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Paradigm Shift Intervention Monitoring
Implement a risk communication plan to
prevent and/or reduce the population’s anxiety. The press has a key
role in disseminating information. It is necessary to inform
(disseminate) that the large majority of infections are asymptomatic or
present non-specific symptoms.
The above instructions on message management are from the recent WHO H1N1 pandemic alert. Although most H1N1 cases are mild, the current outbreak presents serious problems because of the frequency of D225N and associated with severe and fatal cases, as well as the vaccine failures with patients infected with H1N1 closely related to the Chihuahua sub-clade.
The press has bee largely absent since they convince the WHO to declare and end to the pandemic in August 2010. The target population hasn’t changed and the H1N1 continues to evolve, leading to signals of serious problems. In El Paso the pneumonia and influenza (P&I) death rate is at record levels, but there has been no media coverage. One confirmed H1N1 fatality was recently covered, but the much larger story was ignored.
Similarly the week 12 regional update by the Pan American Health Organization described the sequences of the Chihuahua sub-clade by claiming no genetic changes associated with a more virulent H1N1. However, one of the three sequences had D225N, and a second sequence was identical, but missing D225N. The link of D225N as well as D225G to fatal clusters is well known and the title of the Chihuahua submissions noted the D225N receptor binding domain change. Both D225G and D225N were detected at high frequency in autopsy lung samples from Ukraine in the fall of 2009 and again both were detected in the Duke Medical Center death cluster, as well as a recently released sequence from Chihuahua. Thus, D225N was in two of eight samples collected from the upper respiratory tract, but at least five additional Chihuahua samples with D225N have been withheld. Similarly, sequences from earlier outbreaks in Ecuador and Venezuela have been withheld.
The vaccine failures seen in samples from Air Force dependents has also not been covered by the media and instead vaccination programs are highlighted, even though these programs use Califonia/07/2009 which was isolated over two years ago and is unlikely to be efficacious. Moreover, the same target has been shipped to the southern hemisphere, including South America for the 2011 flu season, and more mismatched vaccine is being prepared for the 2011/2012 flu season in the northern hemisphere.
These serious concerns are being ignored by the media, as the H1N1 spreads throughout Central America and the Caribbean and starts to spread worldwide as travelers return from Easter holiday trips to Mexico, Venezuela, and Cuba.
Thus, message management is in place, but H1N1 doesn’t read WHO press releases or alerts.