1. What is Pandemic Influenza?

2. Pandemic Influenza A global outbreak of disease that occurs when a new influenza virus appears or “emerges” in the human population, causes illness, and then spreads easily from person-to-person worldwide

3. Influenza Virus Hemagglutin Neuraminidase

4. Pandemic Strain How does it begin?

5. Virus Transmission

6. Recent History Avian Influenza (H5N1) Swine Flu (H1N1)

7. Today – Pandemic (H1N1) 2009 Influenza Pandemic (H1N1) 2009 influenza is a respiratory illness that causes symptoms similar to those of seasonal flu (fever, fatigue, lack of appetite, coughing, body aches, and sore throat). The virus had its origins in pigs.

8. The Spread of H1N1 Similar to seasonal influenza Respiratory droplets from an infected person are released into the air through coughing and sneezing inhaled by others land on surfaces that are touched by the hands and then spread by contaminated hands to the nose and mouth

9. Global Spread of H1N1

10. Looking to the Past to Predict the Future 1918-19 Spanish Flu (~21 million deaths) 1957-58 Asian Flu (~1-4 million deaths) 1968 Hong Kong Flu (~1 million deaths)

12. Modeling the Impact of Influenza Pandemic: Ontario 4,440,443 may be ill 3,397,536 may seek outpatient care 81,655 may require hospitalization 67,387 may recover 20,383 may die Taken from 2008 Ontario Health Plan for an Influenza Pandemic. Based on a 1968-like virus, numbers shown are based on the worst case scenario.2008 Ontario Health Plan for an Influenza Pandemic

13. Impact of Influenza Pandemic: Sudbury & Manitoulin Districts 69,000 may be ill enough to remain home 52,963 may seek outpatient care 1,318 may require hospitalization 333 may die Taken from 2008 Ontario Health Plan for an Influenza Pandemic. Based on a 1968-like virus, numbers shown are based on the worst case scenario.2008 Ontario Health Plan for an Influenza Pandemic

14. Slowing the Spread Infection control Social distancing Enhanced environmental cleaning Screening and surveillance Staying home when ill Antivirals Vaccine

15. Infection Control Hand hygiene

16. Cover Your Cough! To minimize the spread of germs, cough and sneeze into the fabric of your clothing in the elbow area. Cover your mouth and nose with a disposable tissue when coughing or sneezing and discard the tissue immediately. Wash your hands after handling tissues.

17. Infection Control Hygienic measures

18. Are Masks Effective? The Public Health Agency of Canada does not recommend that members of the general public wear surgical masks to protect against contracting influenza. Incorrect use of masks can actually increase the risk of infection.

19. What Are Antivirals? Medication prescribed to either treat a person who is ill or to prevent illness in a person who was exposed to someone who was ill. Antivirals must not be overused or the influenza virus may become resistant to them.

20. How Are Antiviral Medications Made Available? Antivirals are prescription drugs. Currently physicians are advised to only prescribe antivirals for people with influenza like illness requiring hospitalization or for whom there is a risk of complicated disease. Treatment must start within 48 hours of illness onset to be effective. Canada has a National Antiviral Stockpile that contains 55 million doses of antivirals, made up primarily of oseltamavir (Tamiflu®). The federal stockpile of antivirals will be distributed to provinces and territories on an as-needed basis.

21. What Are Influenza Vaccines? Vaccines are injections that stimulate the body’s immune system so that it produces antibodies against the flu virus. Vaccines are made to prevent illness from a specific virus.

22. Is There a Pandemic (H1N1) 2009 Influenza Vaccine? Canada has a contract with Glaxo- Smith Kline for vaccine production. An H1N1 vaccine is expected to be available in early 2010. The contract in place covers the production of enough pandemic vaccine for all Canadians.

23. Pandemic Influenza Planning and Response

24. Pandemic Influenza Planning: Collaborative Process World Health Organization Federal Government Provincial Government Local Public Health Unit

25. Goal of Influenza Pandemic Planning, Preparedness and Response 1.To minimize serious illness and overall deaths. 2.To minimize societal disruption among Canadians as a result of an influenza pandemic.

26. Challenges Anticipated With Pandemic Influenza Young healthy individuals will be affected. There will be a shortage of medical resources, equipment, and personnel. Essential services will be disrupted due to absenteeism. All areas of the province will be affected simultaneously.

27. WHO Pandemic Periods and Phases PeriodPhaseDescription Interpandemic1212 NO new influenza virus subtype in humans Circulating animal influenza - substantial risk to humans Pandemic alert345345 NO human-to-human spread Small clusters – human-to-human Larger clusters, still clusters Pandemic6Increased and sustained in populations Post pandemicReturn to Interpandemic period

28. Timing Of Public Health Measures

29. Pandemic Influenza Preparedness: Public Health Role Surveillance, reporting and investigation Liaison with community partners Assessment of local health services capacity Confirming pandemic activity locally Mass immunizations and distribution of vaccines, antiviral meds and supplies Collaborating with province to deliver public information/education programs

30. The SDHU Pandemic Plan Is on www.sdhu.com Components of the plan:  Preparedness  Surveillance  Vaccines  Antivirals  Health services  Emergency response  Public health measures  Communications  Response

31. Linkages Community Agency Plans SDHU Plan Health Agency Plans Municipal Plans

32. Do You Have a Plan? Personal preparedness Create your own family/personal pandemic influenza plan. Identify strategies that you can take to address personal and family issues if you are ill or if you have to go to work. List of supplies you should consider having in the event of an emergency. Ways that you may be able to provide assistance to others.

33. “ The only thing harder than planning for an emergency is explaining why you didn’t.”

34. This presentation was prepared by staff at the Sudbury & District Health Unit. This resource may be reproduced, for educational purposes, on the condition that full credit is given to the Sudbury & District Health Unit. This resource may not be reproduced or used for revenue generation purposes. © Sudbury & District Health Unit, 2009