Pandemic Influenza Planning Update

1. Pandemic Influenza Planning Update Your County Department of Health Spring 2006

2. Overview • Seasonal Influenza • Avian Influenza • Pandemic Influenza • What we are doing to prepare

3. Influenza

4. Influenza • Respiratory infection • Spread through coughing, sneezing • 1 to 5 days from exposure to onset of symptoms • Spread 1 day before illness up to 7 days after • Seasonal influenza traditionally occurs October through April

5. Influenza Symptoms • Rapid onset of: • Fever • Chills • Body aches • Sore throat • Non-productive cough • Runny nose • Headache

6. Seasonal Influenza • 36,000 deaths nationally every year; 800-1000 in MN • Vaccine available • High risk for complications include: • Very young • Very old • Fragile immune systems • Pregnant women

7. AVIAN INFLUENZA

8. Avian Influenza (“Bird Flu”) • Birds of all species thought to be susceptible • Two forms • Mild • Severe • Signs and Symptoms • Mild: ruffled feathers, reduced egg production • Severe: extremely contagious, rapidly fatal, case fatality rate ~ 100%

9. Avian Influenza - H5N1 Infection in Humans • Remains an avian flu strain • Living quarters are close to animals • Transmission • Contact with manure • Handling chickens • Walking through live poultry markets

10. Avian Influenza - H5N1Why do we care? • Spreading among birds quickly and across countries • Jumping hosts (across animal groups) • High case fatality rate among people (141 documented cases, 73 deaths) as of February 2006 • Mutating little by little • Has potential to mutate dramatically into a human strain

11. Pandemic • Pandemic • Widespread infection • No immunity within a population • Epidemic • Localized to one population • Low immunity within the population

12. Prerequisites for a Pandemic • A “new” virus transmitted to humans (no immunity within the community) • Virus must be able to cause illness in humans • Virus must be able to pass easily from human to human

14. Could the H5N1 be the cause of the next flu pandemic? • Possibly… but so far the virus cannot pass easily from human to human

15. World Health Organization Influenza Pandemic Phases

16. Current Pandemic Flu Planning Assumptions

17. Local Impact • Insert local numbers on this slide

18. Federal, State, Local Plans Federal State Local

19. Protective Actions • Governor is state decision maker • Close schools • Cancel large gatherings • Encourage people to limit exposure to others • Assure continuation of infrastructure • Make decisions about use of limited resources

20. Goals of MN Planning • Maintain the elements of the community infrastructure necessary to carry out pandemic response • Minimize social disruption and economic loss • Reduce morbidity • Minimize mortality • Stay flexible as the situation unfolds

21. Goals of Regional and Local Planning • Limit the spread of disease • Create & test plans • Integrate non-health entities in planning • Establish community stockpiles & distribution systems • Identify spokespersons • Provide effective public education

22. Goals of Regional and Local Planning (cont) • Maintain community infrastructure • Minimize social disruption • Reduce morbidity/mortality • Response is community based, and flexible

23. PartnershipsOur health department is working with: • Homeland Security and Emergency Management • County and city emergency managers • Schools • Law enforcement/military • Voluntary organizations • Regional hospital coalition • Clinics • Emergency Medical Services • Media

24. Health & Medical Planning • __ County, Tribal and City Public • Health Agencies • ___Hospitals ___ Clinics • Emergency Management • Emergency Medical Services • Other Community partners Insert your regional map

25. Local and Regional Public Health Planning • Education • Businesses, schools, clinics, community groups • Community stakeholders • Trainings • Infection control education for law enforcement, first responders • Psychological First Aid • Communication • Drills/Exercises

26. Working with community partners to address • Disease surveillance • Clinical issues • Laboratory • Infection control • Health care planning • Vaccine and antiviral agents

27. Working with community partners to address (cont) • Community disease control and prevention • Communications • Animal health collaboration • Care of the deceased • Legal issues • Ethical issues

28. Localize this slide • Of the following series (29-40) of slides we suggest you select 2-3 that are relevant to your regional and/or local planning efforts, and are reflected in your previous slide.

29. Disease Surveillance • Tracking influenza disease on ongoing basis • Maintain high alert for H5N1 • Monitor activity in other countries

30. Clinical Issues • Clinicians will question travel history and poultry exposure on influenza-like cases • Clinicians will report critical influenza in young, healthy individuals • Developing treatment and care protocols

31. Laboratory • Developing capacity for rapid testing and confirmation • Statewide network of clinical laboratories • Monitoring agricultural testing • Sharing information quickly • Connection to CDC

32. Infection Control • What are effective measures? • Maintaining stockpiles of supplies • Reuse, disposal • Air handling • Handwashing!!

33. Health Care Planning • Hospitals in 8 regions working together • Predicting and managing surge in demand • Protecting workers and patients • Off-site care facilities • Home care • Minnesota Responds, Medical Reserve Corps

34. Vaccine and Antiviral Agents • Strategic National Stockpile system • Mass dispensing clinics • Vaccine for prevention • Antivirals potentially for prevention and treatment • Get needed material/supplies to the public quickly

35. Community Disease Control and Prevention • Respiratory hygiene • Business continuation • School closing • Limit interaction of people • Home care • Isolation and quarantine

36. Communications • Need many ways to reach people • Consistent, understandable, complete messages • Reaching non-English speakers • Hotlines, web, TV, community organizations and many other means

37. Animal Health Collaboration • Animal health leaders and industry are planning for bird outbreak • Protecting poultry workers • Disposal of birds • Economic impact

38. Care of the Deceased • Manage death certificates • Mortician collaboration • Cremations and burials • Safe, compassionate • Limit interaction

39. Legal Issues • Governor’s authority to manage an emergency • Liability issues • Being able to move quickly • Licenses, sharing resources • Isolation and quarantine

40. Ethical Issues • What if there’s not enough __________? Who should get the limited supply? • Antivirals – treatment or prevention? • Economic impact of closing a business or limiting interaction • Does response change with length of event? • Reduced types of health care because of increased demand

41. Priority Activities for 2006 • Review the federal plan and plans from other states • Update and expand state plans • Support planning by others • Education and training • Public education • Exercising!

42. Business Planning • Forecast and allow for absences • Modify the frequency of face-to-face contact • Encourage annual flu shots • Evaluate access to healthcare • Identify employees and key customers with special needs

43. Is Your County Ready? • More today than yesterday • More tomorrow than today • Continuing process • Requires everyone to participate • State and local government • Businesses • Faith-based and community organizations • Individuals/families

44. Recommended Web Sites www.health.state.mn.us www.hsem.state.mn.us www.ready.gov www.pandemicflu.gov www.fema.gov/areyouready www.ed.gov/emergencyplan www.weprevent.org/usa/cover.pdf