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PubMed2002

Seed viruses containing novel avian HA and NA antigens for prevention against potential influenza pandemic.

An influenza pandemic could arise unexpectedly with rapid spread across the world. The efficiency of production of a vaccine and the ability to administer it widely will be among the most important factors in the ability to protect public health. The current process for producing inactivated or live attenuated influenza vaccines requires six to nine months. That reduces considerably the likelihood that the vaccine will be available during the first wave of the pandemic. Therefore, a key element of preparedness is to optimize the production process and to reduce the vaccine development time. During the 1997 H5N1 outbreak in Hong Kong, seed viruses were prepared for production of inactivated and live-attenuated vaccines. We used the cold-adapted A/Ann Arbor/6/60 as the donor virus to generate live attenuated vaccines containing genetically modified HA and NA genes from H5N1 influenza viruses. These reassortants were shown to be safe and protective in animal models. This study indicates that production of live attenuated avian influenza vaccines is feasible and that development of a library of reassortants containing different subtype HA and NA genes may reduce the vaccine preparation time for future influenza pandemics.

Antigens, Viral↗
PubMed2006

Use of neuraminidase inhibitors to combat pandemic influenza.

Since the last influenza pandemic in 1968, neuraminidase (NA) inhibitors have been licensed for the treatment and prophylaxis of seasonal influenza. Continuing outbreaks of highly pathogenic avian influenza H5N1 since 2004 have focused attention on the timing of the next pandemic and preparedness plans. Although immunization is the principal means of influenza prophylaxis, a well-matched efficacious vaccine is unlikely to be widely available for several months following the emergence of the pandemic strain. NA inhibitors could be used to contain and eliminate an emerging pandemic virus at source. If unsuccessful, they could still play a crucial role in reducing the medical impact of pandemic influenza as it spreads through countries. Accordingly, many authorities are creating stockpiles of NA inhibitors. However, the use of stockpiled drugs for treatment or prophylaxis, the rapid delivery to newly diagnosed cases and unknown characteristics of an emergent pandemic strain pose significant challenges to determining optimal use of stockpiles.

Animals↗
PubMed2004

Advances in detecting and responding to threats from bioterrorism and emerging infectious disease.

Much progress has been made in recent years to strengthen local, state, national and international capacities to detect and respond to bioterrorism events and naturally occurring outbreaks of disease. New tools and systems are available to estimate the potential impact of a biological event and predict resource needs for effective response, enable earlier detection of an attack or outbreak, enhance diagnostic capacity and facilitate rapid intervention to mitigate the impact of an event on a community. These advances have required new approaches to preparedness, planning and surveillance, as well as new partnerships and collaborations across a range of disciplines. We examine some of these developments, discuss potential uses and limitations of these approaches, and identify priorities for the future.

Biological Warfare↗
PubMedDate not supplied

[Influenza pandemic planning].

In this article the most important properties of influenza A viruses are described to understand influenza pandemics. There are at least three possibilities: (1) By reassortment between an avian and the prevailing human influenza A virus viruses with a new surface are created, against which no neutralizing antibodies are present in the human population. Such a virus can spread immediately worldwide. (2) Viruses, which have been present in the human population some time ago, reappear and infect the new generation, which has not been in contact with this virus before. (3) An avian influenza virus crosses the species barrier to humans and forms there a new stable lineage. In relation to pandemic planning, the first possibility can be more or less excluded, since the now-a-days human influenza A viruses have evolved so far away from their original source, the avian influenza viruses, that the formation of a well-growing and well-spreading reassortant is practically not possible anymore. Point two is a dangerous possibility, in that, e.g., a human H2N2 virus could reappear, which had disappeared in 1968 from the human population. The third possibility is at the moment the most dangerous situation, if, e.g., a highly neurotropic H5N1 virus from Southeast Asia crosses the species barrier to humans. An infection with such a pandemic virus presumably cannot be treated efficiently by antivirals. In such a situation only a rapid vaccination would be successful. In this respect in the last year important results have been obtained by using the reverse genetics. Meanwhile in about 50 countries there have been drawn up pandemic-preparedness plans.

Animals↗
PubMed2006

Influenza surveillance: Why?

Surveillance is also one of the few bright spots in influenza preparedness in Europe. A sentinel network of 13,500 physicians provides an early warning in the event of an influenza outbreak. The network is part of the European Influenza Surveillance Scheme (EISS). Germany has one of the most advanced surveillance networks in Europe, and has made the reporting of laboratory-confirmed cases of influenza mandatory. Monitoring avian influenza is a good way to anticipate human influenza outbreaks. Coordinated surveillance of influenza in humans and animals is needed, and the human and veterinary surveillance systems should be linked to exchange information, diagnostic tools and antigens. Although not perfect, the current surveillance network managed by EISS functions effectively, and can play a key role in the early identification and ongoing monitoring of a pandemic influenza virus as well as the annual epidemics.

Animals↗
PubMed2026

Global molecular and serological evidence of dengue and chikungunya infection: a systematic review and meta-analysis of 158,608 tested participants.

INTRODUCTION: Dengue virus (DENV) and chikungunya virus (CHIKV) are Aedes-borne arboviruses with overlapping clinical manifestations, shared vectors, and substantial diagnostic challenges in co-endemic settings. This systematic review and meta-analysis synthesized published evidence on molecular detection, serological positivity, and DENV-CHIKV dual positivity/co-infection in human clinical, surveillance, and community-based study populations. CONTENT: Following PRISMA 2020 guidance, five bibliographic databases (PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, and Google Scholar) and supplementary grey-literature/preprint sources were searched for English-language studies published from 1 January 1980 to 31 December 2024. No prospective PROSPERO or OSF protocol registration was available. Eligible records reported extractable numerators and denominators for DENV and/or CHIKV in humans using recognized molecular or serological assays. A total of 196 studies comprising 158,608 tested or suspected participants were included in the extraction table. The pooled CHIKV estimate was 14.0 % (95 % CI: 12.0-16.4; I2=97.5 %), with molecular and serological estimates of 9.8 and 15.7 %, respectively. The pooled DENV estimate was 13.8 % (95 % CI: 10.9-17.3; I2=99.0 %), with molecular and serological estimates of 13.1 % (95 % CI: 7.9-21.0) and 14.3 % (95 % CI: 10.2-19.8), respectively. DENV-CHIKV dual positivity/co-infection was 52.9 % (95 % CI: 48.7-57.1) among studies that tested and reported both outcomes. Country-level estimates varied widely and should be interpreted as summaries of available studies rather than nationally representative burden estimates. Funnel-plot asymmetry was statistically significant in DENV analyses but not in the overall CHIKV analysis. SUMMARY: Available evidence indicates extensive but highly heterogeneous DENV and CHIKV positivity across selected clinical and surveillance populations. The pooled estimates should be interpreted cautiously because of substantial between-study heterogeneity, diagnostic variability, outbreak-period sampling, and uneven geographic representation. OUTLOOK: The findings support integrated arboviral surveillance, multiplex diagnostics, and vector-control preparedness in co-endemic regions.

Humans↗
PubMed2002

Anthrax 2001--lessons learned: clinical laboratory and beyond.

OBJECTIVE: Re-visit the 2001 anthrax outbreak to assess the ideas and concepts learned from the event as they relate to the illness and to bioterrorism preparedness. DATA SOURCES: Current literature. CONCLUSION: A multitude of lessons have been brought to light. The future of bioterrorism preparedness depends on whether those lessons are acknowledged and acted upon.

Anthrax↗
PubMed2005

Preparedness progress: update on Minnesota hospitals.

Since 2002, all states have received federal funds for disaster preparedness through Health Resources and Services Administration (HRSA) Bioterrorism Hospital Preparedness Program grants. Minnesota has received dollar 19.4 million, which has been spent to improve communications and coordination among hospitals and emergency providers, purchase equipment and medications, and train staff. The Minnesota Department of Health, which administers the funds, recently assessed the state's level of preparedness, finding that the state is well-prepared for smaller events such as a chemical incident or a limited outbreak of an infectious disease. A catastrophic event such as pandemic influenza would likely overwhelm the state's systems and providers.

Disaster Planning↗
PubMed1999

Preventing and preparing for animal health emergencies in the Far East.

The advantageous geographical location of Member Countries of the Office International des Epizooties in the Far East (often islands or peninsulas) provides better isolation than that of countries with terrestrial frontiers. However, in the light of the explosive foot and mouth disease (FMD) outbreak which occurred in Taipei China in 1997 after nearly 70 years of freedom from FMD, countries in the Far East were alerted to the fact that while countries can be physically far or isolated from the rest of the world, they do not necessarily remain protected from epidemics and consequently need to be aware of effective methods of management of animal health emergencies. Countries in the Far East reviewed national management policies from the viewpoint of organisational structure, surveillance system, diagnostic service, vaccine stock, funding, legislation etc., and reconstructed these policies to ensure they were better organised to prevent and control malignant diseases, such as FMD, in the case of an emergency. With the accelerating and increasing movement of animals and animal products internationally, countries in the region met in Tokyo in April 1998 to discuss preparedness and management of animal health emergencies.

Animal Diseases↗
PubMed2000

Forecasting disease risk for increased epidemic preparedness in public health.

Emerging infectious diseases pose a growing threat to human populations. Many of the world's epidemic diseases (particularly those transmitted by intermediate hosts) are known to be highly sensitive to long-term changes in climate and short-term fluctuations in the weather. The application of environmental data to the study of disease offers the capability to demonstrate vector-environment relationships and potentially forecast the risk of disease outbreaks or epidemics. Accurate disease forecasting models would markedly improve epidemic prevention and control capabilities. This chapter examines the potential for epidemic forecasting and discusses the issues associated with the development of global networks for surveillance and prediction. Existing global systems for epidemic preparedness focus on disease surveillance using either expert knowledge or statistical modelling of disease activity and thresholds to identify times and areas of risk. Predictive health information systems would use monitored environmental variables, linked to a disease system, to be observed and provide prior information of outbreaks. The components and varieties of forecasting systems are discussed with selected examples, along with issues relating to further development.

Communicable Diseases↗
PubMedDate not supplied

Psychosomatic medicine and biodefense preparedness--a new role for the American Psychosomatic Society.

Biodefense preparations in the United States have focused mostly on improving biosurveillance and hospital surge capacity in the event of an outbreak or a weapons of mass destruction (WMD) event. However, what if an invisible bioweapon or dirty bomb was released in a major population center, or if avian flu took hold with sustained human to human transmission? Suddenly, we need to combine efforts from psychosomatic medicine and general medicine with public health practice to triage nonexposed patients with somatic symptoms from those with medical sequelae resulting from hazardous exposures. This would better enable the limited acute care resources to be directed to those most in need of urgent medical care. Furthermore, psychosomatic medicine experts are potentially important players in biodefense planning related to risk communication and health education strategies in a WMD scenario or outbreak in which individuals must make informed choices about their need for immediate medical attention.

Biological Warfare↗