Pandemic

1
Pandemic

• From Greekpan (all)demos (people)
• WHOa pandemic is a global epidemic of an
  infectious disease.
• Seasonal flu is not considered pandemic

2
(No Transcript)
3
Pandemics in history

• Small pox (vaccine)
• Cholera (clean water)
• Plague (hygiene,general health)
• Syphilis (attenuation,antibiotics)
• Flu
• Recent HIV

4
Smittkoppor
5
(No Transcript)
6
Monkey pox
7
Pandemics today

• Political awareness (HIV major inducer)
• Rapid diagnosis (SARS,weeksHIV,years)
• Promising drug development.
• Vaccines or - development
• -
• Rapid spread.
• Less robust societies (lean)

8
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,gt50 lethality
• Hendra,40 lethality
• H5N1,avian flu,present lethality 1-5?

9

10
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
  gt35 billion USD.
• 50 million USD cost/individual death.

11
(No Transcript)
12
Influenza virus subtypes unpredictability of a
pandemic threat
Group 1
Group 2
13
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

14
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
15
(No Transcript)
16
Speed/volume of global spread via human travel

• What took months to travel some hundred years
• ago may now take hours.
• International flight passengers
• soon 1 billion/year.
• gt30 humans arrive from foreign countries every
  second.

17
Flu pandemics

• Ten A flu pandemics in last 300 years
• Spanish,H1N1,1918-9
• Asian,H2N2,1957
• HongKong1968
• ?,?,?
• Spanish like avian flu,Asian and HongKong added
  avian flu genes

18
Virus enters the body through nose, mouth and eye
19
(No Transcript)
20
(No Transcript)
21
(No Transcript)
22
(No Transcript)
23
Handling pandemic threats

• Educate politicians/mass media
• Be open about disease information (SARS,MCD)
• Make rational precautions
• Reduce anxiety

24
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 vaccinated18 million
  doses ordered,500 million USD cost
• RealitySwine flu is somewhat more aggressive
  at present compared to seasonal flu.