Avian Influenza by eP7nKyhb

VIEWS: 4 PAGES: 21

									       Update
 Pandemic Influenza
   Avian Influenza
 Seasonal Influenza
    Kevin G. Pearce, MPA
   Peninsula Health District
Virginia Department of Health
         August 2006

                                1
     Why the concern?
• Pandemic (= worldwide) epidemic of
  a new influenza virus
• New virus  Most people will have no
  immunity
• Higher disease attack rates & higher
  death rates than seasonal or “normal”
  influenza



                                      2
Past influenza pandemics
• Pandemic flu is unpredictable,
  like the flu virus itself
• 1968-69 Hong Kong flu
  – 34,000 deaths in US
• 1957-58 Asian flu
  – 70,000 deaths in US
• 1918-1919 Spanish flu
  – >500,000 deaths in US
  – Worst case scenario
                                   3
    Why the concern?
• Pandemic  rapid spread around
  world in repeating waves
 – 1918 waves circled globe in 6-9
   months

                         United Kingdom
                         experience; Jordan E,
                         American Medical
                         Association, 1927




                                                 4
High death rate among
     young adults


      1 of every 100
    25-34 year olds died




  Influenza & pneumonia mortality per
    100,000 person, by age group
                                        5
Why the concern?
• Extremely disruptive
  – Worker absenteeism
  – Lost productivity
    • Unable to get/transport supplies & raw materials
  – Uncertain infrastructure
    • Fuel & utilities; telecom & info technology
    • Public safety personnel & public services
    • Food & medicine suppliers
  – Increased demands on health care
    infrastructure & workforce
  – Reduced tourism, travel, entertaining, hotels
  – No help from other areas—they’re affected
                                                     6
                   What if…
• On the Peninsula…we saw a 35%
  attack rate over 2 months (approx.
  163,000 ill):
 Additional events due        Most likely   Maximum
 to influenza                  estimate     estimate
Deaths                             416        707
Hospitalizations                   1,843     2,380
Outpatient visits              87,817       124,269

Estimates using CDC’s FluAid 2.0                       7
Influenza on the Peninsula
                            35000

                            30000
Persons becoming ill with




                            25000
       influenza




                            20000

                            15000

                            10000

                             5000

Total cases: 0
  163,000                           1st   2nd   3rd   4th   1st 2nd 3rd 4th   1st
                                    Wk    Wk    Wk    Wk    Wk Wk Wk Wk       Wk
  35% of                            Oct   Oct   Oct   Oct   Nov Nov Nov Nov   Dec   8
population
 Does
  H5N1
  avian     ABC Original Movie
            Fatal Contact: Bird Flu in America

influenza   Tuesday, May 9 at 8/7c
            Starring Joely Richardson, Stacy
            Keach, Ann Cusack, Justina Machado,
            Scott Cohen and David Ramsey



            Pandemic
  =
  ?         influenza
                                                  9
    H5N1 avian influenza
• H5N1—current epidemic avian flu strain
  – Highly pathogenic avian influenza (HPAI)
  – Continuous circulation in Asia since 2003
• Historically unprecedented avian
  pandemic
  – Magnitude & duration of pandemic in birds
  – Virus is changing




                                                10
    H5N1 avian influenza
(Nations with confirmed cases July 7, 2006)




                                              11
    H5N1 avian influenza
• Before 1997, H5 influenza virus never
  infected humans
• Now…
  – Human cases from close exposure to ill
    birds
  – No sustained human-to-human transmission
  – Few cases, but high fatality (>50%)
    • 229 cases & 131 deaths, World Health
      Organization, July 4, 2006
• Treatment primarily supportive
  – Antivirals (Tamiflu & Relenza)
                                             12
Is H5N1 a pandemic virus?
• 3 requirements
  √ Novel strain - new H &/or N subtype
  √ Causes significant disease in
   humans
  NO Consistent human-to-human
   transmission
• Avian H5N1 influenza virus is not a
  pandemic virus - but it might
  become one
                                    13
         H5N1 on WHO
       Pandemic Risk Scale
 Inter-pandemic phase         Low risk of human cases        1

New virus in animals; no     Higher risk of human cases      2
     human cases
    Pandemic alert          No or very limited human-to-     3
                                human transmission
                                                             3
  Virus causes human       Evidence of increased human-      4
         cases                to-human transmission

                           Evidence of significant human-    5
                               to-human transmission

       Pandemic            Efficient & sustained human-to-   6
                                  human transmission

                                                                 14
          Preparedness
            Planning
• National Strategy for Pandemic
  Influenza, November 1, 2005
• HHS Pandemic Influenza Plan,
  November 2005
  – www.pandemicflu.gov
• Virginia Department of Health
  Emergency Operations Plan: Pandemic
  Influenza Attachment, Updated March
  2006
  – www.vdh.virginia.gov/PandemicFlu/index.asp

                                                 15
           Preparedness
    Where do we stand?
• No ready-to-use H5N1 vaccine
• Antivirals
 – Limited supply of Tamiflu
   • Production in next 10 years will treat
     only 20% of world population
 – Unclear if Tamiflu will work for
   treatment
 – Not enough available to use for
   prevention
                                              16
Preparedness strategies
• Heightened surveillance*
• Immediate response at 1st sign
  of an outbreak*
 – Respond to limit and confine
   outbreak
 – Buy time to make vaccine and take
   other actions


*Applies to both humans and birds
                                       17
    Control strategies
• Isolation & quarantine
• Non-pharmaceutical approaches
 – Cough & hand hygiene
 – Travel restrictions
 – Social distancing
   • Eliminate mass gatherings
   • Close schools, theaters, etc.
 – General public wears masks
                                     www.pbs.org/wgbh/amex/influenza/


                                                               18
What should you be doing?
         Prepare your family
• Store a two week supply of food.
• Have nonprescription drugs and other health
  supplies on hand.
• Teach your children and model the behavior:
  – To wash hands frequently with soap and water
  – To cover coughs and sneezes with tissues
  – To stay away from others as much as possible if
    they are sick
  – To stay home from work and school if sick.
• Talk with family members and loved ones
  about how they would be cared for if they
  got sick, or what will be needed to care for
  them in their home.
                                                      19
Why?
   A strong network
  of prepared
  people, families,
  and organizations
  is vital to a
  community’s
  successful
  response to
  pandemic
  influenza.      20
What else should you do?
• Get flu shots every year to your entire
  staff.
• Develop adequate stockpiles in case
  of supply chain disruption.
• Plan for personnel decreases and
  novel ways to accomplish your
  objectives.

								
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