The Invention of the swine-flu pandemic Workshop on H1N1: Managing a pandemic between fear and distrust Lucerne University of Applied Sciences and Arts Lucerne, 8 September 2010 Ulrich Keil 1 and Angela Spelsberg 2 Institut für Epidemiologie und Sozialmedizin der Universität Münster 1 Transparency International, German Chapter, Berlin 2
Case Fatality of known Influenza Viruses Influenza Type Case Fatality % Spanish Flu 1 2-3 A/H5N1 (avian flu) 30-50 SARS (corona) 9,6 Seasonal Influenza 0,4 A/H1N1 (swine flu) 0,1
Häufigste Todesursachen in Deutschland 2008 Todesursachen (ICD-10) Todesfälle (Männer und Frauen) Alle 844,439 Krankheiten des Kreislaufsystems (I00 I99) 356,729 Ischämische Herzkrankheiten (I20 I25) 134,822 Schlaganfall (I60 I69) 63,127 Bösartige Neubildungen (C00 C97) 216,010 Lungenkrebs (einschl. Larynx und Trachea) (C32 C34) 43,830 Dickdarm- und Mastdarmkrebs (C18 C21) 26,662 Brustkrebs bei Frauen (C50) 17,209 Lymphatisches und blutbildendes Gewebe (C81 C96) 17,056 Prostatakrebs (C61) 12,134 Krebs der Harnblase (C67) 5,532 Quelle: Statistisches Bundesamt 2010
Häufigste Todesursachen in Deutschland 2008 Todesursachen (ICD-10) Todesfälle (Männer und Frauen) Pneumonie (J12 J18) 21,839 Chronische obstruktive Lungenerkrankungen (J40 J47) 26,235 Chronische Lebererkrankungen und -zirrhose (K70 K77) 15,703 Diabetes mellitus (E10 E14) 22,330 Suizid (X60 X84) 9,331 Verkehrsunfälle (V01 V99) 4,853 Stürze (W00 W19) 7,924 HIV / AIDS (B20 B24) 443 Plötzlicher Kindstod (SIDS) (R95) 215 Schweres akutes Atemwegssyndrom (SARS) 0 Vogelgrippe (A/H5N1) 0 Schweinegrippe (A/H1N1) im Jahre 2009/10 258 Quelle: Statistisches Bundesamt 2010
Shares of total deaths to 10 leading risk factors in the WHO European Region Germany 2002 Risk factor % of total deaths 1. High blood pressure 25.9 2. Tobacco 18.3 3. High cholesterol 15.1 4. High BMI 9.9 5. Physical inactivity 5.9 6. Low fruit and vegetable intake 4.1 7. Unsafe sex 0.7 8. Urban outdoor air pollution 0.6 9. Occupational airborne particulate matter 0.4 10. Illicit drugs 0.4 The European health report 2005. Statistical tables
Shares of DALYs attributable to 10 leading RFs in the WHO European Region Germany 2002 Risk factor % of total DALYs 1. Tobacco 13.7 2. High blood pressure 11.2 3. Alcohol 7.5 4. High cholesterol 7.2 5. High BMI 7.1 6. Physical inactivity 3.2 7. Low fruit and vegetable intake 2.2 8. Illicit drugs 1.7 9. Unsafe sex 0.8 10. Iron deficiency 0.5 The European health report 2005. Statistical tables
Record female life expectancy from 1840 to the present Source: Oeppen J, Vaupel JW. Broken limits to life expectancy. Science 2002; 296: 1029 31
Average life expectancy in Germany between 1980 and 2006, men and women 0.3 yrs Life expectancy in years Women Men West Germany 2.8 yrs East Germany 1 yr West and East combined1.4 yrs 2 yrs West Germany 3.5 yrs East Germany Year Adapted from: Weiland SK, Rapp K, Klenk J, Keil U. Zunahme der Lebenserwartung. Dtsch Ärztebl 2006; 103(16):A 1072 7.
To analyse changes of life expectancy between two points in time, Pollard s method calculates the contribution of each age group and within this group of each cause of death to the observed changes of life expectancy. Pollard JH: The expectation of life and its relationship to mortality. J Inst Actuaries 1982; 109: 225 40
Annual and cumulative contribution of different age groups to the changes in life expectancy between 1962 and 2006 in Germany, men Adapted from: Klenk J, Rapp K, Büchele G, Keil U, Weiland SK. Increasing life expectancy in Germany: quantitative contributions from changes in age- and disease-specific mortality. Eur J Public Health 2007; 17:587 592.
Annual and cumulative contribution of different disease groups to the changes in life expectancy between 1962 and 2006 in Germany, men Adapted from: Klenk J, Rapp K, Büchele G, Keil U, Weiland SK. Increasing life expectancy in Germany: quantitative contributions from changes in age- and disease-specific mortality. Eur J Public Health 2007; 17:587 592.
Annual and cumulative contribution of different age groups to the changes in life expectancy between 1962 and 2006 in Germany, women Adapted from: Klenk J, Rapp K, Büchele G, Keil U, Weiland SK. Increasing life expectancy in Germany: quantitative contributions from changes in age- and disease-specific mortality. Eur J Public Health 2007; 17:587 592.
Annual and cumulative contribution of different disease groups to the changes in life expectancy between 1962 and 2006 in Germany, women Adapted from: Klenk J, Rapp K, Büchele G, Keil U, Weiland SK. Increasing life expectancy in Germany: quantitative contributions from changes in age- and disease-specific mortality. Eur J Public Health 2007; 17:587 592.
Today, 100 times more 100 year-olds live in the western world than 100 years ago J. Vaupel Max Planck Institut für Demographie Rostock
CDC data on numbers of respiratory specimens testing positive for influenza virus in US, January-June 2009 (www.cdc.gov/flu/weekly/weeklyarchives2008-2009/data/whoallregt31.htm Doshi P BMJ 2009;339:bmj.b3471 2009 by British Medical Journal Publishing Group
Proposed classification of impact of new infectious diseases. Doshi P BMJ 2009;339:bmj.b3471 2009 by British Medical Journal Publishing Group