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Pandemic Influenza Preparedness

Pandemic Influenza Preparedness. Maria Natal-Gopin, Ph.D. student Walden University PUBH 8165-1 Dr. David Anderson Winter, 2011. Pandemic Influenza Preparedness Agenda. Objectives Influenza Pandemic definition 20 th Century Pandemics Influenza Pandemic Knowledge Gained

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Pandemic Influenza Preparedness

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  1. Pandemic Influenza Preparedness Maria Natal-Gopin, Ph.D. student Walden University PUBH 8165-1 Dr. David Anderson Winter, 2011

  2. Pandemic Influenza Preparedness Agenda • Objectives • Influenza Pandemic definition • 20th Century Pandemics • Influenza Pandemic Knowledge Gained • Prevention and Control • H5N1 Influenza Virus • H5N1 Risk Reduction • Prevention • Control • Caring for the Ill • Conclusion • Additional Sources • References

  3. Objectives By the end of this presentation you will be able to: • Describe what an influenza pandemic is and discuss the differences and similarities between the seasonal influenza and an influenza pandemic • Describe the actions being taken by various agencies to prepare for and prevent an influenza pandemic • State three things you can do to prevent or limit an influenza pandemic • Describe the potential environmental impact of an influenza pandemic • Verbalize three steps you can take to manage the symptoms • Name three resources in your community you can contact for additional information on influenza pandemics

  4. What is an Influenza Pandemic? • A worldwide outbreak of a new influenza virus • Immunity is nonexistent or very limited • Similar characteristics to seasonal influenza • Infections across age groups • Illness is often self limiting • Different characteristics to seasonal influenza • Higher fatality rates among the young • Greater impact and severity • Not associated with a season • Often zoonotic in origin World Health Organization (WHO). (2010, February 24). What is a pandemic? Retrieved January 14, 2011 from http://www.who.int/csr/disease/swineflu/frequently_asked_questions/pandemic/en/index.html

  5. Comparison Seasonal and Pandemic Influenza Seasonal Influenza Identified influenza virus Previous exposure likely Milder symptoms, less complications Young and elderly at risk Modest societal, economic and environmental impact New influenza virus No previous exposure More severe symptoms and complications Affects healthy people across all ages Severe societal, economic and environmental impact Pandemic Influenza

  6. 20th Century Pandemics • Spanish Influenza- 1918 • caused by an avian (bird) virus (H1N1) • antigenic subtypes of influenza A virus • affected mostly healthy adults (99 % < 65 years) • associated with the most fatalities (↑ pneumonia complications) • Asian Influenza- 1957 • H2N2 • descendant of the 1918 avian virus • antigenic subtypes of influenza A virus • Hong Kong Influenza- 1968 • H3N2 • descendant of the 1918 avian virus • antigenic subtypes of influenza A virus • Kilbourne, E. D. (2006). Influenza Pandemics of the 20th Century. Emerging Infectious Diseases, 12(1), 9-14. Retrieved from Academic Search complete database.

  7. Influenza Pandemic Knowledge Gained • Communication & Coordination • Surveillance • avian influenza viruses (AIVs) • Reassortment and virus mutations Antigenic Drift Antigenic Shift • Viral transmission Permission obtained from EHA Consulting Group, Inc. Pappaioanou, M. & Gramer, M. (2010). Lessons from Pandemic H1N1 2009 to improve prevention, detection, and response to influenza pandemics from a One Health Perspective. Institute for Laboratory Animal Research (ILAR) Journal, 52(2), 268- 280. Retrieved from http://dels old.nas.edu/ilar_n/ilarjournal/51_3/pdfs/v5103Pappaioanou.pdf

  8. Prevention & Control Disease containment • Infection control • Vaccination • Flu Self- Assessment • Use of protective personal equipment • Sick leave • Basic hygiene practices • Hand hygiene • Cough etiquette • Ventilation • Bird proofing • Don’t use untreated water • Filter water • Report dead birds to the USDA-Wildlife Services at 1-866-4-USDA-WS • Know the facts about the quality of the lakes where you fish and visit the New Jersey Department of Environmental Protection Olsen, C. W. (2004). Influenza: Pigs, people and public health. Public health fact sheet, National Pork Board, 2, 1-4. Retrieved January 16, 2012 from http://www.setma.com/pdffiles/influenza_pigs_people_and_public_health.pdf

  9. A New Influenza A Virus Threat • H5N1 • highly pathogenic avian influenza (HPAI) virus • wild birds are the reservoir • several subtypes identified • transmission • fecal/oral • contaminated water • Outbreaks • Decontamination H1N1- 1918 H2N2- 1957 H5N1 H1N1- 2009 H3N2- 1968 • Centers for Disease Control and Prevention (CDC). (2010, November 21). Key facts about Avian Influenza (Bird Flu) and highly pathogenic avian influenza A (H5N1) virus. Retrieved from http://www.cdc.gov/flu/avian/gen-info/facts.htm

  10. H5N1 Cases in 2007 • American Academy of Pediatrics (AAP) & Trust for America's Health (TFAH). (2007, October). Pandemic Influenza: Warning children at-risk. Retrieved from http://healthyamericans.org/reports/fluchildren/KidsPandemicFlu.pdf

  11. H5N1 Risk Reduction • New Jersey Department of Environmental Protection Division of Fish and Wildlife • U. S. Department of Agriculture • “banned the import of birds or poultry products from any country where H5N1 has been reported” (NJDEP, 2007, para. 10) • Poultry and farm inspections Fang, L., de Vlas, S. J., Liang, S., Looman, C. W. N., Gong, P., Xu, B., Yan, L.,…, Cao, W. (2008, May). Environmental factors contributing to the spread of H5N1 Avian Influenza in mainland China. PLoS ONE, 3(5), e2268 – e 2281. Retrieved from http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0002268 New Jersey Department of Environmental Protection, Division of Birds and Wildlife. (2007, October 11). The bird flu. Retrieved January 16, 2012 from http://www.state.nj.us/dep/fgw/birdflu07.htm

  12. H5N1 Prevention • When cleaning birds or gathering eggs • Use gloves • Don’t touch your mouth or face or eat, smoke or drink • Wash hands with soap and water • Clean contaminated surfaces (including knives) with a 10% bleach solution • Cook birds to 165⁰ F and use a minimum temperature of 325 ⁰ F • Observe wildlife from a distance • Don’t touch wildlife New Jersey Department of Environmental Protection, Division of Birds and Wildlife. (2007, October 11). The bird flu. Retrieved January 16, 2012 from http://www.state.nj.us/dep/fgw/birdflu07.htm

  13. In Advance • Be informed • Make a plan • Family Emergency Plan • Build a kit • Get involved • New Jersey State Citizen Corps Council • Medical Reserves Corps • Additional Resources • American Red Cross • Humane Society of the United States • Local fire and rescue professionals • State/ local public health professionals Ready.gov. (n. d.). Prepare, plan, be informed. Retrieved from http://www.ready.gov/

  14. Control • National Influenza Pandemic Plan • State and local collaboration • New Jersey Statewide Pandemic Influenza Plan • Vaccines • Antiviral Medications Permission obtained from CartoonStock Ltd.

  15. Caring for the Ill • Social Distancing • Voluntary • isolation & quarantine • Involuntary • Schools, daycares and business closings • Public gatherings cancelled • Strategic National Stockpile • Vaccines • Antiviral medications • Personal Protective Equipment • Face masks and N 95 respirators • Infection control • hand hygiene • cough etiquette • Discarding contaminated supplies • Medical attention • American Academy of Pediatrics (AAP) & Trust for America's Health (TFAH). (2007, October). Pandemic Influenza: Warning children at-risk. Retrieved from http://healthyamericans.org/reports/fluchildren/KidsPandemicFlu.pdf • Trust for America’s Health. (2007, July 30). Pandemic Flu and the potential for an economic recession. Retrieved from http://healthyamericans.org/reports/flurecession/

  16. Conclusion Clipart from presentationpro.com

  17. Additional Sources • Arinaminpathy, N, & McLean, A.R. (2008, May 6). Antiviral treatment for the control of pandemic influenza: some logistical constraints. Journal of the Royal Society,; 5(22), 545–553. doi: 10.1098/​rsif.2007.1152 • Avian Influenza Page of the U.S. Department of Agriculture's Animal and Plant Health Inspection Service • Centers for Disease Control and Prevention, Influenza Page • Centers for Disease Control & Prevention (CDC). (2006, October). Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Healthcare Settings during an Influenza Pandemic. Retrieved from http://www.flu.gov/planning-preparedness/hospital/maskguidancehc.html

  18. Additional Sources • Gray, G. C., McCarthy, T., Capuano, A. W., Setterquist, S. F., Olsen, C. W., Alavanja, M. C., Lynch, C. F. (2007). Swine workers and swine influenza virus infections. Emerging Infectious Diseases, 13, 1871-1878. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2876739/pdf/06-1323_finalR.pdf • National Research Council. (2005). Microbial threats to health: The threat of pandemic influenza. Washington, DC: The National Academies Press. • National Research Council. (2009). Sustaining global surveillance and response to emerging zoonotic diseases . Washington, DC: The National Academies Press. • National Wildlife Health Center's Avian Influenza pages • New Jersey Department of Health and Senior Services, Avian Influenza Page • New Jersey Department of Agriculture, Avian Influenza Page • World Health Organization's avian influenza website

  19. References • American Academy of Pediatrics (AAP) & Trust for America's Health (TFAH). (2007, October). Pandemic Influenza: Warning children at-risk. Retrieved from http://healthyamericans.org/reports/fluchildren/KidsPandemicFlu.pdf • Centers for Disease Control and Prevention (CDC). (2010, November 21). Key Facts About Avian Influenza (Bird Flu) and Highly Pathogenic Avian Influenza A (H5N1) Virus. Retrieved from http://www.cdc.gov/flu/avian/gen-info/facts.htm • Fang, L., de Vlas, S. J., Liang, S., Looman, C. W. N., Gong, P., Xu, B., Yan, L.,…, Cao, W. (2008, May). Environmental factors contributing to the spread of H5N1 Avian Influenza in mainland China. PLoS ONE, 3(5), e2268 – e 2281. Retrieved from http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0002268

  20. References • Gray, G. C., McCarthy, T., Capuano, A. W., Setterquist, S. F., Olsen, C. W., Alavanja, M. C., Lynch, C. F. (2007). Swine workers and swine influenza virus infections. Emerging Infectious Diseases, 13, 1871-1878. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2876739/pdf/06-1323_finalR.pdf • Johnson, N. P. & Mueller, J. (2002, Spring). Updating the Accounts: Global mortality of the 1918-1920 "Spanish“ Influenza Pandemic. Bulletin of the History of Medicine, 76(1), 105-115. DOI: 10.1353/bhm.2002.0022 • Kilbourne, E. D. (2006). Influenza pandemics of the 20th century. Emerging Infectious Diseases, 12(1), 9-14. Retrieved from Academic Search complete database. • New Jersey Department of Environmental Protection, Division of Birds and Wildlife. (2007, October 11). The bird flu. Retrieved January 16, 2012 from http://www.state.nj.us/dep/fgw/birdflu07.htm

  21. References • Olsen, C. W. (2004). Influenza: Pigs, people and public health. Public health fact sheet, National Pork Board, 2, 1-4. Retrieved January 16, 2012 from http://www.setma.com/pdffiles/influenza_pigs_people_and_public_health.pdf • Moeller, D. W. (2011). Environmental health (4th ed.). Cambridge, MA: Harvard University Press. • Pappaioanou, M. & Gramer, M. (2010). Lessons from Pandemic H1N1 2009 to improve prevention, detection, and response to influenza pandemics from a One Health Perspective. Institute for Laboratory Animal Research (ILAR) Journal, 52(2), 268- 280. Retrieved from http://dels-old.nas.edu/ilar_n/ilarjournal/51_3/pdfs/v5103Pappaioanou.pdf • Rappaport, D. J. (n. d.). Avian Influenza and the environment: An ecohealth perspective. Retrieved from http://www.unep.org/DEWA/products/publications/2006/DRapport_AI_Final_180506_Edit3.doc.pdf

  22. References • Ready.gov. (n. d.). Prepare, plan, be informed. Retrieved from http://www.ready.gov/ • Singer, A. C., Colizza, V., Schmitt, H., Andrews, J., Balcan, D., Huang, W. E., Keller, V. D.J., ...Williams, R. J. Assessing the ecotoxicologic hazards of a pandemic influenza medical response. Environmental Health Perspectives, 119(8), 1084 - 1090. Retrieved from http://ehp03.niehs.nih.gov/article/fetchArticle.action?articleURI=info:doi/10.1289/ehp.1002757 • State of New Jersey. (n. d.). Fast facts. Retrieved from http://www.nj.gov/nj/about/facts/facts/ • Taubengerber, J. K. & Morens, D. M. (2006, January). 1918 Influenza: the mother of all pandemics. Emerging Infectious Diseases, 12(1), 15-22. Retrieved from Academic Search Premier database.

  23. References • Taubengerber, J. K. & Morens, D. M. (2010). Influenza: The once and future pandemic. Public Health Reports, 125(3), 16-26. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2862331/ • Trust for America’s Health. (2007, July 30). Pandemic Flu and the potential for an economic recession. Retrieved from http://healthyamericans.org/reports/flurecession/ • World Health Organization (WHO). (2012, January 12). Cumulative number of confirmed human cases for avian influenza A(H5N1) reported to WHO, 2003-2012. Retrieved from http://www.who.int/influenza/human_animal_interface/EN_GIP_20120116CumulativeNumberH5N1cases.pdf

  24. Contact Information Maria Natal-Gopin Mnatal-gopin@waldenuniversity.edu

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