WHO: Pandemic (H1N1) 2009 briefing note 22: levels of worldwide activity

The WHO continues to issue weekly updates and occasional briefing notes on the H1N1 pandemic at http://www.who.int/csr/disease/swineflu/en/index.html

Monitoring patterns and levels of worldwide activity
Pandemic (H1N1) 2009 briefing note 22
21 JULY 2010

As part of regular monitoring of H1N1 pandemic influenza, the WHO is in close dialogue with public health experts in countries worldwide, specifically to determine whether H1N1 activity has returned to levels and patterns normally seen for seasonal flu.

Worldwide, pandemic influenza activity has remained low over the past few months, and there has been little evidence of outbreaks outside the normal influenza season in most countries since the Northern Hemisphere winter. Temperate regions of the Northern Hemisphere are not presently reporting any outbreaks of influenza following one or two waves of the pandemic, and are adjusting their public health responses accordingly.

The Southern Hemisphere winter, which runs from May to September, is the typical influenza season for this part of the world. In most countries in the temperate zone of the Southern Hemisphere the level of influenza reported at present is low, and countries are reporting a mix of influenza strains comprising pandemic influenza A (H1N1) 2009, H3N2, and influenza B viruses. Where the pandemic H1N1 strain is prevalent, some severe illness and deaths have been reported.

Active transmission of pandemic influenza virus still persists in localized areas of the tropics, particularly in South and Southeast Asia, the Caribbean, Central America and West Africa.

Given the diverse pattern of influenza activity in the tropics and that the influenza season in the Southern Hemisphere is still ongoing, it is too early to determine if these countries have transitioned to levels and patterns expected for seasonal influenza. WHO remains in regular dialogue with countries affected to assess whether the pandemic influenza activity has transitioned to a seasonal pattern.


A(H5N1) epidemic: 6.5 years, 500 notified human cases

The status of A(H5N1) influenza was discussed in Eurosurveillance, Volume 15, Issue 29, 22 July 2010: Rapid communications: The influenza A(H5N1) epidemic at six and a half years: 500 notified human cases and more to come.

Since November 2003, the epidemic intelligence team at the French Institut de Veille Sanitaire has been gathering data on influenza A(H5N1) circulation in poultry and on human cases worldwide. As Indonesia notifies the world’s 500th case to the World Health Organization, we discuss the epidemiological situation and trends of A(H5N1) influenza. Although the overall number of cases reported worldwide has decreased, influenza A(H5N1) continues to circulate intensely in some countries and more cases are to be expected, especially in Egypt and Indonesia.

Authors: A Tarantola 1, P Barboza1, V Gauthier1, S Ioos1, N El Omeiri1, M Gastellu-Etchegorry1, for the Epidemic Intelligence team at InVS 1. International and Tropical Department, Institut de Veille Sanitaire, Saint-Maurice, France


NIAID/Fauci: CAPRISA 004 Microbicide HIV Prevention Study

Statement of Anthony S. Fauci, M.D. Director, National Institute of Allergy and Infectious Diseases National Institutes of Health on Results from the CAPRISA 004 Microbicide HIV Prevention Study

Today we congratulate the Centre for the AIDS Programme of Research in South Africa (CAPRISA) and the people of South Africa on the positive findings from the CAPRISA 004 microbicide study, which marks a significant milestone both for the microbicide research field and HIV prevention as a whole.

For years, antiretroviral medicines have been effectively used to treat HIV infection. Through the successful conduct of the CAPRISA 004 study, we now have proof that an antiretroviral drug, in this case tenofovir, can be formulated into a vaginal gel that can protect women against HIV infection. Given that women make up the majority of new HIV infections throughout the world, this finding is an important step toward empowering an at-risk population with a safe and effective HIV prevention tool.

The CAPRISA 004 study is an exciting scientific achievement that moves us one step forward to gaining another effective tool to prevent HIV infection. However, because no one approach will be appropriate or acceptable to all, we must continue to pursue a range of HIV prevention modalities, including microbicides, pre-exposure prophylaxis (PrEP), and vaccines, as we simultaneously pursue scientific strategies designed to bring us closer to finding a cure for HIV/AIDS.

The daunting nature of the HIV/AIDS pandemic makes it clear that no single organization can tackle the problem alone. The CAPRISA 004 study is an excellent example of what researchers, governments, countries, industry, communities and individual study volunteers can accomplish when working together to find public health solutions. NIAID is proud to be among the many partner organizations that provided significant support and resources to establish the infrastructure and training necessary to conduct this landmark clinical trial.

Now we must build upon the CAPRISA research and identify a highly effective and acceptable microbicide for women and others at high-risk for HIV infection. The NIAID-sponsored VOICE study which launched last fall and is expected to enroll 5,000 women in four southern African countries, will provide additional safety and effectiveness data for a tenofovir-based vaginal gel as an HIV prevention method. The study also will offer some insight as to the gel’s acceptability as a product used once a day rather than one that is used before and after sexual intercourse. Additionally, the VOICE study is examining oral antiretroviral tablets (tenofovir alone or tenofovir plus emtricitabine) as an HIV prevention method. NIAID and other research organizations are exploring PrEP strategies in studies involving a number of at-risk populations with the first results expected early next year.


GAVI Alliance and Bloomberg School of Public Health Celebrate Vaccines, Baltimore

The GAVI Alliance and the Johns Hopkins Bloomberg School of Public Health sponsored an event “to review the impact and promise of new vaccines, particularly those that can prevent some of the most common causes of pneumonia and diarrhea in children…the event also celebrated the City of Baltimore’s success with immunizations to improve the health of even its poorest and hard-to-reach children.” Robert Black, MD, Chair, Johns Hopkins Bloomberg School of Public Health’s (JHSPH) Department of International Health, noted, “We now have in hand the latest country-specific estimates of the major causes of child deaths. This should help to focus national programs and donor assistance on the solutions that are most likely to be effective. Achieving the global goal of reducing child mortality by two-thirds is only possible if the high numbers of deaths are addressed by health interventions, including vaccines.”

GAVI noted that Baltimore is one of six US cities to dramatically improve their immunization rates, showing what political will and the courage to take action can accomplish,” said Helen Evans, Deputy CEO of the GAVI Alliance. “With increased leadership and financial support from the US and other donors, we could do globally what Baltimore is doing locally. With an additional $2.6 billion over the next five years, we can prevent about four million deaths by 2015 among the children most at risk, including one million from pneumococcal disease and rotavirus diarrhea.”


Oxford: multidimensional poverty index (MPI)

The Lancet
Jul 24, 2010  Volume 376  Number 9737  Pages 205 – 302

Poverty index: who is the poorest of them all?
The Lancet

In a working paper by the Oxford Poverty and Human Development Initiative, Oxford, UK, this month, Sabine Akire and Maria Emma Santos present a new method for measuring and comparing poverty in 104 developing countries: the multidimensional poverty index (MPI). This index is a composite of three dimensions that are made up of ten indicators—health (child mortality, nutrition), education (years of school education, child enrolment), and living standards (electricity, drinking water, sanitation, flooring, cooking fuel, assets).

Prepublication Data Release, Latency, and Genome Commons

23 July 2010  Vol 329, Issue 5990, Pages 357-480

Policy Forum
Information Access: Prepublication Data Release, Latency, and Genome Commons
Jorge L. Contreras

Researchers must disclose their data in order to achieve recognition and to enable others to test, validate, and challenge their hypotheses. In doing so, they create bodies of shared knowledge that are analogous to traditional public resources, such as forests and freeways, often referred to as “commons” (1, 2). The rate at which data are added to these information commons, however, varies greatly. The traditional practice has been to contribute experimental and observational data to the commons when, or shortly after, the analysis of that data is published, sometimes years after its initial collection (3, 4). Because of busy schedules, competitive pressures, and other interpersonal vagaries, the sharing of scientific data can be inconsistent even after publication (5, 6). Many traditional data-sharing practices were challenged, with significant and lasting effect, during the race to sequence the human genome.