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U.S. Pandemic Influenza Preparedness and Response: Update


U.S. Pandemic Influenza Preparedness and Response: Update & Progress Report The pandemic influenza clock is ticking. We just don t know what time it is. – PowerPoint PPT presentation

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Title: U.S. Pandemic Influenza Preparedness and Response: Update

U.S. Pandemic Influenza Preparedness and
Response Update Progress Report
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

When Will the Next Influenza Pandemic Occur?
2004 H7N1 Avian virus

2004 H7N3 Avian virus
2004 H5N1 Avian virus
2003 H7N7 Avian virus
2003 H5N1 Avian virus
1999 H9N2 Quail virus
1997 H5N1 Avian virus
1995 H7N7 Duck virus
1993 Swine/avian recombinant
1988 H1N1 Swine virus
1986 H1N1 Swine virus
1976 H1N1 Swine flu
Timeline of human infection with novel influenza
viruses (since the 1968 pandemic)
Current Pandemic Threats
  • H5N1, Asia
  • Domestic poultry infections identified in 9
  • 23 deaths and 34 cases documented in humans (most
    recent case in March 2004)
  • Control efforts (culling 100 million birds) have
    reduced the risk but given difficulties with
    surveillance it cannot be assumed that poultry is
    virus free and no risk to humans remains
  • H7N3, British Columbia, Canada
  • 2 cases of conjunctivitis in persons with contact
    with infected poultry (most recent case April

U.S. Pandemic Influenza Preparedness Activities, 1
  • Enhanced surveillance
  • CDC request for proposals for surveillance in
  • HHS support for WHO surveillance activities
  • Vaccine security and supply
  • HHS funding to assure year-round egg availability
    and to promote expansion and diversification of
    U.S. influenza vaccine production
  • NIH is obtaining and testing pilot lots of H5N1

U.S. Pandemic Influenza Preparedness Activities, 2
  • Antiviral drugs
  • Establishment of an oseltamivir stockpile
  • State/local preparedness
  • Continued support for State planning activities
  • HHS funding for health care system preparedness
  • Development of software to predict impacts and
    tabletop exercises to practice State/local plans

Estimated Impact of an Influenza Pandemic on
Healthcare in Atlanta
Peak-week impacts estimated using Flu-surge
software. Assumes an 8-week period of illness in
a community.
Category Number of Total
Hospitalizations 1915 26
ICU beds 401 45
Ventilators 201 29
Note Hospitals usually run near full capacity
thus, addressing this burden would require
emptying or adding beds
CDC, FluSurge software, 2004
Pandemic Influenza Preparedness Response Plan
  • Plan has been cleared by HHS HHS agencies and
    is being reviewed by other Departments
  • After clearance, plan will be released for public
  • Federal Register and on-line
  • 60-day comment period
  • Revise and post final plan

Key Issues
  • Public and private sector vaccine purchase and
  • Priority groups for early vaccine and antiviral
    chemoprophylaxis and therapy
  • Approach to indemnification, liability
    protection, and compensation

Pandemic Vaccine Purchase Options Public/Private
Sector Roles
Purchase Public sector roles planning needs
All public Best opportunity to target priority groups Requires planning for mass distribution
Increased public Public sector focus on target groups and underserved populations Requires coordination with private sector
Current (mostly private) system Public sector focus on limited target groups and children via VFC
Vaccine Purchase and Distribution Potential for
Changes Over Time
Vaccine available
Increased public
All public
First wave
Second wave
Timeline and waves of pandemic disease
Note This is presented as an illustration and
not to endorse as a preferred option
Priority Groups for Pandemic Vaccine
  • Base definition of priority groups on pandemic
    response goals
  • Reduce health impacts Maintain quality
    healthcare system protect those at highest risk
  • Reduce social and economic impacts Maintain
    essential community services
  • Role of national plan in defining priority groups
  • Need for national guidance vs state-by-state
  • Specific definition of target groups at
    State/local levels (e.g., who provides essential
    community services?)

Potential NVAC Roles in Pandemic Plan Review
  • Provide input on key issues
  • Highlighted decision issues
  • Other issues where NVACs broad stakeholder
    perspective or NVPO priorities (e.g., vaccine
    supply, financing, safety, etc) are relevant
  • Provide a forum for public discussion and input
    through the Public Participation Working Group
  • Other?
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