Preparing for Pandemic Influenza

1. Preparing for Pandemic Influenza

2. Pandemic Influenza “Don’t worry about it, it’s probably just a head cold.”

4. Is Bird Flu H5N1 the Current Pandemic?NO • Bird flu is primarily an animal disease • Bird flu primarily spreads from birds to birds and from birds to humans • … but the virus may change so that it is easily transmissible from person-to-person, thus causing a pandemic

5. What is the flu? Influenza or Flu is a virus -- affects the respiratory tract (nose, throat and lungs) -- proper treatment is antivirals, not antibiotics Flu is very contagious. -- is easily spread when people sneeze or cough

7. Seasonal Influenza • Can spread rapidly from person to person • Is seasonal in the US beginning in the Fall and ending in Spring • US Impact • Average of > 200,000 influenza-related hospitalizations / year • Average of > 36,000 influenza-related deaths / year

8. What is pandemic flu (Influenza)? • Isolation from humans of a novel influenza A virus  Little or no immunity in the population • Demonstrated ability of the virus to replicate and cause disease  Efficient person-to-person transmission • A flu pandemic is a worldwide epidemic spread of a new flu virus

9. Credit: US National Museum of Health and Medicine 20TH Century Pandemics 1968: “Hong Kong Flu” 1957: “Asian Flu” 1918: “Spanish Flu” A(H2N2) A(H3N2) A(H1N1) 1-4 m deaths 34,000 US deaths 1-4 m deaths 70,000 US deaths 20-40 m deaths 675,000 US deaths

10. Seasonal Flu occurs every year, usually in winter, in temperate climates Usually some immunity built up from previous exposure Healthy adults usually not at risk for serious complications Vaccine for seasonal flu is based on known virus strains Pandemic Flu Occur sporadically throughout history – 2-3 waves of 3-4 months- total duration up to 18 months Little or no pre-existing immunity Healthy people of all age groups may be at risk Vaccine probably will not be available in the early stages of a pandemic Differences between seasonal flu and pandemic flu

11. Projected National Impact • 40 - 90 million people clinically ill • 20 - 46 million (low range ) outpatient medical visits • 360,000 – 9,600,000 people hospitalized • 104,000 – 2,200,000 deaths • US losses estimated at $71-$166 billion • Many geographic areas affected at the same time

12. Why The Concern About Pandemic Influenza? Influenza pandemics are inevitable: • Can cause: • High levels of sickness and death • Drastic disruption of critical services • Severe economic losses • Outbreaks occur simultaneously in many areas • There will be little warning time between the onset of spread of a pandemic and its arrival in the U.S. • Impacts will last for weeks to months • Pandemics can disproportionately affect younger, working-age people • Current avian influenza outbreak in Asia • Vaccine not available until 6-9 months after start • Anti-virals: limited supply, questionable efficacy

13. NEW CDC Pre-Pandemic Planning Guidance • Focuses on non-pharmaceutical measures • Asks communities, including schools to plan using these interventions • Introduces a Pandemic Severity Index • Contains tailored planning guides for communities and includes guidance for child care programs, elementary and secondary schools, colleges and universities www.pandemicflu.gov

14. Interim Pre-pandemic Planning Guidance Objectives are to • buy time for production and distribution of a well matched vaccine • reduce the burdens on the healthcare infrastructure • reduce morbidity and mortality

15. Pandemic Severity Index (PSI) • The guidance introduces the Pandemic Severity Index (PSI) • 5-point scale based on the case fatality ratio (CFR) to categorize pandemic severity • Category 1: Seasonal • Category 2-3: 1957, 1968 • Category 4-5: 1918

16. Pandemic Severity Index

17. Summary of Pandemic Severity Index

18. Sample Community Mitigation Recommendations from the CDC • Sick people should remain at home for 7-10 days • Household members of a person who is ill should remain at home for 7 days • Dismiss students from all schools and school-based activities and close of childcare programs for up to 12 weeks at a time. • Increase social distancing by cancellation of large public gatherings and changing workplace environments and schedules.

19. Key Messages to Schools • Collaborate with the local health department • Teach and reinforce preventive hygiene • Encourage staff, students, and parents to get seasonal flu shots • Encourage staff and students who are sick to stay home • Review the CDE checklists: • For K-12 schools • For preschools • Review, update, & practice school emergency plans

20. Pandemic Influenza Preparedness For Schools In August, 2007, Department of Public Health mailed a DVD/CD of the May 17 Webcast to each district and county office. www.ReadyCaSchools.org

21. Pandemic Resources • U. S. Centers for Disease Control and Prevention, http://www.pandemicflu.gov/ • California Department of Health Services, http://www.dhs.ca.gov/ps/dcdc/izgroup/diseases/pandemic_flu.htm • California Department of Education, http://www.cde.ca.gov/ls/he/hn/fluinfo.asp • www.ReadyCaSchools.org • Trinity County Office of Emergency Services – John Hall (530) 623-8216 • Trinity County Health Officer, Kent A. Brusett, M.D. (530) 623-2861 • Tacoma County “Pandemic Flu Model Planning Tool for Schools.” www.tpchd.org/files/library/a4eaa3b511a9687a.pdf