Pandemic Influenza: What do we know, what should we do?

1
Pandemic Influenza What do we know, what should
we do?

• Elizabeth L. McClure, MD, MPH
• AHC Office of Emergency Response
• Center for Infectious Disease Research and Policy
  CIDRAP
• University of Minnesota

2
Seasonal Influenza
Pandemic Influenza
3
What creates a pandemic?

• Novel virus No population immunity
• Cause serious disease
• _ Transmitted person to person

4
Influenza Pandemics in the 20th Century

• 1918 Spanish Flu
• 1957 Asian Flu
• 1969 Hong Kong Flu
• Seasonal influenza strains are pandemic strains
  of years past

5
Avian Influenza and Human Influenza

• All human influenza viruses arise from avian
  viruses
• Sometimes humans become victims of an avian virus
  strain through close contact with birds
• Avian influenza viruses may evolve into new
  strains capable of infecting humans

6
Avian Influenza

• Disease of domestic poultry with a origin in
  migratory birds
• H5N1classification
• Can infect mammals including humans
• Mortality rate of gt60 in humans
• Dont count on seasonal respite

7
Control Strategies Birds
Vaccination
Stamping out
Surveillance
Quarantine
8
Problems.

• Asia is too big
• Lots of pressure for mutation over thirteen
  billion chickens in China alone
• Most chickens live in backyard flocks
• Lack of compensation for sick/dead animals
• People must choose hunger vs. disease control
• Recent successes or too soon to tell?

9
H5N1 in Humans The Beginning
origin of H5N1 Hong Kong 1997
10
Avian flu and people
11
Planning Assumptions

• Risk of an influenza pandemic in the future 100
• H5N1? Unknown
• Susceptibility will be universal
• Planning will be based on severity of illness
• Viral Illness
• Incubation 1-4 days
• Persons may be infectious before signs of illness
• Pandemic will occur in waves
• 6-8 weeks
• Multiple waves may occur over 18months-2 years

12
Dont worry weve got a plan! The YOYO strategy
13
Infection Control Basic Tools

• Vaccine

Antivirals
14
Social Distancing Maneuvers

• Close schools
• Keep children at home
• Social distancing in workplace
• Liberal leave policies
• Home isolation and quarantine
• Personal Preparedness

15
Concerns

• Communities must be ready to implement measures
  rapidly sustain reasonable compliance
• There is lack of traction for personal and
  community based preparedness efforts

16
Is there anything good about the bird flu scare??

• Modernize vaccine production techniques
• Improve surveillance for animals and humans
• Emphasizes the importance of public health
• Modernizes outbreak or disaster communication
  systems
• Encourages citizens to be prepared for all
  hazards

17
Discussion

• Important websites
• CDC www.cdc.gov
• Federal Governmentwww.pandemicflu.gov
• Fed Volunteer www.ready.gov
• World Health Organization www.who.int
• CIDRAP www.cidrap.umn.edu