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June 2009
Vol. 19 No. 6
Top Stories
Pandemic Designation Doesn’t Alter H1N1 Response (Yet)

The World Health Organization’s (WHO) June 11 declaration that the novel influenza A:H1N1 virus is now a pandemic didn’t catch anyone by surprise. Nor did it change U.S. preparedness and response activities, which were already in full gear. What the announcement did do was signal to other countries that now is the time to dust off their pandemic plans, and underscore the importance of maintaining ongoing U.S. efforts.

More than 75 countries and every U.S. state are now reporting cases of human infection with the novel flu. Worldwide, more than 35,000 cases had been reported as of mid-June, according to WHO. The pandemic designation reflects the fact that there are now ongoing community level outbreaks in multiple parts of world. WHO’s decision is based on the spread of the virus, not the severity of illness caused by the virus. The Centers for Disease Control and Prevention (CDC) is focusing its efforts on determining where the virus is spreading, with emphasis on protecting the most vulnerable populations, including  young children, pregnant women, and those with underlying health conditions.

Infectious disease experts in the U.S. and abroad continue to monitor the virus as it circulates in the Southern Hemisphere so that current recommendations and response strategies can shift if evidence suggests that transmission dynamics are changing. Earlier this month, IDSA endorsed a statement developed by the Society for Healthcare Epidemiology of America that urges a shift in CDC’s interim guidance on infection control towards adopting the same practices recommended for the prevention of seasonal influenza.

Also this month, IDSA joined other public health groups in supporting additional emergency federal funding in response to the pandemic. Writing in a June 2 letter on behalf of the Working Group on Pandemic Influenza Preparedness, the organizations called for more than $2 billion in FY2009. The groups also urged lawmakers to consider other pressing needs, including additional funding for the purchase and administration of a vaccine for H1N1, and more money for state and local health departments to complete their antiviral stockpiles, purchase personal protective equipment, and reinforce their workforce, among other issues. Congress has answered by approving a total of $7.7 billion in emergency spending for pandemic influenza preparedness and response activities, including $5.8 billion in a multi-year, non-expiring contingency account.

The need for such funding was supported by a June 4 report by Trust for America’s Health, the Center for Biosecurity, and the Robert Wood Johnson Foundation. The groups’ analysis, Pandemic Flu: Lessons From the Frontlines, found that initial response to the H1N1 outbreak showed strong coordination and communication and an ability to adapt to changing circumstances from U.S. officials. But the response also showed how quickly the nation’s core public health capacity would be overwhelmed if an outbreak were more severe or widespread. The report found that although investments in pandemic planning and stockpiling have paid off, public health departments did not have enough resources to carry out their plans.
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