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Challenges for the next pandemic


Six public health challenges and data needs are evident, based upon lessons learned from the 2009 influenza pandemic. These are the conclusions of Maria Van Kerkhove and colleagues published in this week's PLoS Medicine, which they argue can help shape the response and readiness for future pandemics. As the global epidemiology of the pandemic (H1N1) 2009 influenza (H1N1pdm) virus strain unfolds into 2010, substantial policy challenges will continue to present themselves for the next 12 to 18 months. These are: measuring age-specific immunity to infection; accurately quantifying severity; improving treatment outcomes for severe cases; quantifying the effectiveness of interventions; capturing the full impact of the pandemic on mortality; and rapidly identifying and responding to antigenic variants. The authors argue that serological surveys and monitoring time-sources are critical sources of pandemic data, which need better dissem ination. They suggest that "some of the most valuable data, such as estimates of age-specific serological attack rates, have not become available until far after the time when it would have been needed to support decision making."


Funding: The authors acknowledge support from the Bill & Melinda Gates Foundation (MDVK, CF, NMF); Royal Society (CF); Medical Research Council (MDVK, CF, PJW, NMF); EU FP7 programme (NMF); UK Health Protection Agency (PJW); US National Institutes of Health Models of Infectious Disease Agent Study program through cooperative agreement 1U54GM088588 (ML); NIH Director's Pioneer Award, DP1-OD000490-01 (DS); EU FP7 grant EMPERIE 223498 (DS); the Wellcome Trust (DS); 3R01TW008246-01S1 from Fogerty International Center and RAPIDD program from Fogerty International Center with the Science & Technology Directorate, Department of Homeland Security (SR); and the Institut de Veille Sanitaire Sanitaire funded by the French Ministry of Health (J-CD). The funders played no role in the decision to submit the article or in its preparation.

Competing Interests:PJW is a member of the UK government's Scientific Advisory Group for Emergencies (SAGE) and Scientific Pandemic Influenza Advisory Committee (SPI) and its modeling sub-group (SPI-M). He is employed by the UK Health Protection Agency. ML has received consulting fees from the Avian/Pandemic Flu Registry (Outcome Sciences), which is funded in part by Roche. ML has received consulting from Novartis Vaccines and Diagnostics. All other authors report no competing interests.

Citation: Van Kerkhove MD, Asikainen T, Becker NG, Bjorge S, Desenclos J-C, et al. (2010) Studies Needed to Address Public Health Challenges of the 2009 H1N1 Influenza Pandemic: Insights from Modeling. PLoS Med 7(6):e1000275. doi:10.1371/journal.pmed.1000275.




Maria Van Kerkhove
Imperial College London
Department of Infectious Disease Epidemiology
St. Mary's Campus
Norfolk Place
London, London W2 1PG
United Kingdom

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