Articles: pandemics.
-
The pandemic of 1918 was caused by an H1N1 influenza A virus, which is a negative strand RNA virus; however, little is known about the nature of its direct ancestral strains. Here we applied a broad genetic and phylogenetic analysis of a wide range of influenza virus genes, in particular the PB1 gene, to gain information about the phylogenetic relatedness of the 1918 H1N1 virus. We compared the RNA genome of the 1918 strain to many other influenza strains of different origin by several means, including relative synonymous codon usage (RSCU), effective number of codons (ENC), and phylogenetic relationship. ⋯ Also, according to the RSCU of the PB1 gene, the 1918 virus grouped with all human isolates and "classical" swine H1N1 viruses. The phylogenetic studies of all eight RNA gene segments of influenza A viruses may indicate that the 1918 pandemic strain originated from a H1N1 swine virus, which itself might be derived from a H1N1 avian precursor, which was separated from the bulk of other avian viruses in toto a long time ago. The high stability of the RSCU pattern of the PB1 gene indicated that the integrity of RNA structure is more important for influenza virus evolution than previously thought.
-
Pandemic plans are increasingly attending to groups experiencing health disparities and other social vulnerabilities. Although some pandemic guidance is silent on the issue, guidance that attends to socially vulnerable groups ranges widely, some procedural (often calling for public engagement), and some substantive. Public engagement objectives vary from merely educational to seeking reflective input into the ethical commitments that should guide pandemic planning and response. ⋯ Protecting critical infrastructures on which vulnerable populations and the general public rely; 6. Identifying and removing access barriers during pandemic planning and response; and 7. Collecting and promptly analyzing data during the pandemic to identify groups at disproportionate risk of influenza-related mortality and serious morbidity and to optimize the distribution of resources.
-
In the US, national, regional and even institutional plans for ameliorating the effects of pandemic influenza focus on stockpiling antiviral medications, early production and distribution of vaccine, mass and personal social distancing, and a number of personal hygiene activities. Essential personnel are the first scheduled to receive preventive and therapeutic pharmaceuticals, followed by high risk groups, the largest of which are the elderly. Specific recommendations for protection embody a bunker mentality with a time horizon of two weeks, emulating preparation for a natural disaster. ⋯ The key findings of models of chronic care institutions and others that can control public access, such as corporations, are used to describe programs with a realistic chance of providing protection in even severe pandemics. These principles are further mapped onto individual residences. Materials directing institutional and home planning are cited.