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Pandemic and Avian Influenza

Pandemic and Avian Influenza. James A. Luken Health Commissioner Miami County Health District October 11, 2006. Pandemic & Avian Influenza. What is is? What is being done to prepare?. Miami County Health District October 11, 2006. Overview of This Presentation. What is pandemic flu

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Pandemic and Avian Influenza

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  1. Pandemic and Avian Influenza James A. Luken Health Commissioner Miami County Health District October 11, 2006

  2. Pandemic & Avian Influenza What is is? What is being done to prepare? Miami County Health District October 11, 2006

  3. Overview of This Presentation • What is pandemic flu • Has this happened before? • Avian influenza (bird flu) • Impact of a pandemic • Public Health role • What can you do now • Helpful resources

  4. Germs

  5. What Is Pandemic Flu? • Global or worldwide disease outbreak • Occurs when a new influenza A virus emerges for which there is little or no immunity in humans, causes serious illness, and easily spreads for person to person • Past pandemics have led to high levels of illness, death , social disruption and economic loss

  6. Pandemic Flu in the 20th Century • 1918 Spanish Influenza • 40 to 50 million people died worldwide • 500,000 died in U.S. • Struck all age groups

  7. Pandemic Flu In the 20th Century • 1957-1958 “Asian Flu” • At least 1.5 million people died worldwide • 70,000 deaths in US • 1968-1969 “Hong Kong Flu” • At least 700,000 people died worldwide • 34,000 deaths in US • Typical Influenza Season • 36,000 deaths in US

  8. Current Outbreak of Avian Influenza (Bird Flu) in the World As of May 29, there are 224 cases & 127 deaths in Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq, Thailand, Turkey and Vietnam

  9. How Likely is a Flu Pandemic? • Historical patterns indicate that it happens every 30 to 40 years. • Historical patterns indicate that it is less pathogenic over time • No one really knows with any degree of certainty when the next one will occur, but CDC feels that it will at some point.

  10. U.S. Deaths from Influenza

  11. Why the decline in deaths over the years? • Better sanitation • Better understanding of virus transmission • For the patient, the flu often transitions into pneumonia, of which they die. • Flu is a virus, for which there is no treatment • Pneumonia is a bacteria, for which there are now antibiotics which weren’t available in 1918

  12. Pandemic Flu vs. Avian (Bird) Flu • H5N1 virus • Avian flu generally affects only birds • These bird viruses occur naturally among birds. Wild birds carry viruses in their intestines, but usually do not get sick from them. • However, it is very contagious and pathogenic to domestic birds such as chickens, turkeys, ducks, etc.

  13. Current Outbreak of Avian Influenza (Bird Flu) in the World • Most cases of avian influenza infection in humans have resulted from direct or close contact with infected poultry (e.g., domesticated chicken, ducks, and turkeys).

  14. Can Avian Flu Kill Humans? • Other cultures have more intimate contact with chicken and duck saliva and secretions • It is highly unlikely in the U.S. due to our culture of raising poultry

  15. Avian Flu • H5N1 is a new virus for humans • Causes Serious Illness • It is NOT easily spread from birds to humans or from humans to humans

  16. Human Pandemic Influenza There is currently no human pandemic influenza in the world

  17. Food Safety • Eating properly handled and cooked poultry is safe • Poultry products imported into the US meet all safety standards • No poultry from countries with confirmed bird flu (H5N1) can imported into the U.S.

  18. Hungry?

  19. Impact of A Flu Pandemic – U.S.

  20. Impact of Pandemic Flu – Miami County

  21. Influenza over time in Miami County(Worst Case Scenario)

  22. Can we handle the deaths? • Up to 100 deaths per week for one to two weeks • Miami has 12 funeral homes • They have indicated that they can handle the crowd

  23. Prevention Strategies • Keep in mind that the purpose of Public Health is to PREVENT illness, injury and death. • We take care of well people and make sure that they stay well • Medical care system takes care of sick people

  24. Prevention Strategies • Surveillance • Communication • Quarantine, Isolation, and Limitations on Movement • Immunization • Public Information and Education

  25. Surveillance • Ohio Disease Reporting System (ODRS) • RODS – Surveillance of prescription and non-prescription sales and hospital admissions • Each Health District has an epidemiologist on staff

  26. Communication • HAN – Health Alert Network from CDC • OPHCS – Ohio Public Health Communication System • Broadcast faxes • Use of Media

  27. Quarantine, Etc. • Quarantine is the limitation of movement of person(s) suspected of being exposed to a disease • Isolation is the limitation of movement of person(s) actually having the disease.

  28. Quarantine Legalities • Health Commissioner has the ability to call a quarantine, backed up by formal Board of Health resolution at their next meeting.

  29. Quarantine • Is effective only for individuals or small groups of people. • The effectiveness of quarantine is inversely proportional to to size and geographical scope of the group. • Was ineffective during 1918 Spanish Flu • Not used much today

  30. Quarantine Issues • Board of Health is responsible for the care and feeding of persons under quarantine. • In small groups, Red cross can deliver meals. • In larger groups, it becomes unmanageable and “leaky.” • Remember, these people don’t have a disease; they may have been exposed to the disease.

  31. Quarantine and Law Enforcement • Board of Health may hire quarantine guards to assist in enforcing the quarantine. • How far should law enforcement go in enforcing the quarantine? Use whatever policy you normally use in keeping other people in line.

  32. Social Distancing • A form of voluntary quarantine • Staying at home when you feel sick • Avoiding unnecessary large gatherings of people, such as events and functions, public transportation • “Safe at Home Days”, etc. • Make only necessary trip to grocery; no mall shopping, etc.

  33. Work Quarantine • Essential jobs, such as health care • Employees required to wear PPE, such as gloves, gowns and/or N95 masks. • Some workers work in solitary environment

  34. Flu Shots

  35. Immunizations • The Health District is practiced and proficient in providing immunizations to large numbers of people throughout the county in a short period of time • Be that as it may………

  36. Immunizations (part 2) • The odds of producing and distributing a safe and effective vaccine before the pandemic strikes in the community is between zero and nil • Currently no system exists to ensure that public health departments will receive any vaccine that is produced • However, there is a priority list of persons who will receive it first, in the nil chance that a limited supply exists. Law enforcement?

  37. What about Anti-virals • Tamilflu and Relenza • Lessens severity and length of illness • Is a treatment, not a prophylaxis for influenza • Must be given by a physician to a sick person at the second day of illness • Since it is treatment and not prevention, it is the province of the medical care establishment in the community

  38. Influenza Prevention(and colds, too!) • Stay at home when you are sick • Cough into your sleeve • Wash your hands regularly • Avoid sick people • Eat healthy, exercise and get plenty of sleep

  39. Other Considerations • Business planning • Disruption due to illness of key personnel • Disruption of supplies What will you do?

  40. Bird Flu Hits Florida

  41. Questions? The Most Important Resource: www.pandemicflu.gov

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