HEALTH AND FAMILY SERVICES Division of Public Health DEPARTMENT OF HEALTH AND FAMILY SERVICES Division of Public Health October 12, 2006

Outline In Wisconsin, what can we expect in the next influenza pandemic? How can your business prepare?

IMPORTANT TERMINOLOGY EPIDEMIC: Disease or condition with activity above what is typically seen in a given geographic area. Ex. Annual Influenza activity in Northern Hemisphere PANDEMIC: Disease activity in a large geographic area (worldwide?), usually for longer periods of time Ex. HIV, Obesity(?) Because of the duration of the epidemic, the severity of the illness and the fact that it will simultaneously affect a very large geo graphic area, perhaps worldwide.. Current emergency plans must be updated. An influenza pandemic is indeed unlike any other public health emergency or disaster This slide the shows the magnitude of illness associated with the 2918 Spanish Flu pandemic By preparing for an emergency of this magnitude we hope to avoid this scene from occurring again.

WHAT IS INFLUENZA? A respiratory disease caused by influenza virus. Abrupt onset of fever, cough, sore throat, chills, body aches. Not typically associated with vomiting or diarrhea. Typical incubation period 1–5 days (usually 1-3).

Pandemic Influenza “An influenza pandemic is unlike any other public health emergency or disaster” Because of the duration of the epidemic, the severity of the illness and the fact that it will simultaneously affect a very large geo graphic area, perhaps worldwide.. Current emergency plans must be updated. An influenza pandemic is indeed unlike any other public health emergency or disaster This slide the shows the magnitude of illness associated with the 2918 Spanish Flu pandemic By preparing for an emergency of this magnitude we hope to avoid this scene from occurring again.

SEASONAL VERSUS PANDEMIC INFLUENZA Seasonal Influenza Pandemic Influenza Begins November/December At any time of the year Peaks Late January/early February Not known Duration 4-5 months 2 years or more At Risk Elderly, chronic illness, infants Everyone Vaccine Annual vaccine available in October Not available for 6-8 months after a pandemic begins Reproduction (Spreadability) 1.5 to 2 additional cases 2.5 to 3+ additional cases Seasonal versus pandemic influenza Seasonal usually begins in November December In WI currently in the early stages of annual seasonal epidemic widespread activity usually lasts 4-6 weeks we have not seen widespread activity in Wisconsin this year Pandemic Can begin at anytime thus the need for year round surveillance unknown when it will peak locally or in the state widespread activity will be prolonged and could last for many months

1999 1997 2000 2001 1998

1999 1997 2000 2001 1998

INFLUENZA: SEASONAL IMPACT ~5%-20% Infected 270,000-1.1 million WISCONSIN Population ~5.4 million Outpatient Care 120,000-240,000 ~5%-20% Infected 270,000-1.1 million Deaths ~600-1000 Hospitalized 3,500-7,000

INFLUENZA: PANDEMIC IMPACT WISCONSIN Population ~5.4 million Outpatient Care 1.4 million ~35% Infected 1.9 million Deaths ~8500 Hospitalized 27,500

WHAT CAN WE EXPECT IN THE NEXT PANDEMIC? Absenteeism ( up to 30-40%) Employee illness & family members Death Fear Shortages of materials Possible closures (hopefully short term) Financial Issues

PUBLIC HEALTH INFECTION CONTROL STRATEGIES Personal Hygiene Hand washing Respiratory etiquette Stay home when sick Social distancing and limiting access Public gatherings and events cancelled Public places closed Restricted or suspended travel Isolation/Quarantine

HOW CAN YOUR BUSINESS PREPARE FOR A PANDEMIC? Education of employees Communicating with employees during a pandemic

HOW CAN YOUR BUSINESS PREPARE FOR A PANDEMIC? Plan to keep operating with only 60% staff Don’t plan to close!!

BUSINESS PLANNING Plan how to keep operating with only 60% staff Establish policies for flexible worksite (e.g. telecommuting) Flexible work hours (e.g. staggered shifts). Retraining or cross-training Reduce or combine services

BUSINESS PLANNING Communicating with employees during a pandemic Plan for communicating with vendors, suppliers, and customers inside and outside the worksite

BUSINESS PLANNING Communicating with employees during a pandemic Anticipate employee fear and anxiety, rumors and misinformation

WHAT WE DON’T KNOW… We do not know when the next pandemic it will occur We do not know how severe the next pandemic will be The success of any preparation will depend on the cooperation of the public!!

WHAT WE KNOW….. An influenza pandemic is likely to occur at some time in our life An influenza pandemic will result in increased illness and increased deaths Need to prepare for increased absenteeism Need to prepare now for what we know will occur and be prepared to make intelligent decisions when faced with the unexpected!! The success of any preparation will depend on the cooperation of the public!!

INFLUENZA PANDEMIC RESOURCES www.PandemicFlu.gov Official U.S. Government Web site on pandemic influenza and avian influenza www.cdc.gov/flu/pandemic Centers for Disease Control Pandemic Influenza Info. www.pandemic.wisconsin.gov

Respiratory Disease Epidemiologist Wisconsin Division of Public Health Thomas Haupt M.S. Respiratory Disease Epidemiologist Wisconsin Division of Public Health 608-266-5326 hauptte@dhfs.state.wi.us