A Return to BC19: From Virtual to Real International Travel - the Road is Long.

Editorial - No abstract available

Burden of Severe Pneumonia, Pneumococcal Pneumonia and Pneumonia Deaths in Indian States: Modelling Based Estimates.

The burden of severe pneumonia in terms of morbidity and mortality is unknown in India especially at sub-national level. In this context, we aimed to estimate the number of severe pneumonia episodes, pneumococcal pneumonia episodes and pneumonia deaths in children younger than 5 years in 2010. We adapted and parameterized a mathematical model based on the epidemiological concept of potential impact fraction developed CHERG for this analysis. The key parameters that determine the distribution of severe pneumonia episode across Indian states were state-specific under-5 population, state-specific prevalence of selected definite pneumonia risk factors and meta-estimates of relative risks for each of these risk factors. We applied the incidence estimates and attributable fraction of risk factors to population estimates for 2010 of each Indian state. We then estimated the number of pneumococcal pneumonia cases by applying the vaccine probe methodology to an existing trial. We estimated mortality due to severe pneumonia and pneumococcal pneumonia by combining incidence estimates with case fatality ratios from multi-centric hospital-based studies. Our results suggest that in 2010, 3.6 million (3.3-3.9 million) episodes of severe pneumonia and 0.35 million (0.31-0.40 million) all cause pneumonia deaths occurred in children younger than 5 years in India. The states that merit special mention include Uttar Pradesh where 18.1% children reside but contribute 24% of pneumonia cases and 26% pneumonia deaths, Bihar (11.3% children, 16% cases, 22% deaths) Madhya Pradesh (6.6% children, 9% cases, 12% deaths), and Rajasthan (6.6% children, 8% cases, 11% deaths). Further, we estimated that 0.56 million (0.49-0.64 million) severe episodes of pneumococcal pneumonia and 105 thousand (92-119 thousand) pneumococcal deaths occurred in India. The top contributors to India's pneumococcal pneumonia burden were Uttar Pradesh, Bihar, Madhya Pradesh and Rajasthan in that order. Our results highlight the need to improve access to care and increase coverage and equity of pneumonia preventing vaccines in states with high pneumonia burden

Global Health Security: The Global Outbreak Alert and Response Network

: In the mid-1990s two infectious disease outbreaks – Pneumonic Plague in Surat, India and Ebola in Kikwit, Democratic Republic of Congo (then Zaire) - caused great concern globally. At that time the standard communication system of the World Health Organisation (WHO) - telephone, telex and facsimile – was unable to handle requests and information dissemination in a timely manner, resulting in uncertainty and misunderstanding that increased concern among its member countries. With a vision of using up-to-date communication technologies to avoid such problems in the future, the Global Outbreak Alert and Response Network (GOARN) was created. Its roots were in the World Health Organization’s (WHO’s) emerging infections programme established in 1966, and the goal of GOARN was to increase the sensitivity of global disease detection and the rapidity of global risk assessment, risk communication and outbreak response. By using the most up-to-date communications technologies, GOARN changed the way in which the WHO received, assessed, and responded to information about infectious disease outbreaks

The problems with polio: toward eradication.

The global health effort to eradicate poliomyelitis (polio) has encountered a number of unforeseen and unpredictable challenges. This article provides a timely review of progress made toward eradication, including the polio vaccines in use, and explores the reasons for delays in eradication target dates. It provides an overview of some of the remaining barriers to eradication and looks toward overcoming these through the Polio Eradication and Endgame Strategic Plan

Global Public Health Security

National public health institutes will play a key role in implementation of the revised International Health Regulations

Pandemic preparedness in the 21st century: which way forward?

Comment - No abstract available