Presentation is loading. Please wait.

Presentation is loading. Please wait.

Lessons from the European Experience with A(H1N1) 2009 Angus Nicoll CBE European Centre for Disease Prevention and Control 3 rd meeting of the National.

Published byKristian Mills Modified over 9 years ago

Similar presentations

Presentation on theme: "Lessons from the European Experience with A(H1N1) 2009 Angus Nicoll CBE European Centre for Disease Prevention and Control 3 rd meeting of the National."— Presentation transcript:

1 Lessons from the European Experience with A(H1N1) 2009 Angus Nicoll CBE European Centre for Disease Prevention and Control 3 rd meeting of the National Influenza Centres in the Western Pacific and South East Asian Regions, Beijing

2 Pandemics of influenza H7 H5 H9 * 1980 1997 Recorded new avian influenzas 19962002 1999 2003 195519651975198519952005 H1N1 H2N2 1889 Russian influenza H2N2 1957 Asian influenza H2N2 H3N2 1968 Hong Kong influenza H3N2 H3N8 1900 Old Hong Kong influenza H3N8 1918 Spanish influenza H1N1 19151925195519651975198519952005 18951905 2010 2015 2009 Pandemic influenza H1N1 Recorded human pandemic influenza (early sub-types inferred) Reproduced and adapted (2009) with permission of Dr Masato Tashiro, Director, Center for Influenza Virus Research, National Institute of Infectious Diseases (NIID), Japan. Animated slide: Press space bar H1N1 Pandemic H1N1

3 The situation could be a lot worse for Europe! (Situation circa summer 2009)  A pandemic strain emerging in the Americas.  Immediate virus sharing so rapid diagnostic and vaccines.  Pandemic (H1N1) currently not that pathogenic.  Some seeming residual immunity in a major large risk group (older people).  No known pathogenicity markers.  Initially susceptible to oseltamivir.  Good data and information coming out of North America.  Arriving in Europe in the summer.  Mild presentation in most. A pandemic emerging in SE Asia Delayed virus sharing Based on a more pathogenic strain, e.g. A(H5N1) No residual immunity Heightened pathogenicity Inbuilt antiviral resistance Minimal data until transmission reached Europe Arriving in the late autumn or winter Severe presentation immediately Contrast with what might have happened — and might still happen!

4 Some ‘Lessons Learnt ‘ points  Five years preparation paid off – for those who did it  But need to operationalise and adapt the plans for this pandemic  The ‘acid tests’ have been crucial e.g. can you distribute antivirals quickly and efficiently ?http://ecdc.europa.eu/en/healthtopics/Pages/Pandemic_Influenza_Assessment_Tools.aspx  Built around a regularly updated risk assessment http://ecdc.europa.eu/en/healthtopics/Documents/0907_Influenza_AH1N1_Risk_Assessment.pdf  Planning projections has to be adjusted http://ecdc.europa.eu/en/healthtopics/Documents/0908_InfluenzaA_H1N1_Planning_Assumptions_for_ the_First_Wave_of_Pandemic_A(H1N1)_2009_in_Europe.pdf  Surveillance has had to be adjusted http://ecdc.europa.eu/en/publications/Publications/0908_MER_Surveillance_and_Studies_in_a_Pandemi c_Meeting_Report.pdf  Personal interventions - are justified  Societal Public Health Interventions – mostly not justified http://ecdc.europa.eu/en/publications/Publications/0906_TER_Public_Health_Measures_for_Influenza_ Pandemics.pdf http://ecdc.europa.eu/en/healthtopics/Documents/0908_InfluenzaA_H1N1_Managing_schools_during_the_current_pand emic_(H1N1)_2009.pdf http://ecdc.europa.eu/en/publications/Publications/0906_TER_Public_Health_Measures_for_Influenza_ Pandemics.pdf  Containment vs. Mitigation – beware of policy decisions http://ecdc.europa.eu/en/healthtopics/Documents/0906_Influenza_AH1N1_Mitigation_and_Delaying_St rategies_for_the_Influenza_in_Europe.pdf  Beware of stating numbers – deaths are difficult  The health care sector is a vulnerable point

5 Idealised national curve for planning, Europe 2009: Reality is never so smooth and simple Single-wave profile showing proportion of new clinical cases, consultations, hospitalisations or deaths by week. Based on London, second wave 1918. Source: Department of Health, UK 0% 5% 10% 15% 20% 25% 123456789101112 Week Proportion of total cases, consultations, hospitalisations or de aths InitiationAccelerationPeakDeclining Animated slide: Please wait

6 One possible European scenario — summer 2009 In reality, the initiation phase can be prolonged, especially in the summer months. What cannot be determined is when acceleration takes place. 0% 5% 10% 15% 20% 25% AprMayJunJulAugSepOctNovDecJanFebMar Month Proportion of total cases, consultations, hospitalisations or deaths InitiationAccelerationPeakDeclining Animated slide: Press key Apr

7

8

9 Switch to deaths

10 Some ‘Lessons Learnt ‘ points  Five years preparation paid off – for those who did it  But need to operationalise and adapt the plans for this pandemic  The ‘acid tests’ have been crucial e.g. can you distribute antivirals quickly and efficiently ?http://ecdc.europa.eu/en/healthtopics/Pages/Pandemic_Influenza_Assessment_Tools.aspx  Built around a regularly updated risk assessment http://ecdc.europa.eu/en/healthtopics/Documents/0907_Influenza_AH1N1_Risk_Assessment.pdf  Planning projections has to be adjusted http://ecdc.europa.eu/en/healthtopics/Documents/0908_InfluenzaA_H1N1_Planning_Assumptions_for_ the_First_Wave_of_Pandemic_A(H1N1)_2009_in_Europe.pdf  Surveillance has had to be adjusted http://ecdc.europa.eu/en/publications/Publications/0908_MER_Surveillance_and_Studies_in_a_Pandemi c_Meeting_Report.pdf  Personal interventions - are justified  Societal Public Health Interventions – mostly not justified http://ecdc.europa.eu/en/publications/Publications/0906_TER_Public_Health_Measures_for_Influenza_ Pandemics.pdf http://ecdc.europa.eu/en/healthtopics/Documents/0908_InfluenzaA_H1N1_Managing_schools_during_the_current_pand emic_(H1N1)_2009.pdf http://ecdc.europa.eu/en/publications/Publications/0906_TER_Public_Health_Measures_for_Influenza_ Pandemics.pdf  Containment vs. Mitigation – beware of policy decisions http://ecdc.europa.eu/en/healthtopics/Documents/0906_Influenza_AH1N1_Mitigation_and_Delaying_St rategies_for_the_Influenza_in_Europe.pdf  Beware of stating numbers – deaths are difficult  The health care sector is a vulnerable point

11 RCGP (England and Wales) ILI consultation rate per 100,000 2008/09 and recent seasons.

12 Some revised planning assumptions for the pandemic – first wave A(H1N1) 2009 These represent a reasonable worst case applying to one European country (the United Kingdom) with data available as of July 2009 They should not be used for predictions Source: UK http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_102892http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_102892 Clinical attack rate30% Peak clinical attack rate6.5% (local planning assumptions 4.5% to 8%) per week Complication rate15% of clinical cases Hospitalisation rate2% of clinical cases Case fatality rate0.1% to 0.2% (cannot exclude up to 0.35%) of clinical cases Peak Absence Rate12% of workforce

13 Some ‘Lessons Learnt ‘ points  Five years preparation paid off – for those who did it  But need to operationalise and adapt the plans for this pandemic  The ‘acid tests’ have been crucial e.g. can you distribute antivirals quickly and efficiently ?http://ecdc.europa.eu/en/healthtopics/Pages/Pandemic_Influenza_Assessment_Tools.aspx  Built around a regularly updated risk assessment http://ecdc.europa.eu/en/healthtopics/Documents/0907_Influenza_AH1N1_Risk_Assessment.pdf  Planning projections has to be adjusted http://ecdc.europa.eu/en/healthtopics/Documents/0908_InfluenzaA_H1N1_Planning_Assumptions_for_ the_First_Wave_of_Pandemic_A(H1N1)_2009_in_Europe.pdf  Surveillance has had to be adjusted http://ecdc.europa.eu/en/publications/Publications/0908_MER_Surveillance_and_Studies_in_a_Pandemi c_Meeting_Report.pdf  Personal interventions - are justified  Societal Public Health Interventions – mostly not justified http://ecdc.europa.eu/en/publications/Publications/0906_TER_Public_Health_Measures_for_Influenza_ Pandemics.pdf http://ecdc.europa.eu/en/healthtopics/Documents/0908_InfluenzaA_H1N1_Managing_schools_during_the_current_pand emic_(H1N1)_2009.pdf http://ecdc.europa.eu/en/publications/Publications/0906_TER_Public_Health_Measures_for_Influenza_ Pandemics.pdf  Containment vs. Mitigation – beware of policy decisions http://ecdc.europa.eu/en/healthtopics/Documents/0906_Influenza_AH1N1_Mitigation_and_Delaying_St rategies_for_the_Influenza_in_Europe.pdf  Beware of stating numbers – deaths are difficult  The health care sector is a vulnerable point

14 Daily and Weekly hospitalisations with suspected pandemic influenza in England, by age group. Weekly number (rate per 100,000 population) of new hospitalisations Daily rate per 100,000 population of new hospitalisations.

15 Hospitalised patients England Age group (years) < 55-1516-6465+Total Total number of patients in hospital 462522773371 Number of patients in critical care 2031639 At 12 August 0800

16 Hospitalisation ratios per 100,000 population of that age

17 Some ‘Lessons Learnt ‘ points  Five years preparation paid off – for those who did it  But need to operationalise and adapt the plans for this pandemic  The ‘acid tests’ have been crucial e.g. can you distribute antivirals quickly and efficiently  Built around a regularly updated risk assessment  Planning projections has to be adjusted  Surveillance has had to be adjusted Personal interventions - are justified  Societal Public Health Interventions – mostly not justified  Containment vs. Mitigation – beware of policy decisions  Beware of stating numbers – deaths are difficult  The health care sector is a vulnerable point

18

19

Download ppt "Lessons from the European Experience with A(H1N1) 2009 Angus Nicoll CBE European Centre for Disease Prevention and Control 3 rd meeting of the National."

Similar presentations

The 2009-2010 A(H1N1v) pandemic Situation report Europe and forward look to the autumn Zsuzsanna Jakab, Director European Centre for Disease Prevention.

The A(H1N1v) pandemic Situation report Europe and forward look to the autumn Zsuzsanna Jakab, Director European Centre for Disease Prevention.
Will the Avian Flu Become the Next Epidemic?

Will the Avian Flu Become the Next Epidemic?
Prepared by Dr Alissar Rady, WHO Lebanon

Prepared by Dr Alissar Rady, WHO Lebanon
Disease Travels.  Also known as  Contagious Disease  Communicable Disease  Transmissible Disease  Caused by a pathogen that carries disease  Not.

Disease Travels.  Also known as  Contagious Disease  Communicable Disease  Transmissible Disease  Caused by a pathogen that carries disease  Not.
Surveillance, Forecasting, & Nowcasting in an Influenza Pandemic Peter G Grove Health Protection Analytical Team Department of Health.

Surveillance, Forecasting, & Nowcasting in an Influenza Pandemic Peter G Grove Health Protection Analytical Team Department of Health.
Communicable Disease Surveillance & Response WHO-WPRO Pandemic (H1N1) 2009 situation and response in the Western Pacific Region Takeshi Kasai Communicable.

Communicable Disease Surveillance & Response WHO-WPRO Pandemic (H1N1) 2009 situation and response in the Western Pacific Region Takeshi Kasai Communicable.
Pandemic Influenza: Preparedness & Response at Local Level Royal United Services Institute for Defence & Security Studies 20 July 2005 Joyshri Sarangi,

Pandemic Influenza: Preparedness & Response at Local Level Royal United Services Institute for Defence & Security Studies 20 July 2005 Joyshri Sarangi,
Challenges of the 2009 H1N1 Pandemic Influenza: Charles Penn Global Influenza Programme World Health Organization Geneva.

Challenges of the 2009 H1N1 Pandemic Influenza: Charles Penn Global Influenza Programme World Health Organization Geneva.
Andrew Pelletier, MD, MPH Maine Department of Health and Human Services June 26, 2006 Pandemic Influenza.

Andrew Pelletier, MD, MPH Maine Department of Health and Human Services June 26, 2006 Pandemic Influenza.
U.S. Surveillance Update Anthony Fiore, MD, MPH CAPT, USPHS Influenza Division National Center for Immunizations and Respiratory Disease Centers for Disease.

U.S. Surveillance Update Anthony Fiore, MD, MPH CAPT, USPHS Influenza Division National Center for Immunizations and Respiratory Disease Centers for Disease.
Miriam Nuño Harvard School of Public Health, USA Gerardo Chowell Los Alamos National Laboratory, USA Abba Gumel University of Manitoba, Canada AIMS/DIMACS/SACEMA.

Miriam Nuño Harvard School of Public Health, USA Gerardo Chowell Los Alamos National Laboratory, USA Abba Gumel University of Manitoba, Canada AIMS/DIMACS/SACEMA.
Avian Influenza – What does it all mean? Important Background Information Island Paravets and Residents.

Avian Influenza – What does it all mean? Important Background Information Island Paravets and Residents.
Lessons for Europe from past pandemics and the North American experience so far Evolution of the pandemic of A(H1N1)v influenza European Centre for Disease.

Lessons for Europe from past pandemics and the North American experience so far Evolution of the pandemic of A(H1N1)v influenza European Centre for Disease.
Dr Helen Carter Specialist Registrar Public Health Health Protection Agency Regional Surveillance Unit West Midlands Influenza Surveillance Key Health.

Dr Helen Carter Specialist Registrar Public Health Health Protection Agency Regional Surveillance Unit West Midlands Influenza Surveillance Key Health.
Pandemic Influenza Preparedness Kentucky Department for Public Health Department for Public Health.

Pandemic Influenza Preparedness Kentucky Department for Public Health Department for Public Health.
Pandemic Flu ‘The Bigger Picture’ Response! Shayne Ward Emergency Planning Officer NHS Lincolnshire.

Pandemic Flu ‘The Bigger Picture’ Response! Shayne Ward Emergency Planning Officer NHS Lincolnshire.
Preparing for an Influenza Pandemic in Westminster Health and Community Services Overview and Scrutiny Committee 9 Oct 2006 Dr Margaret Guy Director of.

Preparing for an Influenza Pandemic in Westminster Health and Community Services Overview and Scrutiny Committee 9 Oct 2006 Dr Margaret Guy Director of.
20 Answers About Influenza

20 Answers About Influenza
Lessons for Europe from the evidence to date Evolution of the H1N1 pandemic European Centre for Disease Prevention and Control Based on various talks given.

Lessons for Europe from the evidence to date Evolution of the H1N1 pandemic European Centre for Disease Prevention and Control Based on various talks given.
From Pandemic Preparedness to Management: UK experience Professor Lindsey Davies CBE FRCP FFPH National Director of Pandemic Influenza Preparedness.

From Pandemic Preparedness to Management: UK experience Professor Lindsey Davies CBE FRCP FFPH National Director of Pandemic Influenza Preparedness.

Similar presentations

Ads by Google