Transcript Professor Hans Wigzell, Pandemics in a truly globalized environment

Pandemic
From Greek=pan (=all)+demos (=people)
WHO=a pandemic is a global epidemic of
an infectious disease.
Seasonal flu is not considered pandemic
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Pandemics in history
Small pox (vaccine)
Cholera (clean water)
Plague (hygiene,general health)
Syphilis (attenuation,antibiotics)
Flu
Recent HIV
Smittkoppor
Monkey pox
Pandemics today
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Political awareness (HIV major inducer)
Rapid diagnosis (SARS,weeks;HIV,years)
Promising drug development.
Vaccines + or - development
Rapid spread.
Less robust societies (lean)
New pathogens all the time
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10 pathogenic viruses last 10 years
4 of these lethal for man
SARS,epidemi 2003,10-70% lethality
Nipah,12 epidemies,>50% lethality
Hendra,40% lethality
H5N1,avian flu,present lethality 1-5%?
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 >35 billion USD.
• 50 million USD cost/individual death.
Influenza virus subtypes:
unpredictability of a pandemic threat
Group 1
Group 2
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
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
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.
=>30 humans arrive from foreign countries every
second.
Flu pandemics
Ten A flu pandemics in last 300 years
”Spanish”,H1N1,1918-9
”Asian”,H2N2,1957
”HongKong”1968
”?”,?,?
”Spanish” like avian flu,Asian and
HongKong added avian flu genes
Virus enters the body through nose,
mouth and eye
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Handling pandemic threats
• Educate politicians/mass media
• Be open about disease information
(SARS,MCD)
• Make rational precautions
• Reduce anxiety
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 vaccinated=18 million
doses ordered,500 million USD cost
Reality=”Swine” flu is somewhat more aggressive at
present compared to seasonal flu.