Influenza – What in the world do YOU need to know?

Influenza

Seasonal Avian Pandemic

What is Seasonal Influenza? Acute, febrile respiratory

illness affecting nose, throat, bronchial tubes and lungs

Epidemics caused by influenza viruses A and B(Type C uncommon in people; no epidemics)

Occurs worldwide, causing considerable morbidity (illness) and mortality (death) each year

Symptoms appear rapidly

How You Get the Flu?

Typical incubation: 2 days

Range: 1-4 days Viral shedding

Can begin 1 day before symptom onset

Peak shedding first 3 days of illness

Correlates with temperature

Subsides after 5 days in adults, can be 10+ days in children

Transmission is Transmission is predominately droplet predominately droplet spreadspread

The Burden of Seasonal Influenza

Globally: 250,000 to 500,000 deaths each year

In the United States each year: 36,000 deaths >200,000 hospitalizations $37.5 billion in economic costs from influenza

and pneumonia

What is Avian Influenza?

All flu is bird flu Current concern is H5N1 Worldwide poultry outbreak Rare, but severe in humans NOT EASILY SPREAD HUMAN TO

HUMAN

Source: http://www.pandemicflu.gov/#map

Nations With Confirmed Cases H5N1 Avian Influenza (May 19, 2006)

Current H5N1 situation in humans

229 human cases, world-wide since December of 2003 (as of 7/4/06)

130 deaths

57 % mortality rate (fatality)

Situation Summary: Avian Influenza

Widespread occurrence in migratory birds

Continued outbreaks among domestic poultry

Asymptomatic infections in domestic ducks

Lethal infections in mammals (cat, pigs)

Still lacks ability to travel easily human to human, but every infection provides another opportunity for the virus to change

How Influenza Viruses Change?

Antigenic Drift: Small changes in virus over time New strains appear and replace older strains May not be recognized by antibodies to older strains

Antigenic Shift: Abrupt, major change (reassortment) Results in novel strain or new subtype Can cause pandemic influenza

Will Avian (Bird) Flu Cause the Next Pandemic?

No one knows!

The H5N1 virus could change to spread more easily among humans-but it might not.

It could “swap genes” with another animal virus, or with a human flu virus

What is Pandemic Influenza ?

A global influenza outbreak Caused by a brand new (novel) flu virus Can occur at any time of year

Because it is a new virus, few or no people would be immune

Many people would get sick in every part of the world

Asia is the source of many outbreaks because swine, birds and humans live under the same roof, providing opportunity for viral mixing

Influenza Pandemics 20th Century

A(H1N1) A(H2N2) A(H3N2)1918: “Spanish Flu” 1957: “Asian Flu” 1968: “Hong Kong Flu”

20-40 m deaths

675,000 US deaths

1-4 m deaths

70,000 US deaths

1-4 m deaths

34,000 US deaths

Credit: US National Museum of Health and Medicine

If a Pandemic Happens: What to expect…

At the peak of a moderate pandemic influenza outbreak (i.e. 35% attack rate, 6 week duration), New York State (excluding New York City) can expect: 14,916 influenza-related hospital admissions per week 3,728 influenza-related deaths per week

2,609 deaths in the hospital

Influenza patients will most likely utilize: 63% of hospital bed capacity 125% of intensive care capacity 65% of hospital ventilator capacity.

What is New York State doing to prepare?

HHS Pandemic Influenza Doctrine: Saving Lives

Slow spread, decrease illness and death, buy time Antiviral treatment and isolation for people with illness Quality medical care Quarantine for those exposed (antiviral prophylaxis if

available) Social distancing, travel restrictions Infection control Vaccine when available Maintain essential services Local decisions Communication

Weeks

Impact

Prepared

Unprepared

Public Health Emergency Preparedness -

A Shared Responsibility! Local – state – federal Domestic –

international Public – private Multi-sector Animal – human Health protection –

homeland security – economic protection

Healthcare

DeliverySystem

Federal Partners

Education System

Businesses & Workers

Local/State/Federal Public HealthSystem

What is Ontario County doing to prepare?

Public Health Emergency Planning since 2003 White Powder Plan ChemPak Plan Medical Reserve Corps Isolation and Quarantine Protocol Strategic National Stockpile Plan 9 County Public Health Mutual Aid Agreement Points of Distribution Plan Surveillance Program in Hospitals and Schools

Pandemic Flu Plan

Pandemic Flu Plan

Based on NYSDOH Guidelines Involves Multiple Local Stakeholders Joint Planning with other counties in our region

to create a standardized plan

General Assumptions in a Pandemic

Vaccine may not be available initially

Antivirals may be limited or ineffective

Neighboring communities will also be affected

We need to prepare

Community-Based Infection Control Strategies

Social Distancing

Voluntary self-shielding Stay at home

Cancellation of public events concerts, sports events, movies, plays

Closure of schools and workplaces office buildings, shopping malls

Closure of recreational facilities community swimming pools, youth

clubs, gymnasiums

Businesses, school systems, community infrastructure providers, and other employers should develop plans for continuity of essential operations and modified operation with a significantly reduced workforce.

25 to 30% of persons may become ill during a 6 to 8 week outbreak. An additional 10% of the workforce may be absent due to illness of a

family member. Others may stay home due to a fear of becoming infected.

Work or School Based Infection Control Strategies

Respiratory hygiene/cough etiquette, hand hygiene Stay away if ill (staff stay home, students do not go

to classes) Encourage self-reporting of illness that develops Active screening for

illness in staff/students Send staff/students home

if ill

What can YOU do to prepare?

What is Respiratory Hygiene/Cough Etiquette?

Cover mouth/nose when sneezing or coughing If no tissue, use elbow instead of hands

Use tissues and dispose of appropriately

Perform hand hygiene after contact with respiratory secretions

Distance yourself from others (more than 3 feet)

What is Hand Hygiene?

Traditional hand washing Soap and hot water Minimum of 20 seconds

(the time it takes to sing “Happy Birthday” twice)

Alcohol based hand rubs Acceptable means to

disinfect/sanitize EXCEPT whenhands are visibly soiled

Individual and Family Preparedness Checklist

Store a supply of food and water General emergency supplies

Flashlight, batteries, radio, etc. Have non-prescription drugs and other health

supplies on hand Get involved in your community Talk to your families, friends and neighbors

DO IT NOW!!!!!

On-Line Resources

www.pandemicflu.govwww.ontariocountypublichealth.com

Ontario County Public Health

585-396-4343

1-800-299-2995

Achoo!

God Bless You!