Articles: pandemics.
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Paediatr Respir Rev · Mar 2015
ReviewEvidence compendium and advice on social distancing and other related measures for response to an influenza pandemic.
The role of social distancing measures in mitigating pandemic influenza is not precisely understood. To this end, we have conducted a systematised review, particularly in light of the 2009 pandemic influenza, to better inform the role of social distancing measures against pandemic influenza. Articles were identified from relevant databases and the data were synthesised to provide evidence on the role of school or work place-based interventions, case-based distancing (self-isolation, quarantine), and restriction of mobility and mass gatherings. ⋯ Voluntary home isolation and quarantine are also effective and acceptable measures but there is an increased risk of intra-household transmission from index cases to contacts. Work place-related interventions like work closure and home working are also modestly effective and are acceptable, but likely to be economically disruptive. Internal mobility restriction is effective only if prohibitively high (50% of travel) restrictions are applied and mass gatherings occurring within 10 days before the epidemic peak are likely to increase the risk of transmission of influenza.
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In 2014, Australia updated its health management plan for pandemic influenza. This updated plan builds upon the lessons from the 2009 influenza pandemic and revised guidance from the World Health Organization. ⋯ Recognition of the need for flexibility is a key feature of both the revised WHO guidance and the revised Australian plan. This column provides an overview of the updated WHO guidance and of the revised Australian Health Management Plan for Pandemic Influenza.
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Less than 100 years since it was first transmitted to the human population HIV-1 infects more than 30 million people worldwide and causes almost 2 million AIDS-related deaths every year. Viruses manipulate cellular genes and pathways to benefit their survival, and the study of cell surface proteins downregulated by viruses has provided insights into both viral pathogenesis and crucial aspects of cell biology. We aimed to identify novel cell surface proteins targeted for downregulation by HIV-1. ⋯ Wellcome Trust, Addenbrooke's Charitable Trust, Raymond and Beverly Sackler Foundation.
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Health Technol Assess · Feb 2015
Randomized Controlled Trial Multicenter StudyBlinded randomised controlled trial of low-dose Adjuvant Steroids in Adults admitted to hospital with Pandemic influenza (ASAP): a trial 'in hibernation', ready for rapid activation.
There are no completed randomised trials of the use of corticosteroids in patients with severe influenza infection. Corticosteroid use in influenza is widespread, non-systematic and marked by controversy. A recent meta-analysis of observational studies of adjuvant corticosteroids in influenza found an association with increased mortality but there were important concerns regarding the risks of bias. ⋯ This study demonstrates that advance set-up of a trial to be conducted during a pandemic, with full regulatory approvals in place, is possible. Regular review during the hibernation phase will be required. This study serves as a model for the development of other 'off-the-shelf' trials as part of preparedness planning for public health emergencies.