activity for that area. Depending on whether the current estimate is higher or lower than the baseline, Flu Trends reports the general activity level as Minimal, Low, Moderate, High, or Intense. Each category has a corresponding color that is displayed under the graph.
For Mexico, in the absence of data to provide a historic baseline of flu activity, Flu Trends uses the same scale based on a relative measure of search activity.
How accurate and up-to-date is the information provided by Google Flu Trends?
Historically, national and regional estimates have been very consistent with traditional surveillance data collected by health agencies. Estimates for individual states in the U.S. have not been compared against traditional surveillance data because such data is not publicly available. Because Flu Trends is still new, it's quite possible that future estimates may deviate from actual flu activity, but we're hoping to see similar correlations in the coming years. Flu Trends is still quite experimental for Mexico, as it has not been verified against historic flu data from Mexico.
How is Google Flu Trends useful for pandemic flu?
Google Flu Trends models are built based on historic flu surveillance data. When a new flu virus causes the same symptoms as seasonal flu, Google Flu Trends can detect if overall flu rates are significantly increasing. Some search queries tend to be popular exactly when flu is happening, and are therefore good indicators of flu activity.
How is information gathered to determine countries, regions and states?
Google Flu Trends uses IP address information from our server logs to make a best guess about where queries originated.
For which countries does Google Flu Trends provide estimates?
Anyone connected to the internet can access Google Flu Trends, but we currently have verified estimates for Australia, New Zealand and the United States, and unverified estimates for Mexico. We hope to produce estimates for other countries in the future.
What organizations provided flu data for each country?
* Australia: Data provided publicly by the Victorian Infectious Diseases Reference Laboratory.
* New Zealand: Data provided courtesy of the WHO National Influenza Centre at the Institute of Environmental Science and Research, funded by the New Zealand Ministry of Health.
* United States: Data provided publicly by the U.S. Centers for Disease Control.
Is there a way to export the data? How may the data be used?
Yes. The Download raw data page provides links to exported CSV files. Exported data may be used for any purpose, subject to the Google Terms of Service. If you choose to use the information, please make sure to appropriately attribute it to Google. If you're planning to publish using this data, please send a courtesy notification to flutrends-support@google.com. If possible, a representative will respond and answer additional questions you may have.
When are flu activity estimates revised?
Estimates for the current week are updated daily as new search query data is collected. However, once a week is over, the estimate for that week is final and not revised. Google Flu Trends weeks begin on Sunday and end on Saturday.
Understanding Flu Activity
What is an ILI percentage?
ILI stands for influenza-like illness. Public health agencies like the U.S Centers for Disease Control track the percentage of doctor visits each week which are related to ILI, gathering data from a network of sentinel healthcare providers. A high ILI percentage means that a large fraction of patients are experiencing influenza-like symptoms. These symptoms are often caused by seasonal influenza viruses, but other viruses can also cause influenza-like symptoms. A notable increase in ILI-related doctor visits may indicate a need for a public health inquiry to identify the pathogen or pathogens involved.
How do public health agencies use ILI percentages to monitor seasonal flu?
Traditional surveillance systems often rely on both virologic and clinical data. A network of sentinel laboratories may perform virologic testing by counting and classifying influenza viruses collected from patients, while a network of sentinel physicians will report the fraction of patients presenting with an influenza-like illness (ILI).
What is unique about Google's approach versus traditional collection mechanisms?
Google Flu Trends estimates flu activity for Australia, Mexico, New Zealand and the United States from aggregated search query data. The system provides users and health professionals with up-to-date estimates of flu activity in their region. Traditional surveillance reports come directly from doctors and other health service professionals, sometimes with a delay of up to 1-2 weeks.
When does flu season usually occur?
Flu is a seasonal disease in non-tropical countries, and flu season typically starts in late autumn. In the Northern hemisphere the flu season typically spans from November to March. In the Southern hemisphere the flu season typically spans from May to September. In tropical countries, a strong seasonal pattern may not exist.
How can I learn more about the flu?
To learn more about the flu, please consult the Ministry of Health, Centers for Disease Control, or flu surveillance network for your country.
What should I do if there are high levels of flu activity in my region?
According to U.S. CDC, the single best way to prevent seasonal flu is for individuals, especially people at high risk for serious complications from the flu, to get a vaccination. To learn more, see Key Facts about Flu Vaccine.
For information on H1N1, or swine flu please see the WHO site. Additional information can be found at the U.S. CDC site.
About Google.org
Is Google Flu Trends part of Google.org's work on preventing pandemics?
Google.org's Predict and Prevent initiative supports efforts to identify hotspots where new infectious diseases may emerge, detect new pathogens and outbreaks earlier, and respond quickly to prevent local threats from becoming global crises. The Google Flu Trends team worked closely with the Predict and Prevent team as the product was developed, and we continue to look for ways to use Google's tools and products to predict and prevent infectious disease outbreaks and other emerging threats. Read more about the Predict and Prevent initiative on the Google.org website.
Privacy and Terms of Use
When is it okay to use the information I find on Google Flu Trends?
You're free to use any of the information you find on Google Flu Trends, subject to the Google Terms of Service. If you choose to use the information, please make sure to appropriately attribute it to Google.
This tool makes search information public. What about my personal search data?
Your personal search data remains safe and private. Our graphs are based on aggregated data from millions of Google searches over time. Moreover, the results Google Flu Trends displays are produced by an automated system. See our Privacy Center for more about how we use search query data.
How is this related to Google Health? Is Flu Trends connected to my personal health records?
Google Flu Trends, like Google Health, supports Google's mission to organize the world's information and make it universally accessible and useful. Beyond that, there is no connection between the two products. We don't use personal health records or personally identifiable information to create our flu estimates. Only aggregated search queries are used to provide Google Flu Trends.
Can you tell more about what Google does with my personal search data?
Please read more at the Google Privacy FAQ.
Friday, August 21, 2009
Healthy People May Not Need Tamiflu
LONDON — Healthy people who catch swine flu do not need antivirals like Tamiflu, but the young, the old and the pregnant surely do, the WHO declared today Friday.
WHO said people who are otherwise healthy with mild to moderate cases of swine flu or seasonal flu don't need the drug.
However people thought to be at risk for complications from swine flu — children less than five years old, pregnant women, people over age 65 and those with other health problems like heart disease, HIV or diabetes — should definitely get the drug, WHO said.
WHO also recommended that all patients, including children, who have severe or worsening cases of swine flu, with breathing difficulties, chest pain or severe weakness, should get Tamiflu immediately, perhaps in higher doses than now used.
Read the full story at http://is.gd/2si4F
WHO said people who are otherwise healthy with mild to moderate cases of swine flu or seasonal flu don't need the drug.
However people thought to be at risk for complications from swine flu — children less than five years old, pregnant women, people over age 65 and those with other health problems like heart disease, HIV or diabetes — should definitely get the drug, WHO said.
WHO also recommended that all patients, including children, who have severe or worsening cases of swine flu, with breathing difficulties, chest pain or severe weakness, should get Tamiflu immediately, perhaps in higher doses than now used.
Read the full story at http://is.gd/2si4F
Thursday, August 20, 2009
A mathematical model suggests a new way to allocate vaccines
How to stop an outbreak
Aug 20th 2009
from The Economist print edition
The existing formula is simple. When vaccinating against influenza, inoculate those most susceptible to the disease’s wrath. Such vulnerable types include the elderly (who are the most likely to die if infected) and infants (whose immune systems are not fully developed). This seems a reasonable policy, and it is the one that has long been promulgated by America’s Center for Disease Control (CDC). Only recently has it been extended to include children up to the age of 18, on the basis that they are more likely than other people to catch flu in the first place, through enforced socialising at school—even though they are at little risk of dying from it.
Read the full article at http://is.gd/2qQnp
Aug 20th 2009
from The Economist print edition
The existing formula is simple. When vaccinating against influenza, inoculate those most susceptible to the disease’s wrath. Such vulnerable types include the elderly (who are the most likely to die if infected) and infants (whose immune systems are not fully developed). This seems a reasonable policy, and it is the one that has long been promulgated by America’s Center for Disease Control (CDC). Only recently has it been extended to include children up to the age of 18, on the basis that they are more likely than other people to catch flu in the first place, through enforced socialising at school—even though they are at little risk of dying from it.
Read the full article at http://is.gd/2qQnp
Wednesday, August 19, 2009
Australia H1N1 Influenza 09 Update
National H1N1 Influenza 09 Update
12 noon 19 August 2009
PANDEMIC (H1N1) 2009 UPDATE BULLETIN
1200 AEST on 19 August 2009
Change in name of infection
The World Health Organization (WHO) is now referring to the current pandemic as “Pandemic (H1N1) 2009”.
National case update
At noon today Australia has 32 224 confirmed cases of pandemic (H1N1) 2009.
Deaths
The total number of Australian deaths associated with pandemic (H1N1) 2009 is currently 121, with 2 confirmed deaths in the ACT, 33 in NSW, 5 in the NT, 26 in Qld, 12 in SA, 6 in Tas, 22 in Victoria and 15 in WA.
Hospitalisations
There are currently 460 people in hospital around Australia with pandemic (H1N1) 2009 and 100 of these are in Intensive Care Units.
There are 189 people hospitalised in NSW, 22 in the NT, 106 in Qld, 64 in SA, 7 in Tas, 22 in Victoria and 50 WA.
ICU admissions: Of the 100 people currently in Intensive Care Units, there are 28 in NSW, 5 in the NT, 30 in Qld, 10 in SA, 1 in Tas, 9 in Vic and 17 in WA.
The total number of hospitalisations in Australia since pandemic (H1N1) 2009 was identified is 3802.
12 noon 19 August 2009
PANDEMIC (H1N1) 2009 UPDATE BULLETIN
1200 AEST on 19 August 2009
Change in name of infection
The World Health Organization (WHO) is now referring to the current pandemic as “Pandemic (H1N1) 2009”.
National case update
At noon today Australia has 32 224 confirmed cases of pandemic (H1N1) 2009.
Deaths
The total number of Australian deaths associated with pandemic (H1N1) 2009 is currently 121, with 2 confirmed deaths in the ACT, 33 in NSW, 5 in the NT, 26 in Qld, 12 in SA, 6 in Tas, 22 in Victoria and 15 in WA.
Hospitalisations
There are currently 460 people in hospital around Australia with pandemic (H1N1) 2009 and 100 of these are in Intensive Care Units.
There are 189 people hospitalised in NSW, 22 in the NT, 106 in Qld, 64 in SA, 7 in Tas, 22 in Victoria and 50 WA.
ICU admissions: Of the 100 people currently in Intensive Care Units, there are 28 in NSW, 5 in the NT, 30 in Qld, 10 in SA, 1 in Tas, 9 in Vic and 17 in WA.
The total number of hospitalisations in Australia since pandemic (H1N1) 2009 was identified is 3802.
Flexible Sick Leave Urged Ahead of Possible Swine Flu Outbreak
The U.S. federal government is urging employers to offer flexible sick leave policies as the nation braces for a second wave of the H1N1 influenza pandemic.
HHS offered guidance to businesses on how to prevent the spread of H1N1, also known as swine flu, and to prepare for a major outbreak. They stressed allowing employees who exhibit flu symptoms to go home and to stay home until at least 24 hours have passed since their fevers subsided. They also said businesses should consider eliminating policies that require a doctor's note or other proof in order to justify a sick day and that employers should be prepared to run their operations with fewer people.
Full Story at http://is.gd/2oUgY
HHS offered guidance to businesses on how to prevent the spread of H1N1, also known as swine flu, and to prepare for a major outbreak. They stressed allowing employees who exhibit flu symptoms to go home and to stay home until at least 24 hours have passed since their fevers subsided. They also said businesses should consider eliminating policies that require a doctor's note or other proof in order to justify a sick day and that employers should be prepared to run their operations with fewer people.
Full Story at http://is.gd/2oUgY
Thursday, August 13, 2009
Pandemic Plan - Do Your Homework If You Foresee an Increase in Telecommuting
In a recent article, I discussed having a pandemic plan, something that every company should have. With employees concerned about being in public places and contracting the swine influenza, many companies are looking at the possibility of telecommuting options for their employees.
Last summer, I was invited to speak at the Maryland Bankers Association about business continuity and pandemic planning. There were many questions on telecommuting. I told a story about one day that previous winter. My children were off from school, I was at home, and I noticed how slow my Internet connection was. I called several friends and they noticed the same thing. It struck me that if there were a regional disaster, companies that were planning to have their employees work from home would have a difficult time of it. While I was at the conference, I had the opportunity to speak to an official with the FDIC. He told me that when he goes into a bank for an examination, he looks to see if the bank plans on using telecommuting as an alternative. If so, he raises the same issue about the Internet and how the bank will deal with it. His recommendation almost always is to pay for dedicated DSL lines for key employees and rented space with a dedicated high-speed connection for the other employees.
However, if this strategy is not tested ahead of time, an organization risks leaving its infrastructure open for penetration. Hackers look for companies at risk. Companies that are doing a lot of laying off, in deep financial difficulty, or have merged recently are examples of companies in turmoil and at risk. In addition, a pandemic is an excellent example of a threat that could put a company at risk.
The second concern is that existing employees gain access to systems that they would not normally have access to. When support people are moving fast to keep the organization up and running, mistakes are made.
Finally, organizations should look out for an increase in social engineering. It's easier for a hacker to disguise themselves as a telecommuter with a problem when there is a pandemic versus in normal operations.
We will assume that you have the infrastructure in place to handle the increase in remote connections and employees can access the applications they need and some degree of security is in place. Other things to keep in mind that telecommuters will need to deal with are phone service, printing and hard mailing.
Using telecommuting as part of your pandemic plan is a smart move. A business continuity and pandemic plan are about identifying the business processes that a company needs to keep running to stay in business and telecommuters are part of the process. Security has got to be the number-one concern. My advice is test, test, and test more. You don't want to be in the middle of a disaster and find out that something does not work.
Is your company planning on using telecommuting during a disaster or pandemic? If so, how will your company deal with an Internet slow down?
You can find lots of telecommuting planning documents in the IT Business Edge Knowledge Network including the Telecommuting IT Checklist - http://bit.ly/UoQB3 and the Telecommuting Calculator - http://bit.ly/15DKir
Article Source: http://EzineArticles.com/?expert=Ralph_DeFrangesco
Find a 'flu buddy'
There is an idea that everyone should identify a "flu buddy" willing to help care for them should they get sick with human swine flu.
People should "talk with family, friends and neighbors and figure out how to help each other during the H1N1 pandemic." Also identify elderly or vulnerable relatives who may need your help.
"During a pandemic outbreak, keep an eye on these people, especially those living alone and phone them if you suspect they might be ill."
Concentrate on family preparedness plans, immunization and keeping stockpiles of prescription medication, non-perishable food and water.
The World Health Organization has recommended a flu buddy system.
In the U.K., experts from the Royal College of GPs and the British Medical Association said that in the event of a pandemic, public information campaigns would warn patients to stay away from the GP surgery, even though that would make access to anti-viral drugs, which could reduce the severity of a flu bout, more difficult.
Anyone with flu symptoms would be told to phone a national flu helpline. If the nurse taking the call believed they had flu, the caller could be prescribed drugs after supplying their NHS number and other identification.
Since the patient would be too ill to leave the house, the prescription could be collected by a "flu buddy" – a friend or family member the patient nominates, who must have the patient's identification details.
All of this has to take place within 48 hours of the onset of the flu symptoms, otherwise the drugs do not work.
Nearly 27 million adults in the United States lives alone.
Add to that the number of households with one adult caring for one or more minor children or caring for elderly, disabled, or otherwise unable to fend-for-themselves individuals, and the number goes up dramatically.
During a pandemic (even a relatively mild one), households with only one responsible adult (regardless of the number of inhabitants) are going to be at greater risk.
If single parents, or adults living alone, get sick with the flu, "you won't be sick enough, likely, to go to hospital, but you are not necessarily going to be well enough to go to the drugstore to buy some Tylenol, you're not going to be well enough to check if you need to be driven to the emergency. You won't be well enough to do that.
"We cannot overwhelm our system by having everybody call 911 and say: 'I'm really sick, I need to go the hospital' when you don't. You need to organize, in your community, who is going to be your flu buddy," she said.
While the H1N1 virus has proved to be `relatively mild’ for the vast majority of people infected, that term may be a just a bit deceptive.
`Mild’ generally means not requiring hospitalization.
It doesn’t mean that this flu won’t knock you on your backside for 4 or 5 days. And while the vast majority will recover, that assumes some basic level of care.
Something that some flu victims may be unable to provide for themselves.
It doesn’t take long for the flu, with its fever (and sometimes vomiting and diarrhea), to begin to dehydrate even healthy individuals. Dehydration, if it isn’t reversed, can become a serious, even life threatening condition.
But for this to work, it has to be administered.
And if someone is already dehydrated or otherwise incapacitated by the flu, they may be unable to do that for themselves.
All of this points out the pressing need for those that live alone, or who are the sole responsible adult in a household, to establish a pandemic `safety net’ with friends, relatives, or neighbors by arranging to have (and to be) a `Flu Buddy’.
A `Flu Buddy’ is simply someone you can call if you get sick, who will then check on you every day, make sure you have the medicines you need (including fetching Tamiflu if appropriate), help care for you if needed, and who can call for medical help if your condition deteriorates.
Those people who are charged with the care of others, like single parents, also need to consider who will take care of their dependents if they are sick.
Once again, having a flu buddy or two, who could help with those matters, could prove invaluable.
People should "talk with family, friends and neighbors and figure out how to help each other during the H1N1 pandemic." Also identify elderly or vulnerable relatives who may need your help.
"During a pandemic outbreak, keep an eye on these people, especially those living alone and phone them if you suspect they might be ill."
Concentrate on family preparedness plans, immunization and keeping stockpiles of prescription medication, non-perishable food and water.
The World Health Organization has recommended a flu buddy system.
In the U.K., experts from the Royal College of GPs and the British Medical Association said that in the event of a pandemic, public information campaigns would warn patients to stay away from the GP surgery, even though that would make access to anti-viral drugs, which could reduce the severity of a flu bout, more difficult.
Anyone with flu symptoms would be told to phone a national flu helpline. If the nurse taking the call believed they had flu, the caller could be prescribed drugs after supplying their NHS number and other identification.
Since the patient would be too ill to leave the house, the prescription could be collected by a "flu buddy" – a friend or family member the patient nominates, who must have the patient's identification details.
All of this has to take place within 48 hours of the onset of the flu symptoms, otherwise the drugs do not work.
Nearly 27 million adults in the United States lives alone.
Add to that the number of households with one adult caring for one or more minor children or caring for elderly, disabled, or otherwise unable to fend-for-themselves individuals, and the number goes up dramatically.
During a pandemic (even a relatively mild one), households with only one responsible adult (regardless of the number of inhabitants) are going to be at greater risk.
If single parents, or adults living alone, get sick with the flu, "you won't be sick enough, likely, to go to hospital, but you are not necessarily going to be well enough to go to the drugstore to buy some Tylenol, you're not going to be well enough to check if you need to be driven to the emergency. You won't be well enough to do that.
"We cannot overwhelm our system by having everybody call 911 and say: 'I'm really sick, I need to go the hospital' when you don't. You need to organize, in your community, who is going to be your flu buddy," she said.
While the H1N1 virus has proved to be `relatively mild’ for the vast majority of people infected, that term may be a just a bit deceptive.
`Mild’ generally means not requiring hospitalization.
It doesn’t mean that this flu won’t knock you on your backside for 4 or 5 days. And while the vast majority will recover, that assumes some basic level of care.
Something that some flu victims may be unable to provide for themselves.
It doesn’t take long for the flu, with its fever (and sometimes vomiting and diarrhea), to begin to dehydrate even healthy individuals. Dehydration, if it isn’t reversed, can become a serious, even life threatening condition.
But for this to work, it has to be administered.
And if someone is already dehydrated or otherwise incapacitated by the flu, they may be unable to do that for themselves.
All of this points out the pressing need for those that live alone, or who are the sole responsible adult in a household, to establish a pandemic `safety net’ with friends, relatives, or neighbors by arranging to have (and to be) a `Flu Buddy’.
A `Flu Buddy’ is simply someone you can call if you get sick, who will then check on you every day, make sure you have the medicines you need (including fetching Tamiflu if appropriate), help care for you if needed, and who can call for medical help if your condition deteriorates.
Those people who are charged with the care of others, like single parents, also need to consider who will take care of their dependents if they are sick.
Once again, having a flu buddy or two, who could help with those matters, could prove invaluable.
Why Don't We See More Pandemic News ?
There seems to be several reasons for no media. 1) They only chase the latest story and pandemics are already old-hat to them, 2) Governments have decided that the huge economic losses in trade, travel and tourism from honestly reporting on the current situation can be curtailed by not reporting. 3) There is media concern about the boy-who-cried wolf syndrome. They even think we concocted the Y2K issue. 4) Most 'readers' are tired of this story. It is so difficult to even get friends to understand how severe this problem might be. 5) There has been so much misinformation, such as 'it is the same as seasonal flu', that the public, with their short attention spans, grasps onto these simple explanations. And the media perpetuates these myths.
It is true that Swine Flu, Avian Flu, HxNy, etc. is not in every newspaper and on every newscast every day. But, if you do a search on any of the normal search engines, you will find 20 stories on the expected pandemic every day from all over the English-speaking world (U.S., U.K., Canada, India, Australia, New Zealand, South Africa, etc.). So, there are lots of stories, but they are not being presented to those who wait for the news to come to them. In the U.S., there are newspaper stories on this topic every day if only you would look. There are also lots of stories in the U.K.
If you wish to see even more, set your search engine to find stories in French, Spanish, German and use your browser to translate them.
True, the major mainstream press has relegated the story to the back burner but the stories are there.
It is true that Swine Flu, Avian Flu, HxNy, etc. is not in every newspaper and on every newscast every day. But, if you do a search on any of the normal search engines, you will find 20 stories on the expected pandemic every day from all over the English-speaking world (U.S., U.K., Canada, India, Australia, New Zealand, South Africa, etc.). So, there are lots of stories, but they are not being presented to those who wait for the news to come to them. In the U.S., there are newspaper stories on this topic every day if only you would look. There are also lots of stories in the U.K.
If you wish to see even more, set your search engine to find stories in French, Spanish, German and use your browser to translate them.
True, the major mainstream press has relegated the story to the back burner but the stories are there.
Tuesday, August 11, 2009
Swine Flu and Bird Flu - What If They Join Forces?
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H1N1 and H5N1 may co-mingle. Mutations are not the only concern. Scientists are worried about the possibility that the swine flu virus might co-mingle with the highly deadly bird flu A(H5N1) virus.
Looking at the Southern Hemisphere
Important clues about the likelihood of a lethal swine flu pandemic in the fall may come from the Southern Hemisphere, where the influenza season is just about to begin. Scientists and healthcare officials are actively monitoring the virus behavior in those countries, with particular attention to Colombia, Costa Rica, Guatemala and El Salvador. This would enable them to determine whether the swine flu out breaks actually becoming more severe. The hope is to use such information to develop more effective pandemic plans.
Pandemic Preparedness may help reduce mortality
One thing thats for sure: Putting in place systems that will quickly detect any sign of increasing severity or an upsurge in cases following the first wave is a priority, says McCaw. Pandemic planning, including antiviral distribution strategies and vaccination preparation efforts, need to work on the assumption that a second wave may occur. And that it may be more severe than the first.
Of particular relevance, in this regard, are the findings of a 2006 re-analysis of the Spanish pandemic influenza of 1918, led by professor John Oxford, of the Centre for Infectious Diseases, Bart's and the London, Queen Mary's School of Medicine and Dentistry, London, UK.
Oxfords team found that, contrary to common belief, most of the people infected with the swine flu A(H1N1) virus during the 1918 Spanish flu survived. This, despite the fact that vaccines and antiviral medications were not available at that time. If this tells us anything, its that judicious and careful planning... could help reduce mortality in a new pandemic to figure significantly less than 1918, says Oxford.
There is every reason as we face the first pandemic of the 21st century that we can be optimistic, turn again to history and return to Churchill for inspiration give us the tool and we will finish the job.
Major differences between then and now
Avaccine to protect us in the event of a deadlier swine flu outbreak in the fall is being prepared in countries across the globe. As mentioned above, together with the availability of antiviral medications, this is one major difference between now and the Spanish flu pandemic of 1918-19. However, there is no guarantee that the vaccine will be ready in time, or even effective, because the virus may change in the meantime. And, almost certainly, there will not be enough of it for everyone.
There is also the likelihood that, by fall, the swine flu A(H1N1) virus might become resistant to antiviral medications, hampering any effort of treatment when most needed, as millions of people will likely be infected.
Probably not better off than in 1918
What is the most likely scenario for the world in the eventuality of a second, more severe, wave of swine flu? Experts say this may be more similar than expected to what experienced during the 1918 Spanish flu pandemic. Of particular concern is hospitals' supposedly inability to cope with increasingly large numbers of patients, at a time in which a severe shortage of healthcare professionals, due to sickness, and lack of adequate medical supplies and medications are highly likely. Fear may play a role, as well.
During the Spanish flu, fear of contagious kept caregivers from performing their duties, says Dr. Monica Schoch-Spana, of the Center for Civilian Bio defense Strategies at the Johns Hopkins University, in Baltimore. Hospitals were crippled by influenza's hold on urban population shortage of linens, mattresses, bedpans, and gowns arose in some instances.
Despite 80 years of medical advances and expansive growth in the health care industry, there remains great uncertainty about our capacity to respond to an infectious disease emergency, says Schoch-Spana. In many respects, we may be at a disadvantage today compared with 1918. Then, most people were cared for by family members. Patients did not rely heavily on paid health professionals, nor did they expect today's sophisticated standards of care.
Intentional exposure to the A(H1N1) virus should be avoided
Lastly, health officials warn that getting swine flu, now, does not necessarily give immunity to further, more severe infections. One reason for this is that the virus may not be the same in a few months, as a result of mutations.
Another, and most important, reason is that too little is known about how the swine flu A(H1N1)virus reacts in any one individual. It may cause severe disease and death. Consequently, intentionally mixing with people who have swine flu in the hope of being infected should be avoided.
For more information on Swine Flu visit - http://www.thedeadlyflu.com Webvitality are a Manchester and Oldham Web Design and SEO company - http://www.webvitality.co.uk
Article Source: http://EzineArticles.com/?expert=Mark_Farrell
Pandemic Response Planning is Now Top of the Agenda in Most Board Rooms But Still Many Lag Behind
by Niel Thomas |
In April 2009 the world was 'side swiped' with the news that a new strain H1N1 influenza outbreak had occurred in Mexico, and it was infectious enough to have escaped containment.
I say 'side swiped' because the world's eyes (experts included) were on Asia expecting the H5N1 (Bird Flu) to break out somewhere there, triggering the next pandemic.
The new A/H1N1 strain, dubbed "Swine Flu" due to early (inaccurate) assumptions being that it came from pigs, quickly escaped the confines of Mexico City. It almost immediately surfaced in countries around the world where it established itself with ease.
Within the space of only a few weeks the World Health Organization had raised their pandemic alert threat level from 3 to 4 to 5, and ultimately to 6 indicating a full blown pandemic event was now taking place.
The early numbers out of Mexico indicated it could be a bad one. Out of the first few hundred infections some 2.5% died. This is on par with the 1918 Spanish Influenza Pandemic (the worst in history) in which an estimated 2.75% of those infected died.
Fortunately this mortality rate seemed to quickly subside with the number of deaths versus infections turning out to be much lower in other countries - in the region of 0.2% - leading to a quick calming of the public and governments to the threat which lay ahead.
The exact reason why the mortality rate dropped so dramatically once the disease spread to other countries is still a mystery. A seemingly obvious explanation would be that before the pandemic even escaped Mexico the world was already on alert and any (even suspect) cases surfacing in other countries thereafter were immediately treated with antivirals.
The answer to that question should become evident when the virus reaches poorer countries which do not have antiviral stockpiling, and when those which do start to restrict its distribution. Perhaps by the time you are reading this we will know.
There is also the possibility the virus mixes with other strains (including the circulating H5N1 strain) and mutates again, altering how infectious it is or its virulence.
We should remember however, that from a business perspective it is not the mortality rate of a pandemic which will cause the damage. Even a 3% mortality rate over 18 months is likely less of a loss in number terms than is the normal staff turnover rate.
It is whether your company can carry on operations through weeks or months with a 50% or more personnel absenteeism rate, with staff off work due to sickness, child care, home quarantine, caring for others and just plain fear.
It is also whether the staff feel safe to be in the office to come to work in the first instance, and whether the company can demonstrate it can respond to sickness in the workplace.
Be prepared for staff to evacuate offices. They won't return until they are satisfied it is safe to do so, and without a procedure this could be days later instead of a couple of hours.
The obvious picture which emerges from this is that provided a business can educate its staff on what to expect, how to protect themselves, and satisfy them that it has taken appropriate measures to protect them and their families, those staff are far more likely to come willingly to work, and to return to the workplace quickly should sickness be identified in the office.
The reality is that an office or any other enclosed working environment can and should be made into the safest place for staff to be outside of the home. If the methods used to do this are communicated to staff the business will continue to operate when others around them fall over.
Businesses which still take the pandemic threat seriously and allocate funds and resources into preventative measures will survive or even thrive during and following this pandemic.
You can find more information on how to get ready your business's Swine Flu response so that your company can anticipate and respond to the Swine Flu pandemic when the waves wash through your area at http://www.swinefluresponse.com.
Article Source: http://EzineArticles.com/?expert=Niel_Thomas
Pandemic Planning and Business Continuity
by Bill Dodds |
There is little doubt that a natural disaster or a global pandemic could strike in the future. In fact, the Centers for Disease Control and Prevention (CDC) has estimated that if there were a pandemic of the H5N1 Bird Flu, as much as 40 percent of the workforce could be out at any one time. Mitigation strategies such as voluntary or mandatory social distancing could last for days or even months and have disastrous financial implications for employees and organizations that did not have a readily available way to remotely access their corporate networks.
Governments and health agencies have been urging organizations to prepare for a pandemic or a natural disaster such as a hurricane or tornado. However, in a recent Deloitte survey of 163 large enterprises, 48 percent of respondents said their companies have not adequately prepared for such disasters.
Authorities are thus stressing the importance of developing pandemic plans that will allow organizations to keep functioning in the event of an emergency. An important part of such plans is ensuring adequate network capacity for all employees, contractors, and partners so they can work from home for weeks or possibly months. One of the most critical (and typically unknown) components of pandemic planning is determining whether or not your service providers - and carriers themselves - are ready for a global pandemic outbreak or unforeseen disaster. Capacity planning, redundancy of operations, security, and overall support need to be tightly integrated to truly create an infrastructure that can continue to operate in the face of a major emergency.
Outsourcing a pandemic readiness solution ensures end users are prepared ahead of time and resources are available if they need them. However, rapidly scaling a network can be an organization's greatest challenge if it has not done the appropriate due diligence. Service providers can offer economical, customized services that allow networks to scale up rapidly and support hundreds or even thousands of end users working remotely. These providers have developed solution platforms that allow organizations to host SSL VPN gateways, firewalls, and intrusion prevention equipment at regional centers, allowing customers to connect securely to application servers at their corporate data centers over an MPLS infrastructure.
Managed service providers that have access agreements with multiple MPLS service providers can provide another layer of resiliency by leveraging these carriers to intelligently route customer traffic. Simply stated, the ability to leverage and control the flow of traffic across multiple world-class backbones to provide last-mile access connectivity across a wide geographic area is essential to making any successful pandemic plan for multi-national organizations.
In the event a portion of an organization's network is incapacitated, preventing end users from getting to corporate data centers, managed service providers should be able to exploit multiple data centers for redundancy. Multi-layered connectivity in and out of regional centers provides the highest resiliency and offers the most protection to companies in the event of a pandemic.
With a managed service provider managing the scalability of your network, you can have all key components already in place to not only change the volume of users on your network on a moment's notice but also how they access it.
Ramping Up Remote Access
When deploying a pandemic plan, it is essential to put all of the pieces in place to allow employees to continue working from remote locations and to ensure your network is scalable. Emergency licensing, global load balancing, and security are key to this process.
Emergency licensing is a terrific insurance policy. Clients pay an upfront fee for pre-installed licenses; when emergency licensing is activated, the number of concurrent users per client gateway can immediately be increased to the maximum allowable on the existing hardware. Even better, emergency licensing fees are a fraction of the cost of permanent concurrent-user licenses. A company's existing gateway may be licensed for 200 concurrent users, but when emergency licensing is activated, the same gateway could accommodate 2,000 concurrent users.
In the event social distancing is necessary, excess load will occur on a regional scale as workers are forced to work remotely. Depending on how the pandemic spreads, different regions may experience different levels of adverse impact. Load balancing deals with this by dynamically allocating traffic across multiple data centers in the event remote-access capacity adjustments need to be made. Global load balancing dynamically adjusts the load between regional data centers so idle capacity can be used efficiently.
You must not overlook security when planning for a pandemic. Hackers are waiting for opportunities that will leave a network vulnerable and will likely launch attacks when they think they can do the most damage. Organizations will therefore need perimeter firewalls and intrusion prevention to block malicious activity. Security event correlation is another important feature to seek out from your MSP. For example, integrating the SSL VPN, firewall, and IPS with security event correlation enables service providers to make more informed decisions about what constitutes malicious activity and automatically take action to avert attacks.
Economic Benefits
When putting a pandemic plan into place, one of the greatest benefits of a managed approach is the ability to leverage the existing network infrastructure and existing support staff, without having to add capital expenses or additional headcount. Organizations do not want to build out a costly new infrastructure where capacity may sit idle. However, organizations should not do business without a safety net that will let them leverage the infrastructure in place today, assess where and how critical users can fail over, and support an increase in users.
Being prepared does not have to equal high cost. Take the example of a customer deployment that includes a fully redundant and scalable remote access infrastructure for a large manufacturing company with over 50,000 remote users around the world. The organization chose a hosted, cloud-based solution with six regional centers to host an array of dedicated network and security equipment, standardized around the world.
The regional centers are interconnected to multiple Tier 1-ISPs that vary region by region for maximum interconnectivity and diversity. Each center connects directly to the enterprise MPLS network, so each regional center acts and looks like a customer edge on the MPLS wide area network. All the provider's regional centers are integrated with one another via a multi-carrier MPLS core in the event of a customer circuit failure.
The manufacturer reaps a number of economic benefits from its managed pandemic planning solution:
The company avoided over 80 percent of "idle" pandemic-capacity license costs;
A $2.1 million hardware capital investment was rolled into operational expenses;
The entire rollout, plus management for three years, required zero additional headcount;
The solution required zero footprint on customer premises and data centers.
Organizations can achieve pandemic readiness for as little as 15 percent of the cost of a baseline solution for standard remote access should an epidemic or natural disaster impair a large portion of the workforce. Secure and scalable solutions that allow organizations to build a contingency plan that fits their specific needs can be turned on and off as needed. The benefits of pandemic planning could be vast for organizations that take the time to put plans in place today to avoid a cessation of workforce productivity in the face of a pandemic in the future.
Organizations tasked with this vital responsibility must be prepared in every way possible to prevent, respond to, and recover from large-scale emergencies, and effective communications are essential to this effort. To ensure continuity of operations and enhance recovery efforts, partnering with trusted specialists who can offer relevant expertise, equipment, infrastructure, and services can make the difference when it comes to sustaining business operations in the face of a pandemic.
Bill Dodds is vice president of sales and marketing for Virtela, the global network solutions company. For more information, please visit the company online at http://www.virtela.com Article Source: http://EzineArticles.com/?expert=Bill_Dodds |
Saturday, August 1, 2009
H1N1 Vaccination Recommendations
from U.S. CDC http://www.cdc.gov/h1n1flu/vaccination/acip.htm
With the new H1N1 virus continuing to cause illness, hospitalizations and deaths in the US during the normally flu-free summer months and some uncertainty about what the upcoming flu season might bring, CDC's Advisory Committee on Immunization Practices has taken an important step in preparations for a voluntary novel H1N1 vaccination effort to counter a possibly severe upcoming flu season. On July 29, ACIP met to consider who should receive novel H1N1 vaccine when it becomes available.
Novel H1N1 Vaccine
Every flu season has the potential to cause a lot of illness, doctor’s visits, hospitalizations and deaths. CDC is concerned that the new H1N1 flu virus could result in a particularly severe flu season this year. Vaccines are the best tool we have to prevent influenza. CDC hopes that people will start to go out and get vaccinated against seasonal influenza as soon as vaccines become available at their doctor’s offices and in their communities (this may be as early as August for some). The seasonal flu vaccine is unlikely to provide protection against novel H1N1 influenza. However a novel H1N1 vaccine is currently in production and may be ready for the public in the fall. The novel H1N1 vaccine is not intended to replace the seasonal flu vaccine – it is intended to be used along-side seasonal flu vaccine.
CDC’s Advisory Committee on Immunization Practices (ACIP), a panel made up of medical and public health experts, met July 29, 2009, to make recommendations on who should receive the new H1N1 vaccine when it becomes available. While some issues are still unknown, such as how severe the virus will be during the fall and winter months, the ACIP considered several factors, including current disease patterns, populations most at-risk for severe illness based on current trends in illness, hospitalizations and deaths, how much vaccine is expected to be available, and the timing of vaccine availability.
The groups recommended to receive the novel H1N1 influenza vaccine include:
* Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated;
* Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants less than 6 months old might help protect infants by “cocooning” them from the virus;
* Healthcare and emergency medical services personnel because infections among healthcare workers have been reported and this can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce healthcare system capacity;
* All people from 6 months through 24 years of age
o Children from 6 months through 18 years of age because we have seen many cases of novel H1N1 influenza in children and they are in close contact with each other in school and day care settings, which increases the likelihood of disease spread, and
o Young adults 19 through 24 years of age because we have seen many cases of novel H1N1 influenza in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population; and,
* Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.
We do not expect that there will be a shortage of novel H1N1 vaccine, but flu vaccine availability and demand can be unpredictable and there is some possibility that initially, the vaccine will be available in limited quantities. So, the ACIP also made recommendations regarding which people within the groups listed above should be prioritized if the vaccine is initially available in extremely limited quantities. For more information see the CDC press release CDC Advisors Make Recommendations for Use of Vaccine Against Novel H1N1.
Once the demand for vaccine for the prioritized groups has been met at the local level, programs and providers should also begin vaccinating everyone from the ages of 25 through 64 years. Current studies indicate that the risk for infection among persons age 65 or older is less than the risk for younger age groups. However, once vaccine demand among younger age groups has been met, programs and providers should offer vaccination to people 65 or older.
With the new H1N1 virus continuing to cause illness, hospitalizations and deaths in the US during the normally flu-free summer months and some uncertainty about what the upcoming flu season might bring, CDC's Advisory Committee on Immunization Practices has taken an important step in preparations for a voluntary novel H1N1 vaccination effort to counter a possibly severe upcoming flu season. On July 29, ACIP met to consider who should receive novel H1N1 vaccine when it becomes available.
Novel H1N1 Vaccine
Every flu season has the potential to cause a lot of illness, doctor’s visits, hospitalizations and deaths. CDC is concerned that the new H1N1 flu virus could result in a particularly severe flu season this year. Vaccines are the best tool we have to prevent influenza. CDC hopes that people will start to go out and get vaccinated against seasonal influenza as soon as vaccines become available at their doctor’s offices and in their communities (this may be as early as August for some). The seasonal flu vaccine is unlikely to provide protection against novel H1N1 influenza. However a novel H1N1 vaccine is currently in production and may be ready for the public in the fall. The novel H1N1 vaccine is not intended to replace the seasonal flu vaccine – it is intended to be used along-side seasonal flu vaccine.
CDC’s Advisory Committee on Immunization Practices (ACIP), a panel made up of medical and public health experts, met July 29, 2009, to make recommendations on who should receive the new H1N1 vaccine when it becomes available. While some issues are still unknown, such as how severe the virus will be during the fall and winter months, the ACIP considered several factors, including current disease patterns, populations most at-risk for severe illness based on current trends in illness, hospitalizations and deaths, how much vaccine is expected to be available, and the timing of vaccine availability.
The groups recommended to receive the novel H1N1 influenza vaccine include:
* Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated;
* Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants less than 6 months old might help protect infants by “cocooning” them from the virus;
* Healthcare and emergency medical services personnel because infections among healthcare workers have been reported and this can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce healthcare system capacity;
* All people from 6 months through 24 years of age
o Children from 6 months through 18 years of age because we have seen many cases of novel H1N1 influenza in children and they are in close contact with each other in school and day care settings, which increases the likelihood of disease spread, and
o Young adults 19 through 24 years of age because we have seen many cases of novel H1N1 influenza in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population; and,
* Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.
We do not expect that there will be a shortage of novel H1N1 vaccine, but flu vaccine availability and demand can be unpredictable and there is some possibility that initially, the vaccine will be available in limited quantities. So, the ACIP also made recommendations regarding which people within the groups listed above should be prioritized if the vaccine is initially available in extremely limited quantities. For more information see the CDC press release CDC Advisors Make Recommendations for Use of Vaccine Against Novel H1N1.
Once the demand for vaccine for the prioritized groups has been met at the local level, programs and providers should also begin vaccinating everyone from the ages of 25 through 64 years. Current studies indicate that the risk for infection among persons age 65 or older is less than the risk for younger age groups. However, once vaccine demand among younger age groups has been met, programs and providers should offer vaccination to people 65 or older.
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