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Posted for Declan Butler
French scientists this week proposed an international scheme to monitor closely how the new H1N1 swine flu associated strain behaves in the population. The proposal was presented a meeting of flu scientists in Rennes yesterday by Antoine Flahault, dean of the French School of Public Health, which is based in Rennes and Paris.
The proposal suggests creating within three months a system to track the impact of the new flu strain in a standardized way in 1,000 households in as many countries as possible, with surveillance continuing until at least the end of 2010. It suggests the World Health Organization might be one appropriate coordinator.
Under the proposal, the network would report in almost real time basic epidemiological variables such as the proportion of the cohort infected, ill, and asymptomatic, as well as clinical data on case severity and symptoms. The network would also look at such things as local antiviral availability, and precautions being taken.
It is too soon to say if the project has legs. Participating states would be asked to fund their own 1,000 household studies, but Flahault says he’s confident he can easily find core funding for running the network.
Nature quickly ran the idea past one top US epidemiologist. Here’s what he had to say:
I like the idea that we should be setting up some systematic way to harvest the experience of watching a pandemic unfold in real time. Whether this is a realistic or desirable study design needs some serious reflection and discussion. Perhaps there are more efficient and feasible alternatives.
It also seems to me that the fact of keeping this cohort under observation will affect the outcomes of some of these variables. So my first take is that starting some kind of system to collect information, including biological samples from around the world, is a good idea, but whether this proposal is the one to implement I am less sure.
“Nothing is currently fixed,” says Flahault, adding that he is flagging the idea, but open to considering and participating in alternative flavours of the same basic idea, while moving ahead on his own proposal. Flahault admits to being unsure about how much country buy-in the proposal will get.
“It is absolutely crucial and necessary to launch [such a project], he says, however, “We need to document precisely what is the status in 1,000 families in Mali, Bolivia, Laos, UK, France, Siberia, Bulgaria, USA, and so on. 1,000 families is probably enough if we estimate an attack rate around 30%.”