scholarly journals Public health interventions and epidemic intensity during the 1918 influenza pandemic

2007 ◽  
Vol 104 (18) ◽  
pp. 7582-7587 ◽  
Author(s):  
Richard J. Hatchett ◽  
Carter E. Mecher ◽  
Marc Lipsitch
Keyword(s):  
Disease Transmission ◽  
Early Phase ◽  
Influenza Pandemic ◽  
Death Rates ◽  
Viral Spread ◽  
Early Implementation ◽  
The Difference ◽  
1918 Influenza ◽  
The Impact ◽  
Multiple Interventions

Nonpharmaceutical interventions (NPIs) intended to reduce infectious contacts between persons form an integral part of plans to mitigate the impact of the next influenza pandemic. Although the potential benefits of NPIs are supported by mathematical models, the historical evidence for the impact of such interventions in past pandemics has not been systematically examined. We obtained data on the timing of 19 classes of NPI in 17 U.S. cities during the 1918 pandemic and tested the hypothesis that early implementation of multiple interventions was associated with reduced disease transmission. Consistent with this hypothesis, cities in which multiple interventions were implemented at an early phase of the epidemic had peak death rates ≈50% lower than those that did not and had less-steep epidemic curves. Cities in which multiple interventions were implemented at an early phase of the epidemic also showed a trend toward lower cumulative excess mortality, but the difference was smaller (≈20%) and less statistically significant than that for peak death rates. This finding was not unexpected, given that few cities maintained NPIs longer than 6 weeks in 1918. Early implementation of certain interventions, including closure of schools, churches, and theaters, was associated with lower peak death rates, but no single intervention showed an association with improved aggregate outcomes for the 1918 phase of the pandemic. These findings support the hypothesis that rapid implementation of multiple NPIs can significantly reduce influenza transmission, but that viral spread will be renewed upon relaxation of such measures.

Abstract 14066: O -GlcNAc Levels Stimulation is a New Potential Therapeutic Strategy at the Early Phase of Septic Shock in the Young

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Thomas DUPAS ◽  
Manon DENIS ◽  
Justine Dontaine ◽  
Laurent Bultot ◽  
Antoine Persello ◽  
...  
Keyword(s):  
Septic Shock ◽  
Early Phase ◽  
Therapeutic Strategy ◽  
Troponin T ◽  
Post Translational Modification ◽  
Prism Score ◽  
Endotoxemic Shock ◽  
Old Rats ◽  
The Difference ◽  
The Impact

Background: We have shown that increase in O -GlcNAc levels, a post-translational modification involved in the stress response, at the early phase of septic shock in adult (84 days old rats) is a potential new therapeutic strategy. Most studies focus in adults while the population most affected by septic shock, young children, is rarely studied. Considering that O- GlcNAc levels are higher in the young, the impact of O- GlcNAc on septic shock in the young should be tested. Purpose: Evaluate if O- GlcNAc stimulation could improve sepsis outcomes in young. Methods: Endotoxemic shock was induced in 28 days old rats with an i.v. injection of saline (CTRL, n=10) or LPS (O111:B4, 20mg.kg -1 - LPS, n=9). 1 hour after LPS rats were randomly assigned to no therapy (LPS), fluidotherapy (saline, 10ml.kg -1 - LPS+R, n=10) ± NButGT (10 mg.kg -1 - NButGT, n=11) to increase O- GlcNAc levels. 2 hours later, physiological functions and markers of severity were measured and used in adapted Pediatric RISk of Mortality score (PRISM score). The impact of treatment on survival was evaluated on n=16 per group. Mass spectrometry (MS) study was performed to identify O -GlcNAcylated proteins. Results: LPS induce a shock (mean arterial pressure (MAP): CTRL: 67.2 ± 1.9; LPS: 50.7 ± 2.1; mmHg; p<0.05), alter biological parameters (lactates: CTRL: 3.92 ± 0.26; LPS: 6.42 ± 0.45; mmol.l -1 ; pH: CTRL: 7.27 ± 0.02; LPS: 7.15 ± 0.02; p<0.05), PRISM score (p<0.05) and is associated with multi organs dysfunction (troponin T: CTRL: 19.7 ± 4.0; LPS: 45.4 ± 11.4; ng.l -1 ; creatinine: CTRL: 15.9 ± 1.5; LPS: 25.3 ± 2.6; μmol.l -1 ; p<0.05). LPS+R has no beneficial effect while NButGT improves MAP (p<0.05), PRISM score (p<0.05) and the median survival (NButGT: 36.0; LPS+R: 13.65; hours; p<0.001) compared to LPS+R treatment. MS highlight important variations of O- GlcNAcylation particularly that of mitochondrial proteins. Conclusions: Despite higher O- GlcNAc levels, we demonstrate that O- GlcNAc stimulation is also a potential new therapeutic strategy for septic shock in young. Our results show that it is the difference between the basal levels and the post-stimulation levels which induces a protection against sepsis. Proteins identify by MS will need to be specifically studied to decipher their impact in septic shock.

scholarly journals Lessons From Influenza Pandemics of the Last 100 Years

2019 ◽  
Author(s):  
Arnold S Monto ◽  
Keiji Fukuda
Keyword(s):  
Avian Influenza ◽  
Seasonal Influenza ◽  
Influenza Pandemic ◽  
Risk Groups ◽  
Influenza Viruses ◽  
Avian Influenza Viruses ◽  
Influenza Pandemics ◽  
Fundamental Difficulty ◽  
1918 Influenza ◽  
The Impact

Abstract Seasonal influenza is an annual occurrence, but it is the threat of pandemics that produces universal concern. Recurring reports of avian influenza viruses severely affecting humans have served as constant reminders of the potential for another pandemic. Review of features of the 1918 influenza pandemic and subsequent ones helps in identifying areas where attention in planning is critical. Key among such issues are likely risk groups and which interventions to employ. Past pandemics have repeatedly underscored, for example, the vulnerability of groups such as pregnant women and taught other lessons valuable for future preparedness. While a fundamental difficulty in planning for the next pandemic remains their unpredictability and infrequency, this uncertainty can be mitigated, in part, by optimizing the handling of the much more predictable occurrence of seasonal influenza. Improvements in antivirals and novel vaccine formulations are critical in lessening the impact of both pandemic and seasonal influenza.

scholarly journals News from the front: Estimation of excess mortality and life expectancy in the major epicenters of the COVID-19 pandemic in Italy

2020 ◽  
Author(s):  
Simone Ghislandi ◽  
Raya Muttarak ◽  
Markus Sauerberg ◽  
Benedetta Scotti
Keyword(s):  
Life Expectancy ◽  
Excess Mortality ◽  
Human Life ◽  
Influenza Pandemic ◽  
National Level ◽  
Years Of Life Lost ◽  
Substantial Impact ◽  
Lombardy Region ◽  
1918 Influenza ◽  
The Impact

AbstractExisting studies on the mortality impacts of the COVID-19 pandemic commonly rely on national official reports. However, in a pandemic, deaths from COVID-19 can be miscounted due to under-reporting and inaccurate death registration. Official statistics on COVID-19 mortality are sensitive to classification, estimation and reporting practice which are not consistent across countries. Likewise, the reported mortality is often provided at the national level which results in underestimation of the true scale of the human life impact given that the outbreaks are localised.This study overcomes the problem of under-reporting of COVID-19-related deaths by using all cause daily death registrations data provided by the Italian Statistical Office (ISTAT) from January 1 to April 30, 2020 in comparison with official figures reported by the Civil Protection Department. The study focuses on the five most severely hit provinces in Italy (Bergamo, Brescia, Cremona, Lodi and Piacenza) and Lombardy region. We calculate excess mortality in 2020 compared to the average of the years 2015 to 2019 and estimate life expectancy for the first wave of the epidemic and for the rest of the year 2020. Not only is life expectancy a reliable measure of a country’s health status and development, it also allows us to quantify the impact of COVID-19 on human life.The estimated excess deaths show significantly higher mortality than COVID-19 official mortality statistics, particularly during the peak of the epidemic and amongst people aged 60 years and over. We find that for the first wave of the epidemic, life expectancy in the five provinces reduced by 5.1 to 7.8 and 3.2 to 5.8 years for men and women, respectively. For annual life expectancy for the year 2020, in a scenario with no harvesting effect i.e. mortality rates resume to an average level of the years 2015-2019 after the end of the first epidemic wave, the years of life lost is equivalent to 2 to 3.5 years for men and 1.1. to 2.5 years for women in the five provinces.The COVID-19 pandemic posed a substantial impact on population health in Italy as it represents the largest decline in life expectancy after the 1918 influenza pandemic and the Second World War.

TRANSMISSION DYNAMICS AND OPTIMAL CONTROL OF AN INFLUENZA MODEL WITH QUARANTINE AND TREATMENT

2012 ◽  
Vol 05 (03) ◽  
pp. 1260011 ◽  
Author(s):  
WEI-WEI SHI ◽  
YUAN-SHUN TAN
Keyword(s):  
Optimal Control ◽  
Disease Transmission ◽  
Reproduction Number ◽  
Influenza Pandemic ◽  
Control Measures ◽  
Globally Asymptotically Stable ◽  
Number Formula ◽  
Parameter Values ◽  
The Impact ◽  
Disease Free

We develop an influenza pandemic model with quarantine and treatment, and analyze the dynamics of the model. Analytical results of the model show that, if basic reproduction number [Formula: see text], the disease-free equilibrium (DFE) is globally asymptotically stable, if [Formula: see text], the disease is uniformly persistent. The model is then extended to assess the impact of three anti-influenza control measures, precaution, quarantine and treatment, by re-formulating the model as an optimal control problem. We focus primarily on controlling disease with a possible minimal the systemic cost. Pontryagin's maximum principle is used to characterize the optimal levels of the three controls. Numerical simulations of the optimality system, using a set of reasonable parameter values, indicate that the precaution measure is more effective in reducing disease transmission than the other two control measures. The precaution measure should be emphasized.

scholarly journals Stillbirth Risk during the 1918 Influenza Pandemic in Arizona, USA

Epidemiologia ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 23-30
Author(s):  
Smriti Khare ◽  
Sushma Dahal ◽  
Ruiyan Luo ◽  
Richard Rothenberg ◽  
Kenji Mizumoto ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Retrospective Study ◽  
Pandemic Influenza ◽  
Influenza Pandemic ◽  
Regression Analyses ◽  
Maricopa County ◽  
Mother’S Age ◽  
1918 Influenza ◽  
Birth Records ◽  
The Impact

The 1918 influenza pandemic, the deadliest pandemic on record, affected approximately 1/3rd of the population worldwide. The impact of this pandemic on stillbirth risk has not been studied in depth. In this study, we assessed the stillbirth risk during the 1918 influenza pandemic in Arizona, USA. We carried out a retrospective study using 21,334 birth records for Maricopa County, Arizona, for the period 1915–1925. We conducted logistic regression analyses to assess the effect of that pandemic on stillbirth risk. Though we did not find a statistically significant impact on stillbirth risk during the pandemic, there was a higher risk of stillbirth in July 1919 (42 stillbirths/1000 births), 9 months after the peak pandemic mortality, and a stillbirth risk of 1.42 (95% CI: 1.17, 1.72) in women ≥35 years compared to the women aged <35 years. The risk of stillbirth was lowest if the mother’s age was approximately 26 years at the time of birth. We also report peaks in stillbirth risk 9–10 months after the peak pandemic mortality. Our findings add to our current understanding of the link between pandemic influenza and stillbirth risk.

scholarly journals Transmission frequency of COVID-19 through pre-symptomatic and asymptomatic patients in AJK: a report of 201 cases

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Majid Mahmood ◽  
Noor-ul-ain Ilyas ◽  
Muhammad Faraz Khan ◽  
Muhammad Naseem Hasrat ◽  
Nicholas Richwagen
Keyword(s):  
Disease Transmission ◽  
Transmission Rate ◽  
Human Life ◽  
Influenza Pandemic ◽  
Symptomatic Infection ◽  
Transmission Frequency ◽  
Asymptomatic Patients ◽  
History Of ◽  
1918 Influenza ◽  
Asymptomatic Individuals

Abstract Background The COVID-19 pandemic is a catastrophic global phenomenon, affecting human life in a way unseen since the 1918 influenza pandemic. Effective management of this threat requires halting transmission, a strategy requiring accurate knowledge of SARS-CoV-2 transmission patterns. Methods This was a retrospective contact study aiming to estimate the transmission rate of COVID-19 by tracing contacts in symptomatic, pre-symptomatic, and asymptomatic patients. History of patients’ contacts during 24 h before appearance of symptoms or infection confirmation was traced for disease transmission. Results Overall, a total of 201 COVID-19 patients had contact with 7168 people in 24 h with an average of 35.66 contacts per patient, ranging from a minimum of 4 to maximum of 87 contacts (meetings). Out of 7168 persons met, infection was detected in 64 (0.89%). For the 155 symptomatic patients, a total of 5611 contacted persons were traced before appearance of symptoms (pre-symptomatic) in last 24 h with an average of 36.20 meetings per patient. The infection was transmitted in 63 (1.12%) people with 5548 (98.88%) remaining uninfected. Out of the 63 transmissions, 62 (98.4%) were traced within 6 h before symptom onset, while only 1 was identified in the 6–12 h timeframe before symptoms. A total of 1557 persons were traced having meeting/contacts with asymptomatic cases in last 24 h before infection confirmation. Out of these 1557 persons, only 1 was found to be infected and the infection rate was calculated to be 0.06%. Statistically, the transmission rate by pre-symptomatic patients was found to be significantly higher than the transmission rate by asymptomatic individuals (P < 0.05). Conclusion In the studied population, the risk of pre-symptomatic and asymptomatic transmission of COVID-19 was low, with transmission risks of 1.12% and 0.06% respectively. Pre-symptomatic infection becomes very rare in contacts made longer than 6 h before onset of symptoms. The infection transmission is traced as long as about 9 h before the appearance of clear symptoms in the patients, but the incidence rate was as low as about 0.02% of the total contacts in that period.

scholarly journals Cultural values predict national COVID-19 death rates

2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Damian J. Ruck ◽  
Joshua Borycz ◽  
R. Alexander Bentley
Keyword(s):  
Cultural Values ◽  
Cultural Context ◽  
State Level ◽  
Population Level ◽  
World Values Survey ◽  
Death Rates ◽  
Trust In Institutions ◽  
National Response ◽  
The Difference ◽  
The Impact

AbstractNational responses to a pandemic require populations to comply through personal behaviors that occur in a cultural context. Here we show that aggregated cultural values of nations, derived from World Values Survey data, have been at least as important as top-down government actions in predicting the impact of COVID-19. At the population level, the cultural factor of cosmopolitanism, together with obesity, predict higher numbers of deaths in the first two months of COVID-19 on the scale of nations. At the state level, the complementary variables of government efficiency and public trust in institutions predict lower death numbers. The difference in effect between individual beliefs and behaviors, versus state-level actions, suggests that open cosmopolitan societies may face greater challenges in limiting a future pandemic or other event requiring a coordinated national response among the population. More generally, mass cultural values should be considered in crisis preparations.

scholarly journals Impact of non-pharmaceutical interventions on the COVID-19 epidemic: A modelling study

2020 ◽  
Vol 8 ◽  
pp. 205031212097946
Author(s):  
Salah Al Awaidy ◽  
Ozayr Mahomed
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Disease Transmission ◽  
Large Scale ◽  
Public Health Intervention ◽  
Transmission Model ◽  
Early Implementation ◽  
The Government ◽  
The Impact ◽  
Pharmaceutical Interventions

Objective: This study aimed to assess the impact of non-pharmaceutical interventions on the COVID-19 epidemic in Oman. Methods: Data were retrieved from published national surveillance data between 24 February and 30 June 2020. To show the impact of the Government introduced public health intervention early in the epidemic, we used a simple disease-transmission model equation of the 2019-n CoV epidemic. Results: From all confirmed cases, the rates of intensive care unit admission were 4.56% (1824). We estimated an R0 of 3.11 with no intervention would result in nearly the entire population of Oman being infected within 65 days. A reduction of the R0 to 1.51 provided an estimated 89,056 confirmed cases, with 167 deaths or 0.4% mortality by June 30 with a requirement of 4052 intensive care unit beds. The current scenario (24 February to 30 June 2020) indicates an R0 of 1.41, resulting in 40,070 confirmed COVID-19 cases, 176 deaths and 69% of confirmed cases recovered. Conclusion: In early implementation of non-pharmaceutical interventions, an intensive lockdown has had a profound impact on the mitigation of a large-scale COVID-19 outbreak in Oman.

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