Docstoc

PANDEMIC INFLUENZA

Document Sample
PANDEMIC INFLUENZA Powered By Docstoc
					 PANDEMIC INFLUENZA

BACKGROUND AND GUIDANCE FOR
         SCHOOLS
                  Influenza
• Respiratory infection
• Transmission: contact with respiratory secretions
  from an infected person who is coughing and
  sneezing
• Incubation period: 1 to 5 days from exposure to
  onset of symptoms
• Communicability: Maximum 1-2 days before to 4-
  5 days after onset of symptoms
• Timing: Peak usually occurs December through
  March in North America
  Common Influenza Symptoms
• Rapid onset of:
  –   Fever
  –   Chills
  –   Body aches
  –   Sore throat
  –   Non-productive cough
  –   Runny nose
  –   Headache
   Influenza is a serious illness
• Annual deaths: 36,000
• Annual hospitalizations: >200,000
• Total economic costs: $37.5B

• Who is at greatest risk for serious
  complications?
  –   persons 65 and older
  –   persons with chronic diseases
  –   infants
  –   pregnant women
  –   nursing home residents
              Definitions
• Epidemic: An increase in disease above
  what is normally expected
• Pandemic: A worldwide epidemic
   How Do Influenza Pandemics
              Arise?


• Wild water fowl are natural reservoirs of
  influenza

• They can spread the virus to domestic
  birds
   How Do Influenza Pandemics
              Arise?
• When avian flu viruses experience sudden
  changes in genetic structure
              and
• Are capable of infecting humans
              and
• Can reproduce and spread from person to
  person efficiently
        Why Be Concerned About
         Pandemic Influenza?
• Influenza pandemics are inevitable: naturally recur at
  more-or-less cyclical intervals
• Can cause:
   – High levels of sickness and death
   – Drastic disruption of critical services
   – Severe economic losses
• There will be little warning time between the onset of
  spread of a pandemic and its arrival in the U.S.
  Outbreaks occur simultaneously in many areas
• Impacts will last for weeks to months and likely to
  occur in successive waves
• Pandemics can disproportionately affect younger,
  working-age people
• Current avian influenza outbreak in Asia
     Timeline of Emergence of
   Influenza A Viruses in Humans
                                                Avian
                                              Influenza

                                         H9      H7
                       Russian
                      Influenza         H5       H5
               Asian     H1
             Influenza
 Spanish         H3
Influenza                   Hong Kong
            H2
                            Influenza
  H1

   1918     1957 1968 1977              1997 2003
                                          1998/9
                    Influenza Pandemics 20th Century




Credit: US National Museum of Health and
Medicine


   1918: “Spanish Flu”                     1957: “Asian Flu”   1968: “Hong Kong Flu”
       A(H1N1)                                A(H2N2)                A(H3N2)

       20-40 m deaths                      1-4 m deaths          1-4 m deaths
       675,000 US deaths                   70,000 US deaths      34,000 US deaths
  Planning Assumptions: Health Care
• 50% or more of those who become ill will seek medical care
• Number of hospitalizations and deaths will depend on the virulence
  of the pandemic virus

                            Moderate (1957-like)     Severe (1918-like)
Illness                     90 million (30%)       90 million (30%)
Outpatient medical care     45 million (50%)       45 million (50%)
Hospitalization             865,000                9, 900,000
ICU care                    128,750                1,485,000
Mechanical ventilation      64,875                 745,500
Deaths                      209,000                1,903,000
The 1918
Influenza
Pandemic
Chicken Little and the Sky is Falling
   or The Next Major Disaster?




                      Which is it?
               Current Outbreak:
             Avian Influenza (H5N1)

• Began in fall, 2003.
• At least 252 confirmed human cases in
   Asia, Africa and Europe
  148 deaths in Asia and Africa
        (World Health Organization, 10/06)
• Mammalian infection (cat, pig)
• No efficient person-to-person
   transmission
• Isolated Human disease
• Case-fatality rate > 50%
• Outbreak spreading, not controlled
Current Avian Outbreaks
Clinical illness with H5N1 compared
with typical human influenza illness

• More severe illness in younger persons
• Primary viral pneumonia appears to be
     more common and with rapid onset
• Incubation period may be longer 1-4+ days
     (up to 14 days?)
• Duration of infectious period likely longer,
     particularly in adults 1d. prior to 7d. after
                                 (in adults; children ~longer)


                   Adapted from Guillermo Herrera, CDC, 2005
   Pandemic Effects: Strain on
          Resources
• Health care shortages
  – Vaccine / Antivirals
  – Hospital beds / equipment
  – Masks
• Personnel shortages
• Disruption of essential society
  functions
• Panic
Vaccines, Antivirals, and
   Medical Supplies
Pandemic Influenza Vaccine
       Questions

•   When will it be available?
•   How much will there be?
•   Who will own it?
•   Who should get it?
•   How should it be delivered?
       Treatment and Prevention:
               Vaccine


• Vaccines takes 6-8 months to produce
  following the emergence of a new virus
• Supplies will be limited, if available at all
  – 2nd dose after 30 days will likely be required
  – New vaccine safety and efficacy has
    “unknowns”
  Treatment & Prevention:
      Antiviral Drugs
• Antiviral agents
  – Effective in preventing illness
  – Can prevent severe complications
  – May not be effective against
    pandemic virus
• Supplies will be limited
  – Treatment over prevention
    Nassau County Department of Health
 Pandemic Influenza Preparedness Strategies

• Distribution Planning
  – First Responder Prophylaxis
  – Municipality operated PODs
  – Employer operated PODs (regional)
  – DOH operated PODs
  – School operated PODs through municipalities
        Points of Distribution
• Community based sites used to distribute
  vaccines or medications to healthy citizens
• Would the schools be used?
• Municipalities will coordinate POD
  planning within their communities.
               Individual and Family
                   Preparedness
– We will have to take care of ourselves and those around
  us.

– During a pandemic, public health will maximize resources
  for the greatest impact on the population as a whole.

– Schools should communicate with local/ state public
  health agencies and/or emergency responders about the
  assets/services the districts could contribute to the
  community.
             Influenza Prevention:
              What Can We Do?
   Specific Recommendations
   for Infection Control in
   Schools and Workplaces:
 Pandemic preparedness planning
 Distribution of educational messages
  and infection control guidance
 Social distancing: people stay home when ill
 Promotion of respiratory etiquette
 Provision of materials for respiratory hygiene/
  etiquette: tissues and disposal receptacles
        ISSUES FOR SCHOOL
     DISTRICTS TO THINK ABOUT
•   Absenteeism among children AND staff
•   Resources limited: vendors, buses
•   Role of school nurses
•   Communication with parents and staff and community
•   Advantages and disadvantages to closing schools
    (amount of closure time)
•   Working with local municipalities
•   Implications with State aide
•   Policies sending sick children home (isolation within the
    school, masks, etc)
•   Policies for allowing previously sick children to return to
    schools
   RESOURCES FOR SCHOOLS
  Nassau County Health Department, with
  direction from the New York State Health and
  Education Departments, will provide guidance to
  schools districts
• To create plans
• To create communication materials for students,
  staff and parents
• To provide guidance for closing schools
Key Step for District Preparedness
• Incorporate the pandemic influenza plan
  as an annex in the school district’s all
  hazards plan.
         COMMUNICATION
       Before a Pandemic Hits
• Develop strong relationships with your
  school communities
  – Build confidence that information will be
    distributed accurately and quickly
  - Consider community meetings that describe
    current plans in place
           COMMUNICATION
         Before a Pandemic Hits
•   School Websites
•   Lunch Menus
•   PTAs
•   Letters to the Community
•   BOE Meetings
•   Marquis
•   Proactive
        COMMUNICATION
       Before a Pandemic Hits
• Establish relationship with Public Health
  Officials early on
• Review/update procedures for
  communicable disease reporting
       Pandemic Influenza




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

Presentation compiled and adapted from multiple slide
  sets from the:

   Centers for Disease Control and Prevention
   HHS National Vaccine Program Office
   New York State Department of Health
   Connecticut Department of Health
   Kansas Department of Health
   Department of Defense
   Washington Department of Health

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:3
posted:10/22/2011
language:English
pages:35