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Pandemic Influenza: What YOU Need To Know

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Title: Pandemic Influenza: What YOU Need To Know


1
Pandemic Influenza What YOU Need To Know
  • Katherine M. Williams, RN
  • Masters of Nursing and Healthcare Practices
  • Affiliated with
  • The American Red Cross
  • Service Employees International Union, Local 199

2
What is Pandemic Influenza?
  • Pandemic influenza in humans occurs naturally
    several times a century, on average.
  • Pandemic flu is usually more severe than
    seasonal flu (the kind you get your annual flu
    shot for), with a higher death rate.

3
What is Pandemic Influenza?
  • Pandemic flu affects the entire world, not just a
    country or a continent.

4
Where Does it Come From?
  • Pandemic influenza is a virus to which humans
    have no natural immunity.
  • It originates in wild birds and then jumps to
    other species, including pigs and humans.
  • Swine flu has bird, pig and
  • human genes, a very
  • unusual occurrence.

5
Recent Pandemics
  • 1918-19 - H1N1, "Spanish flu
  • Severe Humans had no immunity to any of
  • the 8 gene sequences
  • 1957-58 Asian flu
  • Mild We had immunity to 5 of 8
  • gene sequences
  • 1968-69 "Hong Kong flu
  • Milder We had immunity to 6 of 8
  • gene sequences
  • 1997- ? H5N1, Bird Flu
  • Severe Humans have no immunity
  • 2009 - ? A/H1N1, Swine Flu
  • Moderate We have no immunity to any of
  • the 8 gene sequences, but have modern
  • medicine to help us this time.

6
Why Should We Be Concerned?
  • The 1918 Spanish flu had a mortality rate of
    approximately 3 and caused widespread social
    disruption.
  • H1N1 currently has a mortality rate of around
    0.5, or 5 times the death rate of seasonal
    influenza, with prompt, first-rate medical care.
  • It has spread rapidly around the globe.
  • It is a new, unstable, unpredictable virus that
    has the capability to mutate soon and often.

7
Where is it Now?

Blue A/H1N1 Red H5N1
Purple Both A/H1N1 H5N1
8
Current Situation Reported deaths
  • 3,969 deaths as of Sept 17, 2009
  • Brazil 899
  • United States 694
  • Argentina 514
  • India 220
  • Mexico 217
  • Australia 172
  • Thailand 153
  • Chile 132
  • Peru 121
  • Great Britain 79
  • Canada 76
  • Malaysia 76

Cases have been confirmed on all continents and
in nearly every country.
9
Deaths in the U.S.
  • First reported death April, 2009
  • Current total 693
  • Last week alone 102

10
Severity
  • This is now considered a moderate pandemic by
    the CDC (Category 2).
  • Expect at least 100,000,000 Americans to become
    ill at some point in the next 6-18 months.
  • Category 2 between 90,000 and 450,000 deaths,
    mostly children and young adults.

11
A/H1N1 Fatalities
  • Average age of death 38 years old.
  • Affecting children and young adults, very
    different from seasonal flu.
  • About 1/3 have NO pre-existing medical
    conditions.
  • Most on ventilators for at least 7 days.

12
Whos Most at Risk?
  • Ages 5-50
  • Pre-existing conditions
  • Asthma
  • Diabetes
  • Pregnancy
  • Heart disease
  • Obesity

13
But Im not hearing much on the news!
  • Complacency and Apathy our two worst enemies.
  • Media censorship dont want to cause panic.
  • Theres more important
  • news out there!

14
What about that 36,000 number?
  • Only around 1,300 people die each year directly
    from seasonal influenza, according to the
    American Lung Assoc.
  • The 36,000 number is an estimated number from a
    2003 study, based on pneumonia death rates.
  • Most at risk of death from seasonal flu gt65 or
    lt2 years old

15
Under-reporting Issues
  • No longer testing all suspected cases
  • Only the severely ill and/or hospitalized
  • Shortage of testing kits
  • Highly unreliable results
  • Need specialized test for definitive diagnosis
    (PCR)

16
What about a vaccine?
  • Wont be available until at least mid-October
  • Just finishing first clinical trials
  • First to receive vaccines
  • Healthcare workers
  • Pregnant women
  • Emergency services
  • High risk people

17
Potential Problems with a vaccine
  • Major questions
  • Safety?
  • Number of shots needed?
  • How well will it work?
  • How many available?
  • How to distribute?
  • 80 of U.S. vaccines are made overseas.

18
What does this flu look like?
  • Fever (but up to 25 have no fever!)
  • Respiratory symptoms cough, congestion,
    respiratory distress
  • Nausea and vomiting
  • Body aches and pains
  • Severe headache mental status changes
  • Conjunctivitis

19
What if you catch it?
  • Most cases are mild, requiring no medical
    intervention.
  • Some cases are NOT mild!
  • If you have increased risk factors
  • DEMAND Tamiflu from your doctor.
  • Pay careful attention to disease progression if
    you experience respiratory distress, high fever,
    gray skin, or extreme lethargy
  • GO TO THE EMERGENCY ROOM ASAP!

20
So What Can YOU Do?
  • Be aware of the people around you is anyone
    coughing or looking sick?
  • If you have increased risk factors,
  • consider avoiding crowded areas
  • like malls, airplanes, churches,
  • and movie theaters.
  • BE AWARE People can spread the flu for the
    first 24-48 hours they are infected and not show
    any symptoms.

21
So What Can YOU Do?
  • If you feel sick, STAY HOME until you have been
    symptom-free for at least 48 hours.
  • Relapse is common watch for this.
  • PREPARE for the
  • second wave
  • starting now.

22
Prepare? For What?
  • Increased virulence in Second Wave?
  • Vaccine production and distribution issues
  • Tamiflu resistance?
  • Possible shortages of food and fuel
  • Combination with H5N1?

23
H1N1 H5N1 The Worst Case Scenario
  • H5N1 (bird flu) has a 60 mortality rate.
  • If the two combine, we may have a virus that is
    easily transmissible and highly lethal.
  • The World Health Organization is VERY worried
    about this recombination.
  • Widespread civilization collapse is possible.

24
Mike Leavitt Former Secretary, U.S. Dept of
Health and Human Services
  • Local preparedness is the foundation of pandemic
    readiness. Any community that fails to prepare
    with the expectation that the federal government
    will, at the last moment, be able to come to the
    rescue will be tragically wrong.
  • - Interview, March 21, 2006

25
Former Secretary Leavitt, again
  • "Anything we say in advance of a pandemic seems
    alarmist. Anything you've done to prepare after
    it begins is inadequate."
  • - March 2006, California
  • Pandemic Planning Summit

26
Who Should Prepare?
  • The U.S. Department of Health and Human Services
    recommends the following entities should begin
    preparations
  • Individuals
  • Businesses
  • Faith-Based Organizations
  • Schools
  • Healthcare Agencies
  • Non-profit agencies
  • State and local Governments

27
Thoughts on Preparedness
  • We CANNOT depend on governmental help.
  • Most states and local governments are woefully
    behind on their pandemic preparedness plans.
  • Does your city have a plan?
  • How do these top-down plans affect you?

28
Individual Preparations
  • You are on your own.
  • What does this mean
  • to the average family?
  • It means we must PREPARE.

29
Why Prepare?
  • 40-50 of the workforce will be absent
  • Some will be sick.
  • Some will need to take care of families.
  • Some will be afraid to come to work.
  • Most businesses do not have a pandemic plan.

30
Why Prepare?
  • Medical services will be overwhelmed
  • Our health care system has no real surge
    capacity to deal with a huge increase in
    patients.
  • Most hospitals do not have adequate supplies of
    personal protective equipment on hand to protect
    healthcare workers.

31
Why Prepare?
  • Basic services may be interrupted
  • Utility workers will be affected, too, resulting
    in electricity, water and natural gas outages.
  • Most communities have only a weeks worth of
    chlorine on hand to treat water supplies.
  • Police and other
  • emergency services
  • may be overwhelmed.

32
Why Prepare?
  • International commerce will be drastically
    reduced
  • About 80 of the raw materials for our
    medications come from overseas.

33
Why Prepare?
  • Just in time thinking will backfire
  • Most businesses and services have very little on
    hand for day-to-day operations.
  • Think of what local grocery
  • stores look like the day
  • before a blizzard is predicted.

34
Why Prepare?
  • Schools may be closed
  • Schools are prime locations for disease
    transmission.
  • Other places people congregate may also close,
    such as malls, churches, etc.

35
Why Prepare?
  • Interstate commerce may break down
  • The people who deliver our
  • food, supplies and fuel will be
  • vulnerable, too.
  • Interstate travel may be restricted.

36
  • So Why Arent People Preparing?

37
Im not preparing because
  • I HAVENT HEARD OF IT
  • There are some folks out of touch with
  • world events and the news -
    they dont want to know whats really
    going on around them.

38
Im not preparing because
  • I BELIEVE THE WHOLE THING IS JUST HYPE
  • News organizations produce scary stories to get
    ratings.
  • Politicians and leaders want to cover their
    butts no matter how small the threat.
  • Big Pharmaceutical companies are encouraging
    fear to get business for their drugs.

39
Im not preparing because
  • I DONT HAVE THE FUNDS TO PREPARE
  • Its hard enough just paying the regular bills
    and you want me to spend money on something that
    probably wont affect me?

40
Im not preparing because
  • MAGICAL THINKING
  • The threat is real but if I dont prepare it
    wont happen. Preparation will just cause it to
    happen.

41
Im not preparing because
  • ILL WAIT AND SEE WHAT HAPPENS
  • Yeah, I know bad things could happen, but there
    will be plenty of time to take
  • steps if it gets worse.

42
Im not preparing because
  • ITS NOT HAPPENING IN MY TOWN
  • Why should I be concerned
  • because a bunch of people
    somewhere else are getting
    sick?

43
Im not preparing because
  • I HAVE NO FEAR
  • So what if it happens,
  • Ill just take my chances
  • Nothing can hurt me!

44
Im not preparing because
  • THERES NO HOPE
  • Preparation is an illusion.
  • The pandemic will last so long
  • and be so bad that I cant avoid it.
  • Everyone will die, so I might as
  • well give up hope now.

45
So you feel the need to start preparing
  • What exactly do I need to do?
  • And for how long?

46
Take the First Steps
  • Start THINKING about how you will react to a
    disaster ANY disaster.
  • Stay INFORMED.
  • TELL OTHERS what you
  • know and learn.
  • AND THE BIG ONE
  • Be ready to make it on your own if things take
    a turn for the worse.

47
How Do We Prepare?
  • Begin to stockpile
  • Food and water supplies
  • Medications
  • Alternative heating and cooking methods
  • Emergency radio / communications
  • Alternative sanitation / hygiene

48
A Kernel of Truth?
49
Things to Consider
  • Food
  • For how long?
  • How much per person?
  • What to buy?
  • How to store it?

50
Things to Consider
  • Water
  • How much?
  • How to store it?
  • Alternative sources?

51
Things to Consider
  • Heating, lighting and cooking
  • Wood
  • Propane
  • Solar
  • Candles and lamps

52
Things to Consider
  • Sanitation
  • Sewage waste
  • Toilet paper!
  • Feminine products
  • Garbage disposal

53
Things to Consider
  • Medications and First Aid
  • Talk to your doctor about prescriptions
  • Buy a good first aid kit
  • Basic OTC medications
  • Take a First Aid course from your local American
    Red Cross chapter
  • Get the flu shot!

54
Also Consider
  • Home schooling for children
  • Security
  • Money
  • Providing for Pets
  • Entertainment

55
For How Long?
  • U.S. Dept of Health and Human Services recommends
    that families have AT LEAST TWO WEEKS of supplies
    ready.
  • The U.S. State Dept. has recommended that all
    U.S. residents overseas stockpile up to THREE
    MONTHS of supplies.

56
THREE MONTHS?!?!?!
  • The best models we have indicate that pandemics
    will travel in waves.
  • Each wave may be in your community for several
    weeks to a month.
  • The waves may contain slightly different versions
    of the virus, so you might get it more than once.

57
Plan Ahead
  • What happens if you get sick or get stuck at
    work?
  • Who will take care of your children?
  • Who will take on the role of nurse? or
    caregiver?
  • Do you have family or neighbors who need extra
    help?

58
Some good advice
  • In your pandemic flu prep plans, dont forget
    mental health. Youll need a hefty supply of
    strength, resolve and useful ways to manage
    stress and maintain resilience as much as you
    will need water and food.

  • - excellent advice from the Fluwiki

59
Why I am Preparing
  • Prepare for the worst,
  • hope for the best.

60
For More Information
  • U.S. Department of Health Human Services
  • www.pandemicflu.gov
  • Centers for Disease Control Prevention (CDC)
  • www.cdc.gov/flu/pandemic/
  • World Health Organization
  • www.who.int/csr/disease/influenza/pandemic

61
For More Information
  • The Flu Wiki the original site for preparation
    and up-to-the-minute news forum.
  • www.fluwiki.info
  • Pandemic Flu Information Forum excellent source
    for current news and preparation.
  • www.singtomeohmuse.com
  • Get Pandemic Ready all the basics on preparation
    for families and individuals, easy to use.
  • http//66.236.6.202/

62
  • Any Questions?
  • Thank you for coming!
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