The Low Hanging Fruit of Pandemic Flu Prevention

While you go out to get your flu vaccines check to see if you should also get the pneumococcal vaccine, and think about how you might help give access to these vaccines to millions of children who need them.
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It's flu season, and the world is watching to see whether this pandemic is going to act like previous ones. Disease trackers from CDC are collecting viruses and distributing vaccines for both seasonal flu and pandemic flu because meeting the challenge of the pandemic influenza requires safe, effective vaccines. But until today, it was unclear whether another fearsome feature of previous pandemics would also come in to play.

Today the CDC released new data from the flu pandemic showing that we need to be prepared for bacterial pneumonia on top of the flu. "Bacterial pneumonia may be contributing to influenza-associated mortality in a manner similar to that in previous pandemics," said epidemiologist Matthew Moore of the Centers for Disease Control and Prevention. By studying the lungs of 77 patients that died from confirmed H1N1 flu, they were able to document the involvement of bacteria from 29% of the patients, and one bacterium, called pneumococcus, was responsible for almost half of the bacterial infections.

The flu virus can make you sick all on its own. But it can also set up your body for a more serious, bacterial infection like pneumonia or meningitis in the following days. In fact, historically, these bacterial pneumonias account for a large fraction of the serious illness and deaths that occurred during an influenza pandemic. A bacteria called pneumococcus that accounts for about 1.5 million worldwide deaths each year on its own, is one of the most common bacterial causes of these pneumonia cases.

Knowing that there is a likely bacterial pneumonia surge that will follow pandemic influenza may seem scary but it is actually helpful. Because in addition to the vaccines that can prevent influenza, we have vaccines that prevent the pneumococcal pneumonias that follow flu illnesses and antibiotics to treat those that get through the vaccinations. Wider use of these vaccines now will help soften the impact of a pandemic while also providing valuable health and economic gains now. CDC's Moore estimates that there are about 70 million Americans who should be getting the pneumococcal vaccine but haven't yet received it. By making sure that you're familiar with the signs of pneumonia and seek care when needed and that doctors are on guard to diagnose and treat it we can minimize the consequences of pneumonia.

There are overlapping challenges as well as opportunities impeding the wider use of influenza and pneumococcal vaccines around the world. In each case, the existing vaccines are helpful but better, more broadly protective vaccines would have a greater impact. For each disease, making better vaccines requires sharing of strains and isolates with a corresponding commitment to supplying the vaccines to the populations that need them the most. Until this year, for example, no countries in Africa -- where the highest risk of pneumococcal disease occurs -- had introduced the life-saving pneumococcal vaccine for their children. Lastly, successful delivery of these vaccines to all the children and adults who need it will require expansion of vaccine supply capacity and extension of systems to deliver the vaccines.

Success against influenza and pneumonia requires some common features. Sustained research, international cooperation and commitment, a massive expansion of vaccine manufacturing capacity, and investments to strengthen immunization and health systems are needed for both. So, while you go out to get your flu vaccines -- seasonal and pandemic -- check to see if you should also get the pneumococcal vaccine. And while you're at it think also about how you might help give access to these vaccines to millions of children around the world who urgently need them.

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