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The newspaper of The Johns Hopkins University November 7, 2005 | Vol. 35 No. 10
Traffic Safety Model Can Help Authorities Prepare for Avian Flu Outbreak

Public Health researchers suggest that matrix can be used for planning response

By Kenna Lowe
School of Public Health

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 or institutions.

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," Barnett said.

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.


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