Influenza Outbreaks and Cruise Ships

Laura Martin25 April 2002

General Information

o Influenza is an acute respiratory illness caused by a virus and transmitted by respiratory secretions through sneezing or coughing.

o Symptoms:o Abrupt onset of fevero Headacheso Muscle acheso Soar throato Non-productive cougho Congestiono Extreme Fatigue

General Information

o Change in the viruso “Antigenic Drift”

o Small changes that occur continuously over time.o Produces new virus strains in both influenza A

and Bo “Antigenic Shift”

o An abrupt and major change in the influenza A viruses.

o Results in a new subtype of influenza A.o Why is this significant?

o Whenever a new subtype or strain is introduced, the body’s immune system will not recognize it.

o Type C causes a mild respiratory illness and is thought not to cause epidemics.

General Information

o Groups at Risk for severe infectiono People over the age of 65.o Residents of nursing homes or chronic care

facilities.o Those with chronic disorders of the

pulmonary or cardiovascular systems.o Patients who have required medication

follow-up or hospitalization during the past year because of chronic metabolic diseases, renal dysfunction, or immunosuppression.

o Children or teens who are receiving long-term aspirin therapy.

General Information

o Preventiono Vaccine

o Administered yearly because of the genetic changes in the virus and decreased immunity over time.

o Also consider vaccination before traveling to the tropics or into the Southern Hemisphere.

o Side effects: o malaise (a feeling of illness or depression), o myalgia (muscular pain), o fever, o or an allergic reaction.

General Information

o Treatmento Bed resto Fluid consumptiono Symptom relief with over the counter

drugs such as pain relievers, decongestants, and cough medicines.

o The use of anti-viral drugso Two are available.o Can prevent infection during continued

exposure to the virus.o Can also reduce the severity and duration of

the illness if administered shortly after the appearance of symptoms.

Cruise Ships

o September and October 1997 – Two Cruise Shipso Majority of passengers 65 and older and at risk for

flu-related complications.o Majority of passengers and crew also unvaccinated.o Action taken:

o Active surveillance o Vaccination of crew memberso Use of antivirals

o The steps taken to control this outbreak were successful.

o However, the overall level of influenza activity is typically low for this time of year, so this situation demonstrates how travel and large groupings of people can increase the likelihood of a problem occurring.

Cruise Shipso Another

possible influenza outbreak was reported by the CDC Morbidity and Mortality Weekly Report after June of 2000 when an outbreak of respiratory illnesses occurred on the MS Rotterdam.

Outbreaks and Pandemics

o 1918 – The Spanish Fluo 20-50 million people died

worldwide.o Many died a few days after

infection and some died of complications later.

o This pandemic was unique because almost half the people that died were young, healthy adults.

This is an image from an emergency hospital in Camp Funston, Kansas during the 1918 influenza epidemic.

Outbreaks and Pandemics

o Other Pandemics include:o The 1957 Asian Flu which killed approximately

70,000 people in the United States.o The 1968 Hong Kong Flu that caused nearly

35,000 deaths in the US.o Other outbreaks include:

o The 1976 Swine Flu that infected soldiers at Fort Dix, New Jersey. Over 40 million Americans were vaccinated as a result to prevent a pandemic.

o The 1997 Avian Flu in which 18 people in Hong Kong were infected with a flu strain previously only seen in birds.

Swine Flu