Douglas A. Holt, MD Director, Hillsborough County Health Department Kelly Granger, MPH, CHES Pandemi

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Douglas A. Holt, MDDirector, Hillsborough
County Health DepartmentKelly Granger, MPH,
CHES Pandemic Influenza Coordinator,
Hillsborough County Health Department
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Expert Opinion

• A pandemic is inevitable
• Possibly H5N1 (Avian Influenza)
• May be muted or catastrophic
• Viral illness affecting people, pigs, and birds

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Disease Description

• Severe influenza pandemics are one of the
  greatest threats to the public's health
• Would be a worldwide epidemic due to it being a
  new strain of influenza
• Develop in two ways
• Wild birds are reservoirs for all influenza
  viruses
• All influenza viruses experience frequent, subtle
  changes to their genetic structure

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Avoiding Influenza

• Wash hands frequently
• Cover mouth when coughing or sneezing
• Stay home if flu symptoms appear
• Thoroughly wash eating utensils
• Avoid close contact with other family members

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Cycles of the Asian H5N1 Virus in Animals and
Humans
Waterfowl
Waterfowl
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Why H5N1 is of Particular Concern
Traditional belief of antigenic shift leading to
pandemics of human influenza
H5NI influenza is able to infect humans directly
?
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Source World Health Organization Web site,
www.pandemicflu.gov
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Potential Future Situation Florida Example

• All communities in Florida would likely be
  affected at the same time
• Each community will have to deal with the
  pandemic primarily on their own
• Based on the conservative estimate of a 25
  attack rate, Hillsborough County would experience
  3,691 influenza-related hospital admissions and
  725 influenza-related deaths over an 8 week
  outbreak

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3-Step Strategy for Pandemic Influenza

• Preparedness and Communication
• Surveillance and Detection
• Response and Containment

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Preparedness

• Recent statewide Influenza Summit
• Existing plan dated March 2004
• Draft White Paper September 2005
• Draft Influenza Pandemic Annex to Department of
  Health Emergency Operations, Version 9
• Finalizing Hillsborough County Pandemic Flu Plan

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Communication

• Public Health and Healthcare System
• Government and First Responders
• Essential Services
• Business Leadership
• The Public

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Surveillance and Detection

• Sentinel Physician Practices
• Influenza culture specimens received, positive
  results, at state Public Health Lab
• Syndromic Tracking and Reporting System (STARS)
• Influenza activity level by county
• www.pandemicflu.gov

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Response and Containment

• Non-pharmaceutical interventions will be key
• Isolation of sick persons
• Quarantine
• Antiviral drugs may be useful for prophylaxis or
  treatment
• Vaccine trials are underway

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Commercial Poultry in Florida
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Pandemic Influenza and Schools

• Collaboration with local school board
• Potential for social distancing measures, such as
  school closure
• Need for discussion NOW
• Challenge of case identification

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Planning Assistance for Schools

• http//www.pandemicflu.gov/plan/schoolchecklist.ht
  ml
• Four general planning sections (K-12)
• - Planning coordination
• - Continuity of student learning core
  operations
• - Infection control policies procedures
• - Communications planning

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Planning and Coordination

• Communicate with local health department
• Become familiar with county plan
• Assist with surveillance activities (student
  absenteeism)
• Plan to assist with surge capacity needs (schools
  used in alternative ways)

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Continuity of Student Learning and Core Operations

• Develop practice scenarios
• Develop alternate types of instruction
  (web-based, mailed lessons, local TV, etc.)
• Update or develop continuity of operations plan
  to keep essentials functions up

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Infection Control Policies and Procedures

• Develop infection control policies in conjunction
  with health department
• Establish good hygiene practices among students
  and staff NOW
• Establish sick leave policies relating to a
  pandemic
• Plan for ways to transport ill students

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Communications Planning

• Develop and test platforms for communications
  (telephone trees, hotlines, dedicated websites,
  etc.)
• Update communication plans
• Identify spokespersons and ensure language,
  cultural and reading level appropriateness of
  messages
• Disseminate factually correct information

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What Local Government and Businesses Can Do

• Identify pandemic coordinator or team
• Identify essential employees and services
• Train the workforce
• Develop and plan for scenarios that may result in
  an increase or decrease in product demand
• Plan for potential financial impact
• Plan on travel impact
• Establish an emergency communications plan

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What Individuals and Families Can Do

• Have a supply of food and water
• Have a supply of your regularly prescribed
  medications
• Have supply of non-prescription medications
• Have a family plan to care for loved ones if they
  are sick
• Volunteer to help with emergency response

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Questions?
[phone] x 6326 kelly_granger_at_doh.state.fl.u
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