(精选)88 Years of Influenza Pandemics in 15 Minutes.pptVIP

Bureau of Emergency Preparedness and Response 88 Years of Influenza Pandemics in 15 Minutes Peter C. Kelly, M.D. Arizona Dept. of Health Services Pandemic Influenza: history and background Peter C. Kelly, M.D., FACP Arizona Dept. of Health Services Drivers for Pan Flu Preparedness WHO Influenza Preparedness SARS and Toronto Hurricane Katrina and New Orleans It’s all about the virus Influenza Virus RNA, 8 segments Unstable,mutates frequently Surface proteins Hemagglutinin Neuraminidase Niche in nature is birds Drift and Shift Both refer to genetic changes Drift: Minor changes in H and N antigens; occur annually or every few years Shift: Major change (30% or more) in H and/or N antigens; “new” virus. Important for starting pandemics Influenza is Global Surface Glycoproteins Used to classify virus; H1, H2 etc Important in disease HA attaches virus to respiratory epithelial cells NA facilitates release of virus from infected cell Immunity/vaccines How does the virus cause disease? Attaches to respiratory epithelium Enters the cell and reproduces Causes cell death Primary target is bronchial tissue Pandemics Required for Influenza Pandemic “New” virus (antigenic shift) Susceptible population Transmitted from animals to humans Cause disease in humans Efficient person to person transmission Influenza Pandemics Have occurred for centuries Occur 11 to 42 years apart Unpredictable but not random Attack rates of 10 to 40% Excess mortality But humanity survives 20th Century Current Model of Pandemics 1918-19 Pandemic aka Spanish Flu H1N1 virus, Genetics: “avian like” First cases in USA Global spread ~1 yr Mortality 20-50 million USA 500,000 Impact High mortality Social disruption Burial Public services Events cancelled Spread along troop transport routes Poor public health response Mortality and “Waves”Taubenberger, Morens. EID. 2006;12: 15-22. “the Mother of All Pandemics”Taubenberger, Morens.EID.2006;12:15-22 H1N1 1918 virus is the ancestor of current in