Foreword

Article Outline

• Copyright

Recent H5N1 pandemic concerns, fanned by extensive coverage by the lay press and media, have created a maelstrom of activity with regard to pandemic planning on the part of schools, corporations, and government at all levels. As a result, medical practitioners have been bombarded by community and patient concerns. What to stockpile? How to prepare? What is the real threat? When will this latest Armageddon arrive?

The current review answers virtually all the questions regarding H5N1 being posed by patients, corporations, as well as local, state and federal government planners. As with all threats we have little experience with, the basis for preparation is formed by the use of sound principles of risk assessment followed by excellent risk communication. These paradigms are developed using evidence based information and will go a long way to providing a reasonable and effective response. The monograph by Dr. McFee weaves the medical evidence with effective risk assessment and risk communication to provide a realistic roadmap for understanding H5N1 related disease. A thoughtful application of these principles is necessary for preparing for a possible pandemic of any etiology on all levels.

The current review emphasizes the fact that H5N1 is of special concern because it mutates rapidly. As a consequence this virus may actually acquire genetic material from viruses infecting other species. In addition, the fact that specific factors including lack of herd immunity, rapid viral spread and inadequate vaccine availability are required for the emergence of a new influenza virus to result in an influenza pandemic is clearly explained. Practitioners need the information presented herein, not only to educate their patients, but to provide proper preparedness advise to the community and the myriad of organizations that will seek counsel on this matter. This monograph provides up to date information and sound advice to the reader who is concerned about pandemic planning. The value of the information contained herein is that it is, in effect, fully applicable to planning for a wide variety of threats both infectious and non-infectious. This monograph emphasizes the very salient principle that primary care providers may identify the sentinel cases for any epidemic and thus be the first to alert authorities initiating “a cascade of events” that will necessarily involve a variety of public health containment strategies.