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Sathish Muthu - One of the best experts on this subject based on the ideXlab platform.
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Pandemic response protocol of a non-frontline specialty in a multispecialty tertiary health care centre—a pilot model in orthopaedics
International Orthopaedics, 2020Co-Authors: Girinivasan Chellamuthu, Sathish MuthuAbstract:Background 3,181,642 cases and 224,301 deaths in 212 regions of the world—this is the status of COVID-19 (Coronavirus Disease 2019) Pandemic as of May 1, 2020. This Pandemic has managed to overwhelm the health care system of the most advanced countries in the world. As the whole of the medical fraternity stands robed as health care professionals to fight against COVID-19, specialty emergencies like trauma continue to pester the already overburdened health care community. This situation calls for the need for a p andemic re sponse p rotocol (PREP) in each specialty that helps the doctors to manage specialty emergencies without chaos and at the same time allowing them to play their part in Pandemic management. Conclusion PREP as an integrated pragmatic approach is essential in containing Pandemics as they need international cooperation at various levels starting from knowledge sharing to monetary support. PREP which is in line with the WHO action plan, will be an essential minimum response of a non-frontline Pandemic response specialty like orthopedics to combat and curtail the effects of a Pandemic in a multispecialty tertiary health care centre.
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Pandemic response protocol of a non-frontline specialty in a multispecialty tertiary health care centre-a pilot model in orthopaedics.
International orthopaedics, 2020Co-Authors: Girinivasan Chellamuthu, Sathish MuthuAbstract:3,181,642 cases and 224,301 deaths in 212 regions of the world—this is the status of COVID-19 (Coronavirus Disease 2019) Pandemic as of May 1, 2020. This Pandemic has managed to overwhelm the health care system of the most advanced countries in the world. As the whole of the medical fraternity stands robed as health care professionals to fight against COVID-19, specialty emergencies like trauma continue to pester the already overburdened health care community. This situation calls for the need for a Pandemic response protocol (PREP) in each specialty that helps the doctors to manage specialty emergencies without chaos and at the same time allowing them to play their part in Pandemic management. PREP as an integrated pragmatic approach is essential in containing Pandemics as they need international cooperation at various levels starting from knowledge sharing to monetary support. PREP which is in line with the WHO action plan, will be an essential minimum response of a non-frontline Pandemic response specialty like orthopedics to combat and curtail the effects of a Pandemic in a multispecialty tertiary health care centre.
Lone Simonsen - One of the best experts on this subject based on the ideXlab platform.
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global mortality estimates for the 2009 influenza Pandemic from the glamor project a modeling study
PLOS Medicine, 2013Co-Authors: Lone Simonsen, Peter Spreeuwenberg, Roger Lustig, Robert J Taylor, D M Fleming, M Kroneman, Maria D Van Kerkhove, Anthony W MountsAbstract:Background Assessing the mortality impact of the 2009 influenza A H1N1 virus (H1N1pdm09) is essential for optimizing public health responses to future Pandemics. The World Health Organization reported 18,631 laboratory-confirmed Pandemic deaths, but the total Pandemic mortality burden was substantially higher. We estimated the 2009 Pandemic mortality burden through statistical modeling of mortality data from multiple countries.
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preliminary estimates of mortality and years of life lost associated with the 2009 a h1n1 Pandemic in the us and comparison with past influenza seasons
PLOS Currents, 2010Co-Authors: Cecile Viboud, Mark A Miller, Donald R Olson, Michael T Osterholm, Lone SimonsenAbstract:The on-going debate about the health burden of the 2009 influenza Pandemic and discussions about the usefulness of vaccine recommendations has been hampered by an absence of directly comparable measures of mortality impact. Here we set out to generate an "apples-to-apples" metric to compare Pandemic and epidemic mortality. We estimated the mortality burden of the Pandemic in the US using a methodology similar to that used to generate excess mortality burden for inter-Pandemic influenza seasons. We also took into account the particularly young age distribution of deaths in the 2009 H1N1 Pandemic, using the metric "Years of Life Lost" instead of numbers of deaths. Estimates are based on the timely pneumonia and influenza mortality surveillance data from 122 US cities, and the age distribution of laboratory-confirmed Pandemic deaths, which has a mean of 37 years. We estimated that between 7,500 and 44,100 deaths are attributable to the A/H1N1 Pandemic virus in the US during May-December 2009, and that between 334,000 and 1,973,000 years of life were lost. The range of years of life lost estimates includes in its lower part the impact of a typical influenza epidemic dominated by the more virulent A/H3N2 subtype, and the impact of the 1968 Pandemic in its upper bound. We conclude that the 2009 A/H1N1 Pandemic virus had a substantial health burden in the US over the first few months of circulation in terms of years of life lost, justifying the efforts to protect the population with vaccination programs. Analysis of historic records from three other Pandemics over the last century suggests that the emerging Pandemic virus will continue to circulate and cause excess mortality in unusually young populations for the next few years. Continuing surveillance for indicators of increased mortality is of key importance, as Pandemics do not always cause the majority of associated deaths in the first season of circulation.
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preliminary estimates of mortality and years of life lost associated with the 2009 a h1n1 Pandemic in the us and comparison with past influenza seasons
PLOS Currents, 2010Co-Authors: Cecile Viboud, Mark A Miller, Donald R Olson, Michael T Osterholm, Lone SimonsenAbstract:The on-going debate about the health burden of the 2009 influenza Pandemic and discussions about the usefulness of vaccine recommendations has been hampered by an absence of directly comparable measures of mortality impact. Here we set out to generate an "apples-to-apples" metric to compare Pandemic and epidemic mortality. We estimated the mortality burden of the Pandemic in the US using a methodology similar to that used to generate excess mortality burden for inter-Pandemic influenza seasons. We also took into account the particularly young age distribution of deaths in the 2009 H1N1 Pandemic, using the metric "Years of Life Lost" instead of numbers of deaths. Estimates are based on the timely pneumonia and influenza mortality surveillance data from 122 US cities, and the age distribution of laboratory-confirmed Pandemic deaths, which has a mean of 37 years. We estimated that between 7,500 and 44,100 deaths are attributable to the A/H1N1 Pandemic virus in the US during May-December 2009, and that between 334,000 and 1,973,000 years of life were lost. The range of years of life lost estimates includes in its lower part the impact of a typical influenza epidemic dominated by the more virulent A/H3N2 subtype, and the impact of the 1968 Pandemic in its upper bound. We conclude that the 2009 A/H1N1 Pandemic virus had a substantial health burden in the US over the first few months of circulation in terms of years of life lost, justifying the efforts to protect the population with vaccination programs. Analysis of historic records from three other Pandemics over the last century suggests that the emerging Pandemic virus will continue to circulate and cause excess mortality in unusually young populations for the next few years. Continuing surveillance for indicators of increased mortality is of key importance, as Pandemics do not always cause the majority of associated deaths in the first season of circulation.
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the signature features of influenza Pandemics implications for policy
The New England Journal of Medicine, 2009Co-Authors: Mark A Miller, Cecile Viboud, Marta Balinska, Lone SimonsenAbstract:Archeo-epidemiologic research can clarify certain “signature features” of three previous influenza Pandemics that should inform both national plans for Pandemic preparedness and required international collaborations. Dr. Mark Miller and colleagues discuss characteristics that are frequently not considered in response plans.
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transmissibility and mortality impact of epidemic and Pandemic influenza with emphasis on the unusually deadly 1951 epidemic
Vaccine, 2006Co-Authors: Cecile Viboud, Theresa Tam, D M Fleming, Andreas Handel, Mark A Miller, Lone SimonsenAbstract:There are important gaps in our current understanding of the influenza virus behavior. In particular, it remains unclear why some inter-Pandemic seasons are associated with unusually high mortality impact, sometimes comparable to that of Pandemics. Here we compare the epidemiological patterns of the unusually deadly 1951 influenza epidemic (A/H1N1) in England and Wales and Canada with those of surrounding epidemic and Pandemic seasons, in terms of overall mortality impact and transmissibility. Based on the statistical and mathematical analysis of vital statistics and morbidity epidemic curves in these two countries, we show that the 1951 epidemic was associated with both higher mortality impact and higher transmissibility than the 1957 and 1968 Pandemics. Surprisingly in Liverpool, considered the 'epicenter' of the severe 1951 epidemic, the mortality impact and transmissibility even surpassed the 1918 Pandemic.
Girinivasan Chellamuthu - One of the best experts on this subject based on the ideXlab platform.
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Pandemic response protocol of a non-frontline specialty in a multispecialty tertiary health care centre—a pilot model in orthopaedics
International Orthopaedics, 2020Co-Authors: Girinivasan Chellamuthu, Sathish MuthuAbstract:Background 3,181,642 cases and 224,301 deaths in 212 regions of the world—this is the status of COVID-19 (Coronavirus Disease 2019) Pandemic as of May 1, 2020. This Pandemic has managed to overwhelm the health care system of the most advanced countries in the world. As the whole of the medical fraternity stands robed as health care professionals to fight against COVID-19, specialty emergencies like trauma continue to pester the already overburdened health care community. This situation calls for the need for a p andemic re sponse p rotocol (PREP) in each specialty that helps the doctors to manage specialty emergencies without chaos and at the same time allowing them to play their part in Pandemic management. Conclusion PREP as an integrated pragmatic approach is essential in containing Pandemics as they need international cooperation at various levels starting from knowledge sharing to monetary support. PREP which is in line with the WHO action plan, will be an essential minimum response of a non-frontline Pandemic response specialty like orthopedics to combat and curtail the effects of a Pandemic in a multispecialty tertiary health care centre.
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Pandemic response protocol of a non-frontline specialty in a multispecialty tertiary health care centre-a pilot model in orthopaedics.
International orthopaedics, 2020Co-Authors: Girinivasan Chellamuthu, Sathish MuthuAbstract:3,181,642 cases and 224,301 deaths in 212 regions of the world—this is the status of COVID-19 (Coronavirus Disease 2019) Pandemic as of May 1, 2020. This Pandemic has managed to overwhelm the health care system of the most advanced countries in the world. As the whole of the medical fraternity stands robed as health care professionals to fight against COVID-19, specialty emergencies like trauma continue to pester the already overburdened health care community. This situation calls for the need for a Pandemic response protocol (PREP) in each specialty that helps the doctors to manage specialty emergencies without chaos and at the same time allowing them to play their part in Pandemic management. PREP as an integrated pragmatic approach is essential in containing Pandemics as they need international cooperation at various levels starting from knowledge sharing to monetary support. PREP which is in line with the WHO action plan, will be an essential minimum response of a non-frontline Pandemic response specialty like orthopedics to combat and curtail the effects of a Pandemic in a multispecialty tertiary health care centre.
David M. Morens - One of the best experts on this subject based on the ideXlab platform.
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Pandemic influenza: certain uncertainties.
Reviews in medical virology, 2011Co-Authors: David M. Morens, Jeffery K TaubenbergerAbstract:SUMMARY For at least five centuries, major epidemics and Pandemics of influenza have occurred unexpectedly and at irregular intervals. Despite the modern notion that Pandemic influenza is a distinct phenomenon obeying such constant (if incompletely understood) rules such as dramatic genetic change, cyclicity, “wave” patterning, virus replacement, and predictable epidemic behavior, much evidence suggests the opposite. Although there is much that we know about Pandemic influenza, there appears to be much more that we do not know. Pandemics arise as a result of various genetic mechanisms, have no predictable patterns of mortality among different age groups, and vary greatly in how and when they arise and recur. Some are followed by new Pandemics, whereas others fade gradually or abruptly into long-term endemicity. Human influenza Pandemics have been caused by viruses that evolved singly or in co-circulation with other Pandemic virus descendants and often have involved significant transmission between, or establishment of, viral reservoirs within other animal hosts. In recent decades, Pandemic influenza has continued to produce numerous unanticipated events that expose fundamental gaps in scientific knowledge. Influenza Pandemics appear to be not a single phenomenon but a heterogeneous collection of viral evolutionary events whose similarities are overshadowed by important differences, the determinants of which remain poorly understood. These uncertainties make it difficult to predict influenza Pandemics and, therefore, to adequately plan to prevent them. Published 2011. This article is a US Government work and is in the public domain in the USA.
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predominant role of bacterial pneumonia as a cause of death in Pandemic influenza implications for Pandemic influenza preparedness
The Journal of Infectious Diseases, 2008Co-Authors: David M. Morens, Jeffery K Taubenberger, Anthony S FauciAbstract:Background. Despite the availability of published data on 4 Pandemics that have occurred over the past 120 years, there is little modern information on the causes of death associated with influenza Pandemics. Methods. We examined relevant information from the most recent influenza Pandemic that occurred during the era prior to the use of antibiotics, the 1918-1919 "Spanish flu" Pandemic. We examined lung tissue sections obtained during 58 autopsies and reviewed pathologic and bacteriologic data from 109 published autopsy series that described 8398 individual autopsy investigations. Results. The postmortem samples we examined from people who died of influenza during 1918-1919 uniformly exhibited severe changes indicative of bacterial pneumonia. Bacteriologic and histopathologic results from published autopsy series clearly and consistently implicated secondary bacterial pneumonia caused by common upper respiratory-tract bacteria in most influenza fatalities. Conclusions. The majority of deaths in the 1918-1919 influenza Pandemic likely resulted directly from secondary bacterial pneumonia caused by common upper respiratory-tract bacteria. Less substantial data from the subsequent 1957 and 1968 Pandemics are consistent with these findings. If severe Pandemic influenza is largely a problem of viral-bacterial copathogenesis, Pandemic planning needs to go beyond addressing the viral cause alone (e.g., influenza vaccines and antiviral drugs). Prevention, diagnosis, prophylaxis, and treatment of secondary bacterial pneumonia, as well as stockpiling of antibiotics and bacterial vaccines, should also be high priorities for Pandemic planning.
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the pathology of influenza virus infections
Annual Review of Pathology-mechanisms of Disease, 2008Co-Authors: Jeffery K Taubenberger, David M. MorensAbstract:Influenza viruses are significant human respiratory pathogens that cause both seasonal, endemic infections and periodic, unpredictable Pandemics. The worst Pandemic on record, in 1918, killed approximately 50 million people worldwide. Human infections caused by H5N1 highly pathogenic avian influenza viruses have raised concern about the emergence of another Pandemic. The histopathology of fatal influenza virus pneumonias as documented over the past 120 years is reviewed here. Strikingly, the spectrum of pathologic changes described in the 1918 influenza Pandemic is not significantly different from the histopathology observed in other less lethal Pandemics or even in deaths occurring during seasonal influenza outbreaks.
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1918 influenza the mother of all Pandemics
Emerging Infectious Diseases, 2006Co-Authors: Jeffery K Taubenberger, David M. MorensAbstract:The “Spanish” influenza Pandemic of 1918–1919, which caused ≈50 million deaths worldwide, remains an ominous warning to public health. Many questions about its origins, its unusual epidemiologic features, and the basis of its pathogenicity remain unanswered. The public health implications of the Pandemic therefore remain in doubt even as we now grapple with the feared emergence of a Pandemic caused by H5N1 or other virus. However, new information about the 1918 virus is emerging, for example, sequencing of the entire genome from archival autopsy tissues. But, the viral genome alone is unlikely to provide answers to some critical questions. Understanding the 1918 Pandemic and its implications for future Pandemics requires careful experimentation and in-depth historical analysis.
Ralf Reintjes - One of the best experts on this subject based on the ideXlab platform.
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evaluation of national Pandemic management policies a hazard analysis of critical control points approach
Health Policy, 2009Co-Authors: Ralf Krumkamp, Ahmed M. Syed, Amena Ahmad, Annette Kassen, Lulu Hjarnoe, Arja R. Aro, Ralf ReintjesAbstract:Analyses of Pandemic preparedness policies revealed weaknesses in control systems of European nations. This reinforces the need to support countries in their endeavours to prevent and contain Pandemics. A Hazard Analysis and Critical Control Points (HACCP) was applied to a generic plan to identify weaknesses in Pandemic management policies, in order to develop recommendations for improving national Pandemic management systems. Policy components considered in our analysis are command and control, early case detection and disease surveillance, and community containment management. The main critical areas identified in national Pandemic control were: communication systems among all institutions and levels involved in Pandemic management, guidelines and regulations describing how key personal and institutions should operate during a Pandemic, training and dissemination of information to health care personnel involved in outbreak management. The HACCP analysis highlighted the need for agreed communication structures, clear division of responsibilities and harmonised policy guidelines at all levels of Pandemic management. Being prepared is the key to successfully coordinate and implement response measures when a Pandemic emerges.
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Prevention and control of infectious diseases with Pandemic potential: The EU-project SARSControl
Gesundheitswesen, 2009Co-Authors: Amena Ahmad, Ralf Krumkamp, Jan Hendrik Richardus, Ralf ReintjesAbstract:textabstractIntroduction: The influenza Pandemics of the 20 th century, the SARS epidemic in 2002 / 03 and the growing number of human cases infected with the H5N1 avian infl uenza virus clearly demonstrate that the threat of new Pandemics is very real. These events have intensifi ed Pandemic prevention and control activities worldwide. " SARSControl " is a three-year project funded by the European Commission with the objective to aid European member states in the public health management of new emerging infections. This article summarises the main research results and recommendations arising from this project. Method: The reports and papers published in the SARSControl project form the basis of this article. In addition, a literature search for SARS and Pandemic infl uenza was conducted and information on Pandemic planning and management guidelines obtained from the WHO and EU websites. The project results are discussed in this context. Results: A lack of knowledge and delayed international communication resulted in the rapid spread of SARS, highlighting the importance of a global system for rapid and transparent information transfer. Epidemiological and economic modelling studies have shown that, in comparison to travel restrictions, applying intervention measures to interrupt local transmission within a country and investing into vaccine research and anti-viral stockpiling, is a more cost-eff ective and effi cient use of resources for the containment of Pandemics. A study investigating the perceived threat associated with Pandemics showed that the subjective risk perception of people varies among countries. This infl uences human behaviour and should hence be considered during risk communication and implementation of Pandemic control measures. Discussion: The basic prerequistes of an effi cient Pandemic management are operationalisable Pandemic plans, subjected to regular exercises, backed by adequate resources and a sound health-care infrastructure. At international level cross-border co-operation and information exchange on infection control is the key to Pandemic mitigation and containment. Strengthening surveillance systems at the international level, to allow the timely monitoring of infectious agents and outbreaks is essen tial. Transferring such outbreak information in real time into mathematical models and the resulting essential epidemiological information to policy makers would facilitate a more effi cient use of scarce resources. Involvement of the public in decisions regarding the implementation of restrictive control measures which often curtail individual liberty is necessary for the acceptance and ultimate success of Pandemic control.
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Evaluation of national Pandemic management policies—A hazard analysis of critical control points approach
Health Policy, 2009Co-Authors: Ralf Krumkamp, Ahmed M. Syed, Amena Ahmad, Annette Kassen, Lulu Hjarnoe, Arja R. Aro, Ralf ReintjesAbstract:Analyses of Pandemic preparedness policies revealed weaknesses in control systems of European nations. This reinforces the need to support countries in their endeavours to prevent and contain Pandemics. A Hazard Analysis and Critical Control Points (HACCP) was applied to a generic plan to identify weaknesses in Pandemic management policies, in order to develop recommendations for improving national Pandemic management systems. Policy components considered in our analysis are command and control, early case detection and disease surveillance, and community containment management. The main critical areas identified in national Pandemic control were: communication systems among all institutions and levels involved in Pandemic management, guidelines and regulations describing how key personal and institutions should operate during a Pandemic, training and dissemination of information to health care personnel involved in outbreak management. The HACCP analysis highlighted the need for agreed communication structures, clear division of responsibilities and harmonised policy guidelines at all levels of Pandemic management. Being prepared is the key to successfully coordinate and implement response measures when a Pandemic emerges.
