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The pandemic influenza plan recently unveiled by the Department of Health and Human Services specifies four major components of preparedness and response to pandemic influenza:
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The virulence of the 1918 pandemic strain was so extraordinary that there are accounts of people who felt well in the morning but were dead by nightfall.
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If avian H5N1 influenza emerges as a pandemic strain, no currently available vaccine will be completely protective. Therefore, the thrust of the nations pandemic influenza plan is aimed at rapidly producing vaccine and stockpiling effective antivirals.
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Based on ongoing research with the resurrected 1918 H1N1 pandemic virus, it appears that avian influenza H5N1 bird flu could rapidly adapt and spread through the human population with a few genetic changes that allow a transmission tipping point.
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On Marh 5, 2005, the Arizona Republic newspaper reported spread of invasive Group A streptococcal infection to a health care worker at the Flagstaff Medical Center, resulting in severe infection requiring hospitalization.
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This was a prospective study involving 308 consecutive patients who had surgery, and whose body temperature was measured twice-daily for up to 14 days after surgery. A temperature of > 38°C was considered a positive test result and postoperative infection was diagnosed microbiologically or on clinical grounds as defined by the CDC.
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In the united states, children receive 5 doses of combined tetanus-diphtheria-acellular pertussis vaccine between the ages of 2 months and 6 years. While otherwise quite effective, the resultant immunity is transient, so that by the time adolescence is reached, many vaccinees are once again at risk of acquiring infections with Bordetella pertussis.
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Mutsch and colleagues prospectively evaluated the incidence of influenza virus infection among 1450 visitors to tropical and subtropical countries who attended the University of Zurich Travel Clinic.
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Kravitz and colleagues identified 5 cases of purpura fulminans associated with Staphylococcus aureus infection in the Minneapolis-St. Paul area during the period 2000-2004. Three of the patients died, and 2 recovered with significant sequelae.
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Human cytomegalovirus (cmv) shedding in breast milk was prospectively studied in 73 mothers and their 89 preterm infants in Berlin, Germany. Gestational age was 24-33 weeks (median, 28 weeks) and birthweight was 380-2010 g (median, 1,119 g). Feeding was initiated as early as possible, usually by 24-48 hours of life.
