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adj 1: epidemic over a wide geographical area; "a pandemic outbreak of malaria" 2: existing everywhere; "pandemic fear of nuclear war" n : an epidemic that is geographically widespread; occurring throughout a region or even throughout the world
The most 'common' pandemic to date has been influenza and this disease provides insight to how it and others are managed and the associated risks. Other diseases include plague, ebola, HIV, cholera, smallpox, diphtheria, tuberculosis and mad cow disease.
However, the real risk is from something totally new or a resistant strain of an existing disease for which there exists no treatment or cure. These 'new' diseases can occur naturally or may even be man-made.
There are three main types of influenza viruses: A, B, and C. Influenza C causes only mild disease and has not been associated with widespread outbreaks. Influenza types A and B, however, cause epidemics nearly every year. Influenza A viruses are divided into subtypes, based on differences in two surface proteins: hemagglutinin (H) and neuraminidase (N). Influenza B viruses are not divided into subtypes. During an influenza flu season, usually one or more influenza A subtype and B viruses circulate at the same time.
A pandemic is possible when an influenza A virus makes a dramatic change (i.e., "shift") and acquires a new H or H+N. This shift results in a new or "novel" virus to which the general population has no immunity. The appearance of a novel virus is the first step toward a pandemic. However, the novel influenza A virus also must spread easily from person to person (and cause serious disease) for a pandemic to occur. Influenza B viruses do not undergo shift and do not cause influenza pandemics.
The reservoir for Type A influenza viruses is wild birds, but influenza A viruses also infect animals such as pigs and horses, as well as people. The last two pandemic viruses were combinations of bird and human influenza viruses. Many persons believe that these new viruses emerged when an intermediate host, such as a pig, was infected by both human and bird influenza A viruses at the same time. A new virus was created. Events in Hong Kong in 1997, however, showed that this is not the only way that humans can become infected with a novel virus. Sometimes, an avian influenza virus can "jump the species barrier" and move directly from chickens to humans and cause disease.
Since, by definition, a novel virus is a virus that has never previously infected humans, or hasn't infected humans for a long time, it's likely that almost no one will have immunity, or antibody to protect them against the novel virus. Therefore, anyone exposed to the virus--young or old, healthy or weak--could become infected and get sick. If the novel virus is related to a virus that circulated long ago, older people might have some level of immunity. It is possible that the novel virus may be especially dangerous to some age groups that are not usually at risk of severe illness or death from annual influenza (such as healthy young adults). Such widespread vulnerability makes a pandemic possible and allows it to have potentially devastating impact.
How Does a Pandemic Spread?
Although all pandemics begin with the appearance of a novel virus, most novel viruses do not spread and cause pandemics. It's more common for a novel virus to be detected and cause illness in a few people, but not go on to infect large numbers of people.
For a novel virus to cause a pandemic, a sequence of events must occur over time. A planning tool, developed by pandemic planners, of how those events might unfold can be found at the following web site: www.who.int/emc-documents/influenza/whoccscsredc991c.html. However, the phases will not occur simultaneously around the world.
The Phases of a Pandemic
To help prepare and respond to a pandemic, WHO has developed a series of "phases" that can be used by planners.
While there is no way to identify exactly when each of the phases will occur, it is estimated that an average pandemic could progress from a Novel Virus Alert to a Pandemic in a matter of months. This time frame could be much longer if the disease is not readily contagious, or it could be shorter if the virus spreads quickly.
The phases described above have been developed to help pandemic planners figure out what to do in conjunction with the changing epidemiology of a novel virus. It's important to understand that actual spread of the virus may or may not be described by these phases. For example, we may not be aware of a novel virus until after it has caused widespread disease. For this reason, pandemic plans must include the flexibility to respond to the specifics of each pandemic virus.
The Impact of a Pandemic: How Serious Might It Be?
There's no simple answer to the question of how serious a pandemic might be. It all depends on how virulent (severe) the virus is, how rapidly it can spread from population to population, and the effectiveness of pandemic prevention and response efforts. The 1918 Spanish flu is an example of a worst-case scenario because the strain was highly contagious and quite deadly. This pandemic killed more Americans than all the wars of the 20th century. Since our world today is vastly more populated, and people travel the globe with ease, the spread of a next pandemic could be more rapid than that of previous pandemics.
The impact of a pandemic isn't measured only by how many people will die. If millions of people get sick at the same time, major social consequences will occur. If many doctors and nurses become ill, it will be difficult to care for the sick. If the majority of a local police force is infected, the safety of the community might be at risk. If air traffic controllers are all sick at once, air travel could grind to a halt, interrupting not only business and personal travel, but also the transport of life-saving vaccines or anti-viral drugs. Therefore, a vital part of pandemic planning is the development of strategies and tactics to address all these potential problems.
2008 TEN YEARS OF AUSSURVIVALIST
April 15, 2008