Pandemic Flu

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Pandemic Flu

• Preparation for individuals and families

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CDC(Centers for Disease Control)

• www.cdc.gov
• click on the pandemic flu links
• Individuals and families planning
• Planning checklist for individuals and families
• Family guide, checklist and Information sheets

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Pandemic Planning Assumptions

• Everyone will be susceptible to the virus
• 30 of the overall population will get the virus
• Highest among school aged children (40)
• Decrease with age
• Working adults will be significantly affected
  (20) will be ill)
• Some people will carry the virus but will not
  have symptoms of illness

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Assumptions (continued)

• Fatalities will be more likely among certain
  groups
• Infants
• Elderly
• Pregnant women
• People with chronic medical problems
• Illness will be significant, however, even among
  young healthy persons
• Working adults

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Assumptions (continued)

• Absenteeism
• May reach 40 due to
• Illness
• Need to care for ill family members
• Fear of infection
• Public health measures may necessarily increase
  the rate of absenteeism
• Closing schools
• Quarantine of household contacts

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Assumptions (continued)

• Incubation Period
• Time between being exposed to the virus and
  having symptoms will be about 2 days
• Persons with virus can spread it to others even
  before they have symptoms
• Children will shed the greatest amount of virus
  and pose the greatest risk of transmission

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Assumptions (continued)

• In any particular community the pandemic outbreak
  will last 6-8 weeks
• Depending on the fatality rate, the effects of
  the pandemic will last longer
• Waves of outbreaks across country may last 2-3
  months
• Largest waves usually occur in Fall and Winter
• Pandemic may act differently - may occur in a
  different season

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Illness, health care usage and death(Estimates
based on past pandemics)

• Ilness
• Around 90 million persons - 1/3 of population
• Outpatient medical care
• 45 million - 1/2 of those that are sick
• Hospitalization
• 1 million to 10 million persons
• ICU 128,000 to 1.5 million
• Mechanical ventilators - 65,000 to 750,000
• Deaths
• 200,000 to 2 million

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Why is a pandemic different?

• Result of a new type of flu virus
• No natural immunity in population
• Vaccines would not prevent infection
• Longer lasting
• Even healthy adults at risk for serious
  complications
• Widespread
• Would affect every level of society because such
  a high proportion of people would be ill at same
  time
• Would affect all communities
• Limited ability of one community to help another

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History

• 3 Pandemics in past century
• 1918
• Most severe
• Almost 675,000 deaths in US
• 50 Million worldwide
• 1957
• Moderately severe
• 70,000 US deaths and 1-2 million worldwide
• 1968
• Least severe
• 34,000 US deaths and 700,000 worldwide
• Normally about 20-36,000 die from flu/year

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Challenges/Disruptions

• Essential services
• Food and water supplies
• Schools and daycares
• Medical care for chronic illnesses

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Challenges/Disruptions Essential Services

• Hospitals/Healthcare facilities
• Banks/ATMs
• Restaurants
• Govt offices
• Phone companies
• Post offices/Delivery services
• Stores

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Challenges/Disruptions Public gatherings

• Meetings
• Prepare/distribute contact lists
• Email
• Conference calls
• Telephone chains
• Worship services
• Transportation limitations
• Public transportation limited
• Gas shortages

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Planning

• Enough medications
• Family emergency plans
• Cash
• Fuel and fuel containers
• Essential supplies - decreased travel ability
• Rotating care schedule for family
• Family requiring medical care
• Children

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Food and WaterProblems

• Food distribution
• Farming/manufacturing
• Wholesale
• Transportation
• Retail
• Decreased ability to go to stores

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Food and Water Planning

• Store 2 weeks of nonperishable food
• Foods that do not require refrigeration or
  preparation using water (save for drinking)
• Nuts
• Breads (freeze)
• Dried fruit
• Frozen meat and vegatables
• Canned foods
• Peanut butter
• Infant formulas
• Special diets for older persons
• Water - 2 weeks
• 1 Gallon per person per day

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Workplace Problems

• May not be possible to work
• Transportation
• Decreased public gatherings
• Discuss with employer
• Staggered shifts
• Work from home
• Telecommuting
• Conference call procedures
• Save for loss of income

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Schools and Daycare

• Schools, colleges, daycare, preschool may be
  closed to limit spread of illness
• Plan for children staying home for extended
  periods of time
• Educational materials
• Entertainment
• Recreation
• Plan with teachers
• Lesson plans
• Internet based courses

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Medical careProblems

• Acute
• Emergency departments and clinics may be able to
  handle only the worst cases
• Chronic
• Visiting nurses and medical supply companies may
  have limited ability to function
• Drug stores may have limited supplies
• Hospitals may have limited resources
• Family care will be important

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Medical CarePlanning

• Continue medications to avoid problems
• Ensure adequate supply of
• Medications
• Other medical supplies (glucose test strips)
• Speak with dialysis and chemo providers about
  plans to continue

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Pandemic InfluenzaPrevention and Treatment

• Stay Healthy
• Cover mouth and nose with tissue when coughing or
  sneezing
• Wash hands
• Soap/Water
• Alcohol based cleaners
• Avoid close contact with sick persons
• If you are sick, stay away from others -
  especially groups
• School
• Work
• Mall

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Vaccination

• Influenza viruses change over time
• Only helps with prevention, not treatment
• Short prodromal period
• Vaccine cannot be develop until a pandemic strain
  becomes identified
• Will take 4-6 months to develop
• Govt plans
• Develop vaccine to known strains
• Increase manufacturing capacity

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Antivirals

• Antivirals are available to treat seasonal
  influenza
• Not a cure but shortened and less severe symptoms
• Unclear of how useful in pandemic flu
• Would not contain the spread but may shorten the
  period of illness
• Government is stockpiling antivirals
• Prescription only

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Stay informed

• Bad information develops easily in disaster
  situations
• Refer to reliable data sources
• www.pandemicflu.gov
• Centers for disease control hotline
• 800-232-4636
• Local Health Department and local government web
  sites
• News media
• Private physician

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Questions and Answers

• Is it safe to eat poultry?
• Cooking destroys viruses and bacteria
• The US has trade restrictions with countries
  where bird flu has been found in domestic
  poultry
• Guidelines for safe preparation
• Wash hands
• Separate raw poultry and juices from other food
• Keep utensils and cutting boards clean
• Use a food thermometer - cook to at least 165
  degrees.

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Questions and Answers (cont)

• What types of birds carry bird flu?
• Avian influenza can infect a wide variety of
  domestic and wild birds including migratory
  birds.

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Questions and Answers (contd)

• Will the flu shot protect against pandemic
  influenza?
• The usual yearly flu vaccine will not protect
  against pandemic influenza but can help avoid the
  seasonal flu which will still be present and
  causes 20,000 to 30,000 deaths a year.
• Get a pneumonia shot to help protect against
  pneumonia.
• Make sure other immunizations are up-to-date.

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What is being done to prepare?

• Monitoring birds for avian flu
• Working with WHO to detect pandemic flu early if
  it occurs
• Improving manufacturing and testing of vaccines
• Supporting local governments in disseminating
  information through summits like this one
• Encouraging and assisting agencies, businesses
  and institutions in planning for the effects of
  a pandemic

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A different focus

• An influenza pandemic will be severely taxing to
  society for a period of several months
• This will require a change in focus and
  priorities
• The usual institutions that we rely on will be
  overwhelmed and will require that each person
  concentrate on providing assistance to their
  family and neighbors
• Neighborhood organization
• Checking on elderly chronically ill
• Helping to care for children
• Volunteers that may be able to help
• Elderly people
• Single parent with small children
• Organized trips for fuel and water
• Drop offs