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Pandemic Influenza. Andrew Pelletier, MD, MPH Maine Department of Health and Human Services June 26, 2006. Oh my goodness! The sky is falling! I must go and tell the king. Chicken Little. Influenza. Seasonal influenza Avian influenza H5N1 Pandemic influenza.
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Pandemic Influenza Andrew Pelletier, MD, MPH Maine Department of Health and Human Services June 26, 2006
Oh my goodness! The sky is falling! I must go and tell the king. Chicken Little
Influenza • Seasonal influenza • Avian influenza • H5N1 • Pandemic influenza
Characteristics of Pandemics • Novel virus • Severe illness in humans • Efficiently transmitted
Recent Pandemics • 1918 • 500,000 deaths in U.S. • 1957 • 70,000 deaths in U.S. • 1968 • 34,000 deaths in U.S.
Pandemic Assumptions • Attack rate of 25%-35% • Duration of a year or more in 2 waves • Each wave lasting 6-8 weeks in community • Healthcare system will be severely taxed if not overwhelmed
Social Disruption from Pandemic Influenza • Absenteeism in essential sectors • Economic impact • Psychological stress
H5N1 • In Asia since 1997 • Initially in poultry • Avian disease now in 50 countries • Asia, Europe and Africa • Current focus of pandemic preparedness
Influenza Control • Vaccination • Antiviral drugs • Infection control/community containment
Assumptions for Vaccination • Two doses will be required • Vaccine will not be available for 3-6 months after start of pandemic • Production will be ~4 million doses per week
Assumptions for Antivirals • Tamiflu and Relenza will be effective in decreasing morbidity and mortality • Expected domestic production for Tamiflu is 1.25 million courses/month • Goal is stockpile of 80 million courses • Current stockpile is 26 million courses
Challenges to Containment • Short incubation period • Ability of persons with asymptomatic infection to transmit virus • Early symptoms of illness are likely to be non-specific, delaying recognition
Summary • Unknown when pandemic will occur or how severe it will be • Progression of H5N1 is worrisome • Current ability to respond to a pandemic is limited • Taking basic steps to prepare is important
Checklist for Schools http://www.pandemicflu.gov/plan/pdf/schoolchecklist.pdf