Science

• Influenza Primer Part I – Influenza and Influenza-like Illnesses
• Influenza Primer Part II – The Influenza Virus
• Naming Influenza Viruses
• Disease Transmission Primer
• What is a Cytokine Storm?
• Other sources
  • Avian Flu Panel Discussion – Video that features hospital administrators, researchers and journalists who cover health issues
  • H5N1 Overview – Details on H5N1 from New England Journal of Medicine
  • Evolution and ecology of influenza A viruses Microbiol Rev. 1992 March; 56(1): 152–179. R G Webster, W J Bean, O T Gorman, T M Chambers, and Y Kawaoka
  • Influenza American Scientist Online article about threat of a pandemic. Good illustrations.
  • Emerging Infectious Diseases, monthly e-journal full scientific articles, some about influenza.
  • Influenza Viruses: Past and Future Threats a videocast of the 2006 NIAID Kinyuon Lecture, delivered by Jeffery K. Taubenberger, M.D., Ph.D., Laboratory of Infectious Diseases, NIAID, October 05, 2006
  • 2006 year end review H5N1 as pandemic threat
  • Avian Flu Laboratories – Comprehensive list of labs studying H5N1 and Influenza A
  • Influenza 101 from the Virology blog

• Countries where H5N1 (bird flu) infections have been reported to occur in humans
  • Asia
    Cambodia | China (Hong Kong) | China (Mainland) | Indonesia | Iraq | Thailand | Viet Nam
  • Europe
    Azerbaijan | Turkey
  • Africa
    Djibouti | Egypt
• Demographics of H5N1 influenza
  • H5N1 fatality table by Age and Country
  • Cumulative Table of H5N1 cases
  • H5N1 Clusters
  • Graph of Cluster Size and Frequency over Time
  • Seroprevalence Studies
  • Review of Reports of Suspected Cases that were Never Followed Up
• Sequence Data
  • H5N1 viral sequences isolated from patients
  • Blast Searching For H5N1 Hemagglutinin Sequences
    May be useful in identifying changes that signal increased transmissibility between humans

• World Organization for Animal Health - OIE used with permission

• Countries where H5N1 (bird flu) infections have been reported to occur in animals
  • Asia
    Afghanistan | Cambodia | China (Hong Kong) | China (Mainland) | India | Israel | Indonesia | Iraq | Japan | Jordan | Kazakhstan | Laos | Malaysia | Mongolia | Myanmar | Pakistan | Palestine | South Korea | | Thailand | Turkey | Viet Nam
  • Europe
    Albania | Austria | Bosnia and Herzegovina | Bulgaria | Croatia | Cyprus | Czech Republic | Denmark | France | Georgia | Germany | Greece | Hungary | Italy | Poland | Romania | Russia | Serbia and Montenegro | Slovak Republic | Slovenia | Spain | Switzerland | Turkey | United Kingdom | Ukraine
  • Africa
    Burkina Faso | Cameroon | Djibouti | Côte d’Ivoire | Egypt | Niger | Nigeria | Sudan
• Animals shown to be infected with H5N1 bird flu
  includes sequence data
  • H5N1 sequences from pig isolates - retracted by submitters
• Experimental Animal Studies

According to the World Health Organization, the world is currently at phase 3 of a flu pandemic. The phase of a pandemic is dependent on several factors including the number and size of clusters of people infected by the virus.

Here are ten things you need to know about pandemic influenza according to the WHO.

• Avian Influenza: Assessing the Pandemic Threat also from WHO, Jan 2005, .pdf, 64pp.
• WHO’s Assessments Over Time
• Expert Opinions about a Flu Pandemic
  including Fauci · Gerberding · Nabarro · Narain · Niman · Osterholm · Ungchusak
• Early history of H5N1
• Influenza in the United States, 1887-1956 Navy Department Library
• Spanish Flu 1918-19 and Links

For general planning purposes, it is usually assumed that approximately 25–30% of the population will be infected by pandemic influenza. However, there are very large differences in the odds of being infected depending on the age of an individual. Some models predict that over 50% of all children will be infected by a pandemic strain of H5N1. The elderly are the least likely to be infected. The percent infected is also known as the “attack rate” of a virus. Equally important is the mortality rate, that is, the percent of infected people that die. Most of the people who have died from H5N1 infections have been children and young adults. This is a very different pattern of mortality from that observed with “normal” flu, which is more likely to kill the elderly than children. The ablility of H5N1 to kill otherwise healthy young people is similar to the very lethal 1918 pandemic strain of influenza but quite different from the milder pandemics of 1957 and 1968. This is one reason experts are so concerned about H5N1. The mortality rate for H5N1 is currently 50%. No one knows what the mortality rate for a pandemic strain of H5N1 would be, or if H5N1 will be the next pandemic strain.

• Case definition WHO, Aug 2006
• Avian flu infections in humans including H7 and H9, from CDC
• Epidemiology of WHO-confirmed human cases of avian A(H5N1) infection 30 June 2006, Weekly Epidemiological Record (WER) vol. 81, 26 (pp 249–260), .pdf
• Demographics of H5N1 influenza
  • H5N1 fatality table by Age and Country
  • Distribution of Indonesian Avian Flu (H5N1) Victims by Age report by William H. White and William Cordner .pdf
  • Cumulative Table of H5N1 cases
  • H5N1 Clusters
  • Seroprevalence
  • Graph of Cluster Size and Frequency over Time
  • Graph of Individual Cases Over Time
• Demographics of the 1918 influenza pandemic
• Demographics of seasonal influenza
• Influenza Epidemiological Models
• CDC Surveillance, seasonal influenza

• There is a growing body of evidence that the most effective way to stop the spread of flu is to vaccinate children.
  • Is it time to vaccinate more kids to stop flu’s spread?
    Canada.com, October 4 2005
  • Recent data from Texas studies on impact of vaccinating school-aged children
    PowerPoint presentation by Paul Glezen at the Pandemic Influenza Working Group on June 15 2005
  • Review of prior modeling studies on influenza vaccination of children
    PowerPoint presentation by Martin Melzer at the Pandemic Influenza Working Group on June 15 2005
  • More information about Vaccines
• Social Distancing. This simply means avoiding contact with other people. Examples include closing schools, malls and theaters. Shelter-in-place may also be applied. This means staying at home. This strategy requires stockpiling, which is why this practice is so frequently mentioned in pandemic preparedness guides.
• Washing one’s hands thoroughly is a simple and effective way to reduce the odds of being infected by any flu virus. See Personal Hygiene.
• Health Care Worker Safety During a Pandemic?

• Case definition WHO, Aug 2006
• Diagnostic Testing for Influenza

• Drug Therapy
  • WHO guideline for antivirals
  • Neuraminidase Inhibitors (Tamiflu, Relenza)
  • M2 Blockers
  • Antiviral Rationing During a Pandemic
    PowerPoint presentation given at the Pandemic Influenza Working Group on June 15 2005
    It is unlikely that there will be sufficient antiviral medication to treat all who need it during a flu pandemic.
• Symptomatic Relief
• Higher Requirement Medical Care
• Oxygen Therapy
• Dehydration
• Phases of a clinical trial
• Where There Is No Doctor
  Online book by David Werner. 23 pdf chapters, multi-part download. Advice on what to do if no doctor is available and when to seek help.
• Donde No Hay Doctor
• Symptom Scale
• Bronchodilators
• Nebulizers
• Everything Tamiflu

• Glossary – a glossary of scientific terms related to influenza

• Bibliography

‹ Sources and Links | Site Map | Pandemic Preparedness ›