Further analysis of the informal media reports allowed researchers to calculate the time elapsed between suspected and confirmed cases of H1N1 by country, whereby the authors identified a significant relationship between a country's national gross domestic product (GDP) and robustness of public health infrastructure.

"We looked at the time it took for a given country, once it had a suspected case of H1N1, to confirm infection and found an important relationship between country GDP and time to confirming a case," said Brownstein. "We found that countries with high GDP demonstrated a short lag in reporting and were confirming cases in a few days, whereby countries with low GDP could experience lags of up to 85 days."

The researchers note that several factors, including deficiencies in public health infrastructures and political pressures, may contribute to a lag in information flow and call for further research to clarify reporting structures and barriers.

"It is important to bring attention to disparities in international public health systems so we can work toward improving global health infrastructures - be that through surveillance, training, lab resources, etc. - and countries' abilities to deal with future pandemics," said Brownstein.

Source: Children's Hospital Boston