"Although exactly when and where the next influenza virus will emerge is not known, it is likely that the outcome will vary from serious to catastrophic . . ."
Pandemic Influenza Preparedness and Response Plan
Department of Health and Human Services
Pandemic influenza is a global outbreak of disease that occurs when a new influenza A virus appears in humans, causes serious illness and then spreads easily from person to person worldwide. Three major influenza pandemics swept the globe in the 20th century causing millions of deaths, and no one knows for sure when the next pandemic may strike. Efforts are underway to plan for the complex issues and serious impact that a new influenza pandemic could cause in Virginia.
A pandemic is caused by a new influenza A virus that most people have never been exposed to, so everyone is susceptible. Pandemic strains also often cause more serious disease. Because of this, past flu pandemics have led to high levels of illness, death, social disruption and economic loss.
Seasonal outbreaks of flu are caused by strains of flu virus similar to those of past years. Some people may have built up immunity, and there is also a vaccine for each year’s flu season.
Flu pandemics are different from many of the threats for which public health and the health-care system are currently planning:
The pandemic will last much longer than most other emergency events and may include waves of flu activity separated by months (in 20th century pandemics, a second wave of flu activity occurred three to 12 months after the first wave).
The numbers of health-care workers and first responders available to work can be expected to be reduced as they will be at high risk of illness through exposure in the community and in health care settings, and some may have to miss work to care for ill family members.
Resources in many locations could be limited because of how widespread an flu pandemic would be.
Three pandemics occurred in the 20th century, all of which spread around the world within one year of being detected. Of these, the pandemic of 1918-1919 was the most severe, with 50 million or more deaths worldwide.
No one can predict when a pandemic might occur, but many scientists believe it is only a matter of time before the next one arises. Experts from around the world are watching the H5N1 Avian (bird) Flu situation in the Middle East, Europe and Asia very closely and are preparing for the possibility that the virus may begin to spread more easily and widely from person to person.
Avian influenza, commonly known as bird flu, refers to a large group of different influenza viruses that primarily affect birds. Wild birds can carry the viruses, but usually do not get sick from them. However, some domesticated birds, including chickens, ducks and turkeys can become infected, and will often die from the virus. Each year, there is a flu season for birds just as there is for humans and, as with people, some forms of the flu are worse than others.
On rare occasions, these avian flu viruses can infect other species, including pigs and humans. The vast majority of avian flu viruses do not infect humans. H5N1, the strain of Avian Flu currently affecting countries in the Middle East, Europe and Asia, has the potential to develop into a human pandemic, since it might ultimately adapt into a strain that is spread easily from person to person. Once this adaptation occurs, it will no longer be a bird virus--it will be a human influenza virus.
n Latest World Health Organization Count of Confirmed Human Cases Of H5N1 Avian Flu.
n Travel advisories for travelers to areas affected by H5N1 Avian Flu
· When a pandemic influenza virus emerges, its global spread is considered inevitable.
· Preparedness activities should assume that the entire world population would be susceptible.
· Countries might, through measures such as border closures and travel restrictions, delay arrival of the virus, but cannot stop it.
· Most people have little or no immunity to a pandemic virus. Infection and illness rates soar. A substantial percentage of the world’s population will require some form of medical care.
· Nations unlikely to have the staff, facilities, equipment and hospital beds needed to cope with large numbers of people who suddenly fall ill.
· Death rates are high, largely determined by four factors: the number of people who become infected, the virulence of the virus, the underlying characteristics and vulnerability of affected populations and the effectiveness of preventive measures.
· Past pandemics have spread globally in two and sometimes three waves.
· The need for vaccine is likely to outstrip supply.
· The need for antiviral drugs is also likely to be inadequate early in a pandemic.
· A pandemic can create a shortage of hospital beds, ventilators and other supplies. Surge capacity at non-traditional sites such as schools may be created to cope with demand
· Difficult decisions will need to be made regarding who gets antiviral drugs and vaccines.
· Travel bans, closings of schools and businesses and cancellations of events could have major impact on communities and citizens.
· Care for sick family members and fear of exposure can result in significant worker absenteeism.
If a new and severe strain of flu were to begin spreading across the globe, Virginia would not be spared from its impact. The severity of the next pandemic cannot be predicted, but modeling studies suggest that its effect in the United States could be severe. In the absence of any control measures (vaccination or drugs), it has been estimated that in the United States a “medium–level” pandemic could cause:
·
Deaths: 89,000 to 207,000
· Hospitalizations:314,000 and 734,000
· Outpatient Visits: 18 to 42 million
· Number of Sick Persons: 20 to 47 million people
In Virginia, pandemic flu impact estimates include:
· Deaths: 2,700 to 6,300
· Hospitalizations:12,000 to 28,500
· Outpatient Visits: 575,000 to 1.35 million
· 1.08 million to 2.52 million people becoming sick
"Hope is not a strategy"
Admiral John O. Agwunobi, MD, MBA, MPH
Assistant Secretary, Department of Health and Human Services
n Pandemic Flu Planning Checklist for Individuals and Families
n Family Emergency Health Information Sheet
n Emergency Medical Services & Medical Transport Planning Checklist
n Home Health Care Services Planning Checklist
n Medical Offices and Clinics Planning Checklist
n Faith-Based & Community Organizations Pandemic Influenza Preparedness Checklist
n Childcare and Preschool Planning Checklist
n School District (K-12) Planning Checklist
n Colleges and Universities Planning Checklist
n Business Pandemic Influenza Planning Checklist
n State and Local Pandemic Influenza Planning Checklist
n Virginia Pandemic Flu Webpage
n Draft Revised Virginia Pandemic Flu Plan
n CDC Pandemic Influenza Worldwide Preparedness Webpage
n Center For Infectious Disease Research And Policy
n International Association of Fire Chiefs downloadable Bird Flu brochure
Contact the authors:
Judy Shuck, Mass Casualty Preparedness Coordinator, Hampton Roads MMRS
Laura Walker, EMS Education Coordinator, Tidewater EMS Council