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TopIntroduction And Motivation
The history of influenza pandemics is a history of enormous societal calamities aggravated by staggering economic forfeitures. In the U.S. alone, the Spanish flu (1918, virus serotype H1N1), the Asian flu (1957, serotype H2N2), and the Hong Kong flu (1968, serotype H3N2) resulted in the death toll of more than 500,000, 70,000 and 34,000 cases, respectively (Longini, Halloran, Nizam, & Yang, 2004). In recent years, a series of scattered outbreaks of the avian-to-human transmittable H5N1 virus has been mapping its way through Asia, the Pacific region, Africa, the Near East, and Europe (Centers for Disease Control and Prevention - CDC, 2008). As of March 2010, WHO has reported 287 deaths in 486 worldwide cases (World Health Organization, 2010a). In Spring 2009, a mutation of the human-to-human transmissible H1N1 serotype resurfaced and propagated to an ongoing global outbreak; as of March 2010, 213 countries have been affected with a total reported number of infections and mortalities of 419,289 and 16,455, respectively (World Health Organization, 2010b). Nowadays, most experts have an ominous expectation that the next pandemic will be triggered by an emerging pathogenic virus, to which there is little or no pre-existing immunity (Schoenstadt, 2010).
The nation's ability to mitigate influenza pandemics depends on available emergency response infrastructure and resources, and at present, challenges abound. Prediction of the exact virus subtype remains a difficult task, and even when identified, reaching an adequate vaccine supply can take between six and nine months (Aunins, Lee, & Volkin, 1995; Fedson, 2003). Even if the emerged virus has a known epidemiology, the existing stockpiles will be limited due to high manufacturing and inventory costs (WHO Global Influenza Programme, 2009; World Health Organization, 2009). The supply of antiviral drugs, healthcare providers, hospital beds, medical supplies, and logistics will also be significantly constrained. Hence, pandemic mitigation will have to be done amidst a limited knowledge of the virus nature, constrained infrastructure, and limited resource availability. This ongoing challenge has been acknowledged by WHO (2009) and echoed by the HHS and CDC (Centers for Disease Control and Prevention, 2009; U.S. Department of Health & Human Services, 2007).