The 1918 Pandemic

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A study showing why the present Pandemic could possibly have even more serious consequences in the UK than the one in 1918.

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Presentation Transcript

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The 1918 Pandemic. Could history repeat itself? ©Anubis Consulting 2009

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©Anubis Consulting 2009 An estimated one third of the world's population (or ˜500 million persons) were infected and had clinically apparent illnesses during the 1918–1919 influenza pandemic. The disease was exceptionally severe. Case-fatality rates were >2.5%, compared to <0.1% in other influenza pandemics.Total deaths were estimated at ˜50 million and were arguably as high as 100 million.

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©Anubis Consulting 2009 The pandemic wave Mortality in different age groups

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©Anubis Consulting 2009

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©Anubis Consulting 2009 The virus is constantly changing Antigenic Shift

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©Anubis Consulting 2009 “Until we can ascertain which of these factors gave rise to the mortality patterns observed and learn more about the formation of the pandemic, predictions are only educated guesses. We can only conclude that since it happened once, analogous conditions could lead to an equally devastating pandemic. Even with modern antiviral and antibacterial drugs, vaccines, and prevention knowledge, the return of a pandemic virus equivalent in pathogenicity to the virus of 1918 would likely kill >100 million people worldwide” US Centre for Disease Control Doctors and scientists don’t ‘know’ for certain how to combat the changing influenza virus they can only hazard a ‘best guess’.

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©Anubis Consulting 2009 With all of the advances in medicine and hygiene why do scientists predict such a high mortality rate?

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©Anubis Consulting 2009 In 1918 the UK population was around 32 million. Today the UK population is around 60 million and it is predicted to rise to around 64.4 million by 2016. Population growth

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©Anubis Consulting 2009 The South East of England was the region of the UK with the largest population, with 8.1 million residents in 2004, followed by London, which was home to 7.4 million people. Over a quarter (26 per cent) of the population was resident in London and the South East combined. This is despite these two regions together covering less than a tenth of the UK’s land area. The North West had the third largest population with 6.8 million residents.Northern Ireland had the smallest population in 2004, with 1.7 million people. It also had the youngest population, with over 22 per cent aged under 16. This above average proportion of children is one reason for Northern Ireland having the highest average household size in the UK and the lowest proportion of one-person households in 2001. Northern Ireland had an average household size of 2.65 people compared with 2.37 in Wales, 2.36 in England and 2.27 people in Scotland Population density

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©Anubis Consulting 2009 The number of people leaving the UK for 12 months or more fell in 2007. An estimated 340,000 people emigrated, down from 400,000 in 2006. Over half of this reduction was as a result of fewer British citizens leaving the UK for more than a year, down from 207,000 in 2006 to 171,000 in 2007. However, in comparison to the 1990s, emigration remains high.An estimated 577,000 people arrived to live in the UK for at least a year in 2007, compared with 591,000 in 2006. These figures represent a continuation of the level of immigration seen since 2004. Of all immigrants, 502,000 (87 per cent) were non-British citizens in 2007. An estimated 96,000 Polish citizens migrated into the UK in 2007, which was the highest inflow of any individual citizenship.Net migration was 237,000, up 46,000 on 2006. This is a result of emigration falling more than immigration. This was slightly lower than the record estimate of 244,000 in 2004. Net migration has remained high since then, in comparison with earlier years Emigration and Immigration

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©Anubis Consulting 2009 The number of passengers using UK airport terminals rose to241 million in 2007. This compares to 7 million in 1957.The numbers of passengers fell in the recession of 1974 by3 million and in the year of the Gulf war 1991, by 7 million, before continuing upward. There was also a marked flattening of the upward trend in 2001, the result of foot-and-mouth disease and September 11. From 2002 passenger numbers have continued to increase each year.The number of passenger kilometres flown on UK airlines increased by nearly 50 per cent over the past decade, from213 billion kilometres in 1997 to 314 billion in 2007. International travel accounts for around 97 per cent of the total passenger kilometres flown each year from 1997.Heathrow is the busiest airport in the UK with 68 million passengers in 2007. Gatwick is the second busiest with 35 million passengers, with Stansted and Manchester airports being the next busiest at 24 and 22 million passengers respectively.Although recent growth in demand for air travel has slowed, in the long term demand is forecast to continue growing as economic growth picks up again. Mid-range estimates from the Department for Transport made in January 2009 suggest that between 2010 and 2030 passenger numbers at UK airports will grow from 270 million to 464 million. Growth in international passengers is forecast to increase by almost 150 million passengers per year: from 215 million to 363 million passengers, while domestic passengers are set to double from 50 million to 101 million passengers annually. Travel

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©Anubis Consulting 2009 There were 509,090 deaths registered in England and Wales in 2008, comprising 243,014 male and 266,076 female deaths. Provisional age-standardised mortality rates for males and females were 6,860 and 4,910 deaths per million population respectively, which are the lowest rates ever recorded in England and Wales. Compared with the 2007 rates, this represents a fall of 1.3 per cent for male deaths and 0.2 per cent for female deaths.Over the course of the 20th century, there have been fairly steady falls in death rates although, during the first half of the century, year-on-year fluctuations were particularly noticeable, due mainly to influenza epidemics and unusually cold winters. The age-standardised mortality rate for males fell from 25,829 per million in 1901, to 8,477 in 2000. The age-standardised rate for females fell from 21,705 to 5,679 per million over the same period. These trends have continued in the 21st century. Between 2001 and 2008 the mortality rate for males fell17 per cent (from 8,230 to 6,860 deaths per million), while for females it decreased by 12 per cent (from 5,566 to 4,910 per million). At the beginning of the last century more than half of all deaths occurred under the age of 45. In 2008, only 4 per cent of deaths occurred at ages under 45. In 2008, there were 3,370 infant deaths (under one year of age) registered in England and Wales, giving a rate of 4.8 per 1,000 live births. This remains the lowest infant mortality rate ever recorded in England and Wales and compares with rates of 151 per 1,000 live births in 1901, and30 per 1,000 in 1951. Childhood mortality has also declined, while decreases in the death rates for young adults (ages 15-44) were mainly seen in the first half of the 20th century. Deaths at the age of 75 and over comprised only 12 per cent of all deaths in 1901, rising to39 per cent in 1951 and 67 per cent in 2008. Declining death rate

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©Anubis Consulting 2009 There were substantial variations in reported health status by social group. Among those in employment, rates of not good health for people in routine occupations were more than double those for people in higher managerial and professional occupations (8.6 per cent and 3.4 per cent respectively). Those who had never worked or were long-term unemployed had even higher rates of not good health (18.5 per cent).Other indicators of social position, such as housing tenure, also point to a social divide in health status. In 2001 those living in social housing had the highest rates of not good health, twice as high as those who rent privately and three times higher than owner-occupiers Health within social groups

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©Anubis Consulting 2009 Pakistani and Bangladeshi men and women in England and Wales reported the highest rates of 'not good' health in 2001. Pakistanis had age-standardised rates of 'not good' health of 13 per cent (men) and 17 per cent (women). The age-standardised rates for Bangladeshis were 14 per cent (men) and 15 per cent (women). These rates, which take account of the difference in age structures between the ethnic groups, were around twice that of their White British counterparts. Chinese men and women were the least likely to report their health as 'not good'. Women were more likely than men to rate their health as 'not good' across all groups, apart from the White Irish and those from Other ethnic groups.Reporting poor health has been shown to be strongly associated with use of health services and mortality. White Irish and Pakistani women in England had higher GP contact rates than women in the general population. Bangladeshi men were three times as likely to visit their GP than men in the general population after standardising for age. Health within ethnic groups

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©Anubis Consulting 2009 Three out of ten (30 per cent) of children aged two to 15 in England were classed as either overweight or obese in 2007. This was a rise of around 6 percentage points since 1995. There was no statistically significant difference between the proportion of overweight or obese boys and girls in 2007. The overall proportion of obese children aged two to 15 was 16 per cent in 2007, a rise of around 5 percentage points since 1995. Between 1995 and 2007 the proportion of boys aged two to 10 who were classed as obese, rose by around 6 percentage points from 10 per cent to 16 per cent. This compares with an increase of 4 percentage points since 1995 among girls aged two to 10 (from 10 per cent to 14 per cent). In 2007 nearly two out of ten (19 per cent) of girls aged 11 to 15 were obese, an increase of around 4 percentage points since 1995. This compares with around 18 per cent of boys aged 11 to 15 classed as obese, unchanged since 2006, but an increase of 4 percentage points since 1995. Health and young people

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©Anubis Consulting 2009 Taking antibiotics for colds and other viral illnesses not only won't work, but also has a dangerous side effect: over time, this practice helps create bacteria that have become more of a challenge to kill. Frequent and inappropriate use of antibiotics selects for strains of bacteria that can resist treatment. This is called bacterial resistance. These resistant bacteria require higher doses of medicine or stronger antibiotics to treat. Doctors have even found bacteria that are resistant to some of the most powerful antibiotics available today. Antibiotic resistance is a widespread problem and "one of the world's most pressing public health problems." Bacteria that were once highly responsive to antibiotics have become increasingly resistant. Among those that are becoming harder to treat are pneumococcal infections (which cause pneumonia, ear infections, sinus infections, and meningitis), skin infections, and tuberculosis. Overuse of antibiotics

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©Anubis Consulting 2009 The way we live our daily lives

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©Anubis Consulting 2009

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©Anubis Consulting 2009 Pooh thought to himself: “If the pig sneezes he’s dead”

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©Anubis Consulting 2009 Anubis Consulting is a wholly owned division of Technochem UK Ltd www.anubisconsulting.co.uk www.technochemuk.co.uk

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