Larry Brilliant: My wish: Help me stop pandemics - 2006

EARLY DETECTION, EARLY RESPONSE = FUNDAMENTAL
1. Bird flu
2. Epidemic curve
  1. Catch it early enough and isolate it to stop it spreading
3. INSTEDD International System for Total Early Disease Detection http://instedd.org/
  1. early detection system built on GPHIN freely available to anyone in the world in 70 languages .Not owned by anyone
    1. text messages or SMS or instant messaging to find out from people who are within 100 meters of the rumor that you hear if it is, in fact, valid. Added satellite confirmation
  2. Gapfinders graphics
4. WORLD HEALTH ORGANISATION
  1. 4th disease that was intended for eradication. Failed on these 3
    1. Malaria
    2. Yellow Fever
    3. YAWS
  2. Global Public Health Information Network
    1. FOUND 3 MONTHS BEFORE WHO ANNOUNCED OUTBREAK OF SARS ABLE TO PREVENT A PANDEMIC
    2. Founded by Ron St. John IN 1997
    3. 800,000 dollars a year, got cracking, 75 percent of all the reports in the world came from GPHIN, 25 percent of all the reports in the world came from all the other 180 nations.
Polio
1. Down to 3 countries (2014) Afghanistan, Nigeria and Pakistan
2. Professor David Heymann
  1. epidemiologist http://www.who.int/dg/adg/heymann/en/
3. Surveillance program is 4 million people going door to door
Seva Foundation
1. 2012 - 2013: 1 million people treated 56 hospitals supported across 20 countries with 14 partners
2. Started as application of door to door surveillance system to a condition that was not at the forefront of eradication efforts Founded 1978
3. First Nepal survey ever done for health, and the first nationwide blindness survey ever done, That discovered blindness also caused by cataract
  1. Can prevent what you dont knwo about
    1. Aravind Eye Hospital
      1. 2006 - give sight back to 300 000 people in Tamil Nadu India
4. http://www.seva.org/site/PageServer
Influenza
1. Pandemic severity index
  1. http://bepast.org/disease_information/Pandemic%20Influenza/Pandemic%20Influenza%20Information/Two%20Color%20Table%20WHO%20Phases%20%20and%20HHS%20Stages%5B1%5D.jpg
  2. http://images2.dailykos.com/images/user/426/usg_who.jpg
  3. http://riskrapper.wordpress.com/2009/04/30/managing-pandemic-risk/
2. In the the event of a pandemic
  1. Getting worse as migration is easier
  2. fluologists and specialists in influenza " What do you think the likelihood is that there'll be a pandemic? If it happens, how bad do you think it will be?"
    1. 15% thought a pandemix would occur within 3 year and 90% thought pandemic in childs or grandchilds lifetime
  3. At least 1 billion would get sick and up to 165 million would die
  4. Global recession and depression
  5. Jobs lost and health care system down
3. Outbreak in HONG KONG picked up by GPHIN reacted by slaughtering 1.5 million chickens
Killer Small Pox 1966 - 1980
1. Forms of small pox
  1. Discrete
    1. Usual form with separate leisions
    2. https://scholarworks.iupui.edu/bitstream/handle/1805/1761/im-iumed-iph-1903-v5n7g4.jpg?sequence=1&isAllowed=y
  2. Confluent
    1. http://www.henriettes-herb.com/eclectic/thomas/pics/thomas-smallpox.html
      1. Form of smallpox (eradicated in 1977) that form large suppurate areas and rapid deterioration of health
  3. Hemorrahagic
    1. http://www.randomhouse.com/features/preston/cobraevent/smallpox4.html
      1. Also known as black pox. Does not form blisters but involves hemorrhaging of skin, mucous membranes, and gastrointestinal tract. High death risk in pregnant woman.
        Highly fatal
  4. variola sine eruptione
    1. Recoverable with no sign of pustulation or raises
  5. Flat small pox
    1. http://www2.cdc.gov/nip/isd/spoxclincian/contents/Photos_files/ref_photos_contents_files/flat-type_CU.htm
      1. Leisions are not raised above the skin
        100% death rate
2. CDC - Smallpox virus
  1. http://www.bt.cdc.gov/agent/smallpox/overview/disease-facts.asp
3. First disease in history to be globally eradicated. Declared eradicated in 1980
  1. Parchment signed at Geneva on 9 December 1979, by the members of the Global Commission for Certification of Smallpox Eradication http://www.who.int/archives/fonds_collections/bytitle/fonds_6/en/
  2. Last case of killer small pox was Rahima Banu in India
4. Caused by the Variola virus and killed 500 million people in the 20th century
  1. 2 million p/ year in the years Larry Page and Sergey Brin was born
5. ERADICATION PROGRAMME
  1. Over a billion door to door house calls/search. Showed the photographs to people to determine if anyone had these symptoms. Score cards were kept for each house and noted the date of the last visit
    1. Every house searched once a month for 2 years
    2. Without door to door searches there was an illusion of small pox eradication as people were less likely to report it Numbers of small pox cases increased with door to door surveillance
      1. Reward that continued to raise and also surveillance systems. Score cards to keep tabs on it. Soon score cards dropped to zero.
      2. Limitations
        Not efficient to just vaccinate everyone
        Time and numbers of available volunteers
        Isolating all cases of small pox at once
        Deity
        In india the small pox deity was Shitala Mata - the cooling mother and it was wrong to bring strangers into your home when the deity was in the house.
        supernatural being
        Issue caused a lack of incentive to report small pox. Occurred in several countries
        10% of the houses were revisited
  2. Global fight against Brought everyone together to fight it (common cause to make the world better

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Larry Brilliant: My wish: Help me stop pandemics - 2006

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