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Pandemic Influenza: What do we know, what should we do? . Elizabeth L. McClure, MD, MPH AHC Office of Emergency Response Center for Infectious Disease Research and Policy CIDRAP University of Minnesota. Seasonal Influenza. Pandemic Influenza. What creates a pandemic?.
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Pandemic Influenza: What do we know, what should we do? Elizabeth L. McClure, MD, MPH AHC Office of Emergency Response Center for Infectious Disease Research and Policy CIDRAP University of Minnesota
Seasonal Influenza Pandemic Influenza
What creates a pandemic? • Novel virus: No population immunity • Cause serious disease • _ Transmitted person to person
Influenza Pandemics in the 20th Century • 1918: Spanish Flu • 1957: Asian Flu • 1969: Hong Kong Flu • Seasonal influenza strains are pandemic strains of years past
Avian Influenza and Human Influenza • All human influenza viruses arise from avian viruses • Sometimes humans become victims of an avian virus strain through close contact with birds • Avian influenza viruses may evolve into new strains capable of infecting humans
Avian Influenza • Disease of domestic poultry with a origin in migratory birds • H5N1classification • Can infect mammals including humans • Mortality rate of >60% in humans • Don’t count on seasonal respite
Control Strategies: Birds Vaccination Stamping out Surveillance Quarantine
Problems…. • Asia is too big • Lots of pressure for mutation: over thirteen billion chickens in China alone • Most chickens live in backyard flocks • Lack of compensation for sick/dead animals • People must choose hunger vs. disease control • Recent successes or too soon to tell?
H5N1 in Humans: The Beginning * origin of H5N1 Hong Kong 1997
Planning Assumptions • Risk of an influenza pandemic in the future: 100% • H5N1?: Unknown • Susceptibility will be universal • Planning will be based on severity of illness • Viral Illness: • Incubation 1-4 days • Persons may be infectious before signs of illness • Pandemic will occur in waves • 6-8 weeks • Multiple waves may occur over 18months-2 years
Don’t worry…… we’ve got a plan! The YOYO strategy
Infection Control: Basic Tools Vaccine Antivirals
Social Distancing Maneuvers • Close schools • Keep children at home • Social distancing in workplace • Liberal leave policies • Home isolation and quarantine • Personal Preparedness
Concerns • Communities must be ready to implement measures rapidly sustain reasonable compliance • There is lack of traction for personal and community based preparedness efforts
Is there anything good about the bird flu scare?? • Modernize vaccine production techniques • Improve surveillance for animals and humans • Emphasizes the importance of public health • Modernizes outbreak or disaster communication systems • Encourages citizens to be prepared for all hazards
Discussion • Important websites • CDC: www.cdc.gov • Federal Government:www.pandemicflu.gov • Fed Volunteer: www.ready.gov • World Health Organization: www.who.int • CIDRAP: www.cidrap.umn.edu