Asia Human Community (AHC) Workshop on Non-Traditional Security
Feb. 28th, 2009 in Waseda University

Networking with Asian countries inthe field of global infectious diseases
Koichiro Kudo, M.D.
International Medical Center of Japan

Contents• Avian Influenza and Pandemic Influenza• Regional and Global Problems• Key points– International cooperation– Preparedness– Human Development• ConclusionAvian Influenza
Human Avian Influenza

Bach Mai Hospital, Hanoi, Vietnam

Areas reporting confirmed occurrence of H5N1 avian influenza in poultry and wild birds since2003
Updated 2008/12/12

http://gamapserver.who.int/mapLibrary/Files/Maps/Global_SubNat_H5N1inAnimalConfirmedCUMULATIVE_20081212.png

Area with confirmed human cases of H5N1 avian
influenza since 2003

Cumulative Number of Confirmed Human Cases ofAvian Influenza A/(H5N1) Reported to WHO

Indonesia

VietnamChina2003

2004

2005

2006

2007

2008

Feb.
2009

Total

Case

00205542240141

Deaths00134537

200115Case

329610862109

Deaths

320

190

55153

Case

1081354738

Deaths105834425・・・・・・・・・・・・・・・・・・・・・・・・・・・・
Total

Case

44698

115

88

44

13408

Deaths

432

4379

59

33

5255

mortality

100%

69.6%

43.9%

68.7%

67%

75%

38.5%

62.5%

Host (animal) for influenza virus

Ｈ３，７

Ｈ１，２，３

Ｈ１－１２
１４－１５

Ｈ１，２，４－７
９－１３，１５
Ｈ１０

poultry

Other water birds
Ｈ１，３，４７，１３
Ｈ１，３

Rout of migrating birds

http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/migrationmap.html

Influenza Pandemic in the 20th century

Credit: US National Museum of Health andMedicine

1918:1957:

1968:“Spanish Flu”

“Asian Flu”

“Hong Kong Flu”

Death: 20 – 40 millions

Death: 1 – 4 millions

1 – 4 millions

A(H1N1)

Avian Influenza as NTS• Disease threatens life and health.
• Disease relates to economic security andenvironmental security• Impact of H5N1 is not limited to any one,country or community.
• To deal with this non-traditional security, wemust seek cooperation, development of
human resources, and cost-effectiveness.
• We must set a notion of people orientedsecurity.

Characteristic of Human Avian FluHospitalization

First visit to out-patient clinic

1 week later

Rapid
Progression
Symptoms

Symptoms

High fever

High fever

Dry coughDry coughMyalgia

Myalgia+Difficult
BreathingReason for visit delay to clinic
Social problems point of view

• Lack of understanding about
disease• Life style and habit• Poverty• Less trust on medical care
• Lack of medical insurance system

Reason of high mortality
Medical providers’ point of view

• Lack of understanding about
disease• Lack of simple diagnosis method• Lack of anti-viral agents• Lack of effective treatment methods

Key Points
Regional and Global• International Collaboration• Preparedness• Human Development

Medical Conference between Vietnam and Japan
via medical TV conferenceComprehensive Strategic Therapy for human H5N1
CST-H5N1
Transfer patient

Step 3at central hospital

Step 2at provincial hospital

Step 1
at local community

1) Intensive care2) Treatments forpneumonia

1) Early diagnosis
2) Early treatment (Anti-viral agents)
3) Infection Control

1) Educational Campaign
2) Encouragement for quick visit

Human Development

Teaching of medical techniqueInternational Cooperation for preparedness toemerging infectious in Vietnam
Pasteur institute

CDC
Pasteur institute

Pasteur institute

Pasteur institute

CDC

Conclusion
The regional and global cooperation
resulting from the H5N1 crisis will lay thegroundwork for further development andprosperity regionally and globally.