Presentation Jefferson

8/9/2019 Presentation Jefferson

1/20

n uenzae

DrTomJefferson

CochraneCollaboration

e erson. om gma .com

(Activitiesandinterestsstatement

withChair)


2/20

1. Influenzaandinfluenzalikeillnessarenot

thesame

thin

2. Seasonalandpandemicinfluenza

3 . T ero e

o

experts

an

me ia

4. Vaccinesandantivirals haveaweakornon

existentscientificevidencebase

.


3/20

Influenzaandinfluenzalikeillnessare

notthe

same

thing


4/20

Influenzalikeillness(flu)definition

(WHO)

ILIisanacuterespiratoryinfectionwithsudden

oneofthefollowing:headache,malaise,rigors

andsweating,

asthenia

and

at

least

one

pharyingitis.


5/20

RESULTSWhat%ofILIinyourstateis

influenza?

Someanswers

, whichisattheclinicallevel

beats

me

we

dont

know

the

actual

extent

of

influenza

..

we

can

make

a

good

epiguessfromcobblingtogetherallthesystemsthatwehave.

Idontknow

therewouldn'tbeawaytoanswerthatquestion

Howmuchareinfluenza?Wedonotknow.

I

couldn't

tell

you

because

ILI

is

not

notifiable. Wedontknow..andthatsthehonestanswer

thatisablackbox,howmuchILIisthere,reallythatisflu

Idontknow...theyregoingtobeanumberofrespiratoryvirusesthatcocirculateinthewinter.

influenzaandtodothatwearepilotinganewsystemthisfalltotryandgetatthatinformation.


6/20

How many flu episodes/year

Man

viruses

InfluenzaAorB

N=93

Nofluepisodes

=

Fluepisodes

Basedon

274

influenza

vaccines

and

28

epi studies

1966

2007

(>

3M

observations)


7/20

Doweknowwhatwearetalking


8/20


9/20

Changeofpandemicinfluenzadefinition

resultinginepidemicsworldwidewithenormousnumbersofdeaths

andillness vanishes

Currentdefinitionemphasisonnewvirusandspread

, .

"(Thatdefinition)wasputupawhileagoandpaintsaratherbleakpicture

andcouldbeveryscary."Thecorrectdefinitionisthat"pandemic"

theworld,

but

has

nothing

to

do

with

the

severity

of

the

illnesses

or

the

numberofdeaths(NatalieBoudou 4th ofMay2009)

And:Wewrotethatdefinition[i.e.theonepredatingthe4th ofMay

StrangemistakesinceallWHOpandemicdocs(200042009)reportthe

pre4th ofMay09definitionanditmakesnomentionofavianinfluenza


10/20

An influenza pandemic is whatever WHO

decides it is


11/20

Theroleofexpertsandmedia


12/20

(CzechpuppetpicturecourtesyoftheBMJ)

Wearesuppose to eprepare ora

pandemicof

some

kind

of

influenza

Becausethefluwatchers,thepeople

whomakealivingoutofstudyingthevirus

andwho

need

to

attract

continued

grant

funding

to

keep

studyingit,mustpersuadethefundingagenciesofthe

urgencyoffightingacomingplague.

PhilipAlcabes.Dread:HowFearandFantasyHaveFueledEpidemicsfromtheBlackDeathtothe

AvianFlu. PublicAffairs,15.99,pp336ISBN:9781586486181


13/20

NewYorkTimes,October24,2004

13


14/20


15/20

Influenzarelatedmortalityvs

prestigeand

citation

of

infuenza vaccines

studies

12

10 MeanJIFofjournalswithJIF>0

recordedinfluenzadeathrate,USA, er

6

100,000persons

Lineare(MeanJIFofjournalswithJIF>0)

4

, ,

per100,000persons)

0

1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006


16/20

Vaccinesandantivirals haveaweak

ornonex s en sc en cev ence


17/20

Effectiveness of influenza vaccine in

ea y a u s(realworld conditions)

Vaccinatedn=100

FromCochrane

review

of

42

clinical

trials


18/20

Unpublisheddataset(peopleaged16and

over)n=

2691

( eo l e

who

entered

treatment

placebocontrolledRCTs)

Requestfordatametwithconfidentiality

agreementandsecrecyclause

.

inpublishedtrials


19/20

WHOpandemicpreparednessandresponse

Antivirals 16hits

Handwashing &

masks

2

hits

each


20/20

Thankyouforlistening

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