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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this site. Copyright 2006, The Johns Hopkins University and Rashid Chotani. All rights reserved. Use of these materials permitted only in accordance with license rights granted. Materials provided “AS IS”; no representations or warranties provided. User assumes all responsibility for use, and all liability related thereto, and must independently review all materials for accuracy and efficacy. May contain materials owned by others. User is responsible for obtaining permissions for use from third parties as needed. 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