Pandemic Flu Can Be Controlled Pending Availability of a Vaccine

Prompt use of social-distancing measures, antiviral treatment and prophylaxis could control an outbreak of pandemic influenza in the United States, pending the availability of a vaccine, according to a recently-published study.

Three teams of researchers in the U.S, and England, in close collaboration with Government officials, studied various intervention combinations to guide national pandemic planning. The three research teams and an informatics group that participated are part of the Models of Infectious Disease Agent Study (MIDAS) Network, an effort funded by the National Institute of General Medical Sciences, or NIGMS.

"The federal government wanted three separate infectious-disease-modeling groups working on the same problem just to make sure the results were robust, since this data would be used to inform national pandemic planning," said the study’s co-author, Ira M. Longini Jr., Ph.D. "We got the highest level of input."

The researchers concentrated on assessing the effectiveness of a blend of antiviral and social-distancing interventions (like closing schools) in preventing a flu pandemic, since a vaccine was unavailable at the time. Other studies had shown that a vaccine would be very helpful in slowing a pandemic.

"The good news was that all three of the disease-modeling groups involved in the study found that an outbreak of pandemic flu similar to the pandemic of 1918 could be mitigated if these measures were implemented quickly," said M. Elizabeth Halloran, M.D., D.Sc., the study’s lead author.

To conduct the study, the researchers used three separate but similar computer models to calculate the spread of influenza within a population similar to that of Chicago, with approximately 8.6 million people. Members of this virtual community interacted the way people normally do: within households, schools and workplaces, and the community at large. All three models were set up to have attack-rate patterns similar to those of past U.S. flu pandemics.

Predicting the spread of an infectious disease such pandemic influenza requires much more than simply connecting dots on a map. Instead, Halloran and colleagues rely on a tool called stochastic modeling to take into account real-world unpredictability, as well as many factors about the disease and the affected population. In constructing these models, the researchers begin with assumptions about how people interact and how the virus spreads. They also introduce and evaluate the effectiveness of various intervention strategies.

These were the findings published in the online Early Edition of PNAS, a publication of the Proceedings of the National Academy of Sciences of the United States of America. M. Elizabeth Halloran, M.D., D.Sc., was the lead author, Ira M. Longini Jr., Ph.D., was the co-author. Both are researchers at Fred Hutchinson Cancer Research Center and professors of biostatistics at the University of Washington, and use mathematical and statistical methods to study the natural course of infectious diseases. Prior to publication, Longini presented the findings at the White House and at the Institute of Medicine.

Industry Standards Needed for Children’s Flu Vaccine, Says Report

Evaluating and establishing industry standards for flu vaccines for hospitalized children could help prevent additional hospitalizations and complications from influenza, according to a study published in a recent issue of Pediatrics.

A research team led by Danielle M. Zerr, MD, MPH, medical director of infection control at Seattle Children’s Hospital and associate professor of Pediatrics at the University of Washington School of Medicine (UWSOM), monitored the number of times children with influenza had been hospitalized, and summarized their findings in an article entitled "Hospital-Based Influenza Vaccination of Children: An Opportunity to Prevent Subsequent Hospitalization."

It was found that 23% of the children admitted to hospital with influenza had a previous hospitalization during the most recent flu season. This suggests that providing in-hospital vaccinations when the children were at highest risk for influenza could reduce the rates of childrens’ influenza during the flu season.

Approximately 14,000 children were hospitalized with influenza—and 170,000 were hospitalized with influenza or a respiratory illness—during a 5-year period (2001–2006) when discharge data provided by the Pediatric Health Information System (PHIS) database was analyzed. The data was checked to see how many children had a previous hospitalization during the most recent flu season.

Researchers found approximately 16% of those hospitalized with influenza and 23% of those hospitalized with influenza and another underlying condition had previous hospital admissions during the vaccination season.

"This information will help pediatricians recognize hospitalization as an important opportunity to vaccinate the highest-risk children, and may hopefully prompt the development of hospital-based flu vaccine programs," said Zerr.

The study looked at five years of hospital discharge data from the Pediatric Health Information System (PHIS) database from 2001 through 2006 to determine how many children hospitalized with influenza or respiratory illness had a previous hospitalization during the most recent flu-vaccine season. PHIS is an administrative database developed by the Child Health Corporation of America (CHCA), used by 42 free-standing pediatric hospitals. Subjects included newborns through age 18. A previous hospitalization during flu vaccination season was considered if it occurred in the two weeks to six months prior to the influenza admission and between September 1 and March 1. Approximately 14,000 cases of children hospitalized with influenza and 170,000 hospitalized with influenza or a respiratory illness were reviewed.

Source: Pediatrics, February, 2008

Shingles Vaccine: What You Need to Know

According to a CDC "vaccine statement" a shingles vaccine was licensed in 2006, and in clinical trials it prevented shingles in 50% of people 60 years or older. In addition, the vaccine reduces the pain associated with the disease.

Shingles occurs only in someone who has had a case of chickenpox, or has had the chickenpox vaccine. The virus stays in one’s body and can reappear much later, causing the shingles outbreak. 

The main symptom is a painful rash, often with blisters. Other symptoms include fever, headache, upset stomach and chills.

 So what should one know in evaluating whether or not to get this vaccine?

First, no-one should get the vaccine if they have HIV /AIDS or another disease that affects the immune systom. Nor should they get the vaccine if they are under treatment with drugs, such as steriods, that affect the immune system. Nor should anyone under cancer treatment with radiation or chemotherapy, or any bone marrow disease (such as leukemia or lymphoma). Tuberculosis and pregnancy are other contraindications for the vaccine.

Then the choice is between you and your health care provider. According to the CDC "no serious problems have been identified with shingles vaccines."

For more information, contact your physician, local or state health department, or the CDC at www.cdc.gov.nip

SOURCE: Centers for Disease Control and Prevention