Preparing for the Next Flu Pandemic

The development of improved flu vaccines, antivirals, and antibacterials are among the recommendations in a report from the Infectious Diseases Society of America.

In order to prepare for the next flu pandemic, the United States needs to improve development and production of vaccines and develop new antiviral and antibacterial medications. These and a number of other recommendations were featured in a report released on September 14, 2012, by the Infectious Diseases Society of America (IDSA).

The report draws on examples from the 2009 H1N1 flu pandemic, which demonstrated how a novel virus could spread across the globe in a matter of months. In the United States, there were approximately 60.8 million H1N1 cases, 274,000 hospitalizations, and 12,500 deaths. Of these deaths, 87% were in those younger than 65 years, an unusually high portion. (Seasonal influenza is associated with 3000 to 50,000 deaths each year.)

The IDSA emphasizes that preparations for seasonal and pandemic flu are closely connected and must be addressed in concert. Its report sets forth 10 principles for improving flu preparedness, 2 of which focus on pharmaceuticals used to prevent and treat influenza and its complications:

Strengthen Influenza Vaccine Efforts

Vaccines are the first line of defense against influenza. Vaccine manufacturing capacity in the United States is at an all-time high, with the seasonal influenza vaccine available in a variety of forms. In addition, international efforts helped to nearly triple worldwide supplies of seasonal trivalent influenza vaccine to 900 million doses between 2006 and 2009. However, during the H1N1 pandemic, vaccine supplies were insufficient, especially in less wealthy nations, demonstrating the need for improved technologies to foster more rapid vaccine development and production. The goal should be production of a universal vaccine to protect against a range of viruses. In addition, more research into improved delivery and uptake of vaccines is needed.

Enhance Pharmaceutical Availability and Medical Management of Influenza

Given the alarming paucity of new antiviral and antibacterial drugs currently under development, government support should be allocated to help develop them, according to the report. New antivirals are needed that are easy to use, widely accessible, and effective against emerging flu variants. Special attention should be given to the development of intravenous formulations for severely ill patients as well as medications geared toward children and pregnant women. In addition, new antibacterials are needed to treat secondary bacterial infections associated with flu, such as pneumonias due to methicillin-resistant Staphylococcus aureus (MRSA) and drug-resistant Streptococcus pneumonia. During the 2009 pandemic, children with H1N1 who were co-infected with MRSA were 8 times as likely to die.

The report’s remaining recommendations call for improving diagnostic tools for influenza; improving communication between government agencies and the public and medical providers; improving influenza surveillance; improving treatment and control of influenza at the community level; preparing the public health and medical care systems to handle a pandemic; protecting health care providers against influenza, including requiring mandatory vaccination of providers; strengthening international collaboration; and providing consistent, adequate funding to put the preceding recommendations into place and allow for long-term planning.

To download a pdf of the complete report, click here.