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08:10

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Mammalian-transmissible H5N1 influenza: facts and perspective

Michael T Osterholm1, Nicholas S Kelley

  • 1Center for Infectious Disease Research and Policy, University of Minnesota, Minneapolis, Minnesota, USA. mto@umn.edu

Mbio
|February 28, 2012
PubMed

Insights

Highly transmissible H5N1 influenza A virus strains raise concerns. This review examines H5N1 case-fatality rates and the limited impact of medical countermeasures during a potential pandemic.

Area of Science:

  • Virology
  • Epidemiology
  • Public Health

Background:

  • Recent studies created transmissible H5N1 influenza A virus variants in ferrets.
  • Concerns exist regarding human-to-human transmissibility of lab-generated H5N1.
  • Debates surround H5N1 case-fatality rates and the efficacy of medical countermeasures.

Purpose of the Study:

  • To review H5N1 seroepidemiology data.
  • To analyze how case-finding strategies affect reported H5N1 case-fatality rates.
  • To assess the potential impact of medical countermeasures during an H5N1 pandemic.

Main Methods:

  • Review of existing seroepidemiology data for H5N1 infection.
  • Analysis of case-finding strategies and their influence on WHO-reported case-fatality rates.
  • Evaluation of the potential effectiveness of medical countermeasures.

Main Results:

  • Case-finding strategies significantly influence the reported H5N1 case-fatality rate.
  • Available medical countermeasures (vaccines, antivirals) would likely have limited impact on morbidity and mortality in an H5N1 pandemic.
  • The transmissibility and public health implications of novel H5N1 strains are under scrutiny.

Conclusions:

  • The true H5N1 case-fatality rate may be lower than reported due to case-finding methods.
  • Medical countermeasures are unlikely to significantly mitigate the impact of a widespread H5N1 influenza pandemic.
  • Further research and public health preparedness are crucial for addressing potential H5N1 threats.

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