U.S. Pandemic Influenza Preparedness and Response: Planning and Activities

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U.S. Pandemic Influenza Preparedness and
Response Planning and Activities
The pandemic influenza clock is ticking. We
just dont know what time it is. This is the
one health threat were preparing for that we
know will happen

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H5N1 Avian Influenza

• Infection in domestic poultry in 9 Asian
  countries
• 14 documented human cases and 11 deaths
• No documented person-to-person transmission
• Some ongoing circulation of H3N2 influenza
• Control measures and ongoing activities
• Culling infected flocks
• Case investigations
• Enhanced surveillance
• Vaccine development

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Goals of Pandemic Influenza Response

• Decrease the burden of disease
• Minimize social disruption
• Reduce economic impacts

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Pandemic Influenza Preparedness
Vaccine issues
Research
Antiviral supply use
Preparedness response plan
Infect. control
State planning
Intl. coord.
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Pandemic Response Components
Pandemic influenza disease
Impact
Vaccination
Time
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Recent Developments Affecting Pandemic Influenza
Planning

• Increased focus on influenza other threats
• Avian influenza outbreaks (1997, 1999, 2003,
  2004)
• Global spread of SARS
• Improved infrastructures and technologies
• Improved vaccine development technologies
• New antiviral medications
• New communications systems
• Experience from 2003-04 influenza season
• Other emergency preparedness activities

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The U.S. Pandemic Influenza Preparedness and
Response Plan

• Core Plan
• Describes National coordination and
  decision-making
• Provides an overview of key preparedness issues
• Outlines response actions at national, state,
  local levels
• Guides (2)
• Guidance for State/local Health Departments
  planning
• Guidance for health care system planning
• Annexes (10)
• More detailed and technical information on key
  preparedness and response issues

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Vaccine and Vaccination Preparedness Goals

• Assure surge production capacity
• Shorten timelines to availability
• Ensure effective distribution administration to
  achieve pandemic response goals

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Improving Vaccine Preparedness

• Assure year-round egg supply
• Increase U.S. manufacturing capacity
• Develop and test vaccine pilot lots for strains
  with pandemic potential
• Conduct research to improve ability to rapidly
  develop reference strains that grow well in
  production systems

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Antiviral Drug Issues

• Chemoprophylaxis and therapy can have major
  health impacts
• Drug availability manufacturing capacity
  limited
• Small oseltamivir stockpile in SNS
• Key preparedness issues
• Develop antiviral use strategies and estimate
  impacts
• Assess availability and consider stockpile
  options
• Work with health departments to develop
  strategies for effective distribution and use

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Interventions to Decrease Disease Spread in an
Influenza Pandemic

• Health care system interventions
• Infection control and isolation of patients in
  hospitals
• Vaccination/antiviral prophylaxis of HCWs and in
  LCTF
• Community interventions
• Travel advisories and precautions
• Screening travelers from areas with disease
• Quarantine of exposed persons
• based on the epidemiology transmission of
  infection

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State Local Preparedness

• State and local health departments
• Pandemic/BT/other preparedness planning
• HRSA grants to coordinate medical care and
  enhance capacity
• CDC support for surveillance and public health
  laboratories
• Tabletop and field exercises
• Health care system
• Need for planning and education

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International Coordination GHSI and APEC

• Global Health Security Initiative
• G7 countries Mexico
• Foci - vaccine development supply antiviral
  strategies
• Asia-Pacific Economic Cooperation
• 19 Pacific rim economies
• Foci enhance national planning surveillance
  potential interventions in absence of
  vaccine/antivirals

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Influenza Pandemic Preparedness Next Steps

• Finalize national plan
• Promote and support planning at State/local
  levels with testing of plans in tabletop and
  field exercises
• Address key issues to enhance preparedness
  improving response capacity
• Monitor progress and revise plan