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The Impact of Pandemic Influenza on Public Health
Rashid A. Chotani, MD, MPH
Director, Global Infectious Disease Surveillance and Alert System
Johns Hopkins University
Part Four of Six
H5N1 Human Outbreaks
Avian Influenza A(H5N1), 1997
„
„
Avian Influenza A(H5N1) caused 18 cases of influenza with six deaths in
the Hong Kong area
Experts are concerned that the virus may acquire a mutation encouraging
human-to-human transmission.
Notes Available
4
The H5N1 Influenza Pandemic Threat
• Avian infection in
nine countries
• 34 human cases and
23 deaths (68%)
• Culled >100 m
chickens
• Avian infection in
Hong Kong
• 18 human cases and
six deaths (33%)
• Culled poultry
• Avian infection in four
countries
• Seven human cases and
six deaths (86%)
• Person-to-person?
• Ongoing avian H5N1 infections
1997
1998
1999
2000
2001
2002
2003
2004
5
Affected Countries with Confirmed H5N1 Human Cases
Notes Available
6
Affected Countries with Confirmed H5N1 Human Cases
Notes Available
7
Cumulative Number of Confirmed H5N1 Human Cases
Data from December 26th, 2003, to April 4th, 2006
108 Deaths
93
100
75
42
50
30
25
16
7 5
5 5
11
23
22
4 2
14
12
2 2
4
am
ey
Vi
et
N
rk
Tu
nd
la
ai
Th
si
do
ne
q
a
t
Eg
C
yp
In
am
C
hi
a
di
bo
ja
ai
rb
ze
A
na
0
n
No. of Reported Cases
191 Cases
Ir a
„
Countries
Source: WHO
8
Cumulative Number of Confirmed H5N1 Human Cases
„
Data from December 26th, 2003, to April 4th, 2006
No. of Reported Cases
100
90
80
70
60
50
40
30
20
10
0
Mortality: 43%
Deaths
Cases
95
Mortality: 70%
46
Mortality: 100%
3
Mortality: 68%
41
32
47
32
3
2003
2004
2005
2006
Countries
Source: WHO
9
Cumulative Number of Confirmed H5N1 Human Cases
„
Data from December 26th, 2003, to April 4th, 2006
Survived, 83,
43%
Source: WHO
Deaths, 108,
57%
10
Avian and Human H5N1 Identified in No. of Countries
„
Data from December 26th, 2003, to April 4th, 2006
No. of Reported Cases
40
Cases in Birds
Cases in Humans
37
35
30
25
18
20
15
11
10
5
1
1
5
2
7
0
2003
2004
2005
2006
Countries
Source: WHO
11
Nations with Confirmed H5N1 Avian Influenza (April, 2006)
Source: U.S. Department of Health and Human Services
12