Articles: pandemics.
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A strong evidence base provides the foundation for planning and response strategies. Investments in pandemic preparedness included support for research that aided early detection, response, and control of the 2009 influenza A (H1N1) (pH1N1) pandemic. Scientific investigations conducted during the pandemic guided understanding of the virus, disease severity, and epidemiologic risk factors. ⋯ Communication of this evolving evidence base was important to sustaining credibility of public health. Areas where substantial controversy emerged, such as the optimal approach to respiratory protection of healthcare workers, often suffered from gaps in the evidence base. Many aspects of the 2009-2010 pandemic influenza experience provide ongoing opportunities for additional study, which will strengthen plans for future pandemic response as well as control of seasonal influenza.
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Influenza A viruses cause recurrent, seasonal epidemics and occasional global pandemics with devastating levels of morbidity and mortality. The ability of influenza A viruses to adapt to various hosts and undergo reassortment events ensures constant generation of new strains with unpredictable degrees of pathogenicity, transmissibility, and pandemic potential. Currently, the combination of factors that drives the emergence of pandemic influenza is unclear, making it impossible to foresee the details of a future outbreak. Identification and characterization of influenza A virus virulence determinants may provide insight into genotypic signatures of pathogenicity as well as a more thorough understanding of the factors that give rise to pandemics.
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Health Technol Assess · Dec 2010
ReviewThe Swine Flu Triage (SwiFT) study: development and ongoing refinement of a triage tool to provide regular information to guide immediate policy and practice for the use of critical care services during the H1N1 swine influenza pandemic.
To use, existing critical care and early pandemic, data to inform care during the pandemic influenza A 2009 (H1N1) pandemic (with a possible use for triage - if the demand for critical care seriously exceeded supply). To monitor the impact of the H1N1 pandemic on critical care services, in real time, with regular feedback to critical care clinicians and other relevant jurisdictions to inform ongoing policy and practice. ⋯ The National Institute for Health Research Health Technology Assessment programme.
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J Extra Corpor Technol · Dec 2010
ReviewExtracorporeal life support for pandemic influenza: the role of extracorporeal membrane oxygenation in pandemic management.
The recent global threat of a severe pandemic influenza outbreak has suggested that extracorporeal life support will begin to play an evolving role in the care of critically ill influenza stricken patients. The highly communicable attributes of influenza could result in widespread infection and an associated increased need for advanced life support. ⋯ Protocol oriented planning, research analysis, and advanced technologies are critical factors in averting catastrophe. This review article details the epidemiology, diagnostic techniques, and interventions for the influenza A virus, including H1N1.
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Vaccination is considered the most effective strategy to control influenza and becomes particularly important when a new subtype or distantly related strain of virus enters the human population causing a world-wide epidemic or "pandemic". Depending upon the virulence of the emerging virus, a lack of pre-existing immunity can lead to overwhelming morbidity and deaths ranging in the millions. While the correlates of immunity to influenza are yet to be fully understood, our experience with vaccines over many decades enables pre-pandemic planning to develop strategies to minimise the impact of a human pandemic. This review explores developing pandemic and pre-pandemic vaccines in the context of highly virulent avian H5N1 virus and the influenza H1N1 pandemic of 2009.