FrenchieGirl
Senior Moderator
Opinion piece I found in The Lancet, Vol.373, Issue 9675, Page 1590, May 9, 2009 (subscription required)
Influenza begs many questions
?Will we all die?? is just one question I was asked by the mass media after the outbreak of influenza A (H1N1) in Mexico. The answer (given wisely by another commentator) is ?yes we will, but probably not from flu?.
Outside Mexico, the strain of H1N1 seems to cause mild disease, no worse than seasonal influenza, with low mortality. Nevertheless, cases have been confirmed in 20 countries on four continents, and there is evidence of chains of transmission in two countries in the WHO American (Mexico and USA) and European (Spain and UK) regions. WHO is reported to be considering raising the pandemic alert level to six, which will signify that we are in the midst of the first influenza pandemic since 1968.
Fortunately, advances in medicine over the past 40 years, including availability of antiviral drugs, mean we are now in a better position to manage a pandemic than ever before. However, if a pandemic is declared, an urgent issue will be whether to continue the practice of giving oseltamivir prophylactically to contacts of confirmed cases. At four schools in the UK where pupils have confirmed infection, prophylactic oseltamivir has been issued to hundreds of fellow students. Although this policy follows Health Protection Agency advice, I wonder about sustainability. At a Lancet conference on pandemic influenza in 2006, Frederick Hayden (University of Virginia, USA) stated that for a group of 1000 people 16 times as much antiviral was needed to prevent influenza infection as to treat it. By this measure, the UK has stockpiles of oseltamivir sufficient to treat 30 million people (about half the population) but to prevent infection in only 1.9 million.
On May 17, The Lancet will be supporting a latebreaker session on influenza A (H1N1) at the European Conference on Clinical Microbiology and Infectious Diseases in Helsinki, Finland. We plan to make freely available from thelancet.com website a video recording of this session, plus additional content relevant to the current outbreak taken from the Lancet journals and others published by Elsevier.
John McConnell
The Lancet Infectious Diseases, London NW1 7BY, UK
Influenza begs many questions
?Will we all die?? is just one question I was asked by the mass media after the outbreak of influenza A (H1N1) in Mexico. The answer (given wisely by another commentator) is ?yes we will, but probably not from flu?.
Outside Mexico, the strain of H1N1 seems to cause mild disease, no worse than seasonal influenza, with low mortality. Nevertheless, cases have been confirmed in 20 countries on four continents, and there is evidence of chains of transmission in two countries in the WHO American (Mexico and USA) and European (Spain and UK) regions. WHO is reported to be considering raising the pandemic alert level to six, which will signify that we are in the midst of the first influenza pandemic since 1968.
Fortunately, advances in medicine over the past 40 years, including availability of antiviral drugs, mean we are now in a better position to manage a pandemic than ever before. However, if a pandemic is declared, an urgent issue will be whether to continue the practice of giving oseltamivir prophylactically to contacts of confirmed cases. At four schools in the UK where pupils have confirmed infection, prophylactic oseltamivir has been issued to hundreds of fellow students. Although this policy follows Health Protection Agency advice, I wonder about sustainability. At a Lancet conference on pandemic influenza in 2006, Frederick Hayden (University of Virginia, USA) stated that for a group of 1000 people 16 times as much antiviral was needed to prevent influenza infection as to treat it. By this measure, the UK has stockpiles of oseltamivir sufficient to treat 30 million people (about half the population) but to prevent infection in only 1.9 million.
On May 17, The Lancet will be supporting a latebreaker session on influenza A (H1N1) at the European Conference on Clinical Microbiology and Infectious Diseases in Helsinki, Finland. We plan to make freely available from thelancet.com website a video recording of this session, plus additional content relevant to the current outbreak taken from the Lancet journals and others published by Elsevier.
John McConnell
The Lancet Infectious Diseases, London NW1 7BY, UK