Presentation on theme: "Introduction to Pandemic Influenza"— Presentation transcript:
1 Introduction to Pandemic Influenza Public Health emergencies and international disaster response
2 Objectives To understand the pattern of infectious disease outbreaks To understand the historical significance and impacts of pandemic influenza outbreaksTo learn the WHO protocols and guidelines for combating infectious diseasesTo understand the steps in the process of identifying, responding to, and recovering from pandemic influenza pandemics
5 World Health Organization Phases of a Pandemic WHO has six phases for a pandemic that are under review following the H1N1 pandemicEach Phase has specific activities recommended to governmentsEach phase has communication recommendationsInternational Health Regulations of 2005Novel virus and severity of the virus must be linked in new phase release
8 How do we identify infected individuals EpidemiologySARS5 to 7 days1 to 2 weeksWhen symptomaticAll illIncubation period about 1 to 4 days2-3 days for H1N1, 2-8 days for H5N1Infective for about 5 to 7 daysup to 2 weeks in high-risk individualsInfectious up to 24 hours BEFORE symptomsMay be asymptomatic ( %)How do we identify infectedindividualsPicture:
11 High Risk Populations Schools Military facilities Incarcerated Children have longer viral shedding periodGreater opportunities for spreadMilitary facilitiesClose living quartersField hygieneIncarceratedPrisonsMental facilitiesElderly care facilities
12 Who is a “close contact”? People who came within 1 meter of shared space with a confirmed or suspect case patient beginning 1 day before onset of symptoms through 14 days after onset of symptoms.
14 Droplet Precautions Prevent infection by large droplets from Examples SneezingCoughingTalkingExamplesNeisseria meningitidisPertussisInfluenzaAvian influenza (probable)
15 Rapid ResponseStrong Surveillance systems will provide the opportunity to “Contain” a virus or bacteria before it can spread; Two weeks responseLaunching a Containment Operation to seal off a geographically defined area requires a PRE-DEFINED DECISION-MAKING PROCESSLogistical support and trained personnelA Risk Communication Plan and support from the local authoritiesPlan for 6 weeks of support for 10,000 people
17 Rapid Containment Cannot Be “Business as Usual” Start containmentCountry and WHO involvedResults from WHO lab“When is it too late to contain?”Specimen to WHO labResults from national labSpecimen to national labInitial investigationDetection of Index ClusterReport to local officeStart of Index ClusterOnset of first case
19 Societal Impacts School closures Air transportation and general movement of goodsPotential Border Closures (Tourism decline)Economic slow downHealth system overload from flu patientsCare for normal sick is reducedSupplies and staff become over burdened
20 Sustaining Essential Services Planning estimates are that 40% of the work forces will be affectedEssential services will deteriorate slowlyHealth services (patient care and Public Health)Water and SanitationFood and agriculture productionPower (fuel and power grids)CommunicationsBanking and financeTransportationRule of law (police, courts, prisons, and national security
21 Non-Pharmaceutical Interventions Infection controlsVoluntary isolation of sick peopleVoluntary quarantine of healthy contactsSchool closuresSocial distancingTravel restrictionsMask useHand washing
22 Current Seasonal Influenza Vaccine Production Timeline: 6 - 9 months Enough eggs? Strain selection? Adjuvants? Repeat doses? Expiration?
23 Potential Strategies to Decrease the Impact of a Pandemic Prevent or delay introduction, slow spreadDecrease illness and deathVaccine when availableAntiviral treatment and isolation for people with illnessNon-pharmaceutical interventionsWeeksImpactPreparedUnprepared
24 Summary Combating a Pandemic; the three keys to success Knowledge of the virus is criticalMutations and movementLaboratory testing capabilities (Field and Lab testing)Vaccines (6-9 months)DevelopmentManufacturingDistributionNon-Pharmaceutical interventionsPopulation compliance or non-compliance