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Are We Ready? Influenza Pandemic Summit June 20, 2006

Are We Ready? Influenza Pandemic Summit June 20, 2006. Sponsored by: Nuclear, Biological, Chemical (NBC) Public Health Workgroup Funded by: New York State Department of Health. Influenza 101. What do WE need to know?.

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Are We Ready? Influenza Pandemic Summit June 20, 2006

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  1. Are We Ready?Influenza Pandemic SummitJune 20, 2006 Sponsored by:Nuclear, Biological, Chemical (NBC)Public Health WorkgroupFunded by: New York State Department of Health

  2. Influenza 101 What do WE need to know? Paula Calkins Lacombe, B.S. M.S. Director of Public Health Clinton County Health Department June 20, 2006

  3. Outline • Describe • Seasonal Influenza • Avian Influenza • Pandemic Influenza • Differences between cold and flu • Factors In Emergence of Flu Pandemic • Strategies to Reduce Impact Public Health

  4. Flu – What it is and is NOT • The actual term for flu is influenza • It is respiratory infection • It is not a GI illness with vomiting, diarrhea • It is not a cold

  5. Flu or Cold

  6. Flu Viruses • Three types of flu virus • A,B,C ( A & B cause the most serious illness) • Type A • Many subtypes that cause most serious disease in humans • Can cause human epidemics and pandemics • Can sicken many other birds and mammals. chickens, ducks, geese, pigs, and horses

  7. Mutation • Viruses routinely mutate • Antigenic drift - small changes in the viruses • Antigenic shift – occurs when rare, abrupt and major change in a type A virus that results in new subtype not previously found in humans (Novel virus) • If this new virus has the ability to spread easily to humans can lead to pandemic

  8. How is Flu Spread • Close contact – spread by exposure to large respiratory droplets, direct contact, or near-range exposure to aerosols, within 3 feet. • Little evidence of airborne transmission over long distances or prolonged periods of time (as is seen with M. tuberculosis).

  9. Influenza Infection Timeline British Columbia Ministry of Health

  10. Types of Influenza/Flu • Seasonal Flu:Contagious respiratory illness caused by influenza viruses occurs every year • Avian Flu:Bird flu is caused by avian influenza viruses; occurs naturally among birds. • Pandemic Flu:Currently none. A flu pandemic is a global outbreak with a new influenza A virus that causes serious human illness and that spreads easily from person to person.

  11. Seasonal Influenza • Seasonal influenza • Outbreaks are predictable - seasonal patterns • Occur annually- usually in winter • People usually build up some immunity from previous exposure • Most healthy adults – no serious complications • Highest risk of complications – elderly and very young • Vaccines are usually available

  12. Seasonal Influenza • Average deaths in US per year 36,000 • Modest impact on society Influenza A Virus

  13. AVIAN INFLUENZA

  14. Avian Flu • Why all the concern? • Subtype H5N1 is an influenza Type A • Before 1997 only found in birds and few other animals • Bird influenza viruses can mutate into a form which is easily transmitted human to human. This will represent a dramatic antigenic shift. • Humans have no immunity to this virus thus the risk.

  15. Avian Flu • Reassortment • Avian viruses & human viruses may also “reassort” in another animal and create a new virus • Mixing vessels • Humans – with those who survive H5N1 • Pigs get avian and human influenza • If virus changes (New/Novel virus) and develops ability to spread human to human an influenza pandemic can begin

  16. June 6 – WHO (World Health Organization)

  17. Why It is Spreading in Asia • Large, dense population of people, poultry, and animals in close quarters • Lifestyle • Additional mammals involved • Housecats in Netherlands • Tigers in Thailand • Pigs in China

  18. Avian Influenza • Avian influenza (Bird Flu)is not the same as pandemic flu • No one knows if this current avian virus (H5N1) will cause the next pandemic IF Bird Flu Arrives in the US… • It does NOT mean that lots of people will get sick • People who have gotten sick from bird flu had a lot of contact with sick birds and touched them with their bare hands • Bird flu is easy for birds to catch, but hard for people to catch

  19. Bird Handling Advice • Even in the absence of bird flu, you should not handle wild birds • Many healthy birds can carry germs that can make people sick • Wear gloves if you have to touch a wild bird, and wash your hands afterward

  20. PANDEMIC INFLUENZACould it Happen, and What if it Does?

  21. What is a Pandemic Flu? • A globalinfluenza outbreak caused by a brand new (novel) flu virus

  22. Facts About a Flu Pandemic • No immunityno previous exposure • Occurs rarely3x in 20th century not since 1968 • Complications • More severe symptoms • With more frequent complications • Can effect young and healthy people

  23. Facts About a Flu Pandemic • Death toll high In US,1918 pandemic 675,000 • Health systems Overwhelmed • Vaccine Not available early on, not for 6-8 months • AntiviralsLimited supply of effective anitvirals

  24. Pandemic Flu • Societal impact • Widespread restrictions to travel • Closings of schools, businesses • Cancellation of large public gatherings • Economy • Potential for severe impact on domestic and world economy

  25. Assumptions • Vaccine • Will not be available • Takes 6 – 8 months to produce • May need two doses • Decreased Workforce • Plan 25 – 50% unavailable to work • Time is our friend

  26. Timeline of Human Flu Pandemics Major pandemic The appearance of a new influenza strain in the human population

  27. Credit: US National Museum of Health and Medicine Influenza Pandemics 20th Century 1918: “Spanish Flu” 1957: “Asian Flu” 1968: “Hong Kong Flu” A(H1N1) A(H2N2) A(H3N2) 20 - 40 million deaths 675,000 US deaths 1 - 4 million deaths 70,000 US deaths 1 - 4 million deaths 34,000 US deaths

  28. Deja Flu - Similarities in 1918 • Originated in birds • The avian influenza virus we are seeing in Southeast Asia attacks humans similar to 1918; those with healthiest immune system are most susceptible

  29. 1918 Influenza Pandemic

  30. This May 29, 1919 photograph showed rows of tents that had been set up on a lawn at Emery Hill in Lawrence, Massachusetts where victims of the 1918 influenza pandemic were treated.

  31. Deja Flu - Similarities in 1918 • 1918 numbers extrapolated to today • 1.7 million deaths in U. S. • 30 – 384 million deaths worldwide • Age projected deaths in U.S. • < 5 years 233,000 • 15 – 24 years 214,000 • 25 – 34 years 378,000 • 35 – 44 years 268,000 • > 65 years 426,000 From APIC News -Vol. 24 Issue 2- Preparing for the Next Pandemic by Michaie Osterholm, PHD, MPH, Director, Center for Infectious Disease Research and Policy

  32. Flu Pandemic Timeline • Past shown several waves of illness • Each wave lasts about six to eight weeks • Can be separated by 3 - 9 months

  33. Factors in Emergence of Flu Pandemic • Microbial adaptation and change • Host susceptibility to infection • Climate and weather • Changing ecosystems

  34. Factors in Emergence • Economic development and land use • Human demographics and behavior • Technology and industry • International travel and commerce

  35. Factors in Emergence • Poverty and social inequality • War and famine • Lack of political will • Breakdown of public health measures

  36. Individual Healthcare Delivery System Local /State / Federal Public Health System Business Government & Workers Education, Law Enforcement, Emergency Services What Can We Do About It?Share Responsibility! Faith Communities

  37. Unprepared Impact Prepared Weeks Planning Will Make A Difference

  38. Key Public Health Strategies to Reduce Impact • Surveillance Monitor disease activity • Coordination Local, state, and federal planning, systems and resources

  39. Key Public Health Strategies to Reduce Impact • Utilize Isolation and Quarantine • Limit exposure of cases (sick) • Limit exposure of contacts to others • Social Distancing • Closing schools • Reduce crowds and places where people gather • Work from home

  40. Key Public Health Strategies to Reduce Impact • An informed and responsive public • Develop public education and communications to keep the public informed. • Essential to minimizing the health effects

  41. Key Public Health Strategies to Reduce Impact • Reduce stress on health care system • Care for people at home or other facilities • Protect limited assets – use effectively • Empower people to do so • Ethics – Discuss NOW! • Hot lines, support services • Keep people healthy • Back to basics • Respiratory Etiquette and Hand Hygiene

  42. Key Public Health Strategies to Reduce Impact • Distribute vaccine rapidly when available • Establish PODs – clinics • Use antivirals effectively • Protect limited asset

  43. Messages to Take Home • Understand the facts about Influenza and a Pandemic • Communicate what you have learned • Integrate the messages and apply them to your setting • Make plans • Communicate, Cooperate, and Collaborate

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