Title: Pandemic Influenza Renee Frauendienst, RN, PHN, BSN Division Director Public Health Division Stearns County Human Services
1Pandemic InfluenzaRenee Frauendienst, RN, PHN,
BSNDivision DirectorPublic Health
DivisionStearns County Human Services
2Preparing for Pandemic Influenza Business will
not be as Usual
3Recent Pandemics
- 1918/1919 Spanish Influenza
- 40/50 million deaths worldwide
- 1957 Asian Flu
- 2 million deaths worldwide
- 1968 Hong Kong Flu
- 1 million deaths worldwide
41918 Spanish Flu
- Devastating
- Hospitals filled up and soon became overwhelmed
as doctors and nurses got sick. Children lost
their parents, and people hid in their homes to
avoid a new and mysterious virus. So many people
died that there was no time to make coffins many
victims had to be buried in mass graves. - Shops, offices and factories shut down without
enough staff to keep them going, and schools,
hotels and theatres were closed by order of the
government.
5Pandemic Flu Planning
- strong evidence that the 1918 flu virus was
derived wholly from an ancestor that originally
infected birds Andreas von Bubnoff (Nature) -
- Two subsequent influenza pandemics one in 1957
and one in 1968 have also been linked to avian
flu viruses.
6Avian Influenza (Bird Flu)
- Viral infection of birds
- Believed to be spread by co-mingling of wild and
domestic birds - Controlled by culling infected and exposed birds
(Over 200 million birds destroyed to date)
7Bird to Human Transmission
- Predominantly via contact with feces from
infected birds - Handling infected poultry
- Disposing of dead infected poultry
- No sustained human to human transmission to date
8Avian Influenza - H5N1Why do we care?
- 238 documented cases, 139 deaths as of August
14, 2006 (58) - Mutating little by little
- Has potential to mutate into a human strain
9Conditions of a Pandemic
- Widely spread without early detection
- Novel virus highly infectious to humans, with no
immunity - Virus strain is easily transmissible human to
human - Virus causes serious illness
- There is no adequate supply of vaccine
immediately available - Supply of antiviral medication is limited
10Could the H5N1 virus cause the next pandemic?
- Possibly
- So far the virus cannot pass easily from human
to human. - But
- Eventually, there will be another pandemic, we
just cant be sure it will be caused by this H5N1
virus
11World Health Organization Influenza Pandemic
Phases
Interpandemic Period Interpandemic Period
Novel subtypes in animals but not humans Phase 1
Circulating subtypes in animals posing threat to humans Phase 2
Pandemic Alert Period Pandemic Alert Period
Novel subtypes in humans, but no human-to-human transmission Phase 3
Limited human-to-human transmission Phase 4
Localized clusters of human cases Phase 5
Pandemic Period Pandemic Period
Increased and sustained transmission in the general population on a large scale Phase 6
12Projected Pandemic Impact Based on 2004 U.S.
Population Estimate of 294 Million(0.05 of
World Population)
13Projected Pandemic Impact Based on 2004 Minnesota
Population Estimate of 5.1 Million (1.75 of
U.S. Population)
14Assumptions
- Not a matter of if but when
- All countries will be impacted
- Medical supplies and care may be inadequate
- Impacts will last for weeks to months
15Assumptions
- Two to three waves of illness
- Pandemics can disproportionately affect
younger people creating workforce issue - Potential for high levels of
- Sickness and death
- Disruption of critical services
- Economic loss
16Goals of Pandemic Planning and Response
- Maintain community infrastructure
- Minimize social disruption
- Reduce morbidity/mortality
- Provide effective public education (before,
during and after)
17Public Health Messages
- Off site care facilities
- Home care activities
- Social distancing
- Snow Days
- Active Surveillance
- Isolation and Quarantine
- Vaccines and antivirals
18Planning Priorities
- Family/Individual Planning
- Business Continuity Planning
- Community Planning
19Family Emergency Preparedness Awareness
- Food and water
- Change of clothes for each person
- Sleeping bags or blankets
- First aid kit
- Battery powered radio and flashlight with extra
batteries - Social distancing or snow day preparations
20Key Elements of Preparedness From a Business
Perspective
- Business Continuity Planning
- Prioritize critical functions
- Identify functions that could be suspended for up
to two months - Identify positions needed to carry out critical
functions - Build depth through cross training
- Plan for alternative work schedules
- Explore telecommuting capabilities large scale
21Regional and Local Planning Considerations
- Integrate non-health entities in planning and
response - Establish community stockpiles (e.g. of vaccine
and antivirals) distribution systems - Identify spokespersons
- Provide effective public education
- Surveillance systems
22Priority Activities for 2006
- Review the federal and state plans
- Plans from other states
- Update local plans
- Assure response is community based, and flexible
23Planning Priorities
- Community meetings
- Education and training staff
- Creating messages ahead of time regarding
response - Stockpiles of anti-virals and vaccines
- How to get them distributed-local vs. regional
- Who will get them- essential personnel
- Where to distribute
24Planning Priorities
- Coordinated information to public and other
partners - HAN-health alert network
- Special and vulnerable populations
- Vaccinations/prophylaxis
- Messaging
- Community resources
- Community surveillance-early, during, expanded
sites - Mass fatalities
25Planning Priorities
- Working with healthcare regarding
- Continuity of services
- Supply contingency plans
- Surge capacity
- Isolation/Quarantine of compliant/non-compliant
- Protection for workers
- Mortuary Services
26Are We Ready?
- More today than yesterday
- More tomorrow than today