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Oshkosh Pandemic Avian Flu Plan
Group 6 H5N1 Resistance
Daniel Gehrke Robert Haas Kimberly Hoppe Maggie
Ridder Mallory Weiland
University of Wisconsin - Oshkosh Department of
Biology and Microbiology 800 Algoma
Boulevard Oshkosh, WI 54901 USA

• Quarantine Measures
• A quarantine of Oshkosh and surrounding
  cities in the event of a pandemic is extremely
  necessary. This quarantine will be placed on
  each individual that has symptoms. Once they
  have visited a health care provider, they must
  stay at home until they are no longer contagious.
  If their symptoms place them in a hospital, they
  will be quarantined to their room with no
  visitors. City wide quarantine will be placed on
  travel once the number of cases reaches in
  Oshkosh and surrounding areas reaches 100. This
  will help contain the epidemic. This quarantine
  will be enforced by police, sheriffs and the
  military setting up road blocks at the freeway
  exits and watching other main routes in and out
  of the city. Certain individuals will have an
  exemption to the quarantine including police,
  health care personnel, critical supply truck
  drivers and others of equal importance. Finally,
  there will be a public gathering restriction in
  effect during the duration of the pandemic.
  Examples of banned gatherings are concerts,
  movies, fairs, festivals, etc.

• Individual Preparedness
• Having your own emergency flu care kit will be
  essential in the event of a Avian flu pandemic.
  The kit should include the following items
• Bottled water 1 gallon per person per day for
  5-6 weeks
• 4 bottles of Tylenol/or other fever and pain
  reducer
• 4 boxes of crackers
• 4 boxes of anti-diarrheals
• tamiflu, or other antiviral medications
• instant hot/cold packs (4)
• 4 boxes (packages) of cough suppressants
• fluids with electrolytes 2 bottles per person
• 12 boxes of anti-viral tissues
• thermometer (2)
• 4 boxes of decongestant (pseudoephedrine)
• Food, water and other miscellaneous items are
  also vital. Make sure you have at a minimum the
  following
• Enough non-perishable food to last 5-6 weeks
• One gallon of water per person per day (Ideally
  for 5-6 weeks)
• Bulk water for washing, cleaning, bathing, etc

Introduction Those who cannot learn from history
are doomed to repeat it. -George Santayana
(12) In 1918, the world witnessed a pandemic of
deadly proportions. The 1918 Flu, also known as
the Spanish Flu, infected a fifth of the
worlds population and killed 675,000 Americans
(13). A similar strain of this deadly flu has
begun appearing in almost every country around
the world. Avian Flu, scientifically known as
the A(H5N1) virus, is causing great concern
throughout the scientific community as having the
potential to be more deadly than the 1918 Flu
(2). Avian Flu is currently only contagious in
birds, but humans have contracted the illness.
The fear is that the virus will mutate and then
it will be able to pass freely from human to
human. This would create a pandemic. So far, no
vaccine has been made that is over 60 effective
at treating the illness. Today humans can
contract the disease by being in direct contact
with infected birds. The disease can only be
passed from bird to bird or bird to mammal
(humans) (3). Symptoms of Avian Flu are similar
to the common influenza strains but they can
increase in severity drastically. The reported
symptoms of avian influenza in humans have ranged
from typical influenza-like symptoms (e.g.,
fever, cough, sore throat, and muscle aches) to
eye infections (conjunctivitis), pneumonia, acute
respiratory distress, viral pneumonia, and other
severe and life-threatening complications. (14).
To help prevent a pandemic of Avian Flu, many
precautions can be taken today. The different
steps that the state, county, local community,
and everyone individually can take will be
discussed thoroughly. These steps include what
people can do to prepare in the event of an
outbreak, actions that can be taken once the
pandemic has begun, and other organizational
issues that should be addressed. A disastrous
pandemic occurred in 1918. We have the knowledge
today to help prevent widespread death and panic
if another pandemic occurs. Right now, we are on
the edge of a possible outbreak and the following
precautions should be implemented to help
decrease the severity of the possible pandemic.

Vaccines A vaccine priority list for the city of
Oshkosh should be created by the Board of Health,
Mayor and City Manager. They should assess the
necessary people needed to keep the city running
and the citizens healthy. The priority list
should descend from highest priority to lowest in
this order 1. Healthcare workers 2.
Funeral/Cremation workers 3. Police/Firefighters/E
mergency workers 4. Sanitation/Water Treatment
workers 5. Military 6. Truck/Transport drivers 7.
Teachers/Daycare workers (only if schools remain
open) 8. General public
Role of Winnebago County Health Department Board
of Health and the Oshkosh Board of Health The
board will be in charge of coordinating the
public response to the pandemic, including the
closing of schools and public events,
coordinating where and how hospitals are set up,
address morgue overcrowding problems, and
informing law enforcement and fire personnel how
to carry out the necessary procedures to maintain
order (closing bars, preventing looting, keeping
the peace, etc.). The following is a list of
the Members of the Board of Health in the Oshkosh
area (5, 10, 11) Current Board of Health
Members Dr. Barbara Strand Chair, Affinity
Medical GroupJamie Bonell, CFNP, APNP, Aurora
Medical GroupBurk Tower - Council
RepresentativeChristine Kniep,
UW-ExtensionSusan Panek, United WayStan Kline-
AlternateMardell Sowers Alternate City of
Oshkosh Board of Health Members Jamie Bonell Sta
n Kline Chris Knup Sue Panek Mardell Sowers Dr.
Barbara Strand Burk Tower
Picture courtesy of Whyfiles.org
Hospitals Hospital beds will be in very high
demand at the height of the flu pandemic. It is
likely that there will be a shortage of hospital
beds and in this case, alternate temporary sick
wards will have to be established. The following
table represents what will be available in the
city of Oshkosh
Table of Hospitals in Oshkosh and their Supplies Table of Hospitals in Oshkosh and their Supplies Table of Hospitals in Oshkosh and their Supplies Table of Hospitals in Oshkosh and their Supplies
  Mercy Medical Center Aurora Medical Center Total Available Supplies for the City of Oshkosh
General Hospital Beds 157 48 205
Intensive Care Beds 15 12 27
Standard Ventilators 6 7 13
Portable Ventilators 1 0 1
Possible Isolation Beds 11 10 21
Picture courtesy of Interbrand

• Emergency Workforce Team
• If a flu pandemic occurs, a dedicated workforce
  team will be necessary to the proper handling of
  the situation. This list represents some of the
  many roles that will be needed in the case of a
  pandemic
• Health Director - Paul Spiegel help coordinate
  medical teams, police/firemen, and coroners,
  implement organized system in hospitals and
  clinics to rapidly dispense vaccines, drugs, and
  treatment (11)
• -Water treatment workers to maintain water
  safety and usability of Lake Winnebago, to ensure
  that it does not get contaminated, to ensure that
  enough chemicals are being used to prevent
  contamination.
• Doctors/Nurses/Emergency Staff (ambulance
  drivers, etc.) to care for the sick and try to
  find more effective preventive measures. This
  includes Mercy Medical Center, Aurora Medical
  Center, and Affinity Clinics along with their
  staff coming together to ensure great health care
  in a time of emergency.
• Electricians/WPS to keep vital electric
  operations and communications running and in the
  event of an outage, do as much as possible to get
  the system back up and running.
• Oshkosh Board of Education (President J. Thomas
  McDermott) monitor health conditions of
  schools, carry out closings, inform students of
  risks
• Radio, telephone, and TV employees To keep the
  public informed on the current status of the
  pandemic, what courses of action to take, what
  businesses are closed and other vital
  information.
• Police, firemen, truck drivers, pharmacy workers,
  garbage men, grocery employees, coroners, vets,
  funeral directors and religious leaders

(4, 6, 7, 8)

• Anti-viral Drug Distribution and Long Term Care
• antiviral drugs will be kept until the outbreak
  is massive and extremely contagious. They should
  be saved as long as possible and then used to
  treat as many people as possible. Hopefully this
  will then catch the flu at its peak and will
  prevent the virus from mutating into a more
  lethal strain. Priority for the anti-virals will
  be given to
• healthcare workers
• law enforcement
• firefighters
• emergency (ER) workers
• water treatment workers
• sanitation employees
• utility workers
• city manager
• mayor
• Board of Health
• military personnel
• school teachers (as long as schools are still in
  session)
• Anti-viral drugs will only be used to treat
  severe cases. Not everyone will be able to
  obtain these drugs unless they are in critical
  health status or have created their own supply of
  medication.
• Long-term living arrangements such as nursing
  homes will also be handled cautiously. If an
  outbreak occurs there should be strict
  regulations as to who will be allowed to enter
  the facility. There should be no outside
  visitors allowed to enter the facility, but only
  the healthcare workers needed to treat and care
  for the patients. This will help lower the
  chances of an outbreak within the facility.
  Health care workers and the maintenance personnel
  of these buildings should also have priority in
  receiving the antiviral medications.

Picture courtesy of News24.com
ACKNOWLEDGMENTS We would like to thank everyone
who assisted us in the creation of this Pandemic
Flu plan including Dr. Shors, Winnebago County
Health Director/Officer Doug Gieryn, and Justin
Bohn.
REFERENCES 1) World Health Organization Avian
Flu Preparedness Plan http//www.who.int/csr/di
sease/influenza/pandemic/en/ 2) CDC Center for
Disease Control and Prevention Pandemic Flu
http//www.cdc.gov/flu/pandemic/ 3)
PandemicFlu.gov official government website
http//www.pandemicflu.gov/ 4) City of Oshkosh
Web Site http//www.ci.oshkosh.wi.us/Health/Heal
th.htm 5) City of Oshkosh School District Web
site http//www.oshkosh.k12.wi.us/aboutus/boe_me
mbers.cfm 6) Affinity Health Systems
http//www.affinityhealth.org/page/home 7)
Michael Pfaffenroth of Affinity Medical Center
email address mpfaffen_at_affinityhealth.org 8)
Frances R. Finley, DHA, FACHE of Aurora Medical
Center email address fran.finley_at_aurora.org
phone number [phone] 9) The U.S.
Governments Official web portal
http//www.firstgov.gov/ 10) Oshkosh web page
http//www.ci.oshkosh.wi.us/Department_Contacts.ht
m 11) Oshkosh Board Of Health home page
http//www.ci.oshkosh.wi.us/Health/Health.htm 12)
Johnson Lewis, Jone . "From Wisdom Quotes
Quotations to inspire and challenge." History
Quotes. 16 Apr. 2006 lthttp//www.wisdomquotes.co
m/cat_history.htmlgt. 13) Billings, Molly. "The
Influenze Pandemic of 1918." 2005. Stanford
University. 16 Apr. 2006 lthttp//virus.stanf
ord.edu/uda/gt. 14) "Avian Influenza Infection in
Humans." Avian Inffluenza (Flu). 31 1006. Centers
for Disease Control and Prevention. 16 Apr.
2006 lthttp//www.cdc.gov/flu/avian/gen-info/avian-
flu- humans.htmgt.
Picture courtesy of Tim Smith at
http//www.omedon.co.uk