pandemic influenza: what do we know, what should we do?

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

Elizabeth L. McClure, MD, MPHAHC Office of Emergency Response

Center for Infectious Disease Research and Policy CIDRAP

University of Minnesota

Seasonal Influenza

Pandemic Influenza

What creates a pandemic?

Novel virus: No population immunity Cause serious disease_ Transmitted person to person

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

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

Avian Influenza• Disease of domestic

poultry with a origin in migratory birds

• H5N1classification• Can infect mammals

including humans• Mortality rate of >60%

in humans• Don’t count on

seasonal respite

Control Strategies: Birds

Surveillance

Vaccination

Quarantine

Stamping out

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?

H5N1 in Humans: The Beginning

* origin of H5N1 Hong Kong 1997

Avian flu and people

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

Don’t worry……we’ve got a plan!

The YOYO strategy

Infection Control: Basic Tools

Vaccine

Antivirals

Social Distancing Maneuvers

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

Concerns

• Communities must be ready to implement measures rapidly sustain reasonable compliance

• There is lack of traction for personal and community based preparedness efforts

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

Discussion

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