Global Health is a specialist bibliographic database for academics and researchers in public and international health.

CDC staff say the reorganization is a change for the worse

US data on influenza deaths are a mess. The Centers for Disease Control and Prevention (CDC) acknowledges a difference between flu death and flu associated death yet uses the terms interchangeably. Additionally, there are significant statistical incompatibilities between official estimates and national vital statistics data. Compounding these problems is a marketing of fear—a CDC communications strategy in which medical experts "predict dire outcomes" during flu seasons.

The pandemic influenza virus of 1918–1919 killed an estimated 20 to 50 million people worldwide. With the recent availability of the complete 1918 influenza virus coding sequence, we used reverse genetics to generate an influenza virus bearing all eight gene segments of the pandemic virus to study the properties associated with its extraordinary virulence. In stark contrast to contemporary human influenza H1N1 viruses, the 1918 pandemic virus had the ability to replicate in the absence of trypsin, caused death in mice and embryonated chicken eggs, and displayed a high-growth phenotype in human bronchial epithelial cells. Moreover, the coordinated expression of the 1918 virus genes most certainly confers the unique high-virulence phenotype observed with this pandemic virus.

An unprecedented epizootic avian influenza A (H5N1) virus that is highly pathogenic has crossed the species barrier in Asia to cause many human fatalities and poses an increasing pandemic threat. This summary describes the features of human infection with influenza A (H5N1) and reviews recommendations for prevention and clinical management presented in part at the recent World Health Organization (WHO) Meeting on Case Management and Research on Human Influenza A/H5, which was held in Hanoi, May 10 through 12, 2005. Because many critical questions remain, modifications of these recommendations are likely.

We evaluated the ability of local public health agencies (LPHAs) to meet a preparedness standard set by the U.S. Centers for Disease Control and Prevention (CDC): to receive and respond to urgent case reports of communicable diseases twenty-four hours a day, seven days a week. We found substantial variability in performance and in the systems in place to respond to such reports. Development and implementation of measures of public health agencies' performance are crucial to improving public health preparedness and, ultimately, to assuring the agencies' accountability.