Mitigation strategies for the protection of health care workers and first responders
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Mitigation strategies for the protection of health care workers and first responders
- 1. Mitigation strategies for the protection of health care workers and first responders Dr John Watkins Department of Primary Care and Public Health School of Medicine Cardiff University Consultant National Public Heath Service for Wales UK
- 4. Cases of laboratory confirmed swine-lineage influenza A H1N1 by day of report and travel history, United Kingdom, 06 May 2009 (n=32)
- 12. Who is at risk?
- 13. Age specific attack rate confirmed cases reported by México 0.75 109,955,400 822 Total 3 No details 0.20 9,640,294 19 60 + 0.54 14,349,342 77 45 to 59 0.57 23,687,456 134 30 to 44 0.94 29,722,159 279 15 to 29 0.95 21,783,444 208 5 to 14 0.95 10,772,705 102 < 5 rate per 100,000 Population from US census office N° Age (years)
- 21. From Rashid A. Chotani Just-in-Time Lecture
- 22. 1918-MOST FATAL EVENT IN HUMAN HISTORY WORLDWIDE FATALITIES: 50-100 MILLION US FATALITIES: 675,000 U.S. LIFE EXPECTANCY AT BIRTH
- 25. Kaiser et al , 2003 Reduction in complications Patients (%) 55% 52% 61% **, p<0.001 vs placebo Placebo (n=1063) Tamiflu ® (oseltamivir) (n=1350) 10.3 8.2 1.8 4.6** 3.9 0.7 n=109 n=87 n=19 n=62 n=53 n=9 Kaiser et al. Arch Intern Med 2003; 163: 1667-72.
- 26. Kaiser et al, 2003 Reduction in hospitalisations 59% 62% 50% 1.7 0.7* 0.8 0.3 3.2 1.6 n=18 n=9 n=5 n=3 n=13 n=6 Placebo (n=1063) Tamiflu (n=1350) Placebo (n=662) Tamiflu (n=982) Placebo (n=401) Tamiflu (n=369) P=0.17 P=0.02 Patients (%) Placebo Tamiflu ® (oseltamivir) Kaiser et al. Arch Intern Med 2003; 163: 1667-72.
- 27. Earlier Treatment With Oseltamivir Maximises Clinical Benefits Reduction of Illness Duration ( Days) Compared With Intervention at 48 h Time From Symptom Onset to Treatment (h) Modeled time to treatment P < 0.0001. – 3.1 d – 1.2 d – 2.2 d 12 24 36 – 3.8 d 0
- 32. INDOOR CHURCH SERVICES WERE BANNED BY HEALTH DEPARTMENTS
- 34. Poem from a lady afflicted Cannot speak-got no voice Cannot walk-got no legs Cannot sleep-got too much head Cannot lie down-cough too much Cannot sit up-sneeze too much Cannot eat-got too big a throat Cannot write-got nothing to say. Why? INFLUENZA Lancet January 11 th 1890 p72