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Some news on swine flu, obesity and other disasters

Some links to new publications – on everything from the history of swine flu to obesity prevention and disaster planning –  that may be of use or interest:

• History of swine flu

The latest issue of The New England Journal of Medicine has two interesting articles exploring the history of swine flu, otherwise known as  influenza A (H1N1) strain (S-OIV). See here and here.

The latter article concludes somewhat poetically:

The 1918 influenza virus and its progeny, and the human immunity developed in response to them, have for nearly a century evolved in an elaborate dance; the partners have remained linked and in step, even as each strives to take the lead. This complex interplay between rapid viral evolution and virally driven changes in human population immunity has created a “pandemic era” lasting for 91 years and counting. There is little evidence that this era is about to come to an end.

If there is good news, it is that successive pandemics and pandemic-like events generally appear to be decreasing in severity over time. This diminution is surely due in part to advances in medicine and public health, but it may also reflect viral evolutionary “choices” that favor optimal transmissibility with minimal pathogenicity — a virus that kills its hosts or sends them to bed is not optimally transmissible. Although we must be prepared to deal with the possibility of a new and clinically severe influenza pandemic caused by an entirely new virus, we must also understand in greater depth, and continue to explore, the determinants and dynamics of the pandemic era in which we live.

• Disasters and vulnerable groups

On a related theme, this article suggests that governments and planners need to pay more attention to protecting vulnerable groups when preparing for disasters. The article is very much focused on the US context but no doubt has wider relevance. It is by Sharona Hoffman, Professor of Law & Bioethics  and Co-Director of the Law-Medicine Center at Case Western Reserve University School of Law.

She argues that the needs of those with physical and mental impairments, the elderly, those with language barriers, children, pregnant women, the impoverished, certain ethnic minorities, and prisoners are often overlooked. “As the Hurricane Katrina experience made clear, preparedness fiascos will result in humiliation and a loss of public faith in the government as well.”

• Progress against obesity?

The latest assessment of America’s progress against obesity reaches dismal conclusions. “F as in Fat: How Obesity Policies Are Failing in America 2009”, a report from the Trust for America’s Health and the Robert Wood Johnson Foundation  found adult obesity rates increased in 23 states and did not decrease in a single state in the past year. Meanwhile, the percentage of obese or overweight children is at or above 30 percent in 30 states.

On a more positive front, there’s a wealth of information and resources about what governments, planners and others can do to encourage healthy eating and physical activity in this toolkit. It is “a collection of current best approaches in healthy eating and physical activity policy”.

• Tracking US health reform

For those with an interest in following developments in US health reform, this interactive website will enable comparative analysis of the various proposals (due to go live on July 20). The National Health Reform Comparative Analysis Project is an intitiative of the George Washington University’s Hirsh Health Law and Policy Program.

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