Pandemic Influenza 2006 Local Activities and Response Plans

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Pandemic Influenza - 2006 Local Activitiesand
Response Plans
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Definitions

• Epidemic An increase in disease above what is
  normally expected
• Pandemic A worldwide epidemic

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Why The Concern About Pandemic Influenza?

• Influenza pandemics are inevitable naturally
  recur at more-or-less cyclical intervals
• Can cause
• High levels of sickness and death
• Drastic disruption of critical services
• Severe economic losses
• There can be little warning time between the
  onset of a pandemic and its arrival in the U.S.

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Why The Concern About Pandemic Influenza?

• Outbreaks occur simultaneously in many areas
• Impacts will last for weeks to months
• Pandemics can disproportionately affect younger,
  working-age people
• Current avian influenza outbreak in Asia

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Influenza Pandemics in the 20th Century
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Excess US Deaths in Previous Influenza Pandemics

• 1918-19 500,000 - 650,000
• Ten times as many Americans died of flu than died
  in WW I
• 1957-58 70,000
• 1968-69 40,000
• Typical annual influenza season 36,000

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How Do Influenza Pandemics Arise?

• Fowl are natural reservoirs of influenza and can
  spread the virus to other birds
• All human influenza viruses arise from avian
  viruses
• Avian influenza viruses evolve into new strains
  capable of infecting humans
• A new avian-derived flu virus that can reproduce
  and spread in humans leads to a pandemic

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Current Outbreak Avian Influenza (H5N1)

• Began in fall, 2003.
• At least 161 confirmed human cases, 86 deaths in
  Vietnam, Thailand, Cambodia, Indonesia, Turkey,
  Iraq as of Feb. 2, 2006
• No sustained person-to-person transmission
• Information from World Health Organization

Avian influenza
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World Health Organization Phases of an Influenza
Pandemic
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World Health Organization Phases of an Influenza
Pandemic
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Potential Impact of Pandemic Flu in the US and
Locally

• Assumptions
• Susceptibility to virus will be universal
• Sustained person to person transmission
• Attack rate 20 to 40(not all symptomatic)
• Community outbreak will last 6 8 weeks

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National Impact

• Up to 200 million people infected
• 40 - 90 million people clinically ill
• 20 - 46 million (low range estimate only)
  outpatient medical visits
• 360,000 9,000,000 people hospitalized
• 104,000 2,000,000 deaths

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National Impact

• US losses estimated at 71-166 billion
• Many geographic areas affected at the same time

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Local Impact Health Status

• Pennsylvania Local (Moderate Severity)
• 3.0 million cases in PA 35,000 cases locally
• 112,600 hospitalizations in PA 1200
  hospitalizations locally
• 27,000 deaths in PA 92 deaths locally

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Treatment and Prevention Vaccine

• Vaccine takes 6-8 months to produce following the
  emergence of a new virus
• Supplies will be limited, if available at all
• Establish priority groups for use of limited
  vaccine
• 2nd dose after 30 days will likely be required
• Need to monitor vaccine safety and efficacy

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Treatment Prevention Antiviral Drugs

• Antiviral agents
• Effective in preventing illness
• Can prevent severe complications
• May not be effective against pandemic virus
• Supplies will be limited
• Establish priority groups for use of available
  drug
• Treatment over prevention

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Federal Roles Responsibilities

• Coordinate national Influenza Pandemic Response
  Planning (IPRP)
• Develop a national information database/exchange
  clearinghouse and surveillance
• Develop generic guidelines and information
  templates for modification of pandemic response
  planning, as needed

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State Roles Responsibilities

• Maintain surveillance and data management systems
  to implement the IPRP
• Incorporate the IPRP with the Commonwealths and
  the PA Health Depts existing emergency response
  plans
• Review and exercise the IPRP on an annual basis

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State Roles Responsibilities

• Develop and maintain legal documents for
  volunteer resources, quarantine, etc.
• Coordinate agreements with the State Police
• Develop a plan to close and reopen schools,
  businesses and other public places/events
• Prepare to activate operations for a pandemic
  appropriate for the occurring infectious disease

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Local Roles Responsibilities

• Coordinate security provisions for vaccine, human
  resources and clinic locations
• Identify local administrative and medical
  decision makers
• Develop local preparedness plans that correspond
  to statewide plans
• Identify local surveillance teams

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Local Roles Responsibilities

• Meet with local stakeholders and review major
  elements of local emergency response preparedness
• Modify local Points of Dispensing (PODs) to
  account for target groups, projected vaccine
  supply and available human resources
• Secure written agreements from hospitals and
  other community properties that will be utilized
  to keep/administer vaccines/antivirals

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Local Roles Responsibilities

• Obtain written commitments from agencies and
  institutions that will provide volunteers
• Maintain a current plan for local surveillance,
  medical/emergency response, vaccine/ antiviral
  administration and communications
• Develop a plan utilizing communication templates,
  in languages common for the area, to educate the
  public

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Local Roles Responsibilities

• Communicate with schools, businesses and other
  venue for potential closures
• Develop collaborations with adjoining
  counties/districts/states
• Conduct local and county exercises/drills
  annually for an emergency influenza pandemic
  response.
• (from PA Influenza Pandemic Response Plan)

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Influenza Prevention What We Are Doing

• University Response Plan
• Plan will provide for cooperation with Community
• Plan will establish an information program
• Plan will establish what their response actions
  will be in case of a flu pandemic
• Plan will establish priorities and what
  students/faculty need to do

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Influenza Prevention What We Are Doing

• University Response Plan
• University planning group will continue to meet
  until plan is complete
• Plan will be reviewed periodically

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Influenza Prevention What We Are Doing

• Local Community Response Plan
• Coordinate Plan with University and Emergency
  Operations Plan
• ID Key local needs and persons who need to be
  involved medical, police, public works, social
  services, schools, utilities
• Establish a Local Steering Committee with
  Sub-committees

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Influenza Prevention What We Are Doing

• Local Plans
• Sub-committees charged with specific tasks and
  preparation of an action plan
• Steering Committee will coordinate and compile
  overall plan
• Plan will provide for public information
• Plan will designate local authority
• Coordinate plan with PA Health CDC

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Influenza Prevention What We Are Doing

• Local Plans
• Plan will set priorities for anti-virals and/or
  vaccines and for their mass distribution
• Plan will provide for emergency housing, food
  distribution, etc.
• Completed Plan made available

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Influenza Prevention What Can People Do?

• Stay home when sick
• Respiratory hand hygiene
• Cover your cough/sneezes
• Wash hands and/or
• use alcohol hand gel
• Avoid touching eyes, nose, mouth
• Stay informed
• Avoid crowds during an outbreak

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The Next Pandemic Where When?

• It is not possible to predict precisely where or
• when the next pandemic will emerge, but
• I think what were concerned about is looking
• at whats going on in Asia right now with avian
• flu, and a very big worry is that this is a time
• bomb ticking.
• Dr. Julie L. Gerberding, Director, Centers for
  Disease Control and Prevention
• We may be at almost the last stage before the
• pandemic virus may emerge.
• Dr. Jai P. Narain, World Health Organization,
  9/9/05

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More Information About Pandemic Influenza

• Websites
• www.pandemicflu.gov information and federal
  plan
• www.health.state.pa.us Pennsylvania state plan
  and information