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Pandemic Influenza A Guide for Healthcare Providers

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The Next Influenza Pandemic An influenza pandemic occurs when a novel and highly contagious strain of the influenza virus ... a patient may have avian influenza, ... – PowerPoint PPT presentation

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Title: Pandemic Influenza A Guide for Healthcare Providers


1
Pandemic InfluenzaA Guide for Healthcare
Providers
Escambia County Health Department
Click anywhere to continue
Trusted Professionals Protecting You Since 1821
2
Main Menu
Choose from the following menu options, or click
anywhere to continue.
  • Historical Background
  • Flu Definitions
  • Nature of the Virus
  • Physician Testing and Reporting
  • The Roles of ECHD and the Bureau of Laboratories
  • Infection Control Procedures
  • Treatment Algorithm and Proper use of Antiviral
    Medications
  • Healthcare Facility Preparedness
  • Community Preparedness
  • Personal Preparedness
  • Worried Well
  • FAQ
  • More Information

If you suspect that a patient may have avian
influenza, click here and call the Escambia
County Health Department immediately at
(850)595-6683 if necessary.
3
Historical Background
Choose from the following menu options, or click
anywhere to continue.
The Spanish Flu Effects of Past Pandemics on the
U.S. The Next Influenza Pandemic Floridas
At-Risk Characteristics
Main Menu
4
The Spanish Flu
  • In the spring of 1918, as the nation mobilized
    for war, Private Albert Gitchell reported to an
    Army Hospital in Kansas where he was diagnosed
    with the flu -- a disease doctors knew little
    about
  • Before the year was out, America would be ravaged
    by a flu pandemic that killed 675,000 in the U.S.
    and 25 to 50 million worldwidemore than all the
    war deaths of this century combined

Historical Background
Main Menu
5
Effects of Past Pandemics on the U.S.
Pandemic Estimated U.S. Deaths Influenza A Strain Populations at greatest risk
1918 1919 Spanish Flu 500,000 H1N1 Young, healthy adults
1957 1958 Asian Flu 70,000 H2N2 Infants, Elderly
1968 1969 Hong Kong Flu 34,000 H3N2 Infants, Elderly
Main Menu
Historical Background
6
The Next Influenza Pandemic
  • An influenza pandemic occurs when a novel and
    highly contagious strain of the influenza virus
    emerges, affecting populations around the world
  • Historically, influenza pandemics have occurred
    every 11 to 39 years
  • It has been more than 30 years since the last
    pandemic
  • Experts advise that another influenza pandemic
    may occur within the next few years, but no one
    can predict exactly when

Main Menu
Historical Background
7
Floridas At-Risk Characteristics
  • The 4th most populous state in the U.S.
  • Demographic and population density
    characteristics provide significant risks for
    rapid spread of influenza
  • Tourism increases risk of infection transmission
    introduced from affected countries
  • Vast natural areas function as important breeding
    areas and flyways for wild bird and duck
    populations
  • Robust agricultural economy supports significant
    domestic poultry businesses

Main Menu
Historical Background
8
Flu Definitions
Choose from the following menu options, or click
anywhere to continue.
Seasonal or Regular Flu Pandemic Flu Projected
Number of Episodes of Illness, Healthcare,
Utilization, and Death (HHS Plan, 2005) Avian
Bird Flu Criteria Required for a
Pandemic Pandemic Challenges
Main Menu
9
Seasonal or Regular Flu
  • The normal yearly flu of late fall and winter
  • Some immunity built up from previous exposures
  • Most at risk are young children, older adults,
    pregnant women, and the immunocompromised
  • About 226,000 Americans are hospitalized
  • 36,000 die from the disease
  • Most deaths occur among people older than 65
    (90)
  • Prevention competent vaccine good hygiene
    practices

Flu Definitions
Main Menu
10
Pandemic Flu
  • Global outbreak of the flu that occurs when a new
    virus emerges in the human population
  • Occurs over a very wide area (several countries
    or continents)
  • 30 or more of the population likely to become
    ill
  • Lasts longer and occurs at unexpected times
  • No pre-existing immunity
  • Symptoms usually more severe
  • Different groups may be at higher risk
  • At least 2 waves are likely
  • For an up-to-date chart of reported cases of
  • H5N1, visit http//www.who.int/csr/disease/avian_
    influenza/country/cases_table_2006_10_31/en/index.
    html

Main Menu
Flu Definitions
11
Projected Number of Episodes of Illness,
Healthcare, Utilization, and Death (HHS Plan,
2005)
Characteristic Moderate (1958/68 - like) Severe (1918 - like)
Illness 90 Million (30) 90 Million (30)
Outpatient Care 45 Million (50) 45 Million (50)
Hospitalization 865,000 9,900,000
ICU Care 128,750 1,485,000
Mechanical Ventilation 64,875 742,500
Deaths 209,000 1,903,000
Main Menu
Flu Definitions
12
Avian Bird Flu
  • Usually infects wild birds and poultry
  • Wild birds carry the viruses in their intestines,
    but usually do not get sick
  • Wild birds can easily transmit the virus to
    domesticated birds like chickens, ducks, and
    turkeys
  • Domestic birds usually acquire the virus by
    coming in contact with contaminated
    excretionsthey usually die
  • May be transmitted to other species
  • On rare occasions, the virus spreads to humans
  • Human to human transmission can occur
  • Potential for a flu pandemic
  • High mortality rate (100 poultry / 80 human)
  • No current approved vaccine
  • Current antiviral drugs somewhat ineffective

Main Menu
Flu Definitions
13
Criteria Required for a Pandemic
  • The new strain is widespread and endemic
  • There are continuous outbreaks in poultry
  • It has resulted in lethal mammalian infections
  • Virus is evolving
  • Sporadic human cases
  • mostly young, healthy adults
  • Case fatality rate is 50
  • Rare instances of person-to-person transmission
  • Sustained and rapid human-to-human transmission

Main Menu
Flu Definitions
14
Pandemic Challenges
  • Almost all locations will be affected
    simultaneously
  • There will not be enough vaccine
  • There will not be enough antiviral medicine
  • The healthcare system will be stretched beyond
    its limits

Main Menu
Flu Definitions
15
Nature of the Virus
Choose from the following menu options, or click
anywhere to continue.
Virology Disease Mechanism The Next Pandemic
Strain Cause of a Pandemic Flu How the Flu
Spreads in the Environment How the Flu Spreads
among Humans Clinical Symptoms in Humans
Main Menu
16
Virology
  • A globular particle (about 100 nm in
    diameter)smallest unit of life
  • Cannot move or replicate on its own
  • Sheathed in a lipid bilayer (derived from the
    plasma membrane of its host)
  • 8 RNA Molecules
  • HA genes (Hemagglutinin)
  • NA genes (Neuraminidase)
  • NP (Nucleoproteins)
  • Variety of matrix, proteins,
  • and polymerases
  • 16 HA and 9 NA subtypes
  • 144 combinations possible

Virus Subtype H5N1
Nature of the Virus
Main Menu
17
Disease Mechanism
Main Menu
Nature of the Virus
18
The Next Pandemic Strain
  • Virus subtype H5N1 is the most likely pandemic
    candidate TODAY
  • Can survive 35 days in low temperatures (4 C/39
    F)
  • Can survive 6 days in high temperatures (37
    C/98.6 F)
  • Can survive on surfaces for several weeks
  • Is NOT killed by refrigeration or freezing

Main Menu
Nature of the Virus
19
Cause of a Pandemic Flu
  • Antigenic Drift
  • Mild genetic re-assortment of H N types
  • Occurs every year, resulting in a new yearly
    vaccine
  • Antigenic Shift
  • Over periods of time, human viruses re-assort
    with avian viruses leading to major changes in
    the proteins of influenza
  • Normal hosts for the flu that lead to shifts are
    migratory birds such as ducks and geese
  • There is limited or no immunity to these strains,
    leading to pandemics

Main Menu
Nature of the Virus
20
How the Flu Spreads in the Environment
  • International movement/travel
  • Illegal commerce (fighting cocks, captive birds,
    etc.)
  • Commercial meat imports
  • Migratory birds
  • Foodborne raw, undercooked meat, blood or eggs
  • Close contact with infected animal

Main Menu
Nature of the Virus
21
How the Flu Spreads among Humans
  • Contact with a persons mouth, nose, or eyes
  • Coughing or sneezing
  • Unwashed hands
  • Sharing personal items
  • Patient is infectious 1-2 days before and up to 5
    days after symptoms start
  • Other influenza types show patients shedding
    cells from 3 to 21 days

Main Menu
Nature of the Virus
22
Clinical Symptoms in Humans
  • Fever
  • Cough
  • Sore throat
  • Muscle aches
  • Conjunctivitis
  • Meningitis
  • May cause severe breathing problems and pneumonia
  • Primary and secondary pneumonia can be fatal

Main Menu
Nature of the Virus
23
Physician Testing and Reporting
Choose from the following menu options, or click
anywhere to continue.
Physician Testing and Reporting
Procedures Specimen Collection Information Specime
n Collection Procedures Response Protocol WHO
Phase 3 Response WHO Phases 4/5 Response WHO
Early Phase 6 Response
Main Menu
24
Physician Testing and Reporting Procedures
  • If it is suspected that a patient may have avian
    influenza, compare the case to the current case
    definitions
  • For Case Definitions, click here
  • If the case meets the case definitions of
    Moderate or High-suspicion of infection,
    immediately call
  • Escambia County Health Department
  • (850)595-6683
  • Fax (850)595-6268
  • After hours, weekends, holidays (850)418-5566
  • ECHD will come to the location of the case and
    provide swabs for testing

Physician Testing and Reporting
Main Menu
25
Specimen Collection Information
  • Specimens must be collected prior to treating the
    patient with antivirals
  • Beyond the first 3 to 5 days post onset of
    disease, the probability of recovering virus is
    low
  • Sputum, tracheal aspirates or bronchiolar lavage
    specimens are recommended
  • Oropharyngeal swab specimens and lower
    respiratory tract specimens (e.g.,
    bronchoalveolar lavage or tracheal aspirates)
    appear to contain the highest quantity of virus
    for influenza H5N1 detection
  • Nasal or nasopharyngeal swab specimens are
    acceptable, but may contain less virus
  • Commercial rapid influenza antigen testing in the
    evaluation of suspected influenza H5N1 cases
    should be interpreted with caution-- These tests
    have relatively low sensitivities, and
  • a negative result would not exclude a diagnosis
    of influenza H5N1
  • a positive result does not distinguish between
    seasonal and avian influenza A viruses

Main Menu
Physician Testing and Reporting
26
Specimen Collection Procedures
  • Oropharyngeal swab
  • Have the patient give a deep cough
  • Swab the oropharynx, or far back in the throat,
    using a Dacron tipped plastic shaft swab
  • Reinsert the swab back into the culturette and
    crush the ampoule at the base of the culturette
    OR Insert the swab into a tube of transport
    media remove excess shaft from the swab and
    close the tube tightly
  • Sputum, tracheal or nasopharyngeal
    washes/aspirates or bronchial lavage Follow
    facility protocols for collection of these
    specimen types
  • 4. Label each specimen with the patients name
    and specimen type
  • ECHD will pack and ship the sample to the state
    laboratory

Main Menu
Physician Testing and Reporting
27
Response Protocol
  • The provider should follow the proper response
    protocol for a suspected/confirmed case as
    follows
  • WHO Phase 3 Response click here
  • WHO Phases 4/5 Response click here
  • WHO Early Phase 6 Response click here
  • Combined Response Table - click here

Main Menu
Physician Testing and Reporting
28
WHO Phase 3 Response
High-Suspicion Act without waiting for lab result
Moderate-Suspicion Act without waiting for lab result if rapid testing shows influenza A is present, otherwise wait for lab confirmation to implement measures
Location Voluntary isolation in healthcare facility if in need of healthcare or Self isolate at home otherwise
Treatment Includes a full course of antiviral agent to which organism is sensitive, if any
Follow-up CHD checks on case location and status daily
 Definition of Contact Household members and others in similar prolonged face-to-face contact with the patient
Location Locate all contacts, on and off site - No activity restrictions for contacts (Voluntary agreement for contacts)
Treatment Antivirals for all contacts, including exposed healthcare workers. If any contacts have or develop symptoms- Manage case as phase 4/5 infection till proved not to be H5N1- Treat contact as new case if the original case was high suspicion
Follow-up Instruct contacts to call CHD immediately if symptoms develop - No action needed
Management of Case

Management of Contacts
Response Protocol Home
Physician Testing and Reporting
29
WHO Phases 4/5 Response
High-Suspicion Act without waiting for lab result
Moderate-Suspicion Implement phase 3 containment measures while waiting for lab result
Location FORMAL ISOLATION ORDER in hospital if in need of healthcare or at home otherwise
Treatment Includes a full course of antiviral agent to which organism is sensitive, if any
Follow-up CHD checks on patient location and status twice daily
 Definition of Contact Persons who have been in the same room with the patient or talking with the patient face-to-face for 5 minutes or more
Location Locate all contacts on and off site -VOLUNTARY QUARANTINE Immediate self-quarantine of all contacts to home.
Treatment Antivirals for all contacts, including exposed healthcare workers. If contacts have or develop symptoms - Treat contact as a new case of phase 4/5 infection and initiate contact tracing, until proved not to be H5N1
Follow-up Instruct contacts to call CHD immediately if symptoms develop- CHD checks on location and status of all contacts once daily
Management of Case

Management of Contacts
Response Protocol Home
Physician Testing and Reporting
30
WHO Early Phase 6 Response
High-Suspicion Act without waiting for lab result
Moderate-Suspicion Implement phase 4/5 containment measures while waiting for lab result
Location FORMAL ISOLATION ORDER in hospital if in need of healthcare or at home otherwise
Treatment Includes a full course of antiviral agent to which organism is sensitive, if any
Follow-up CHD checks on patient location and status twice daily
 Definition of Contact Persons who have been in the same room with the patient or talking with the patient face-to-face for 5 minutes or more
Location Locate all contacts on and off site -FORMAL QUARANTINE ORDER all contacts at home or in designated location
Treatment Antivirals for all contacts, including exposed healthcare workers. If contacts have or develop symptoms- Treat contact as a new case of phase 6 infection and initiate contact tracing, until proved not to be H5N1
Follow-up Instruct contacts to call CHD immediately if symptoms develop- CHD checks on location and status of all contacts twice daily
Management of Case

Management of Contacts
Response Protocol Home
Physician Testing and Reporting
31
The Roles of ECHD and the Bureau of Laboratories
Choose from the following menu options, or click
anywhere to continue.
The Role of ECHD The Role of the Bureau of
Laboratories
Main Menu
32
The Role of ECHD
  • Upon notification of a moderate or
  • high suspicion case,
  • The Health Department will
  • Alert state laboratory of testing
  • Ensure ability to obtain test kit within
  • 30 min from the state lab if unavailable
  • at case location
  • Gather test kit, cooler, and forms
  • Acquire sample from case within 30 min of arrival
    at case location
  • Transport sample to state lab within 6 hrs
  • Alert state laboratory about delivery of case
    specimen

Roles of ECHD and Bureau of Laboratories
Main Menu
33
The Role of the Bureau of Laboratories
  • The Bureau of Laboratories will
  • Provide guidance to hospital and clinical
    laboratories for specimen collection and handling
  • Transport specimens when a novel strain is
    suspected, in conjunction with the Division of
    Disease Control and partner agencies
  • Procure appropriate reagents from the CDC or
    other appropriate sources to detect and identify
    the novel virus strain
  • Partner with local private labs without virus
    strain identification capacity to obtain and use
    rapid antigen testing kits
  • Inform ECHD of the test result, which will then
    be passed on to the healthcare provider

Main Menu
Roles of ECHD and Bureau of Laboratories
34
Infection Control Procedures
Choose from the following menu options, or click
anywhere to continue.
Enhanced Precautions for Avian Flu The Waiting
Room Disinfectants Healthcare Facility
Signs Infection Control for Healthcare Workers
Main Menu
35
Enhanced Precautions for Avian Flu
  • CDC recommends the use of Standard, Contact,
    Airborne isolation and the use of eye protection
    when dealing with individuals under evaluation
    for avian influenza
  • Contact precautions include use of gloves and
    gown dedicated equipment (such as stethoscopes,
    disposable blood pressure cuffs, disposable
    thermometers, etc) for all patient contact
  • Airborne precautions
  • Place the patient in an airborne isolation room
    (AIR)
  • Use a fit-tested respirator when entering the
    room
  • Personal Protective Equipment (PPE) should always
    be used in conjunction with basic infection
    control measures

Infection Control Procedures
Main Menu
36
The Waiting Room
  • Post signs in languages appropriate to the
    populations served with instructions to cover the
    mouth/nose with a tissue when coughing and to
    dispose of used tissues
  • Implement frequent hand washing / cleansing after
    contact with respiratory secretions
  • Implement spatial separation, ideally 3 feet, of
    persons with respiratory infections in common
    waiting areas, when possible
  • Provide tissues and hand soap for patients
  • Disinfect items and surfaces, paying particular
    attention to frequently touched items

Main Menu
Infection Control Procedures
37
Disinfectants
  • Certain disinfectants are recommended for
    specific materials and surfaces
  • Find a list of recommended disinfectants for use
    in healthcare facilities here
  • Table of Disinfectants click here
  • Interim recommendations for infection control in
    health-care facilities caring for patients with
    known or suspected avian influenza are available
    at
  • http//www.pandemicflu.gov/plan/healthcare/maskgui
    dancehc.html

Main Menu
Infection Control Procedures
38
Healthcare Facility Signs
  • The following are suggested signs to print and
    post in a healthcare facility to aid in infection
    control
  • Travelers Alert click here
  • Dont Spread the Flu click here

Main Menu
Infection Control Procedures
39
Infection Control for Healthcare Workers
  • Receive current flu vaccine as soon as possible
  • Observe good hand and respiratory hygiene at all
    times
  • Monitor for symptoms of flu-like illness (cough,
    sore throat, difficulty breathing)
  • Use appropriate personal protective equipment
    (PPE)
  • Observe all other infection control practices
  • PPE should be used in correspondence with the
    current phase as follows
  • Personal Protective Equipment click here
  • A helpful guide for the sequence of donning PPE
    is below
  • Sequence for Donning PPE click here

Main Menu
Infection Control Procedures
40
Treatment Algorithm and Proper Use of Antiviral
Medications
Choose from the following menu options, or click
anywhere to continue.
Determining Necessary Treatment Recommendations
for Prioritizing Antivirals Vaccine Testing
Main Menu
41
Determining Necessary Treatment
  • If the patient meets the moderate or high
    suspicion case definitions, a full course of
    antiviral agents to which the organism is
    sensitive should be administered
  • Antivirals should also be administered to all
    contacts, including exposed healthcare workers
  • The following document includes helpful
    information concerning Treatment/Prophylaxis
    Algorithm
  • Treatment/Prophylaxis Algorithm click here

Treatment and Antiviral Medications
Main Menu
42
Recommendations for Prioritizing Antivirals
  • Hospitalized patients with influenza
  • HCWs and EMS workers with direct patient contact
  • Highest risk outpatients
  • Pandemic health responders, public safety and key
    government decision makers
  • Other high risk outpatients
  • Outbreak response
  • Prophylaxis HCWs in ER, ICU, EMS dialysis
  • Pandemic societal responders and other HCWs
  • Other outpatients
  • Prophylaxis for highest risk outpatients
  • Prophylaxis for other HCWs with patient contact

Main Menu
Treatment and Antiviral Medications
43
Vaccine Testing
  • There are currently no avian influenza vaccines
    approved in the U.S. for use on humans
  • Vaccine candidate under development (Clade 1)
  • Use as pre-pandemic vaccine
  • Hope for improvement and acceleration in
    cell-based technology to expedite vaccine
    production vs. egg based production which
    requires 3 eggs for each vaccine dose produced
    (300 million doses requires 900 million eggs)
  • Genetic identification of current H5N1 and
    previous strains from the 1918 pandemic have
    further promise for vaccine production
  • Protocol for testing in place between DOH labs
    and Bureau of Epidemiology
  • Close coordination with CDC testing not
    available at private reference labs

Main Menu
Treatment and Antiviral Medications
44
Healthcare Facility Preparedness
Choose from the following menu options, or click
anywhere to continue.
Begin Your Planning NOW Equipment
Main Menu
45
Begin Your Planning NOW
  • Think about ways to keep your practice open
    during a pandemic
  • Divide office into infectious/non-infectious
    sections
  • What will you do if 1 out of 3 staff members are
    ill?
  • What are the necessary functions that will need
    to be done?
  • Develop basic procedures such as who staff
    members should call when ill, etc.
  • Practice plan through frequent drills
  • If desired, consult ECHD to determine feasibility
    of plan

Healthcare Facility Preparedness
Main Menu
46
Equipment
  • The following is a table of sample calculations
    for estimating healthcare personal protective
    equipment needs during a pandemic event
  • Estimate PPE needs click here

Main Menu
Healthcare Facility Preparedness
47
Community Preparedness
Choose from the following menu options, or click
anywhere to continue.
Florida Plan ESF 8 Functions Response Plans
Main Menu
48
Florida Plan
  • The primary Support Function addressing this
    pandemic possibility is designated as Emergency
    Support Function 8 or ESF 8
  • ESF 8 response is based on the principle that all
    emergencies are local, and we are engaged to
    provide human and material resource to help
    impacted communities through preplanning and
    mitigation
  • Coordination of Health and Medical Resources
    along pre-existing lines of Emergency Management
    using an All Hazards approach which should be
    familiar in response to the numerous weather
    disasters in the State of Florida

Community Preparedness
Main Menu
49
ESF 8 Functions
  • Mass Casualty Systems
  • Epidemiology/Disease Surveillance and Control
  • Immunizations
  • Facility Assessments
  • Evacuation/Repopulation
  • Risk Communications
  • Renal Facility Support
  • Nutritional Services
  • Statistical Reporting
  • Behavior Health/CISD
  • Rapid Impact Assessment/Urban Search Rescue
  • DEET (Bug Spray)
  • Environmental Health Services
  • County/Regional Health Dept. Support
  • Lab Services
  • FEMORS/DMORT
  • SanPacs
  • Oxygen
  • EMS Services
  • Hospital Infrastructure/Staffing
  • Disaster Medical Assessment Teams
  • Special Needs Shelters
  • Pharmaceuticals/State and Nation Strategic
    Stockpiles

Main Menu
Community Preparedness
50
Response Plans
  • The Escambia County Health Department will follow
    the procedures outlined in the Florida Department
    of Health Pandemic Influenza Plan during all
    phases of a pandemic
  • In case of a suspected or confirmed case, the
    Escambia County Health Department will follow the
    ECHD Pandemic Influenza Plan
  • View the ECHD Plan for Pandemic Influenza
  • click here

Main Menu
Community Preparedness
51
Personal Preparedness
Choose from the following menu options, or click
anywhere to continue.
Storage and Supplies Plan for Disruption
Main Menu
52
Storage and Supplies
  • Store at least 2 weeks worth
  • of food
  • At least 1 gallon of water
  • per person per day
  • Consider special needs
  • Rotate stock every 6 months
  • Store medical and health supplies
  • Create an emergency kit - Checklists are
    available at www.ready.gov

Personal Preparedness
Main Menu
53
Plan for Disruption
  • Prepare for work disruption - Make backup plans
  • Ask about flu pandemic plans at your childs
    school
  • Transportation services may be disrupted -
    Prepare backup plans
  • Plan for the possibility that usual services may
    be disrupted--banks, stores, restaurants,
    government offices, post offices, etc.
  • Stay informed and up-to-date through trusted
    media outlets

Main Menu
Personal Preparedness
54
Worried Well
Choose from the following menu options, or click
anywhere to continue.
Worried Patients Screening Tool p.1 Screening
Tool p.2 Frequently Asked Questions More
Information
Main Menu
55
Worried Patients
  • Patients may be concerned that they have avian
    influenza, whether they are experiencing symptoms
    or not
  • It is important to be understanding of concerns
  • The screening tool on the next page may be used
    as a questionnaire for worried patients

Worried Well
Main Menu
56
Screening Tool p.1
  • Have you recently visited one of these countries?
    - Azerbaijan, Cambodia, China, Djibouti, Egypt,
    Indonesia, Iraq, Malaysia, Romania, Russia,
    Thailand, Turkey, Vietnam, other
  • If the answer is NO Explain that avian influenza
    has not been found in the United States - Unless
    one has traveled to one of the countries with
    suspected or confirmed cases, it is highly
    unlikely that this is avian flu
  • If the answer is YES Move on to the next
    question
  • 2. Have you been in close contact (within 3 feet)
    of someone that has been diagnosed with avian
    influenza?
  • 3. Have you been in close contact with sick or
    dead wild or domestic birds or their feces?
  • 4. Have you worked with live H5N1 influenza virus
    in a laboratory?
  • If the answer to 3/4/5 is NO Explain that avian
    influenza is spread through contact of the virus
    or infected animals and humans
  • If the answer to any of the above is YES Move on
    to the next question

Main Menu
Worried Well
57
Screening Tool p.2
  • 5. Are you experiencing fever greater than or
    equal to 100.4 F along with sore throat, cough,
    or shortness of breath?
  • If the answer is NO If the patient is not
    experiencing any symptoms, do not test. If the
    patient is experiencing some but not all
    symptoms, follow the YES instructions below
  • If the answer is YES Compare the patient to the
    Case Definitions and if necessary, call the
    Escambia County Health Department immediately at
    (805)595-6683 for testing
  • For printable format, click here

Main Menu
Worried Well
58
Frequently Asked Questions
Choose from the following menu options, or click
anywhere to continue.
  • What is avian influenza or bird flu?
  • What is a pandemic? Could bird flu become the
    next pandemic?
  • How would a pandemic impact this community?
  • Is there a vaccine for bird flu that will protect
    humans?
  • How is Escambia County preparing for a pandemic?
  • Can I prepare for a pandemic?
  • With concerns about bird flu, is it safe to eat
    chicken and duck in the United States?
  • What do I do if I see a dead bird?
  • If I have chickens or live near a poultry farm,
    what should I do?

Main Menu
59
What is avian influenza or bird flu?
  • Avian influenza - commonly called "bird flu" -
    is an infection caused by influenza viruses that
    occur naturally in birds. One strain of bird flu
    the H5N1 virus -- has recently killed birds in
    a number of countries and some humans who were in
    close contact with those infected poultry were
    infected. At this time, there is no H5N1 bird flu
    in the United States and the U.S. government is
    watching closely to make sure we detect H5N1 bird
    flu if it were to arrive in the United States.

FAQ Home
60
What is a pandemic? Could bird flu become the
next pandemic?
  • A pandemic is a worldwide outbreak of disease in
    humans there is not an influenza pandemic in
    the world at this time. There have been three
    influenza pandemics since 1918 that affected the
    United States. Scientists tell us that a pandemic
    occurs every 30-40 years and there has not been a
    pandemic in more than 35 years. An influenza
    pandemic happens when a new influenza virus
    emerges, most people have little or no immunity,
    and there is no vaccine for the virus. In a
    pandemic situation, the disease spreads easily
    person-to-person, causes serious illness, and can
    sweep across the country and around the world in
    very short time. Studies confirm that the bird
    flu virus H5N1 is able to mutate rapidly. If H5N1
    adapts to allow easy human-to-human transmission,
    a pandemic could ensue although this has not
    happened at this point.

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How would a pandemic impact this community?
  • An especially severe influenza pandemic could
    lead to high levels of illness, death, social
    disruption, and economic loss. Everyday life
    would be disrupted because so many people in so
    many places become seriously ill at the same
    time. Impacts can range from school and business
    closings to the interruption of basic services
    such as public transportation and food delivery.
    The federal government estimates that 25-30 of
    people living in the United States would be
    affected by a pandemic.

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Is there a vaccine for bird flu that will
protect humans?
  • There currently is no commercially-available
    vaccine to protect humans against H5N1 virus that
    is being seen in Asia, Europe, and Africa. A
    pandemic vaccine cannot be produced until a new
    pandemic influenza virus emerges and is
    identified. The U.S. Department of Health and
    Human Services (HHS) is addressing the problem in
    a number of ways -- developing pre-pandemic
    vaccines based on current lethal strains of H5N1,
    collaborating with industry to increase the
    Nation's vaccine production capacity, and seeking
    ways to expand or extend the existing supply.

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How is Escambia County preparing for a pandemic?
  • Your health department, government, hospitals
    and businesses are taking the threat of a
    pandemic very seriously and began planning months
    ago. The effects of a pandemic can be lessened by
    these advance preparations. The focus of the
    health departments work is educating the public
    about pandemic and the current status of bird
    flu, preparing to make every effort to contain
    the infection using public health measures such
    as contact tracing and isolation, planning on how
    to maintain essential services if an outbreak
    should occur, and providing other government
    agencies and businesses with the tools they need
    to prepare effectively.

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Can I prepare for a pandemic?
  • Yes, there are several steps that individuals,
    families and
  • communities can take to prepare
  • Practice good public health measures like
    frequent hand washing and staying home when you
    are sick. Keep your immunizations up to date,
    including tetanus and, for those at risk, the
    pneumonia shot, which would decrease the risk of
    complications from any influenza infection.
  • Just as you do for hurricane season, you can keep
    a supply of non-perishable food and your
    prescription medication on hand in case you have
    to stay home as protection from the virus.
  • Begin staying informed through the local news
    media and websites like www.PandemicFlu.gov and
    www.BeReadyEscambia.com both local news media
    and websites will be the first place to get
    information on protecting yourself if a pandemic
    impacts Escambia County.
  • There is a checklist for family preparedness at
    www.PandemicFlu.gov. If you are a business owner,
    there are also checklists for business
    preparedness at www.PandemicFlu.gov.

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With concerns about bird flu, is it safe to eat
chicken and duck in the United States?
  • Yes, it is safe to eat properly cooked poultry
    in the United States. The United States bans
    imports of poultry from areas with bird flu. The
    H5N1 bird flu virus has not been found in the
    United States. Cooking destroys germs, including
    the bird flu virus.

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What do I do if I see a dead bird?
If you see a dead bird, to not touch it with your
bare hands. Put on gloves and then place the bird
into two plastic bags this is called
double-bagging before you throw it in the
trash. To report dead birds, you should contact
the Florida Fish and Wildlife Conservation
Commission through their online reporting form at
www.MyFWC.com/bird. Their contact number in
Tallahassee is (888)404-3922.
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If I have chickens or live near a poultry farm,
what should I do?
  • Remember, the deadly H5N1 bird flu virus is not
    in the United States at this point so there is no
    reason to be alarmed about living near chickens
    or a poultry farm. Information about protecting
    chickens from bird flu is available through the
    Florida Department of Agriculture at
    www.doacs.state.fl.us. Information about wild
    birds is available through the Florida Fish and
    Wildlife Conservation Commission at
    www.MyFWC.com.

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More Information
  • For more information about bird flu and pandemic
    preparedness, visit these websites
  • www.PandemicFlu.gov
  • www.Ready.gov
  • www.CDC.gov/flu/avian
  • www.BeReadyEscambia.com
  • www.who.int/csr/disease/avian_influenza/en
  • Physicians can claim the following activity for 1
    1/2 hours of CME/AMA PRA Category 2 credit
    http//www2.sph.unc.edu/nccphp//training/flu_pande
    mic/certificate.htm

For the latest information on pandemic flu for
Escambia County healthcare providers, visit
www.escambiahealth.com and click on the link for
providers.
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