Pandemic Pandemic FluFlu

Know the Facts

Pandemic Flu CommitteePandemic Flu Committee

Peggy Powell Tony Pescatore Janet Kurzynske Andrea Husband Peggy Riley Kim Henken Ricky Yeargan Deborah Murray

Various Types of FluVarious Types of Flu

Seasonal FluPandemic FluAvian Flu

Flu Pandemics of the Flu Pandemics of the PastPast

Spanish FluAsian FluHong Kong Flu

Spanish Flu PandemicSpanish Flu Pandemic

Began September 1918 & Ended April 1919

About 675,000 people died in the United States

Rapidly spread and killed those infected

Asian Flu PandemicAsian Flu Pandemic

Began in February 1957 and ended in early 1958

Was quickly identified and vaccine was created

About 70,000 people died in the United States

Hong Kong Flu PandemicHong Kong Flu Pandemic

Began in September 1968 and ended in March 1969

Virus was similar to Asian fluApproximately 34,000 people died in the

United States

Avian FluAvian FluCurrently no human cases in the United States Currently excellent screening system for

migratory birdsExcellent commercial poultry protectionNo evidence of humans effected by properly

cooked poultryCurrently no effective vaccine Work is proceeding on vaccine for poultry and

humans

Avian Flu Health EstimatesAvian Flu Health Estimates

Should Avian Flu occur as a serious case in the US it is estimated that 90 million people would be effected with 2 million deaths

Short term impacts are projected to be 30% of workers sick in most industries with 2.5% expected to die. Average survivors miss 3 weeks of work.

Avian Health con’t.Avian Health con’t.

In a severe case, it is projected there would be 700,000 hospitalizations, 18-42 million out patient visits

Source: Center for Disease Control and Prevention.

Projected Avian Flu Economic Projected Avian Flu Economic ImpactImpact

Severe case applying average worker productivity rates loss to the economy would be $600 billion or 5% of the GNP

Huge adverse impact on size of future labor pool

Conclusion- Money spent preventing a pandemic will be well spent.

Source: Congressional Budge Office

Pandemic Flu WebsitePandemic Flu Website

Pandemic Flu InformationPandemic Flu Information

HomeUnderstanding FluPreparing for a PandemicDuring an OutbreakMaterials for County Extension Agents

Avian Influenza in the USis NOT the same Virus as

“Bird” Flu in Asia

Avian InfluenzaAvian InfluenzaNomenclatureNomenclature

Birds: Influenza A type virus

Influenza A is divided into Subtypes based on their surface proteins:

Hemagglutin (HA): 15 subtypes

Neuraminidase (NA): 9 subtypes

H5N1

Influenzavirus AInfluenzavirus A

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DomesticPoultryShorebirdsDucksEquineSwine

Mammalia Aves

Host of Origin

H1H2H3

H4/6H5H7H8H9

H10/11H12H13H14H15

HumanHA

Subtype

Poultry FAD 2005

Influenza Virus (Flu)Influenza Virus (Flu)

Mammals and birds always have flu viruses circulating in their respective populations

Horses, Hogs, Humans, and Birds are just a few of the species that are susceptible to flu viruses

Flu viruses generally stay within species There are some exceptions like Swine flu, which

resides in hogs but can infect turkeys Flu viruses are always changing, that’s why the

human vaccine changes yearly

Avian Influenza (AI)Avian Influenza (AI)

North America has always had Avian Influenza strains circulating in waterfowl, wild birds, and live bird markets

“Asian Bird Flu”(H5N1) is one of many strains of Avian Influenza

Poultry companies are concerned about all avian influenza strains, not just “Asian Bird Flu”

Some Perspective on Some Perspective on Asian Bird Flu (H5N1)Asian Bird Flu (H5N1)

Less than 160 people have died from “Asian Bird Flu” and 265 are known to have gotten sick out of 3.7 Billion people in Asia. Since 2006 48% of the cases and 58% of the deaths have been in Indonesia.

It is not contagious between people People afflicted with this disease had very close

contact with sick birds (live with them, butchered and ate products from sick birds.)

It has been known to be in Asia since 1997 but recently has moved into Africa and Europe

Asian Bird Flu (H5N1) infects Asian Bird Flu (H5N1) infects birds easily but does not infect birds easily but does not infect

people easilypeople easily

Factors in Asia that have Factors in Asia that have facilitated H5N1 Infectionfacilitated H5N1 Infection

Eastern Asia has the most poultry and people living in very close proximity

Unsanitary conditions Live Bird (Wet) Markets are a primary source for

poultry in cities Sick animals are likely to be eaten by impoverished

people Consumption of uncooked meat or poultry products

(such as raw blood) Cockfighting (highly mobile)

Asian Bird Flu(H5N1)Asian Bird Flu(H5N1)

This is not a subtle disease in birdsIt kills birds very quickly and in large

numbers (90% plus)With few exceptions, cases have been in

live markets, free roaming birds or birds kept in primitive conditions

What do you need to know What do you need to know about “Asian Bird Flu”?about “Asian Bird Flu”?

This disease will not sneak up on the U.S. U.S. commercial poultry are at a lower risk of

getting “Asian Bird Flu” than free roaming birds Wild birds, free range poultry, backyard birds,

Live bird markets, and gamecocks are at the highest risk of all Avian Flu

U.S. Poultry companies understand that this is “not just another AI virus” and are taking precautions

How are Poultry Companies How are Poultry Companies responding to the threat?responding to the threat?

All of the major poultry companies are testing all flocks prior to processing to ensure that poultry products are AI free

In the unlikely event of a H5N1 infection in commercial poultry, the flock would not be processed for food. (euthanized on farm)

Consumer Education Message: U.S. poultry products will be safe even if Asian Bird flu comes to U.S. (websites, brochures, articles)

What is being done in USWhat is being done in US

Voluntary (mandatory) surveillance program.

Must test for exports. Mandatory surveillance of live bird markets in

NY, NJ and east coast Increase awareness among poultry health

officials and state officials USDA increase information to small flocks

producers Import ban on poultry from Asia

What is being done in Kentucky?

•Commercial Surveillance Program

•Poultry Health Advisory Board

•Emergency Disease Plan

•Catastrophic Loss Training

•Creation of an indemnity fund for small flocks ($ 204,000) by commercial industry ($102,000) and Ag Development Fund Match ($102,000)

How Poultry Companies are How Poultry Companies are structured to prevent diseasestructured to prevent disease

Chickens are raised indoors to protect from disease-carrying wild birds

A company representative visits the farm weekly to evaluate flock health

Producers alert the company immediately to changes in flock health status

Biosecurity: Procedures that keep disease away from the flock

Poultry BiosecurityPoultry Biosecurity

Unauthorized visitors are not permitted on farm Clean coveralls, hairnets, and disposable boots are

used when visiting farms Step pans disinfect footwear prior to entering Water systems sanitized (especially lake systems) Producers avoid contact with waterfowl,

gamecocks, poultry swap meets, etc.

Why aren’t we vaccinating our Why aren’t we vaccinating our chickens for Asian Bird Flu?chickens for Asian Bird Flu?

Historically, vaccinating for AI meant that a country was not serious about eradication

US Poultry relies heavily on exports: Breast meat stays in domestic markets, Leg quarters go overseas

U.S. companies believe that trade barriers would be imposed if U.S. vaccinated for AI

Overseas opposition to vaccination may vanish as more countries vaccinate for “Asian Bird Flu”

FFLUSTOPLUSTOPFlock Observation

•Observe Flocks Daily

•Changes in appearance, behavior, drinking and eating behavior

•Disease symptoms eat less, respiratory signs, lack of coordination, increase death loss

•Dispose of dead birds properly

FFLLUSTOPUSTOPLimit TrafficAllow only necessary people and vehicles

to enter the farmPost warning signsLog book for visitorsBe aware of areas with birds (hunting,

farm ponds, pet stores, zoos, parks)Minimum level of security is clean boots

FLFLUUSTOPSTOPUnwanted CrittersPrevent contact with wild birdsClean up grain and feed to control wild

birds and rodentsIsolate or cull sick birdsA chicken is the only animal that should be

in a chicken house (keep dogs and cats out)Isolate new or returning poultry from

resident birds for at least 30 days

FLUFLUSSTOPTOPSanitationKeep pens and buildings neat and cleanPrevent wet and damp bedding and eliminate

standing water in pensClean and disinfect all equipment and crates

before returning to the farmEstablish a wash area away from the poultry

buildingsProvide clean boots and clothes for workers

FLUSFLUSTTOPOPTalk to a vet Early detection and reporting are important

steps in preventing a disease outbreak If you notice unusual symptoms or increase

death contact local vet or the office of the State Veterinarian

To report sick wild birds (more than 5 or waterfowl) contact US Fish and Wildlife or the KY Department of Fish and Wildlife

FLUSTFLUSTOOPPObjects spread disease Diseases spread through direct contact with

infected birds Diseases also can be spread by manure,

equipment, vehicles, egg flats, eggshells, crates, and boots

Avoid visiting other poultry farms Do not share equipment but if you must, wash

and disinfect any shared equipment before it is returned to the farm

Do not reuse egg cartons, egg flats or packing materials

FLUSTOFLUSTOPPPrepare food properlyDo not eat, drink or use tobacco products when

handling poultryWash hands and surfaces with hot soapy water

before and after handling raw poultry or eggsKeep raw poultry and their juices away from

other foodsCook poultry to 165o F

Hunter and TaxidermistsHunter and Taxidermists Limit exposure to feces and bodily fluids from

game animals Do not handle or process birds found sick or dead Wear rubber or latex gloves and washable

clothing while handling game Dispose of internal organs, feathers, bones skin,

and trimmings in a safe manner Do not eat, drink, or use tobacco products while

handling game Wash hands with soapy water or alcohol wipes

immediately after handling game

Hunter and TaxidermistsHunter and Taxidermists

Clean all tools and work surfaces with hot soapy water then disinfect with 10% chlorine bleach or other disinfection

Thoroughly cook meat is safe to eat (165oF) Use caution around water sources and roosting

areas were feces from wild birds may accumulate

When finished hunting, clean clothing, boots, vehicles as soon as possible

Do not bring game birds onto poultry farms

http://wildlifedisease.nbii.gov/ai/LPAI-Table.jsp

Kentucky429 Wild bird samples197 Environmental Samples626 Total Samples

PandemicPandemic

Family and Youth Materials

Vulnerable Population GroupsVulnerable Population Groups

Death rate for 1918 flu = 2%; death rate for Avian Flu H5N1 = 60%

US estimate 2 million deaths Spanish Flu 1918-1919 killed mostly young adults

– 675,000 US deaths Asian Flu 1957-1958 school age, young adults,

pregnant women most often infected - 70,000 US deaths

Hong Kong 1968-1969 highest death rate in 65 and over – 34,000 US deaths

Typical At-Risk PopulationsTypical At-Risk Populations

The very young– Lack of reserves (fluid, fat etc.)

The very old– Lack of reserves (fluid, fat, etc.)– More likely to have other health issues making

complications (such as pneumonia) more likely

Typical At-Risk Populations cont.Typical At-Risk Populations cont.

Pregnant womenHealth compromised individuals

– Lack of reserves– Complications more likely

What Happened in 1918?What Happened in 1918?

No one had immunityEach individual needed to develop antibodies

so that the individual can fight off the virus.Healthy young adults went into

immunological overload. Caused unexpected high death rate in young

adults.

Would Having a Weak Immune Would Having a Weak Immune Lower the Death Rate in the Lower the Death Rate in the

1918 Pandemic?1918 Pandemic?

There is no evidence that having a weak immune system before the pandemic would have reduced the possibility of having gone into an immune system overload.

Having a weak immune system will make an individual more susceptible to the typical complications of a pandemic or flu.

Most Vulnerable Population for Most Vulnerable Population for the Future Pandemicthe Future Pandemic

Avian Flu H5N1 presently does not discriminate

No way to predict but it might not be the very old and the very young.

Everyone should be prepared

College of Agriculture Pandemic College of Agriculture Pandemic WebsiteWebsite

http://www.ca.uky.edu/fcs/pandemicflu/index.html

Build Your Immune System with Build Your Immune System with Good Nutrition, cont.Good Nutrition, cont.

Describes function of immune system Stop the disease from entering the body Kills bacteria or viruses once they enter to body but

before they make you sick Destroys viruses and/or bacteria after they have

created disease

Good Nutrition cont.Good Nutrition cont.

What will good nutrition do for you? Help you develop the best possible immune system Increase the ability of your body to know a virus has

entered it, lowering your chances of getting sick Increase the ability of your body to attack the virus,

helping you fight the pandemic once you get it Provides reserves that can be used when you are too

ill to eat

When is it best to start?

What is best to eat?What is best to eat?

Variety5 fruits and vegetables every day

consume fruits and vegetable of great color – blueberries, cherries, blackberries, broccoli, Brussels sprouts, red bell peppers, etc.

3 servings of low fat dairy each day6 servings of whole grain breads and cereals

to your meals each day2 servings of protein each day

Food for Emergencies – Food for Emergencies – Pandemic FluPandemic Flu

Why do we need to store food? Basic services may be effected You may not be able to get to the store – illness,

quarantine Why do we need to store food?

How much food should you store? Minimum one week supply of food that does not need to

be kept cold, prepared or heated Look at what you normally eat Don’t forget the refrigerator Be creative in storage Consume less food, but not fluid

Check ListsCheck Lists

Faith-Based and Community Organizations Pandemic Flu Checklist

Family Emergency Health Information Sheet - Pandemic Flu

Checklist for Schools - Pandemic Flu

Checklist for Preschool and Child Care Facilities - Pandemic Flu

Home Nursing Care – Pandemic Home Nursing Care – Pandemic FluFlu

Taking care of the caregiver One dedicated caregiver Sleep, nutrition, exercise, hand washing

Taking care of the sick Fluids, keep them comfortable Know when needs to get additional medical care

What the patient can do Face mask, wash hands, stay home in small location of house,

isolate body fluid General information

Isolate person and body fluids Family Emergency Health Information Maintain pandemic medicine kit

Pandemic Medicine KitPandemic Medicine Kit Fever reducer Anti-nausea and anti-diarrhea medicine Cough, cold, flu medicines Vitamins Prescribed medicine Emergency medicine such as glucose tablets for diabetics Blood pressure monitoring equipment Thermometers Face masks Hand sanitizer Alcohol

Pandemic Ready for BusinessesPandemic Ready for Businesseshttp://eden.lsu.edu/LearningOps/Pandemic/

Guidance onGuidance onPreparing Workplaces for an Preparing Workplaces for an

Influenza Pandemic Influenza Pandemic http://www.osha.gov/Publications/influenza_pandemic.html

How would taking precautions How would taking precautions help?help?

How might a Pandemic Affect my How might a Pandemic Affect my Community?Community?

Absenteeism - A pandemic could affect as many as 40 percent of the workforce during periods of peak influenza illness. Employees could be absent because they are sick, must care for sick family members or for children if schools or day care centers are closed, are afraid to come to work, or the employer might not be notified that the employee has died.

Change in patterns of commerce - During a pandemic, consumer demand for items related to infection control is likely to increase dramatically, while consumer interest in other goods may decline. Consumers may also change the ways in which they shop as a result of the pandemic. Consumers may try to shop at off-peak hours to reduce contact with other people, show increased interest in home delivery services, or prefer other options, such as drive-through service, to reduce person-to-person contact.

How might a Pandemic Affect my How might a Pandemic Affect my Community?Community?

Interrupted supply/delivery - Shipments of items from those geographic areas severely affected by the pandemic may be delayed or cancelled.

How might a Pandemic Affect my How might a Pandemic Affect my Community?Community?

What would your office

do?

Ask a Pandemic Flu QuestionAsk a Pandemic Flu QuestionClick on question on UK Pandemic websiteType in your questionQuestion will go to a person in a centralized dissemination position

Links to Other SitesLinks to Other Sites

Extension Disaster Education NetworkPandemicFlu.govKentucky Cabinet for Health & Family

ServicesHEELUniversity of Kentucky Avian Flu

Resources

AdditionalResources

Needed

QUESTIONS?

Educational programs of the Kentucky Cooperative Extension Service serve all people regardless of race,

color, age, sex, religion, disability or national origin. Disabilities accommodated with prior notification.