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Pandemic Influenza Preparedness and Response November 2005 Update

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Surveillance and Detection. Ensuring rapid reporting of outbreaks ... Antiviral Drug Distribution and Use. Community Disease Control and Prevention ... – PowerPoint PPT presentation

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Title: Pandemic Influenza Preparedness and Response November 2005 Update


1
Pandemic Influenza Preparedness and
ResponseNovember 2005 Update
  • Raymond A. Strikas, MD
  • Associate Director for Adult Immunization
  • Immunization Services Division, National
    Immunization Program
  • Coordinating Center for Infectious Diseases
  • Centers for Disease Control and Prevention

2
Defining a Pandemic WHO Phases
  • Phase 1. No new influenza virus subtypes detected
    in humans. If animals are infected, risk to
    humans is low.
  • Phase 2. No new influenza virus subtypes detected
    in humans. However, a circulating animal
    influenza virus subtype poses a substantial risk
    of human disease.
  • Phase 3. Isolated human infections, no
    human-to-human spread except rare close
    contacts.
  • Phase 4. Small, highly localized cluster(s),
    limited human-to- human transmission.
  • Phase 5. Larger localized cluster(s) limited
    human-to-human spread. Substantial pandemic
    risk.
  • Phase 6. Pandemic phase Sustained transmission
    among humans occurs.

3
Current Situation
  • National plan revised, available 11/2/05
  • H5N1 vaccine
  • Clinical trials, 90 mcg x2
  • Adjuvants or Intradermal?
  • Antiviral drugs
  • Drug resistance, stockpile supplies
  • Isolation and quarantine
  • Executive order April 2005
  • FY2006 Emergency Supplemental Budget
  • 7.1 B?

4
National Strategy for Pandemic Influenza - 1
  • Announced 11/1/05
  • Available at www.pandemicflu.gov
  • Goals
  • Stopping, slowing, otherwise limiting spread of a
    pandemic to the United States
  • Limiting domestic spread, and mitigating disease,
    suffering, and death
  • Sustaining infrastructure and mitigating impact
    to economy and functioning of society

5
National Strategy for Pandemic Influenza - 2
  • Three Pillars of the National Strategy
  • Preparedness and Communications
  • Surveillance and Detection
  • Response and Containment

6
National Strategy for Pandemic Influenza - 3
  • Preparedness and Communications
  • Planning for a pandemic
  • Communicating expectations
  • Producing and stockpiling vaccines, antivirals,
    and medical material
  • Establishing distribution plans for vaccines and
    antivirals
  • Advancing scientific knowledge and accelerating
    development

7
National Strategy for Pandemic Influenza - 4
  • Surveillance and Detection
  • Ensuring rapid reporting of outbreaks
  • Using surveillance to limit spread

8
National Strategy for Pandemic Influenza - 5
  • Response and Containment
  • Containing outbreaks
  • Leveraging national medical and public health
    surge capacity
  • Sustaining infrastructure, essential services and
    the economy
  • Ensuring effective risk communications

9
Roles and Responsibilities - 1
  • Federal
  • Advancing international preparedness
  • Supporting establishment of countermeasure
    stockpiles and production capacity
  • Ensuring federal depts., agencies have developed,
    exercised plans
  • Facilitating state and local planning
  • Providing guidance to the private sector and the
    public, in conjunction with states and communities

10
Roles and Responsibilities - 2
  • States and localities
  • Ensuring all reasonable measures taken to limit
    spread of outbreak
  • Establishing comprehensive, credible preparedness
    and response plans, and exercising them
  • Integrating non-health entities into planning
  • Establishing state and community-based stockpiles
    and distribution systems
  • Identifying key spokespersons
  • Providing public education campaigns

11
Roles and Responsibilities - 3
  • Private Sector
  • Establishing an ethic of infection control in the
    workplace
  • Establishing contingency systems to maintain
    delivery of essential goods and services
  • Establishing mechanisms to allow workers to
    provide services from home (where possible)
  • Establishing partnership with other sector
    members to maintain essential services

12
Roles and Responsibilities - 4
  • Individuals and families
  • Taking precautions to prevent spread of infection
    if an individual or family member has symptoms of
    influenza
  • Being prepared to follow public health guidance
    may include limits on public gatherings and
    travel
  • Keeping supplies at home to support essential
    needs for several days if necessary

13
National Pandemic Influenza Plan
  • Issued 11/2/05, revised from draft of 8/04
  • Two parts
  • Strategic Plan
  • Public Health Guidance to State and Local Partners

14
National Pandemic Influenza Plan Doctrine - 1
  • Preparedness will require coordination in all
    sectors
  • An informed and responsive public is essential to
    minimizing pandemic health effects
  • Domestic vaccine production capacity sufficient
    to produce vaccine for the entire US population
    is critical
  • Quantities of antiviral drugs sufficient to treat
    25 of the population should be stockpiled

15
National Pandemic Influenza Plan Doctrine - 2
  • Sustained human-to-human transmission anywhere in
    the world will trigger US pandemic response
  • Protective public health measures will be
    employed to reduce transmission, prevent or delay
    outbreaks (when possible)
  • At onset of a pandemic, HHS will procure vaccine
    and distribute to state and local health
    departments for pre-determined priority groups
  • At onset of a pandemic, antiviral drugs from
    public stockpiles will be distributed to health
    care providers for administration to
    pre-determined priority groups

16
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17
National Pandemic Influenza Plan,Part 2 Public
Health Guidance to State and Local Partners
  • Introduction
  • Surveillance
  • Laboratory Diagnostics
  • Healthcare Planning
  • Infection Control
  • Clinical Guidelines
  • Vaccine Distribution and Use
  • Antiviral Drug Distribution and Use
  • Community Disease Control and Prevention
  • Managing Travel-related Risks of Disease
  • Public Health Communications
  • Workforce Support Psychosocial Considerations
    and Information Needs

18
State Local Pandemic PlanningAccomplishments
  • All states submitted a plan by July 05
  • Plans under formal review by CDC feedback due
    soon
  • Many have conducted large-scale vaccination
    exercises
  • A few states have conducted tabletop exercises to
    form more comprehensive response

19
State Level Pandemic PlanningChallenges
  • Indeterminate availability of vaccine or
    antiviral drugs
  • Surge capacity of health care system

20
So now what for State Planning?
  • Ensure all appropriate planning partners are
    involved
  • Ensure coordination
  • Establish incident command/control
  • Promote/facilitate development of local plans
  • Ensure tribes are involved/addressed
  • Review legal authorities
  • Annual review/updating of plan
  • Move beyond plan to plan

21
Remember
  • Hurricane Katrina was the most anticipated
    natural disaster in American history, and still
    government managed to fail at every level.
  • David Brooks, NY Times, 9/11/05

22
                                               
                                                  
      
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