Student and faculty perceptions about mandatory influenza vaccinations on a health sciences campus

Objective: To examine the perceptions among faculty and health professional students regarding mandatory vaccination policies on a health sciences campus. Participants: A total of 296 faculty and 244 students completed surveys during Fall 2015. Methods: The online survey administered to individuals who received the influenza vaccine during the fall 2015 influenza vaccination clinic season included five items evaluating perceptions of employer mandatory vaccination requirements. Results: Chi-square analysis indicated that although faculty and students agree mandatory vaccinations in a health care environment are appropriate, faculty are more likely than students to get vaccinated in the absence of a mandate. Additionally, a small fraction of faculty would consider employment elsewhere when facing this mandate. Conclusions: Overall, faculty and students had favorable perceptions about mandatory influenza vaccine policies. Since students were less likely to be vaccinated in the absence of a mandate, education of students should be improved to support the importance of vaccinations in a health care environment.     

Total Economic Consequences of an Influenza Outbreak in the United States

Pandemic influenza represents a serious threat not only to the population of the United States, but also to its economy. In this study, we analyze the total economic consequences of potential influenza outbreaks in the United States for four cases based on the distinctions between disease severity and the presence/absence of vaccinations. The analysis is based on data and parameters on influenza obtained from the Centers for Disease Control and the general literature. A state‐of‐the‐art economic impact modeling approach, computable general equilibrium, is applied to analyze a wide range of potential impacts stemming from the outbreaks. This study examines the economic impacts from changes in medical expenditures and workforce participation, and also takes into consideration different types of avoidance behavior and resilience actions not previously fully studied. Our results indicate that, in the absence of avoidance and resilience effects, a pandemic influenza outbreak could result in a loss in U.S. GDP of $25.4 billion, but that vaccination could reduce the losses to $19.9 billion. When behavioral and resilience factors are taken into account, a pandemic influenza outbreak could result in GDP losses of $45.3 billion without vaccination and $34.4 billion with vaccination. These results indicate the importance of including a broader set of causal factors to achieve more accurate estimates of the total economic impacts of not just pandemic influenza but biothreats in general. The results also highlight a number of actionable items that government policymakers and public health officials can use to help reduce potential economic losses from the outbreaks.     

禽流感风险、多元化经营与中国养禽户家庭生计研究

现有研究普遍认为禽流感的发生会对养禽户家庭生计造成严重负向冲击,而统计数据显示禽流感发生之后养禽户家禽收入显著下降,但家庭收入仍呈上升趋势。 基于农村固定观察点 2 520 个养禽户 2004—2012 年家禽养殖跟踪数据,本文采用固定效应模型,分析禽流感冲击下养禽户家庭生计变化,探讨禽流感、多元化经营与中国养禽农户家庭生计之间的关系。 结果表明,禽流感的爆发确实对家禽养殖农户生计造成了巨大的冲击,但多元化经营可以削弱禽流感对养禽户家庭经营收入的负向影响,且相比于种植业,养禽户更倾向于通过增加畜牧业投入和非农就业投入来避免禽流感造成的家庭经营收入波动。 我国现有禽流感补偿政策仅按照扑杀数量发放,为制定更为精准的扑杀补偿标准和灾后扶持政策,应关注禽流感对养禽户生计冲击的农户异质性,充分考虑养禽户多元化经营状况,扩大政策关注范围,正确引导农户进行兼业经营。     

Avian Flu and Embodied Global Imagery: A Study of Pandemic Geopolitics in the Media

Avian influenza is caused by viruses adapted to birds. The causative agents can, in rare cases, spread to humans, although no human-to-human transmission has been demonstrated. However, the mere possibility of mutation into a human form allowed for media, states and international organizations to speculate about the meaning of the disease's movement across species and localities. The hypothetical scenarios focused on national preparedness and resilience. Such imageries of elastic and shock absorbing communities offer insights into how diseases are used to contain and border in an age of vanishing boundaries and interconnected global reaches. This study tracks the historical trajectory of public cognitions regarding avian flu as it turned from an ordinary livestock disease into a hyperbolic mutable ‘killer disease’. Excerpts from articles carried in The New York Times and Helsingin Sanomat, a Finnish mainstream daily, are used to map how the disease turned into a register of the hostilities inherent in the world. In the American public cognition, the tangible disease threat was triggered when the dangers of mutation were associated with China. For the small peripheral Finland, the pandemic scare instigated public imaginaries of a resilient and efficient Nordic society.

La influenza aviar es causada por virus adaptados a los pájaros. En casos raros, los agentes causativos pueden propagarse a humanos, aunque no se ha demostrado ninguna transmisión entre humanos. Sin embargo, la simple posibilidad de mutación a una forma humana, permitió a los medios, estados y organizaciones internacionales especular sobre el sentido del movimiento de la enfermedad entre las especies y localidades. Los escenarios hipotéticos se enfocaron en la preparación y resistencia nacionales. Tales imágenes de comunidades elásticas y absorbentes de impactos ayudan a comprender mejor cómo se usan las enfermedades para contener y colindar fronteras en una época que están desapareciendo y de extensa interconexión global. Este estudio sigue la trayectoria histórica de conocimiento público respecto a la gripa aviar cuando pasó de una enfermedad ordinaria de ganado a una ‘enfermedad mortal’ hiperbólica mutable. Extractos de artículos publicados en el New York Times y el Helsinki Sanomat, un diario finlandés predominante, se usaron para representar cómo la enfermedad se convirtió en un registro de las hostilidades inherentes en el mundo. En el conocimiento americano, la amenaza tangible de la enfermedad se desencadenó cuando los peligros de la mutación fueron asociados con China. Para la pequeña Finlandia, el susto pandémico instigó la imaginación pública de una resistente y eficiente sociedad nórdica.

禽流感是由鸟类携带的病毒引起的。尽管目前还未发现人到人传播的案例,但在某些罕见的情况下,这些病原体可以传染给人类。尽管如此,仅仅是能变异为人类病毒的可能性就足以让媒体、国家和国际组织思考这种跨物种和地域的病毒传播的后果。这种假想关注国家的准备情况和应变能力。这种关于具有弹性和能吸收震荡的社会的意象让我们能够洞察,在一个边界正在消失、各领域相互联系的时代中,疾病可以如何被用来阻止国家边界的消失并界定国家边界。禽流感已经从一种普通的家畜疾病变为一种夸张的可变异的致命疾病。本文追踪了这一公众认知变化的历史轨迹。通过刊登在《纽约时报》和芬兰主流日报《赫尔辛基新闻》上的文章节选,本文表明了禽流感是如何变为各国固有敌意的记录器的。在美国的公众认知中,禽流感在中国的变异危险导致了这场有形的疾病威胁。对于处于边缘的小国芬兰而言,这种禽流感大流行的恐慌驱使公众想象一个灵活高效的北欧社会。

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基于疫情上报意愿的禽流感补偿标准研究

鼓励养殖户及时上报疫情是控制禽流感扩散蔓延、维护社会公众生命安全的重要举措。那么,如果要使养殖户自愿上报疫情,合理的补偿标准应该是多少？利用宁夏中卫沙坡区实地调查数据,采用Heckman两阶段模型分析养殖户上报疫情意愿及其意愿受偿强度的影响因素,进而测算养殖户在愿意上报疫情情景下可接受的补偿标准。散养户和规模养殖户可接受的补偿标准分别平均为22.41元/只、31.87元/只,对5个月龄蛋鸡的意愿受偿标准最高,分别达到35.21元/只、53.55元/只。提出建立疫情损失的联动补偿机制,提高疫情补偿标准,对散养户和规模养殖户实行差异化疫情补偿政策。     

Assessing Infection Control Measures for Pandemic Influenza

We construct a mathematical model of aerosol (i.e., droplet-nuclei) transmission of influenza within a household containing one infected and embed it into an epidemic households model in which infecteds occasionally infect someone from another household; in a companion paper, we argue that the contribution from contact transmission is trivial for influenza and the contribution from droplet transmission is likely to be small. Our model predicts that the key infection control measure is the use of N95 respirators, and that the combination of respirators, humidifiers, and ventilation reduces the threshold parameter (which dictates whether or not an epidemic breaks out) by ≈20% if 70% of households comply, and by ≈40% if 70% of households and workplaces comply (≈28% reduction would have been required to control the 1918 pandemic). However, only ≈30% of the benefits in the household are achieved if these interventions are used only after the infected develops symptoms. It is also important for people to sleep in separate bedrooms throughout the pandemic, space permitting. Surgical masks with a device (e.g., nylon hosiery) to reduce face-seal leakage are a reasonable alternative to N95 respirators if the latter are in short supply.     

Evaluation of the Influenza Risk Reduction from Antimicrobial Spray Application on Porous Surfaces

Antimicrobial spray products are used by millions of people around the world for cleaning and disinfection of commonly touched surfaces. Influenza A is a pathogen of major concern, leading to up to 49,000 deaths and 114,000 hospitalizations per year in the United States alone. One of the recognized routes of transmission for influenza A is by transfer of viruses from surfaces to hands and subsequently to mucous membranes. Therefore, routine cleaning and disinfection of surfaces is an important part of the environmental management of influenza A. While the emphasis is generally on spraying hard surfaces and laundering cloth and linens with high temperature machine drying, not all surfaces can be treated in this manner. The quantitative microbial risk assessment (QMRA) approach was used to develop a stochastic risk model for estimating the risk of infection from indirect contact with porous fomite with and without surface treatment with an antimicrobial spray. The data collected from laboratory analysis combined with the risk model show that influenza A infection risk can be lowered by four logs after using an antimicrobial spray on a porous surface. Median risk associated with a single touch to a contaminated fabric was estimated to be 1.25 × 10⁻⁴ for the untreated surface, and 3.6 × 10⁻⁸ for the treated surface as a base case assumption. This single touch scenario was used to develop a generalizable model for estimating risks and comparing scenarios with and without treatment to more realistic multiple touch scenarios over time periods and with contact rates previously reported in the literature. The results of this study and understanding of product efficacy on risk reduction inform and broaden the range of risk management strategies for influenza A by demonstrating effective risk reduction associated with treating nonporous fomites that cannot be laundered at high temperatures.     

Modeling the Effectiveness of Respiratory Protective Devices in Reducing Influenza Outbreak

Outbreaks of influenza represent an important health concern worldwide. In many cases, vaccines are only partially successful in reducing the infection rate, and respiratory protective devices (RPDs) are used as a complementary countermeasure. In devising a protection strategy against influenza for a given population, estimates of the level of protection afforded by different RPDs is valuable. In this article, a risk assessment model previously developed in general form was used to estimate the effectiveness of different types of protective equipment in reducing the rate of infection in an influenza outbreak. It was found that a 50% compliance in donning the device resulted in a significant (at least 50% prevalence and 20% cumulative incidence) reduction in risk for fitted and unfitted N95 respirators, high‐filtration surgical masks, and both low‐filtration and high‐filtration pediatric masks. An 80% compliance rate essentially eliminated the influenza outbreak. The results of the present study, as well as the application of the model to related influenza scenarios, are potentially useful to public health officials in decisions involving resource allocation or education strategies.