It is not a matter of IF this is going to happen, but WHEN…

2. It is not a matter of IF this is going to happen, but WHEN… Every day you are not prepared is another day to PLAN!

3. Seasonal Flu • There are thousands of flu viruses • Caused by respiratory viruses • Easily transmitted from person to person • People may have some residual immunity to the virus • A vaccine is available

5. Pandemic • Causes global outbreak • Highly pathogenic for humans • Spreads easily from person to person worldwide • Genetically unique • High morbidity & mortality

6. New influenza virus • Little/No immunity in human population • Infects & replicates in humans • Spreads easily and is sustained among humans • Currently, there is No pandemic

7. Avian Flu • (a.k.a. H5N1) • Caused by influenza viruses that naturally infect wild birds • Can be deadly for domesticated birds such as chickens, ducks, and turkeys • Can be transmitted from birds to humans • No human immunity or vaccine is available at this time

8. Influenza-like diseases appeared as early as 412 BC • First Recorded Pandemic – 1580 • 19th century- three pandemics, including the Russian Flu of 1889

9. 1918 – Spanish Flu • 1957 - Asian Flu • 1968 - Hong Kong Flu Library of Congress, Prints & Photographs Division, Reproduction number unknown

10. The most catastrophic pandemic • Over 500,000 U.S. deaths • Up to 40 million deaths worldwide • More died in one year than in four (4) years of the Black Death

11. The attack rate and mortality rate was highest among young adults ages 25-50 years old. • The body responds to the infection by triggering the immune system to over respond, which includes an increase in fluid in the lungs. • You need to be placed on a ventilator to pump out the fluid. • The government is using what happened during the Spanish Flu as an example to help plan for the next Pandemic.

12. Over 70,000 U.S. deaths • 1-2 million deaths worldwide • Elderly had the highest rates of death Library of Congress, Prints & Photographs Division, Reproduction number LC-USZ62-126995

13. Over 34,000 U.S. deaths • 700,000 deaths worldwide • Mildest of the pandemics) • *This would not have been declared a pandemic if it was not worldwide Library of Congress, Prints & Photographs Division, Reproduction number LC-USZ62-126995

14. Closed saloons, dance halls, and cinemas • Schools were closed • Banned large crowd gatherings • Prohibited public funerals

15. Hong Kong • Source of infection - Close contact with live poultry (sharing living quarters, contact with fecal matter, etc.) • 18 humans infected; 6 deaths • Prevention - 1.5 million birds were destroyed in three days to try to eradicate the virus

16. Mutates rapidly • Causes severe disease in humans • Since 2003 – over 300 human H5N1 cases have been reported

17. For current information go to: http://www.pandemicflu.gov/ Total number of cases includes number of deaths. WHO reports only laboratory-confirmed cases. High fatality rate (61% death rate)

18. More infected birds • = increased chance for human infection • More exposure to infected birds = increase chance of human-to-human mutated strain, which may lead to the next pandemic. This photo depicts the burying of dead birds

19. H5N1 currently transmits through birds • Nasal/body secretions (saliva, mucus membranes, oils, droppings, etc.) • Most human H5N1 cases have a history of prolonged contact with sick birds

20. Currently there is NO pandemic! • SB County has a population of 1.9 million. • Of those approximately 30% (600,000) may become infected with H5N1. • Approximately 5% (30,000) of those infected may die • We are currently in a phase 3 alert stage which means there has been no or very limited human to human transmission (as determined by the World Health Organization).

21. Resemble those of the common flu (fever, cough, sore throat, shortness of breath, eye infections, & muscle aches) • Increased symptoms include pneumonia, severe respiratory diseases, and other severe and life threatening complications (multi-organ failure) • Patients do not get better • See your doctor for treatment

22. Adults can shed the virus 3-5 days prior to showing symptoms • Children can shed the virus 5-7 days prior to showing symptoms

23. Bird Migration • Illegal smuggling of birds and poultry products • Travel by infected people • People traveling with virus contaminated items (i.e. clothing, gloves, etc.)

24. Vaccine may take 6-9 months to develop from the time it passes from human to human • Obstacles: • Limited production capacity • Only a few companies that can produce the vaccine • Long standing technology • New technology

25. Non-medical control measures: • Risk Communication • Pre-event • During event • Isolation of Cases • Self-imposed (shelter-in-place) • Mandated

26. Non-medical control measures: • Tracing and Management of Contacts • Social Distancing • Schools • Furloughing non- essential workers • Canceling mass gatherings • Limiting travel

27. Proactive Education • Planning • Surveillance • Antiviral Medications • Vaccine Development • Health Care Planning • Public Health Interventions

28. Promote public health efforts in your community & stay informed! • Practice good health habits: • *Wash hands frequently • *Cover coughs and sneezes • *Stay away from others when sick (follow the 3 – 6 foot rule) *Continue practicing proper handling and cooking of poultry and egg products

29. Individual • Family • Community • Organization We need to work together!

30. pandemicflu.gov • cdc.gov • sbcounty.gov/pubhlth • sbcounty.gov/pubhlth/prepandresponse For more information, please call the Preparedness and Response Program at: (909) 387-6280 or (800) 782-4264 THANK YOU!