Online resources on 2009 pandemic influenza for clinicians

Numerous resources relevant to the 2009 pandemic influenza are available online. A casual search in Google using the phrase “swine flu resources” yields 9,180,000 items, making a time-bound search less fruitful for an average health care professional. This review summarizes the contents useful to practicing clinician available in 12 web sites that were selected based on their relevance to clinical care.


Introduction
The frequency of voluntary health enquiry by the public with health care professionals regarding the 2009 pandemic influenza is extremely high in comparison with enquiries made by patients regarding other life-threatening diseases.This may be partly due to the media's influence through different modes of communication across the globe.Doctors and other health care professionals are looked upon as educators about transmission, clinical features, investigations, treatment, and prevention of this pandemic illness.Given the robust expansion in medical knowledge about the current pandemic, clinicians consider the Internet a major source of information.A casual search in Google using the phrase "swine flu resources" yields 9,180,000 items, making a time-bound search less fruitful for an average health care professional.This review discusses the best online resources on the 2009 pandemic influenza and ways to access them.

Selection of web resources
Independent searches were made by both authors using the search phrases "swine flu resources", "swine flu update", "swine flu CME", and "swine flu health care professionals" at http://google.com and http://scirus.com,followed by consensus on the choice of web sites for discussion.The Google abstracts of the web pages were screened for possible scientific content of global interest.These sites were then surveyed for technical quality of the scientific content, usefulness for a health care professional, and free access to its contents.Twelve sites were selected and studied in detail to identify the type of resources available and, in particular, the salient feature on swine flu that was unique to that web site.The hierarchy described in this article was too close to measure and it was a subjective assessment of clinical relevance by the authors and does not strictly equate to a quality hierarchy.Table 1 shows the web addresses of the study web sites.

Summary of online resources on 2009 Pandemic Influenza
World Health Organization (WHO) [1] Developed by WHO, this web page on pandemic influenza provides links to frequently asked questions (FAQs), guidance documents, and recent updates on the pandemic [2][3][4].The site provides links to web pages of all regional offices under WHO.The salient feature is the downloadable PDF documents on clinical care that discuss the recommended anti-viral dose, details on adverse effects of anti-viral drugs, and available formulations of anti-virals [5,6].Similar downloadable documents on health care management, laboratory guidelines, and vaccines that are recommended as standards of practice worldwide make this site the most relevant for an average practicing clinician [7][8][9].

Center for Disease Control [10]
The web page was developed by the Center for Disease Control, Atlanta, Georgia, United States.The "general information" topics on H1N1 are a suitable quick read for a health professional beginning to acquire knowledge of the disease [11].The information on "facemask and respirator use" is appreciable [12].It provides links to resources for specific groups such as schools, colleges and universities, parents, caregivers, travelers, and the travel industry.It has a social media link that provides users with e-cards, image sharing, micro-blogs, online videos, widgets, etc.

EBSCO Publishing [13]
The web page was made available by the editors of Dynamed (a clinical reference tool by physicians for physicians) Nurse Reference Centre (a reference tool for nurses), and Patient Education Reference Centre (a resource on patient education).Though the EBSCO Publishing sites need subscription, information on pandemic influenza is free.It has a comprehensive literature review for clinicians and nurses on the illness in children, adults, and pregnant women.The patient resource on influenza needs special mention [14].The material is written in a simplified form and explains the pandemic from development of novel H1N1 virus to the treatment and prevention of illness.The patient information is available in 17 languages.It is a mustread for patients and doctors because it gives a simplified picture on pandemic influenza that may enable the clinician to explain the illness to patients in a more effective way.

United States Health Services [15]
Managed and sponsored by the United States Department of Health and Human Services, this site provides updates that are most useful for clinicians in the United States.From a global viewpoint, resources on hospital planning are most useful [16].Other facts useful for doctors include infection control measures, anti-viral safety, and information on pregnancy, HIV, and infants in relation to the disease [17][18][19][20][21]. [22] Provided by the BMJ group, this site is unique because it offers learning modules on pandemic influenza.These BMJ Learning modules give structured tutorials on the topic that includes objectivebased discussion followed by assessment.Free registration is required to attend the learning activity, and a certificate is issued for each module after satisfactory completion.

Medscape [23]
Medscape is a part of the WebMD Health professional network that is well known for its continuing medical education resources.This flu alert page provides expert video commentaries on common topics, comprehensive news updates on the emerging information on pandemic influenza, and peer-to-peer discussions on the topic.Access to the site requires a free registration.

New England Journal of Medicine [24]
Developed by the publishers of New England Journal of Medicine, the webpage has links to abstracts of research articles on pandemic influenza in Journal Watch.Full text links to corresponding journal articles are available from the respective Journal Watch pages.
The Lancet -Elsevier Global Medical News [25] The webpage is an open access initiative by Elsevier society partners, editors, and publishers.It provides full text access to articles relevant to pandemic influenza from Lancet, Lancet Infectious Diseases, Journal of Virological Methods, Journal of Clinical Virology, and Clinical and Applied Immunology Reviews.Articles are categorized as diagnosis, epidemiology, immunity, pathogenesis, preparedness, surveillance, treatment, vaccination, and virology.

European Centre for Disease Prevention and Control (ECDC) [26]
The webpage focuses mainly on information relevant to pandemic influenza in Europe.The educational materials in the form of open webcast and general information resources on influenza are commendable [26].Epidemiological updates give the current status of the influenza pandemic in Europe.

UK-Department of Health [27]
The available resources are primarily meant for health practitioners in the United Kingdom; however, they may promote adoption of similar or modified health policies in practice settings outside the United Kingdom.The national framework and supporting guidance, infection control guidance, and influenza awareness program may be useful to clinicians from less developed countries [28][29][30].
. ProMed Mail [31] Developed by the International Society for Infectious Diseases, the Program for Monitoring Emerging Diseases [ProMed] is part of the global electronic reporting system for outbreaks of emerging infections.The site provides day-to-day information on the H1N1 pandemic in addition to other emerging diseases.
American Medical Association-Influenza information [32] Developed by the American Medical Association, the web site provides useful information regarding clinical guidance, H1N1 vaccine, and patient information.