As the threat of a potential influenza pandemic looms,
researchers from the Johns
Hopkins Bloomberg School of Public Health and
Ben-Gurion University of the Negev, Israel, believe that a
1960s traffic safety model can be a useful tool for
preparing for a potential outbreak.
The model, known as the Haddon matrix, gives a
multidimensional approach to the factors that contribute to
injury before, during and after an event. By dividing the
event into phases, the matrix breaks a complex problem into
more manageable segments. The researchers believe the same
can be done for public health emergency preparedness
situations. The study is published in the December 2005
issue of PLoS Medicine.
Scientists continue to monitor the movement of the
influenza A virus H5N1, which is also known as avian flu.
The H5N1 virus has been found in birds, pigs and tigers. It
has also infected and killed a small number of humans, but
there is no evidence of regular human-to-human transmission
of the virus. Scientists are concerned that H5N1 could
mutate in such a way that it would be easily transmissible
from person to person, leading to a pandemic.
"The urgent need for more comprehensive pandemic
influenza planning is profound. An influenza pandemic today
could have major international consequences," said Daniel
J. Barnett, lead author of the study and an instructor with
the Johns Hopkins Center for Public Health Preparedness.
"Current preparedness plans need to be re-examined, updated
and supported by appropriate legislation."
Barnett said that by identifying the pre-event, event
and post-event factors that impact the outcome of each
phase of a disaster, researchers and planners can prescribe
measures to combat each factor. He stressed that for the
measures to be effective, planning for each must take place
before the pandemic begins.
The study authors used the Haddon matrix to examine
influenza pandemic readiness efforts in Thailand and
Israel. They looked at human factors, vectors, physical
environment and sociocultural factors that impact the
preparation for and response to pandemic influenza.
Although the Thailand and Israel examples are national
plans, the researchers said the matrix can be used
internationally, as well as in individual counties, cities
The authors cautioned that the matrix is not a
stand-alone planning tool and that choices for events
included in the matrix are not absolute. They also say that
their study should be thought of as a planning framework,
not as a final checklist for pandemic preparation.
"The planning window for an influenza pandemic may be
rapidly closing. The Haddon matrix sheds light on
opportunities for prevention, mitigation and consequence
management strategies to address a global health threat,"
Co-authors of the study from Johns Hopkins are
Barnett, George S. Everly Jr., Saad B. Omer and Mark C.
Steinhoff. Ran D. Balicer and Itamar Grotto, with
Ben-Gurion University of the Negev, and Daniel R. Lucey,
with Georgetown University School of Medicine, also
co-authored the study, which was supported by a grant from
the Centers for Disease Control and Prevention.