Many countries, including Nepal, have been affected with highly pathogenic avian influenza (HPAI) outbreaks. There have been human mortalities in some countries and large numbers of poultry either died or were culled due to HPAI. The overall objective of this thesis was to improve our understanding of the epidemiology and economics of avian influenza (AI), and particularly HPAI, in Nepal. We determined the seroprevalence of and risk factors for AI virus antibodies presence in ducks in Kathmandu, Nepal. The estimated true prevalence of AI viruses (AIV) antibodies was 27.2% [95% Confidence Interval (CI): 24.6- 29.5]. Age of the ducks was identified as the only risk factor for AIV seropositivity. Ducks older than one year were more likely to be seropositive compared to ducks less than six months of age [Odds Ratio= 2.17 (95% CI: 1.07- 4.39)]. This study provided baseline information about seroprevalence of AIVs in Kathmandu that will benefit further research to differentiate the subtypes of AIVs circulating in Kathmandu. We also evaluated alternatives to the current control program (CCP) for HPAI in Nepal. The considered alternatives were: (i) absence of control measures (ACM) and (ii) vaccinating 60% of the domestic poultry flock twice per year. Cost-benefit analysis approach was used to evaluate the economic feasibility of the programs. In terms of the benefit-cost ratio, our findings indicated that there is a return of 1.96 dollars for every dollar spent in the CCP compared to ACM. The net present value of the CCP versus ACM was US$ 989,918. The vaccination program yielded a return of 2.41 dollars for every dollar spent when compared to the CCP. The net present value of vaccination versus implementing the CCP was US$ 13,745,454. These results support a continued investment into the CCP rather than ceasing to implement government regulated control measures and suggest that vaccination may be an even better control alternative. In summary, our studies have highlighted the value of epidemiologic and economic analysis in research of AI. Our results are expected to lead to an improved understanding and awareness of AI in Nepal and to formulation of better control strategies.

No description available.

During the 2009 H1N1 influenza pandemic, public health nurses (PHNs) were called upon to protect their communities against a deadly influenza virus. Currently, there appears to be no literature that describes the experience of Canadian PHNs responding to the first influenza pandemic of the 21st century. A qualitative research study was conducted and the data were analyzed by using content analysis. Thirteen nurses were interviewed from an Urban, Rural and Northern health region in Manitoba. Focus groups were conducted for the Urban and Rural nurses while Northern nurses were interviewed by telephone. Communication and dissemination of information, personal and professional challenges, personal face of the pandemic, regional support and lessons learned were themes generated from the data analysis. Communication and information flow was a major theme that impacted the overall PHNs’ response experience. Practice, administration, research and education implications and the limitations of the study are presented in the study.

Equine influenza virus causes a mild, self-limiting upper respiratory disease in its natural host. In stark contrast, equine influenza viruses of the H7N7 subtype produce lethal infection in BALB/c mice. This dissertation explored the mechanism underlying the differential pathogenicity of the equine H7N7 influenza virus observed in horses and BALB/c mice. Initially, a comparative study of the pathogenesis was conducted in BALB/c mice inoculated intranasally with a representative isolate of either H7N7 or H3N8 subtype equine influenza virus. All H3N8 virus-infected mice survived the infection whereas 100% mortality was documented for the mice receiving the H7N7 virus by day 8 post infection. Both viruses replicated to a similar degree in the lungs at the early stages of infection. However, after day 2 post infection until the death of the mice, the pulmonary viral loads of the H7N7 group were significantly higher than those of the control, whereas the H3N8 virus was eventually eradicated from the mice at day 7 p.i. Correspondingly, a vigorous pro-inflammatory cytokine response in the lung was induced by the H7N7 virus but not the H3N8 virus, which reflected a desperate attempt by the host immune responses to restrain the overwhelming infection. The H7N7 virus was poorly sensitive to the innate immune containment, resulting in a significant higher cumulative mortality rate than that of the control virus in chicken embryos aged 9 days and older. On the contrary, in horses, replication of the paired viruses was completely cleared by the host immune responses at day 7 p.i. and the infections produced an acute yet non-lethal illness, albeit the H3N8 virus induced generally more pronounced clinical manifestations than the H7N7 virus. The clinical severity correlated to the difference in cytokine-inducing capacity between the two viruses in horses, as evidenced by the finding that the H3N8 virus triggered significantly higher levels of gene transcription of multiple key inflammatory cytokines in the circulation than those seen for the H7N7 virus. In addition, equine peripheral monocyte-derived macrophages were found to be a target of equine influenza virus and can support the productive replication of the virus in vitro.

Those who are interested in the public mood, including politicians and economists, comment that the public are becoming ever more sceptical about many things, but health risk information should not be one of them. If health risk information is perceived by the public as ‘just another scary story’, or ‘more of the same we heard last month’, then the ability of risk messages to convey urgency and recommend action could be greatly diminished; the ‘cry wolf’ scenario becomes more real every time a threat appears in the media but fails to materialise. This thesis explores how avian influenza, (H₅N₁), as a health risk category, has been reported and represented in the New Zealand media. By analysing avian influenza-related items in four New Zealand newspapers over a six-year period, 2002-2008, and by comparing results with those found in a U.S. study by Dudo, Dahlstrom & Brossard (2007), this thesis explores the dominant themes and discourses the media drew upon when reporting the health threat of avian influenza. In addition, data from four focus groups sessions was analysed for the purpose of exploring public perceptions of health risk messages and the influence of the media on those perceptions. This thesis was situated within a constructionist epistemology, and employed a mixed-methods methodology with content, thematic and textual analyses. Risk communication theories and models, media conventions of agenda-setting and framing, and sociological concepts informed how the topic of health risk communication was operationalised. The analysis of the focus group data explored how the participants discussed the threat of H₅N₁; how they constructed concepts of personal and community risk, what role, if any, they attributed to the media in their construction and how they positioned themselves in regards to illness and contagion. The focus group analysis revealed that three dominant themes - risk, media and ‘othering’ – represented how the focus group participants talked about the risk of avian influenza. These and several sub-dominant themes shared similarities to those found in the newspaper analysis. Whilst initial discussions seemed to indicate a nonchalant attitude towards the risk of avian influenza, the many topics and themes that characterised the way the participants discussed the risk between them, showed that they had thought about the personal consequences of a possible health risk, and had formed strong opinions about many facets of that risk. Results from the newspaper analysis largely mirrored those of the above U.S. study, and showed that the New Zealand media favoured episodic over thematic framing; sensationalising the reporting of avian influenza, whilst providing little in the way of scientific and contextual information. Moreover, the analysis showed that, when reporting health risks, media templates are well established. The analysis of the focus group data revealed that the participants wanted media health risk messages to be clear, concrete and factual. However, this desire for messages that communicate certainty about risk, which is, by definition inherently uncertain, raises questions about the very nature of risk communication. Findings of this thesis suggest that future risk communication research should focus, not on how the media are reporting health risks, but how the public conceptualise risk, construct it in times of crisis and evaluate their ability to control it.

No description available.

Surveillance of domestic poultry flocks for antibodies against avian influenza and Newcastle disease to detect and differentiate between these diseases is very important. The ability to determine if the detected influenza virus antibodies belong to one of the reportable H5 or H7 subtypes is imperative. These two major viruses are continually responsible for economic loss in poultry industries all over the world. Current serological methods of detection are an effective means of detecting antibody responses to these viruses, however continually investigating improved methods of surveillance is important. Development of a serological assay using Luminex technology which involves the use of recombinantly generated influenza A nucleoprotein, hemagglutinin H5, hemagglutinin H7, and Newcastle disease nucleocapsid proteins bound to Magplex beads allowed for the simultaneous detection of antibodies against these proteins that matches the efficiency of past methods while maintaining high levels of specificity and overall accuracy. Assay development took the form of two connected projects beginning with construction of an assay that operated in duplex, detecting antibodies against influenza nucleoprotein (AIV-NP) and Newcastle disease nucleocapsid protein (APMV-1-NC). Once optimized, the second half of development involved expansion of the assay to include detection of H5 (AIV-H5) and H7 (AIV-H7) subtypes, as well as the addition of internal assay quality controls to monitor assay performance over time. Assay thresholds and overall performance of both of these functional assays were evaluated using large quantities of field and experimental sera from chickens and turkeys to maximize specificity and overall accuracy.

The goal of this research is to identify a compound or family of compounds that would allow effective treatment of the influenza virus without unnecessary risks and side-effects. Influenza is a substantial problem in today’s society. Each year 36,000 people die in the United States due to influenza, or influenza related causes. Influenza is caused by two types of the virus, Type-A and Type-B. There are currently four FDA approved drugs to treat influenza—two are proton channel blockers and two are neuraminidase inhibitors. The goal of my research was to design a new drug that would allow physicians to effectively treat Type-A and Type-B influenza virus without having their patients endure unnecessary risks and side-effects. Density functional theory calculations were used to optimize the geometries of the ligands. Using sophisticated resources such as the Protein Data Bank and AutoDock, a library of twenty five ligands were docked into the N4 protein. Each docking was performed five times, resulting in one overall average docked energy. The averaged energies for each of the ligands were ranked from lowest to highest. Based upon a different study, one of my ligands were shown to have antiviral activity. From the docked energy for the ligand with confirmed antiviral activity, the results of the highest ranking ligand could be determined to have promising antiviral activity. The ligand shown below is the promising ligand, which will undergo further alterations and dockings to attempt to improve the antiviral activity. / Department of Chemistry

On June 11, 2009, the World Health Organization declared a global influenza pandemic due to a novel influenza A virus subtype of H1N1. Public health emergencies, such as an influenza pandemic, can potentially impact disadvantaged populations disproportionately due to underlying social factors. Canada???s First Nation population was severely impacted by the 2009 H1N1 influenza pandemic. Most First Nation communities suffer from poor living conditions, impoverished lifestyles, lack of access to adequate health care, and uncoordinated health care delivery. Also, there are vulnerable populations who suffer from co-morbidities who are at a greater risk of falling ill. Moreover, First Nation communities that are geographically remote (nearest service center with year-round road access is located over 350 kilometers away) and isolated (only accessible by planes year-round) face additional challenges. For example, transportation of supplies and resources may be limited, especially during extreme weather conditions. Therefore, remote and isolated First Nation communities face unique challenges which must be addressed by policy planners in order to mitigate the injustice that may occur during a public health emergency. The Assembly of First Nations noted that there has been very little inclusion of First Nations??? input into current federal and provincial pandemic plans. Disadvantaged groups know best how they will be affected by a public health emergency and are able to identify barriers and solutions. Therefore, the objective of my research was to gain retrospective insight into the barriers faced by three remote and isolated First Nation communities of sub-arctic Ontario (i.e., Fort Albany, Attawapiskat, and Kashechewan) during their 2009 H1N1 pandemic response. Culturally-appropriate community-based suggestions for improvement of existing community-level pandemic plans were also elicited. Collected data informed modifications to community-level pandemic plans, thereby directly applying research findings. Being a qualitative community-based participatory study, First Nation community members were involved in many aspects of this research. Semi-directed interviews were conducted with adult key informants (n=13) using purposive sampling of participants representing the three main sectors responsible for health care services (i.e., federal health centers, provincial hospitals, and Band Councils). Data were manually transcribed and coded using deductive and inductive thematic analysis to reveal similarities and differences experienced within and between each community (and government body) regarding their respective pandemic response. Another round of semi-directed interviews (n=4) and community pandemic committee meetings were conducted to collect additional information to guide the modifications to the community-level pandemic plans. Reported barriers due to being geographically remote and isolated included the following: overcrowding in houses, insufficient human resources, and inadequate community awareness. Primary barriers faced by government bodies responsible for health care delivery were reported as follows: receiving contradicting governmental guidelines and direction from many sources, lack of health information sharing, and insufficient details in community-level pandemic plans. Suggested areas for improvement included increasing human resources (i.e., nurses and trained health care professionals), funding for supplies, and community awareness. Additionally, participants recommended that complementary communication plans should be developed. As suggested by participants, community-specific information was added to update community-level pandemic plans. Remote and isolated First Nation communities faced some barriers during their 2009 H1N1 health sector pandemic response. Government bodies should focus efforts to provide more support in terms of human resources, monies, and education. In addition, various government organizations should collaborate to improve housing conditions, timely access to resources, and the level of coordination regarding health care delivery. Furthermore, as pandemic plans are dynamic, government bodies should continue to aide First Nation communities with updating their community-level pandemic plans to satisfy their evolving needs. These recommendations should be addressed so that remote and isolated western James Bay First Nation communities and other similar communities can be better prepared for the next public health emergency.

During the 2009 H1N1 influenza pandemic, public health nurses (PHNs) were called upon to protect their communities against a deadly influenza virus. Currently, there appears to be no literature that describes the experience of Canadian PHNs responding to the first influenza pandemic of the 21st century. A qualitative research study was conducted and the data were analyzed by using content analysis. Thirteen nurses were interviewed from an Urban, Rural and Northern health region in Manitoba. Focus groups were conducted for the Urban and Rural nurses while Northern nurses were interviewed by telephone. Communication and dissemination of information, personal and professional challenges, personal face of the pandemic, regional support and lessons learned were themes generated from the data analysis. Communication and information flow was a major theme that impacted the overall PHNs’ response experience. Practice, administration, research and education implications and the limitations of the study are presented in the study.