pandemic

Pandemic

From Greek=pan (=all)+demos (=people)

WHO=a pandemic is a global epidemic of an infectious disease.

Seasonal flu is not considered pandemic

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Pandemics in history

Small pox (vaccine)

Cholera (clean water)

Plague (hygiene,general health)

Syphilis (attenuation,antibiotics)

Flu

Recent HIV

Smittkoppor

Monkey pox

Pandemics today+Political awareness (HIV major inducer)Rapid diagnosis (SARS,weeks;HIV,years)Promising drug development.Vaccines + or - development-Rapid spread.Less robust societies (lean)

New pathogens all the time

• 10 pathogenic viruses last 10 years

• 4 of these lethal for man

• SARS,epidemi 2003,10-70% lethality

• Nipah,12 epidemies,>50% lethality

• Hendra,40% lethality

• H5N1,avian flu,present lethality 1-5%?

Economy of the SARS scare

• GDP growth rate in China 2003 reduced by more than 1%.

• Four months epidemic in Hong Kong, average reduction of 60% of air passengers

• Global cost of epidemic with some 700 mortalities >35 billion USD.

• 50 million USD cost/individual death.

Group 1

Group 2

Influenza virus subtypes: unpredictability of a pandemic threat

Increasing flu pandemics?

”Pandemic” strains may be generated= 1.directly but mutated straight from a foreign

animal species (Spanish). 2.exchange genes with flu from other species

(pig,bird). In China 1968 2008 Increase Pigs 5 million 1.3 billion x260 Poultry 12 million 13 billion x1050

China not the source of H5N1?Robert G. Wallace, HoangMinh HoDac, Richard H. Lathrop, and Walter M. Fitch A statistical phylogeography of influenza A H5N1 PNAS 2007 104: 4473-4478

Foto Reuters

Speed/volume of global spread via human travel

What took months to travel some hundred yearsago may now take hours.

International flight passengers =soon 1 billion/year.=>30 humans arrive from foreign countries every

second.

Flu pandemicsTen A flu pandemics in last 300 years

”Spanish”,H1N1,1918-9

”Asian”,H2N2,1957

”HongKong”1968

”?”,?,?

”Spanish” like avian flu,Asian and HongKong added avian flu genes

Virus enters the body through nose, mouth and eye

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Handling pandemic threats

• Educate politicians/mass media

• Be open about disease information (SARS,MCD)

• Make rational precautions

• Reduce anxiety

Swine flu August 21,2009 Price of pork in USA down 72 % Rumours in Swedish press that flu vaccine is a)contaminated with squalene b)will induce neural paralysis In Stockholm suggestions that one person in Ministry of Health may be infected caused Ministry of Finance officials to give walk-over in budget discussions. All Swedes expected to be vaccinated=18 million doses

ordered,500 million USD cost Reality=”Swine” flu is somewhat more aggressive at present

compared to seasonal flu.