Pandemic Flu Preparedness is Good Business: Protecting Our Employees, Our most Valuable Resource Agenda Influenza viruses introduction What makes a pandemic History of pandemics How a future pandemic might look Preparing for pandemic influenza Influenza (or flu) The flu is a contagious respiratory illness caused by a virus. It can cause mild to severe illness, and at times can lead to death. A person infected with the flu virus can transmit it one-two days before they have symptoms. A person infected with the flu virus can transmit it four-five days after symptoms start. Influenza spread Spread by contact with an infected person through: Sneezing Coughing Touching items recently contaminated by a person with the flu virus Influenza symptoms Symptoms include: Fever (usually high) and chills Extreme tiredness (fatigue) Body aches Sore throat Non-productive cough (dry) Runny or stuffy nose Headache Diarrhea (rare in seasonal flu) Seasonal flu Occurs yearly during the winter months Every year in the US on average: >200,000 people are hospitalized 36,000 people die Most people who get the flu recover within 1-2 weeks without medical treatment The difference between seasonal flu and pandemic flu Seasonal flu is predictable while pandemic flu is not predictable Pandemic flu is caused by a new flu virus strain so everyone is susceptible Pandemic flu infects large numbers of people of different ages all over the world and causes serious illness and deaths Pandemic A worldwide outbreak of disease in numbers clearly in excess of normal. Characteristics A new influenza virus emerges (H5N1 meets this criteria) It can infect humans, causing serious illness (H5N1 meets this criteria) It spreads easily and sustainably among humans (H5N1 does NOT meet this criteria) How influenza viruses change Drift – gradual mutation of the virus allowing human to human transmission How new influenza viruses emerge Shift – genetic material is exchanged between human and avian viruses during co-infection of a human or a pig - reassortment Past influenza pandemics Pandemic Deaths in Deaths Population the US Worldwide Affected Spanish Flu (H1N1) 500,000 40 million Persons 20-40 1918-1919 years old Asian Flu (H2N2) 70,000 1-2 million Infants, elderly 1957-58 Hong Kong Flu (H3N2) 36,000 700,000 Infants, elderly 1968-69 Russian Flu (H1N1) 8,300 Persons under 20 1977-78 years old Pandemic waves Pandemics occur in multiple waves of disease outbreaks The first wave in a local area is likely to last six to eight weeks The time between pandemic waves varies and can not be easily predicted. The severity of illness may vary among waves Avian influenza Normal reservoir is wild bird population H5N1 is a new avian influenza virus H5N1 currently is found in birds in Asia, Europe and Africa but not in North America H5N1 might cause pandemic influenza High pathogenic vs. low pathogenic Low Pathogenic Avian Influenza (LPAI) virus – common in wild birds with no symptoms or minor symptoms, not a risk to human health High Pathogenic Avian Influenza (HPAI) virus – also found in wild birds, can cause severe illness and death in domestic birds, can spread rapidly, capable of causing severe disease and death in humans Transmission of virus from birds to humans People can get avian flu through direct contact with nasal secretions from infected birds The regions of the world where humans have been affected keep domesticated chickens as pets which roam in and around their homes Inhalation, rather than consumption of the virus is the mode of transmission Current concerns about avian (bird) flu Historicallyunprecedented disease outbreak in poultry caused by H5N1 Human cases reported as of October 31, 2006: 256 cases 152 deaths No sustained human to human transmission identified. Case reported 8/21/06 35 year old female from Garut, West Java Province, Indonesia Hospitalized 8/17 with severe respiratory disease, died shortly after Third confirmed case from Garut that week Chickens purchased from a market and added to local flocks in late June; throughout July/August large numbers of chickens died Case reported 8/17/06 9 year old girl from Garut district, West Java Province, Indonesia Developed symptoms on 8/1, hospitalized on 8/14 and died on 8/15 Reports of recent chicken deaths in her household Case reported 8/14/06 17 year old male from West Java Province, Indonesia Developed symptoms on 7/26 Hospitalized on 8/9, recovering Chicken/duck deaths in patient’s household and neighborhood, patient disposed of chicken carcasses 20 year old male cousin symptomatic on 7/26, treated 8/5 and died on 8/6 Avian flu in the United States At this time (HPAI) H5N1 has not been detected in North America The US Fish & Wildlife Service monitors migratory patterns of wild birds The Ohio Department of Agriculture monitors and tests poultry to ensure food safety US Department of Agriculture has imposed import restrictions on birds and bird products What to expect from pan flu Unlike other disasters Will not damage property or cause obvious damage like a natural disaster If people are absent from work public services may be interrupted Daily routines may be disrupted and you may be asked to take actions to limit the spread of the virus Protection against the fIu A vaccine to protect people from pandemic flu is not available now. A vaccine may not be available at the start of a flu pandemic. Antivirals will also be in limited supply and might not be effective against a new flu virus The best protection is to practice healthy hygiene to stay well now and during a flu pandemic. Practice healthy hygiene Clean hands often Wash with soap and water or Clean with hand sanitizer Cover mouth and nose when you sneeze or cough and clean hands afterwards Keep hands away from face Stay away from people who are sick Prepare at home Plan now to care for yourself or loved ones who get the flu. Determine what supplies you will need to provide care at home. Plan how you will care for someone in your household who becomes sick. Remember your pets when planning. Stock up now Reduce your need to go out during a local flu pandemic (self shielding) by stocking extra food, water and supplies at home. If you do get sick and have extra supplies on hand, you will help reduce the spread of pandemic flu by staying home. If stores are open during pandemic flu they may be poorly stocked. Home care Contact doctor or hospital’s help line for advice Physically separate ill person from others in the household Designate one person as caregiver Restrict patient to home during infectious period except to travel to obtain medical care Restrict visitors Cover your cough Home care Hand hygiene – thoroughly cleanse hands with soap and water and/or alcohol based hand sanitizer Wash dishes in dish washer or with warm water and soap Wash patient’s bed linen and clothes in washing machine, unnecessary to separate from other household laundry Clean environmental surfaces as usual Home care Caregiver and/or patient may use masks during interactions however the effectiveness of masks has not been documented Patient is advised to wear a mask when leaving home to obtain medical care Have disposable tissues available for patient and provide a bag for disposal Prepare your workplace Ask about plans: for employees who get sick during a pandemic and need to stay home to keep the business functioning if key staff can’t come to work for sick leave, benefits and wages when employees are asked to remain at home Prepare at school Ask about plans: to prepare for an influenza pandemic at your child’s school or day care center to encourage parents to keep sick children home in order to reduce the spread of the flu during a local pandemic Help your community Volunteers are needed Assist local communities in the event of an emergency Promote community awareness of potential hazards and preparedness measures Assist with training exercises Supplement staffing at events Assist with evacuations and traffic control www.citizencorps.gov/cert Rebecca Hysing (216) 201-2001 x1602, firstname.lastname@example.org Resources Ohio Department of Health Pandemic Flu Plan http://www.ohiopandemicflu.gov Cuyahoga County Response Plan www.ccbh.net U.S. Dept. of Health & Human Services www.pandemicflu.gov World Health Organization Current Information http://www.who.int/csr/disease/avian_influen za/en Contacts Cuyahoga County Board of Health (216) 201-2000 Cleveland Department of Public Health (216) 664-2324 Lakewood Health Department (216) 529-7690 Shaker Heights Health Department (216) 491-1480 American Red Cross – Cleveland Chapter (216) 431-3010 Thank you Please remember to wash your hands.