PANDEMIC FLU

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PANDEMIC FLU

• THE THREAT FOR
• SAN MATEO COUNTY

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CRS REPORT FOR CONGRESS

• Pandemic Influenza
• Domestic Preparedness Efforts

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What are we facing ?

• Limited availability of a vaccine
• Limited availability of certain drugs used to
  treat severe flu infections
• General lack of surge capacity

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PANDEMIC

• An epidemic of human disease occurring over a
  very wide area, crossing international boundaries
  and affecting a large number of people.

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San Mateo County

• Why we and the Bay Area could see the initial
  impact of a Avian Flu pandemic
• We are one of the major entrances to people
  coming from Asia because of our airports.

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Avian flu H5N1

• Surface antigens that are responsible for
  virulence
• HA hemagglutinin (16)
• NA neuraminidase (9)

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Only Three Known A Subtypesof Human Flu Viruses

• H1N1
• H1N2
• H3N2

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Past Pandemics

• 1918 Spanish Flu (H1N1)
• 1957 Asian Flu (H2N2)
• 1968 Hong Kong Flu (H3N2)
• 1976 Swine Flu Scare (H1N1)
• 1977 Russian Flu Scare (H1N1)
• 1997 Avian Flu (H5N1)

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Two Steps to Become aPandemic Virus

• Reassortment Event genetic material is
  exchanged between human and avian viruses during
  co-infection of a human of pig.
• Adaptive mutation the capability of the virus
  to bind to human cells increases during
  subsequent infections of humans.

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Why is the Avian Flu so deadly ?

• Studies suggest that there is rapid and severe
  damage to the lungs not responsive to antibiotics
  or antiviral drugs
• Victims may die quickly even with rapid and good
  care
• Present mortality gt50
• Tends to affect healthy young people

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Estimate effects on San MateoCountys Population
(700,000)

• Up to 35 will become ill 245,000
• Up to 19 will require out-patient visits
  133,000
• Up to 0.4 will require hospitalization 2,800
• Up to 0.1 will die of flu-related causes - 700

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What About

• The effect of the worried well
• The demand for limited resources
• Vaccine
• Antivirals
• Presently enough to Rx 1.5 of the U.S.
  population
• Antibiotics

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Other Causes for Concern

• Domestic Ducks excrete large amounts of virus
  while remaining asymptomatic (Silent Reservoir)
• Present circulating virus are more lethal to
  experimentally infected mice and ferrets and
  survive longer in the environment

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Other Concerns (continued)

• H5N1 appears to have expanded its host range to
  mammalian species previously thought resistant
• The behavior of the virus in its natural
  reservoir, wild waterfowl, may be changing.

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The Challenge

• Surge Capability
• Surge Capacity
• Staff
• Beds
• Equipment
• Supplies