Public & Community Health Nursing

Major influenza pandemics pose a constant threat. As evidenced by recent H5N1 avian flu and novel H1N1, influenza outbreaks can come in close succession, yet differ in their transmission and impact. With accelerated levels of commercial and population mobility, new forms of flu virus can also spread across the globe with unprecedented speed. Responding quickly and adequately to each outbreak becomes imperative on the part of governments and global public health organizations, but the difficulties of doing so are legion. One tool for pandemic planning is analysis of responses to past pandemics that provide insight into productive ways forward. This book investigates past influenza pandemics in light of today's, so as to afford critical insights into possible transmission patterns, experiences, mistakes, and interventions. It explores several pandemics over the past century, from the infamous 1918 Spanish Influenza, the avian flu epidemic of 2003, and the novel H1N1 pandemic of 2009, to lesser-known outbreaks such as the 1889-90 influenza pandemic and the Hong Kong Flu of 1968. Contributors to the volume examine cases from a wide range of disciplines, including history, sociology, epidemiology, virology, geography, and public health, identifying patterns that cut across pandemics in order to guide contemporary responses to infectious outbreaks.

Recent disease events such as SARS, H1N1 and avian influenza, and haemorrhagic fevers have focussed policy and public concern as never before on epidemics and so-called'emerging infectious diseases'. Understanding and responding to these often unpredictable events have become major challenges for local, national and international bodies. All too often, responses can become restricted by implicit assumptions about who or what is to blame that may not capture the dynamics and uncertainties at play in the multi-scale interactions of people, animals and microbes. As a result, policies intended to forestall epidemics may fail, and may even further threaten health, livelihoods and human rights. The book takes a unique approach by focusing on how different policy-makers, scientists, and local populations construct alternative narratives-accounts of the causes and appropriate responses to outbreaks- about epidemics at the global, national and local level. The contrast between emergency-oriented, top-down responses to what are perceived as potentially global outbreaks and longer-term approaches to diseases, such as AIDS, which may now be considered endemic, is highlighted. Case studies-on avian influenza, SARS, obesity, H1N1 influenza, HIV/AIDS, tuberculosis, and haemorrhagic fevers-cover a broad historical, geographical and biological range. As this book explores, it is often the most vulnerable members of a population-the poor, the social excluded and the already ill-who are likely to suffer most from epidemic diseases. At the same time, they may be less likely to benefit from responses that may be designed from a global perspective that neglects social, ecological and political conditions on the ground. This book aims to bring the focus back to these marginal populations to reveal the often unintended consequences of current policy responses to epidemics. Important implications emerge - for how epidemics are thought about and represented; for how surveillance and response is designed; and for whose knowledge and perspectives should be included. Published in association with the Economic and Social Research Council (ESRC)