Credit NEJM
# 8435
Although it seems like just yesterday, it’s been nearly five years since we first received word that a new swine-origin H1N1 virus had been identified in both San Diego and Imperial County, California and in San Antonio, Texas (see CDC Issues Outbreak Notice On Swine Flu). Soon it became apparent that an outbreak had been ongoing for several weeks in Mexico, and early reports suggested a worrisome morbidity and mortality rate.
While it would take another six weeks - as the World Health Organization waited to see if the virus would continue to spread - on June 11th, 2009 the `swine’ H1N1 outbreak was declared a pandemic (see Chan Declares Level 6, Calls Pandemic `Moderate’ Severity).
This week Harvey V. Fineberg, M.D., Ph.D. - President of the Institute of Medicine (IOM) – has penned a review for the NEJM on what went right, and what went wrong, during the first pandemic response of the 21st century. After a frank recounting of the public health challenges (both met and unmet) during the pandemic, Dr. Fineberg notes:
In light of these structural impediments and operational deficiencies, the world was very fortunate that the 2009 H1N1 influenza pandemic was not more severe.
In 2011, an expert panel - chaired by Dr. Fineberg - produced a 180-page assessment of the International pandemic response (see WHO Panel: World Ill-Prepared To Deal With A Pandemic), which concluded:
“The world is ill prepared to respond to a severe influenza pandemic or to any similarly global, sustained and threatening public-health emergency.”
In this latest review, Dr. Fineberg finds that – despite progress made over the past three years - that this original assessment remains basically unchanged.
The full article is available on the site, which I’m certain you’ll want to read in its entirety.
Pandemic Preparedness and Response — Lessons from the H1N1 Influenza of 2009
Harvey V. Fineberg, M.D., Ph.D.
N Engl J Med 2014; 370:1335-1342April 3, 2014DOI: 10.1056/NEJMra1208802
Lessons from the 2009 H1N1 Influenza Pandemic.
A number of viruses have pandemic potential. For example, the coronavirus responsible for the severe acute respiratory syndrome (SARS), which first appeared in southern China in November 2002, caused 8096 cases and 774 deaths in 26 countries before coming to a halt by July 2003 mainly owing to isolation and quarantine.1 In terms of persistence, versatility, potential severity, and speed of spread, however, few viruses rival influenza virus. Endemic in a number of species, including humans, birds, and pigs, influenza virus causes annual outbreaks punctuated by occasional worldwide pandemics, which are characterized by sustained community spread in multiple regions of the world.
