COMMUNICATION STRATEGY FOR PRECAUTION DURING A PANDEMIC OUTBREAK

Hence, to carry out this research study a focus group method was applied where, and a group discussion was carried out amongst 4 groups of people, each group containing 4 students from different countries. The Time, date, method and venue of the data collection were previously decided and the amount of researcher participation was decided thereafter. The participants taking part in the Focus group was an observer and therefore negotiated an active participation in the range of activities carried out in the group discussions thereby setting up an open acknowledgement of this exploratory form of study (Kent, 2003). Qualitative research through focus group is one of the frequently used methodology in evaluation of such a social marketing campaign. According to the Theory of Planned Behaviour (Ajzen (1988, 1991), the TPB theory helps in understanding the ways on how we can change the behaviour of the people because behaviour is often deliberate or planned. On the extension of the TPB theory, Behavioural attitude is incorporated when the measures of intensions and behavioural changes are compatible and expectations are realistic.

Hence, Four focus groups containing four students each were organized amongst the students from the Middlesex university Business school comprising of participants aged between 18 to 30 years. Both male and female undergraduate and postgraduate students participated in the group discussions. The set of participants were students from different countries having cross cultural diversities. The group discussions were conducted in form of two phases wherein, in the 1^st phase of group discussions, discussions were made on a pandemic          situation outbreak and the role and effect of influenza virus as a major pandemic threat as mentioned in the above literature review. The explanation discussed the various types and sub-types of the influenza strains and its impact on the global health population over the years considering the death ratios due to the global pandemic outbreak of influenza. The death rate graphs and the notable influenza pandemics over the years were explained and a layout of the strains of influenza viruses were graphically demonstrated. General practices, measures and the preparation strategy of the influenza pandemics were explained to all the participants participating in the focus group discussions.      

COMMUNICATION STRATEGY FOR PRECAUTION DURING A PANDEMIC OUTBREAK

Therefore, considering the existing literature on the social marketing campaigns and the national plans that were subjected to specific countries or regions for a pandemic communication outcome through social marketing, relatively less importance and study has been dedicated towards understanding the effectiveness of the message through these social marketing campaigns in pursue of a pandemic planning strategy. Hence, with the application of the “Theory of planned behaviour” as a social marketing concept, the study of message effectiveness through these social marketing campaigns can be used as a further point of research study during a communicable form of a pandemic outbreak like Influenza.

METHODOLOGY:

On the basis of the research aim segments, an exploratory qualitative based research is the methodology that is used to carry out this study. A qualitative based research is an exploratory form of a research. It seeks to explore and understand people’s perception, attitude and motivational factors that influence a behavioural change in an individual. The execution and analysis of the findings is predominantly based on the available qualitative data (Kent, 2003). Therefore, a qualitative based research methodology helps in evaluating a set of complex data thereby developing a sense of social marketing ideology amongst the target audience (Huberman and Miles, 2002). In accordance to the adoption of new concepts in order to conduct a research, new theories are enlightened which creates new conclusions on the existing information of the study. Thus, the research work ideally is more flexible as the newly derived theories expand onto the new horizons forming a whole new scope and agenda of a research study (Adams and Schavaneveldt, 1991).        

COMMUNICATION STRATEGY FOR PRECAUTION DURING A PANDEMIC OUTBREAK

NOTABLE INFLUENZA PANDEMICS AND CORRESSPONDING DEATH RATIOS:

Name of pandemic	Date	Deaths	Subtype involved
Asiatic (Russian) Flu	1889–90	1 million	possibly H2N2
Spanish Flu	1918–20	50 million	H1N1
Asian Flu	1957–58	1.5 to 2 million	H2N2
Hong Kong Flu	1968–69	1 million	H3N2
Swine Flu	As of June 25th, 2010	over 18,209[6]	novel H1N1

The above table signifies the impact of an influenza flu pandemic that has been occurring throughout the years and the role of the influenza strains and their subtypes involved in the corresponding death ratios dated from 1889-2010.

SOURCE: http://en.wikipedia.org/wiki/Influenza_pandemic

The above illustration demonstrates the impact of influenza ‘A’ virus sub-types in human population over the years leading to possible pandemic threat in the upcoming future. The solid squares indicate the appearance of a new strain while broken strain indicate uncertain strain identifications.  

Planning to overcome an influenza pandemic is entirely a role that is subjective to central government and in order for proper implementation and execution of the plans, acknowledging the frameworks of health system governance is a mandatory activity. The district health governance planning authority has a vital role to play in order to ensure and monitor the completion of district plans at a national level.

Strategy to use anti-viral drugs with basic prophylaxis treatment methodologies combined with implementation of social distancing measures is a key to success and effective working of the national plans. Government commitment in most of the European countries has a strong solid foundation in laying out an upbeat level of pandemic preparedness. Monitoring and Surveillance capabilities and laboratory diagnostic operations are well scrutinized where public health infrastructure is significant and widely accepted. 

COMMUNICATION STRATEGY FOR PRECAUTION DURING A PANDEMIC OUTBREAK

Age groups from 65 yrs of age accounted for nearly 99 percent of influenza related deaths in 1918. However, people under age groups of 65 yrs in 1957 and 1968 accounted only 36 and 48percent influenza related deaths (Simonsen et al; 1998). On the basis of recent survey done on pandemic influenza outbreak, it has been estimated for USA alone to result with 2,07,000 deaths and 7,34,000 hospitalizations, 47 million additional illness and 42 million outpatient visits(Meltzer et al, 1999).

This graph estimates the number of residents that were affected during an influenza pandemic outbreaks (from 1917- 2006).

However, during an influenza pandemic, large proportions of deaths are a result of secondary bacterial infections. By 1979, the influenza strain started infecting pigs in the European territory thereby establishing a stable viral lineage with the dormant pandemic strain (Ludwig, et al; 1995). One extra-ordinary situation has a significant mark in the history of world global pandemic, wherein a family living in a village in Sumatra, seven members were infected with influenza ‘A’ strain virus (Wulandri and Lyn, 2006), thereby indicating an extended chain of human transmission(Butler, 2006,p.554).

In all, if we analyze the cases of likely number of death cases from the previous influenza epidemics, the estimated death rates are between 4.4 and 6.7 per 1000 persons (Brundage, 2006). The national and international government health organizations have developed country and regional level public communicating materials for pandemic preparedness (Horwarth et al, 2006; Barret et al, 2005, Jennings and lush, 2004).

COMMUNICATION STRATEGY FOR PRECAUTION DURING A PANDEMIC OUTBREAK

The threat of an influenza pandemic has a severe widespread public concern around the high economic class society as 1918 marked the beginning of  the influenza pandemic outbreak killing nearly 7,00,000 Americans and 40 million population worldwide. Thereafter, considering the historical experience 1918-19 i.e. Spanish flu, Asian flu in 1957 and Hong-Kong flu in 1968, several national plans with respect to pandemic influenza preparedness plans were constructed in the European countries with a common objective in achieving international harmonization in preparedness planning. The 1918 “Spanish flu” pandemic outbreak had a clinical significance with regards to same symptoms as in 1957 and 1968 pandemic outbreaks and therefore, the disease had similarity with other pandemics as the damage was largely confined to the respiratory tract (Wolbach, 1919; Winternitz et al, 1920).In 1918, The most severely hit class of people concentrated amongst young age groups (Linder and Grove , 1943;Marks and Beatty, 1976; Rosenau and last, 1980).   

COMMUNICATION STRATEGY FOR PRECAUTION DURING A PANDEMIC OUTBREAK

Influenza

“Influenza” is a common dreadful viral infection which has its prevalence in the history of world pandemics. The exact reason of origin of the virus is still a debatable issue, however, the magnitude and the severity of an influenza outbreak is a ruthless public health challenge. The widely remembered influenza outbreak in 1918 is a classic model of influenza epidemics affecting 20 to 40 percent of the world global population. As stated by (Brammer et al, 2002), the influenza virus capitulates its dormant form during the late winter having high mortality rate initially affecting the respiratory tract of the humans, ideally Throat, Lungs and Nose. In USA, the hospitalization rate during a influenza outbreak is over 1,00,000 individuals which kills over 30,000 individuals in an average year (Simonsen et al, 2000 and Thompson et al 2003).The dreadful aspect of this viral outbreak is that it is difficult to predict the nature and timing of its next potential outbreak leaving the researchers to depend upon the past genetic and historical epidemiological evidences in order to identify a possible threat(Layne et al , 2001 ; Taubenberger and Layne , 2001).The nature of its pandemic occurrence pre-dominantly has its existence every 10 to 50 years during several centuries alone targeting children under 15 yrs of age with highest rate of infection.(Beveridge, 1977, Cox and Subbarao ,2000;Wright and Webster, 2001).

Influenza Types, Sub-types and Strains:

INFLUENZA STRAINS	SUB-TYPES		SYMPTOMS	MORTALITY RATE	DEATH RATE
INFLUENZA TYPE ‘A’	-H1N1 -H2N2 -H3N2 -H5N1 -H7N7 -H1N2 -H9N2 -H7N2	‘A’ type of virus strain (H5N1) is also known as bird flu which is highly pathogenic and has the capability of causing more than one influenza pandemic due to its genomic mutation capability. Highly existing forms are transcribed in avian genomes.	-Fever -Cough -Cold -Muscle aches -Conjunctivitis -Pneumonia	Very High	60%
INFLUENZA TYPE ‘B’	- None	This type of strain is a sub- type of influenza virus which can cause epidemics but not Pandemics. It is a contagious respiratory infection having the capability to mutate and produce different strains.	-Headache -Muscle ache -Mild frequent -Fever -Common   Cold	Medium	25%
INFLUENZA TYPE ‘C’	- None	This type of strain is the mildest of all types of strains never connected to any form of epidemics and is just a type of mild respiratory infection.	-Common Cold	Very Low	2%

Source: http://www.medicinenet.com/influenza/article.htm

COMMUNICATION STRATEGY FOR PRECAUTION DURING A PANDEMIC OUTBREAK

Preparation of a pandemic plan is a pre-requisite to a nation’s self- defence mechanism in a course of a potential pandemic outbreak. Based on the principles of world health organization’s pandemic planning guidelines, several countries like New- Zealand and Australia have their planning programmes working with an objective to facilitate and co-ordinate effective national response to a pandemic alert. With the involvement of the District health boards, Public health units and other agencies, the preparedness level are subjected to WHO designed plans. Vaccinations and production of antibiotic vials are a key phenomenon in countries like France, UK, Netherlands, Romania, Italy and Germany. Other countries like Switzerland, Norway, Denmark and Sweden have negotiated future plans for vaccinations and health care facilities.

With respect to the research study, Influenza will be taken as a possible pandemic outbreak example wherein social marketing campaigns can be designed to establish communication and precautionary strategy against it. The discussions will consider influenza as a pandemic and a detailed overview of Influenza is given below.