Pandemic

1. Pandemic Georgia CTAE Resource Network Instructional Resources Office Written by: Amanda Supra and Dr. Frank Flanders July 2009

2. What is a pandemic? • Pandemic – spread of infectious diseases through large regions of populations; generally from continent to continent • Has to meet three conditions: • Emergence of a disease new to a population • Agents infect humans, causing serious illness • Agents spread easily and be sustainable among humans

3. What is the difference between a pandemic and an epidemic? Pandemics are epidemics at a much larger scale; they affect much more people at a larger geographical scale • An epidemic must be a disease or condition that is NOT infectious, such as cancer. Pandemics MUST be infectious or contagious.

4. Historical Pandemics Bubonic Plague Smallpox Cholera Malaria Influenza Yellow Fever

5. Bubonic Plague • A zoonotic disease (can be transferred from animals to humans) • Transmitted between animals and humans thru flea bites • Incubation Period: 7-10 days after infection • Symptoms: Bacteria enters from the bite and goes to the nearest lymph node, which then swells up and may become an open sore • Treatment: antibiotics and supportive therapy.

6. Cholera • Cholera is an acute intestinal infection caused by ingesting food or water that is contaminated • Incubation period: 1 – 5 days • Symptoms: Extreme watery diarrhea that can lead to severe dehydration and death, vomiting also occurs • Treatment: oral rehydration salts to replace lost fluids usually results in cure; in severe cases, intravenous administration of fluids may be required

7. Yellow Fever • A zoonotic disease transmitted by mosquitoes between humans and monkeys • Incubation Period: 3-6 days after infection • Symptoms: • “Acute Phase” – fever, muscle pain, headache, shivers, vomiting • “Toxic Phase” – fever reappears, jaundice, bleeding, bloody vomit • If a patient enters the “toxic phase” there is only a 50% chance they will survive. • Treatment: No specific treatments, though vaccination is highly recommended as a preventive measure

8. Smallpox • Smallpox is a contagious disease caused by a virus and is said to have originated over 3,000 years ago in India or Egypt • Incubation Period: 7-17 days after exposure • Symptoms: Fever, vomiting, severe muscle aches, smallpox rash, blindness • Treatment: No treatments were ever developed, however a vaccine was created and successfully eradicated the disease in 1980

9. Malaria • Malaria is a zoonotic disease caused by a parasite and is transmitted by the bites of infected mosquitoes • Incubation Period: 10-15 days after bite • Symptoms: fever, headache, vomiting • If not treated, it can quickly become life-threatening by disrupting the blood supply to organs • Treatment: Antimalarial medicine within 24 hours of the onset of symptoms, supportive therapy

10. Introduction to Influenza • Influenza is a viral infection that affects mainly the nose, throat, bronchi, and lungs • Generally lasts for a week, but in the very young, elderly, and those with serious medical conditions, it can lead to severe complications and death

11. Background on Influenza Pandemics • Influenza pandemics are rare, but have a high fatality rate. • Three flu pandemics have occurred in the past century: The Spanish flu of 1918, Asian flu of 1957, and the 1968 Hong Kong flu. • Death toll from the Spanish flu of 1918 was estimated to be 20-50 million worldwide. • Over half a million people died in the U.S. from the Spanish Flu. • More people died from the Spanish flu than were killed in World War I.

12. H5N1 Avian Influenza(Bird Flu) • Important Points to Remember: • There is no bird flu present in the U.S. today. • The U.S. does NOT import poultry products from other countries. • There is no danger of getting bird flu from eating chicken. You cannot get bird flu from properly cooked chicken. Cooking would kill any virus. • Keep all poultry products properly refrigerated and cook thoroughly before eating.

13. Introduction to Bird Flu • Bird flu is a lethal variant of the flu virus that poses a major threat to the world’s population. • The deadly flu pandemic of 1918 (the Spanish flu) was a strain related to bird flu. • Bird flu has reappeared in the past decade, and there is growing concern that another pandemic will occur in the near future.

14. Education about bird flu will be important in an outbreak to help prevent infection and control panic. • Scientists have stated that we are “overdue” for another flu pandemic.

15. What causes avian influenza? • Wild birds such as ducks and geese have been shown to be “silent carriers” of the virus. • Wild birds can spread the virus to domestic poultry flocks. • Bird flu is especially devastating to domestic poultry. • In the 1997 Hong Kong outbreak, every chicken was killed to prevent the spread to humans.

16. Two forms of the virus can be found in birds. One form is mild while the other is extremely contagious and rapidly fatal. • A strain known as the H5N1 virus has caused widespread domestic poultry outbreaks since 2003. • The H5N1 is a zoonotic strain. It has the unique ability to cross the species barrier from birds to humans. What causes avian influenza?

17. H5N1 Pandemic Potential • Research shows that the H5N1 virus could have pandemic potential. • The virus that infects birds has mutated into a strain that is contagious to humans. • If the virus adapts into a contagious strain capable of infecting humans, the H5N1 virus will no longer be a “bird flu.” It will be a “human flu.”

18. H1N1 Swine Influenza A(Swine Flu) • Important Points to Remember: • There is no danger of getting swine flu from eating pork. Properly cooking any meat would kill viruses. • There is no danger in touching pigs, though you should avoid sneezing, sick-looking animals. • Generally, the H1N1 virus is spread by human-to-human contact, not swine-to-human contact

19. Introduction to Swine Flu • Swine flu is also a lethal variant of the flu virus that may potentially pose a major threat to the world’s population • The technical term for the most recent 2009 outbreak is the H1N1 virus

20. Introduction to Swine Flu • There have only been four major variations of the flu found in swine: H1N1, H1N2, H3N2, and H3N1 • The symptoms that appear tend to be very similar to a regular flu: fever, cough, sore throat, body aches, etc. The major difference, however, is that if left untreated, the H1N1 virus has a bigger probability of causing severe problems that might lead to death.

21. What causes swine influenza? • The most recent outbreak of the H1N1 virus formed in Mexico. • The form of flu that originated in Mexico is a genetic mixture of viruses that have been seen in pigs, birds and people. • The reason why it’s being called a “swine flu” is because the overall structure of the virus is of the type that affects pigs.

22. H1N1 Pandemic Potential • Researchers believe that even though the H1N1 virus is deadly, it isn’t currently at a pandemic stage. It does, however, have the potential of becoming a pandemic if not quickly taken care of. • There is danger in having a strain originating from swine because swine is similar to both humans and to other animals when it comes to its genetics. So catching a flu from another animal, such as a bird, and then spreading the virus to humans is possible.

23. Ways to prevent influenza • Get a yearly flu vaccination – though this won’t prevent you from getting a new strain of the virus, it can help reduce the chance of you catching the virus. • Basic flu prevention can include: staying away from people who seem to be sick with the flu, washing hands constantly, etc. • Masks also can be worn to prevent inhaling germs, but may not prevent all germs from entering the body.