Airports in N.Y., L.A., Hawaii Deemed Worst for Pandemic Spread

HealthDay – 6 mins ago WEDNESDAY, July 25 (HealthDay News) -- Among airports in the United States, JFK in New York City, LAX in Los Angeles and Honolulu International Airport in Hawaii are most likely to play a major role in the spread of a pandemic, according to a new study.

Recent global public health crises -- such as the 2009 H1N1 "swine" flu pandemic that killed about 300,000 worldwide and the 2003 SARS outbreak that affected 37 countries and caused about 1,000 deaths -- have increased awareness about how air travel can help quickly spread dangerous bacteria and viruses around the world.

In this study, researchers in the department of civil and environmental engineering at the Massachusetts Institute of Technology (MIT) used a new mathematical model to determine how the 40 largest U.S. airports would influence the spread of a contagious disease that originated in the cities where the airports are located.

John F. Kennedy International Airport in New York City would have the most influence, followed by airports in Los Angeles, Honolulu, San Francisco, Newark, Chicago (O'Hare) and Washington, D.C. (Dulles), the investigators found.

Even though it handles the largest number of flights, Atlanta's Hartsfield-Jackson International Airport ranks eighth in influence. Boston's Logan International Airport ranks 15th, according to the study published online July 19 in the journal PLoS One.

The MIT model differs from existing models in that it incorporates factors such as variations in travel patterns among individuals, the geographic locations of airports, and waiting times at individual airports.

"The findings could form the basis for an initial evaluation of vaccine allocation strategies in the event of an outbreak, and could inform national security agencies of the most vulnerable pathways for biological attacks in a densely connected world," researcher Ruben Juanes, an associate professor in energy studies in civil and environmental engineering, explained in an MIT news release.

More information

The U.S. Federal Communications Commission has more about pandemics.

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Researcher calls for global action on pandemic of physical inactivity

ScienceDaily (July 18, 2012) — The high prevalence and consequences of physical inactivity should be recognized as a global pandemic, according to a new publication by Harold W. Kohl, III, Ph.D., professor of epidemiology at The University of Texas School of Public Health, part of The University of Texas Health Science Center at Houston (UTHealth).

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“Physical inactivity continues to be undervalued among people who can make a difference despite evidence of its health benefits and the evident cost burden posed by present levels of physical inactivity globally,” said Kohl, who is also with the Michael & Susan Dell Center for Healthy Living at the UT School of Public Health.

The paper is the fifth and final paper in The Lancet “Series on Physical Activity” published this week and outlines key strategies and resources needed to make physical activity a global public health priority. “This series emphasizes the need to focus on population physical activity levels as an outcome, not just decreasing obesity,” said Kohl, professor of kinesiology at The University of Texas at Austin.

The health burden of physical inactivity is substantial, according to Kohl. “Although regular physical activity is critical for weight control, it is equally or more important for lowering risk of many different chronic diseases such as heart disease, some cancers, osteoporosis and diabetes.”

According to Kohl, research on physical activity needs to be its own priority within public health research of non-communicable diseases.

Globally nearly one-third of persons 15 and over were insufficiently active in 2008 and approximately 3.2 million deaths each year are attributable to insufficient physical activity, according to the World Health Organization. In 2008, the prevalence of insufficient physical activity was highest in the Americas and Eastern Mediterranean regions.

In the paper, the researchers argue for increased prioritizing of physical activity across multiple sectors of influence including health, transportation, sports, education and business. “This issue is of particular importance in countries with low-to-middle incomes, where rapid economic and social changes are likely to reduce the domestic, work and transport-related physical activity demands of daily life,” said Kohl. “Improved understanding of what works best in these nations will be key to developing national policies and action plans.

Kohl recommends a multi-sector and systems-wide approach to physical activity promotion to increase population levels of activity worldwide rather than efforts focused on individual health. “Traditional approaches, where responsibility for change has resided with the health sector, will not be sufficient,” said Kohl. “Improvements must happen at every level including planning and policy, leadership and advocacy and workforce training.”

In 2008, 25.4 percent of U.S. adults reported no leisure time physical activity, according to the Centers for Disease Control and Prevention (CDC). County estimates of leisure-time physical inactivity range from 10.1 percent to 43 percent in the United States. These rates reflect adults who report no physical activity or exercise other than at their regular job.

“The response to physical inactivity has been incomplete, unfocused, understaffed and underfunded compared with other risk factors for non-communicable diseases,” said Kohl. “This has put physical activity in reverse gear compared with population trends and advances in tobacco and alcohol control and diet.”

Kohl said Texas is one of a few states that have a plan to promote physical activity, Active Texas 2020. He led the development of the plan with the Governor’s Advisory Council on Physical Fitness. The Active Texas plan includes strategies and ideas that can be used by communities throughout the state.

“Physical education in schools is still one of the most effective means promoting physical activity, particularly among children,” said Kohl. Texas Education Code requires elementary school students to receive at least 30 minutes of daily physical activity and 225 minutes of physical activity per two weeks for four of six semesters for middle school students.

Kohl was recently appointed to lead the Institute of Medicine’s committee on Physical Activity and Physical Education in the School Environment. He is on the President’s Council of Fitness, Sports & Nutrition Science Board. Kohl also led development of the 2008 U.S. Physical Activity Guidelines.

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Once-Banned Bird Flu Study Suggests Pandemic Threat Is Real

HealthDay – 3 hrs ago WEDNESDAY, May 2 (HealthDay News) -- Data in a formerly banned study detailing how the H5N1 avian (bird) flu virus can morph -- with the possibility that it could spread from person to person and cause a global pandemic -- may help nations prepare for the impending threat.

That's some of the motivation for lifting the ban and publishing the study in the May 2 online issue of Nature, experts say.

The initial ban applied to two studies slated to be published in two medical journals, Nature and Science. In December, the U.S. government intervened, requesting that both journals censor some of the data for national security purposes. The concern was that terrorists might use the information to create a lethal biological weapon.

The ban was lifted in April, after the U.S. government conducted a risk assessment in March. Nature also commissioned an independent assessment. Both showed that publication would confer more public benefit than risk.

In the Nature study, Yoshihiro Kawaoka, a professor of virology at the University of Wisconsin-Madison, and colleagues tweaked the H5N1 virus using genetic material borrowed from H1N1 'swine' flu to see if it would transmit easily between ferrets -- an animal model thought to be closely related to humans.

It did.

These genetic changes can make the virus easier to transmit, the study found. Knowing their footprints can help researchers know what to look out for and hopefully catch the virus early before it begins to spread.

"H5N1 viruses remain a significant threat for humans as a potential pandemic flu strain," Kawaoka said. "We have found that relatively few mutations enable this virus to transmit in mammals."

The information provided by this study is important as the virus could mutate on its own. Now "we can better prepare should a pandemic virus emerge in nature," Kawaoka said. Currently available vaccines and antivirals are effective treatments for this engineered virus.

"Stockpiling H5N1 vaccines and antivirals will be important for pandemic preparedness," he said, and flu trackers too can use this information when they develop vaccines in the future. "Just as for a seasonal flu vaccine, it will be important for an H5N1 vaccine to be made to a closely related virus, so knowing which mutations may confer transmissibility will help prioritize vaccine candidates," Kawaoka explained.

The new data also help advance science by increasing the understanding of the basic biology of flu transmission. "Sharing the data with other scientists will lead to important additional discoveries that may aid the development of improved vaccines and therapeutics," Kawaoka said.

There had been doubt that the bird flu could mutate and cause a pandemic, said microbiologist Joseph Sriyal Malik Peiris, of the University of Hong Kong. He was a co-author of a journal editorial accompanying the new study. He said this research does suggest that bird flu can mutate. "It suggests that the H5N1 virus can potentially acquire transmissibility in humans. However, whether it will ever do so is another matter."

While there have been sporadic cases of bird flu in humans, these have been traced to people directly handling live birds, for instance while working in a poultry market.

Importantly, this research and its publication are not a threat to U.S. security, Peiris said. "This research only tells us that the mutated H5N1 transmits in ferrets. It also tells us that the mutated virus no longer kills ferrets," he said. "Why would anyone who wanted to 'create harm' put so much effort into generation of such a virus with so much uncertainty on how it would work in practice?"

But, Peiris noted, the study "is important for pandemic risk assessment because it gives indications of the mutations that we should be watching out for."

Dr. Bruce Hirsch, an infectious diseases specialist at North Shore University Hospital in Manhasset, N.Y., agreed that publication is likely to do more good than harm. "We should be aware of the fact that this influenza can mutate," he said. "Publication makes us safer because we know what to look out for now. This can help facilitate preventive strategies and can eventually lead to more effective vaccine development and antiviral therapy."

He added, "We live in a much smaller world because of air travel and population density and certainly we are more vulnerable to viruses as a result."

This virus is not likely to be used by terrorists to cause a pandemic, Hirsch said. "It became less lethal in the animal model. I am reassured by the fact that the ability to make it a 'terror' virus has not really been demonstrated."

More information

Learn more about bird flu at the U.S. Centers for Disease Control and Prevention.

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