1. Preparing for Pandemic Flu Algean Garner II, Psy.D. Director, Health and Human Services Village of Hoffman Estates

2. Understanding Flu Influenza (flu) has been a health threat for centuries Influenza (flu) has been a health threat for centuries Flu has caused three pandemics in the 20 th century Flu has caused three pandemics in the 20 th century The most severe flu pandemic occurred in 1918. The most severe flu pandemic occurred in 1918. Caused by the “Spanish Flu” Caused by the “Spanish Flu” Tens of millions of people died worldwide. Tens of millions of people died worldwide. 500,000 – 675,000 died in the U.S. 500,000 – 675,000 died in the U.S. 1957 – “Asian Flu” 1957 – “Asian Flu” Two million deaths worldwide. Two million deaths worldwide. 70,000 deaths in the U.S. 70,000 deaths in the U.S. 1968 –”Hong Kong Flu” 1968 –”Hong Kong Flu” One million deaths One million deaths 34,000 deaths in the U.S. 34,000 deaths in the U.S.

3. There are three variations of flu There are three variations of flu Seasonal Seasonal Avian Avian Pandemic Pandemic

4. Seasonal Flu refers to the periodic outbreak of respiratory infection caused by circulating strains of human influenza viruses. Seasonal Flu refers to the periodic outbreak of respiratory infection caused by circulating strains of human influenza viruses. Three types A, B, C Three types A, B, C Types A and B are linked to seasonal outbreaks Types A and B are linked to seasonal outbreaks Type C, causes mild illness Type C, causes mild illness Type A is linked to pandemics Type A is linked to pandemics Occurs generally during the cooler months (October – April). Occurs generally during the cooler months (October – April). Most people have immunity Most people have immunity Vaccine is available. Vaccine is available. 5 to 20 percent of the population is infected annually 5 to 20 percent of the population is infected annually Causes approximately 36,000 deaths and 226,000 hospitalizations annually Causes approximately 36,000 deaths and 226,000 hospitalizations annually

5. Avian flu (Bird Flu) refers to influenza virus that occurs naturally in wild birds and domestic poultry. Avian flu (Bird Flu) refers to influenza virus that occurs naturally in wild birds and domestic poultry. Two subtypes: Low pathogenic avian influenza and Highly pathogenic avian influenza (H5N1). Two subtypes: Low pathogenic avian influenza and Highly pathogenic avian influenza (H5N1). Low pathogenic Low pathogenic Occurs naturally in wild birds and can infect domestic birds Occurs naturally in wild birds and can infect domestic birds Causes minor symptoms Causes minor symptoms Poses no threat to humans Poses no threat to humans High pathogenic (H5N1) High pathogenic (H5N1) High death rate among infected birds High death rate among infected birds Spreads rapidly Spreads rapidly Has infected humans (limited and sporadic cases) Has infected humans (limited and sporadic cases) May cause the next pandemic if mutation allows for easy human transmission May cause the next pandemic if mutation allows for easy human transmission

6. Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO 10 September 2007 Country 20032004200520062007Total casesdeathscasesdeathscasesdeathscasesdeathscasesdeathscasesdeaths Azerbaijan000000850085 Cambodia000044221177 China110085138322516 Djibouti000000100010 Egypt00000018102053815 Indonesia 000020135545312710685 Iraq000000320032 Lao People's Democratic Republic 000000002222 Nigeria000000001111 Thailand0017125233002517 Turkey00000012400 4 Viet Nam3329206119007410046 Total4446329843115796542328200 Total number of cases includes number of deaths. WHO reports only laboratory-confirmed cases. All dates refer to onset of illness.

7. Pandemic Flu refers to global disease outbreak. Pandemic Flu refers to global disease outbreak. Occurs when a new strain of the influenza Type A virus emerges. Occurs when a new strain of the influenza Type A virus emerges. Humans have little or no immunity. Humans have little or no immunity. No vaccine is available No vaccine is available Spreads quickly from person to person. Spreads quickly from person to person. Can cause serious illness and many deaths. Can cause serious illness and many deaths. Spreads around the world rapidly. Spreads around the world rapidly. Last pandemic was in 1968. Last pandemic was in 1968. Mutation of the avian flu virus may cause the next pandemic. Mutation of the avian flu virus may cause the next pandemic.

8. How Does Seasonal Flu Differ From Pandemic Flu? Seasonal Flu  Outbreaks follow predictable seasonal patterns; occurs annually, usually in winter, in temperate climates.  Usually some immunity built up from previous exposure  Healthy adults usually not at risk for serious complications; the very young, the elderly and those with certain preexisting health conditions are at increased risk for serious complications.  Health systems can usually meet public and patient needs  Vaccine developed based on known flu strains and available for annual flu season.

9.  Adequate supplies of antivirals are usually available  Average U.S. deaths approximately 36,000/yr  Symptoms: fever, cough, runny nose, muscle pain.  Deaths often caused by complications, such as pneumonia.  Generally causes modest impact on society (e.g., school closings, encouragement of people who are sick to stay home).  Manageable impact on domestic and world economy.

10. Pandemic Flu Rare occurrence (three times in 20th century - last in 1968) Rare occurrence (three times in 20th century - last in 1968) Little or no pre-existing immunity Little or no pre-existing immunity Increased risk of serious complications Increased risk of serious complications Health systems may be overwhelmed Health systems may be overwhelmed Vaccine limited or not available Vaccine limited or not available Effective antivirals may be in limited supply Effective antivirals may be in limited supply Number of deaths could be high (e.g., U.S. 1918 death toll approximately 675,000) Number of deaths could be high (e.g., U.S. 1918 death toll approximately 675,000)

11. More severe symptoms and complications More severe symptoms and complications May cause major impact on society (e.g. widespread restrictions on travel, closings of schools and businesses, cancellation of large public gatherings) May cause major impact on society (e.g. widespread restrictions on travel, closings of schools and businesses, cancellation of large public gatherings) Potential for severe impact on domestic and world economy Potential for severe impact on domestic and world economy

12. Health experts believe another flu pandemic is likely; however: Health experts believe another flu pandemic is likely; however: Cannot predict when it will occur Cannot predict when it will occur May start without warning in any country May start without warning in any country May spread quickly because of modern travel and densely populated area. May spread quickly because of modern travel and densely populated area. May come in multiple waves over several months. May come in multiple waves over several months. Different areas, communities, and populations may be affected by the different waves. Different areas, communities, and populations may be affected by the different waves. Each outbreak may last 6 – 8 weeks. Each outbreak may last 6 – 8 weeks. Estimates suggest the 20% to 40% of the population may become ill. Estimates suggest the 20% to 40% of the population may become ill.

13. Personal health and wellness –General Tips Personal health and wellness –General Tips Eat and rest. Eat and rest. Exercise in moderation. Exercise in moderation. Wash your hands frequently. Wash your hands frequently. Cover your mouth and nose when coughing and sneezing. Cover your mouth and nose when coughing and sneezing. Avoid touching eyes, nose, and mouth. Avoid touching eyes, nose, and mouth. Follow proper hand washing procures. Follow proper hand washing procures. Minimize contact with ill individuals. Minimize contact with ill individuals. Get the influenza vaccine when available, consult with your physician first. Get the influenza vaccine when available, consult with your physician first. Know the symptoms of influenza. Know the symptoms of influenza. If you do not feel well, stay home and consult with your physician! If you do not feel well, stay home and consult with your physician!

14. Hand Hygiene Hand washing with soap and water or liquid hand sanitizer is one of the most effective methods of reducing the risk of contracting or transmitting the influenza virus. Hand washing with soap and water or liquid hand sanitizer is one of the most effective methods of reducing the risk of contracting or transmitting the influenza virus. Procedures for Hand Washing (Soap and Water) Remove all Jewelry. Remove all Jewelry. Wet hands with warm water Wet hands with warm water Apply soap to palms. Apply soap to palms. Rub hands together to create a lather Rub hands together to create a lather Cover all surfaces of the hands and fingers Cover all surfaces of the hands and fingers Clean knuckles, back of hands, and fingers Clean knuckles, back of hands, and fingers Clean the space between the thumb and index finger Clean the space between the thumb and index finger Work the finger tips into the palms to clean under the nails Work the finger tips into the palms to clean under the nails Rinse well under warm running water Rinse well under warm running water Dry with a paper towel, then use towel to turn off sink Dry with a paper towel, then use towel to turn off sink Minimum wash time should be 15 – 20 seconds. Minimum wash time should be 15 – 20 seconds.

15. Procedure for Hand Sanitizer Remove all Jewelry. Remove all Jewelry. Apply hand sanitizer (enough to keep hands moist for at least 15 seconds) Apply hand sanitizer (enough to keep hands moist for at least 15 seconds) Rub hands together Rub hands together Rub between fingers and around nails Rub between fingers and around nails Cover all surfaces of hands and fingers Cover all surfaces of hands and fingers Be sure to rub the backs of hands and fingers Be sure to rub the backs of hands and fingers Rub fingertips of each hand in the opposite palm Rub fingertips of each hand in the opposite palm Keep rubbing until hands are dry Keep rubbing until hands are dry ** Don’t not use water with hand sanitizing products ** Don’t not use water with hand sanitizing products ** Don’t use paper towels to dry ** Don’t use paper towels to dry

16. Additional Information www.who.int/topics/influenza/en/ www.who.int/topics/influenza/en/ www.who.int/topics/influenza/en/ www.pandemicflu.gov www.pandemicflu.gov www.pandemicflu.gov www.osha.gov www.osha.gov www.osha.gov