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The Domestic and International Impacts of the 2009-H1N1 Influenza A Pandemic: Global Challenges, Global Solutions: Workshop Summary (2010)
Board on Global Health (BGH)

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. "Workshop Overview." The Domestic and International Impacts of the 2009-H1N1 Influenza A Pandemic: Global Challenges, Global Solutions: Workshop Summary. Washington, DC: The National Academies Press, 2010.

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The Domestic and International Impacts of the 2009-H1N1 Influenza a Pandemic: Global Challenges, Global Solutions - Workshop Summary

BOX WO-3

Clinical and Epidemiological Overview of 2009-H1N1 Influenza A

Transmission characteristics: In general, household secondary attack rates (a measure of the risk of someone being infected with a disease by an ill close contact) for 2009-H1N1 influenza A are slightly lower than attack rates for seasonal influenza. This suggests that pharmaceutical and nonpharmaceutical mitigation measures may appreciably limit the spread of 2009-H1N1 influenza A prior to the development of an effective vaccine. Indeed, the use of antiviral medications (which can reduce viral shedding) to treat cases or prevent influenza in household contacts may already have decreased secondary attack rates.


Age profile: Age-specific frequency of cases is highest among school-age children and young adults; the lowest frequency of cases occurs among the elderly.


Symptoms: Most people infected with 2009-H1N1 influenza A virus experience uncomplicated influenza-like illness, with full recovery within a week, even without medical treatment.


Severe cases: Small subsets of 2009-H1N1 influenza A patients rapidly develop very severe progressive pneumonia, which in turn is often associated with failure of other organs, or marked worsening of underlying asthma or chronic obstructive airway disease. Primary viral pneumonia is the most common finding in severe cases and a frequent cause of death. This is markedly different from severe cases of seasonal influenza, which tend to involve secondary bacterial infections.

  

aThe early treatment of bacterial infections may prevent severe complications and death. Antiviral treatment is recommended to treat infection and has also been used prophylactically in persons who have been exposed to H1N1 virus.

and H5N1 avian influenza virus) had been detected in any of the 2009-H1N1 influenza A virus isolates.

Several speakers described the recent Southern Hemisphere influenza season, during which the clinical and epidemiological characteristics of the morbidity and mortality associated with the 2009-H1N1 influenza A pandemic, as reflected in Box WO-3, remained essentially unchanged. Some Southern Hemisphere countries experienced simultaneous or serial epidemics of multiple viral diseases, as shown in Box WO-4. In many, but not all, cases the 2009-H1N1 influenza A virus eventually dominated other seasonal influenza strains. Much as Ruiz-Palacios found co-infections with multiple respiratory viruses (including parainfluenza 1, 2, and 3; respiratory syncytial virus [RSV]; and the coronavirus that causes bronchitis) in a majority of Mexican patients with severe disease, one might expect to find similar co-infections in other locations with multiple viral epidemics.

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Front Matter (R1-R22)
Workshop Overview (1-94)
Appendix A1 Technical Report for State and Local Public Health Officials and School Administrators on CDC Guidance for School (K-12) Responses to Influenza during the 2009-2010 School Year (95-110)
A2 Predicting Emerging Diseases in the Twenty-first Century: The Case of Zoonotic Influenza (111-119)
A3 The Spring 2009 Influenza A H1N1 Outbreak: A Local Public Health Perspective (120-136)
A4 I nternational Law and Equitable Access to Vaccines and Antivirals in the Context of 2009-H1N1 Influenza (137-154)
A5 In Vitro and In Vivo Characterization of New Swine-Origin H1N1 Influenza Viruses (155-190)
A6 Estimation of the Reproductive Number and the Serial Interval in Early Phase of the 2009 Influenza A⁄H1N1 Pandemic in the USA (191-207)
A7 The Severity of Pandemic H1N1 Influenza in the United States, from April to July 2009: A Bayesian Analysis (208-247)
A8 Hard Choices in Difficult Situations: Ethical Issues in Public Health Emergencies (248-268)
A9 Rumors of Pandemic: Monitoring Emerging Disease Outbreaks on the Internet (269-282)
A10 Preliminary Observation of the Epidemiology of Seasonal and Pandemic Influenza A (H1N1) in South Africa, 2009 (283-296)
A11 Reflections on the 1976 Swine Flu Vaccination Program (297-305)
A12 Southern Hemisphere, Northern Hemisphere: A Global Influenza World (306-326)
A13 Influenza (H1N1) Pandemic 2009 (327-341)
A14 Origins and Evolutionary Genomics of the 2009 Swine-Origin H1N1 Influenza A Epidemic (342-380)
Appendix B Agenda (381-385)
Appendix C Acronyms (386-388)
Appendix D Glossary (389-396)
Appendix E Forum Member Biographies (397-418)