Lessons Learned from Influenza A(H1N1)pdm09 Pandemic Response in Thailand

Ungchusak, Kumnuan; Sawanpanyalert, Pathom; Hanchoworakul, Wanna; Sawanpanyalert, Narumol; Maloney, Susan A.; Brown, Richard Clive; Birmingham, Maureen; Chusuttiwat, Supamit

doi:10.3201/eid1807.110976

Cited by 17 publications

(14 citation statements)

References 5 publications

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“…The study period (October 2009–April 2010) occurred between the two peaks of influenza activity, when community influenza transmission was low. 55 However, prophylaxis failure has also been associated with asymptomatic influenza, and we cannot exclude this possibility. 56 This may be important for infection control in the hospital environment and is an area of future research.…”

Section: Discussionmentioning

confidence: 93%

Oseltamivir and inhaled zanamivir as influenza prophylaxis in Thai health workers: a randomized, double-blind, placebo-controlled safety trial over 16 weeks

Anekthananon

Pukrittayakamee

Ratanasuwan

et al. 2012

Journal of Antimicrobial Chemotherapy

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ObjectivesLong-term chemoprophylaxis using neuraminidase inhibitors may be needed during influenza epidemics but safety data are limited to several weeks. We sought to assess the tolerability of oseltamivir and zanamivir as primary prophylaxis over 16 weeks.MethodsWe conducted a parallel group, double blind, 2 (active drug) :1 (placebo) randomized trial of oral oseltamivir/placebo or inhaled zanamivir/placebo over 16 weeks in healthy, Thai hospital professionals at two Bangkok hospitals. The primary endpoint was study withdrawal due to drug-related (possibly, probably, definitely) serious or adverse events (AEs) graded ≥2.ResultsRecruited subjects numbered 129 oseltamivir/65 placebo and 131 zanamivir/65 placebo. A total of 102 grade ≥2 AEs were reported or detected in 69 subjects: 23/129 (17.8%) versus 15/65 (23.1%) (P = 0.26), and 23/131 (17.6%) versus 8/65 (12.3%) (P = 0.28). Intercurrent infections/fevers [26/102 (25.5%)], abnormal biochemistry [25/102 (24.5%)] and gastrointestinal symptoms [18/102 (17.6%)] were the most frequently reported AEs. There were no drug-related study withdrawals. Eight serious AEs were all due to intercurrent illnesses. Laboratory, lung function and ECG parameters were similar between drugs and placebos.ConclusionsOseltamivir and zanamivir were well tolerated in healthy hospital professionals. Both drugs can be recommended for primary influenza prophylaxis for up to 16 weeks.

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Section: Discussionmentioning

confidence: 93%

Oseltamivir and inhaled zanamivir as influenza prophylaxis in Thai health workers: a randomized, double-blind, placebo-controlled safety trial over 16 weeks

Anekthananon

Pukrittayakamee

Ratanasuwan

et al. 2012

Journal of Antimicrobial Chemotherapy

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“…The antiviral treatment stockpile in Thailand was sufficient to treat 0.5% of the population at the beginning of the pandemic, with one million treatment courses added during the first wave of the pandemic [31]. However, treatment was initiated within 48 hours of symptom onset in only 16 (18%) patients.…”

Section: Discussionmentioning

confidence: 99%

Influenza A(H1N1)pdm09-Associated Pneumonia Deaths in Thailand

et al. 2013

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BackgroundThe first human infections with influenza A(H1N1)pdm09 virus were confirmed in April 2009. We describe the clinical and epidemiological characteristics of influenza A(H1N1)pdm09-associated pneumonia deaths in Thailand from May 2009-January 2010.MethodsWe identified influenza A(H1N1)pdm09-associated pneumonia deaths from a national influenza surveillance system and performed detailed reviews of a subset.ResultsOf 198 deaths reported, 49% were male and the median age was 37 years; 146 (73%) were 20–60 years. Among 90 deaths with records available for review, 46% had no identified risk factors for severe influenza. Eighty-eight patients (98%) received antiviral treatment, but only 16 (18%) initiated therapy within 48 hours of symptom onset.ConclusionsMost influenza A(H1N1)pdm09 pneumonia fatalities in Thailand occurred in adults aged 20–60 years. Nearly half lacked high-risk conditions. Antiviral treatment recommendations may be especially important early in a pandemic before vaccine is available. Treatment should be considered as soon as influenza is suspected.

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“…The WHO Regional Office for the Eastern Mediterranean had organized preparedness sub-regional meetings up to 2016. Reports generated from these meetings were published and available on IDRNET database (21)(22)(23)(24). Moreover, a regional strategy on preparedness and response was issued and contained steps for protection of the international community against pandemic influenza according to International Health Regulations (IHR) (2005).…”

Section: Non-peer-reviewed Literature Publications From Emr Databasesmentioning

confidence: 99%

“…Ethical and legal issues, special country circumstances, border screening, integration of international bodies were almost ignored. Continuous active surveillance was ignored in most of the countries after the post-pandemic phase although it was the most important lesson learned from the pandemic (24). Communication and collaboration of assigned authorities in almost all plans were taken into consideration, but risk communication was not always clearly defined.…”

Section: Pandemic Preparedness Plans In Emrmentioning

confidence: 99%

Influenza pandemic preparedness in the World Health Organization Eastern Mediterranean Region

Khan

Rifay

Malik

et al. 2019

East Mediterr Health J

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Background: Preparedness is key to controlling influenza pandemics and epidemics. Aims: A comprehensive literature review was conducted to analyse the response and preparedness to influenza pandemics in the World Health Organization Eastern Mediterranean Region (WHO/EMR). Methods: Published and grey literatures were searched in PubMed, Scopus, and Google scholar, and the WHO/EMR online databases. International and national plans were searched via official websites of the relevant ministries of the countries. Results: We found that the response from EMR countries was minimal and scientific papers published were limited. Moreover, most of those papers studied the preparedness plan partially by focusing on one or more elements such as infection control measures and vaccines, or were directed to certain populations such as health workers. Continuous active surveillance is ignored in most of the countries although it was the most important lesson learned from the pandemic. Conclusions: The national preparedness plans should be updated, taking guidance from the findings in the present report, to address any emerging pandemic virus as well as attending to surges of seasonal influenza cases.

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Lessons Learned from Influenza A(H1N1)pdm09 Pandemic Response in Thailand

Abstract: The strengths and weaknesses of this response can inform planning for pandemics and other prolonged public health emergencies.

Cited by 17 publications

References 5 publications

Oseltamivir and inhaled zanamivir as influenza prophylaxis in Thai health workers: a randomized, double-blind, placebo-controlled safety trial over 16 weeks

Oseltamivir and inhaled zanamivir as influenza prophylaxis in Thai health workers: a randomized, double-blind, placebo-controlled safety trial over 16 weeks

Influenza A(H1N1)pdm09-Associated Pneumonia Deaths in Thailand

Influenza pandemic preparedness in the World Health Organization Eastern Mediterranean Region

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