Pandemic Flu

Introduction An influenza pandemic is an epidemic of an influenza virus that spreads on a worldwide scale and infects a large proportion of the human population. It is a rare but recurrent event. An influenza pandemic occurs when a new influenza virus emerges, Influenza viruses are grouped into three types, designated A, B, and C. Influenza A and B viruses are of concern for human health.

‘Spanish’ Flu The influenza pandemic of 1918-1919 killed more people than the Great War, World War I (WWI), at somewhere between 20 and 40 million people. This pandemic is considered one of the deadliest disease events in human history. More people died of influenza in a single year than in four-years of the Black Death Bubonic Plague from 1347 to 1351. The pandemic is estimated to have infected 50% of the world's population; Total excess mortality was between 40 to 50 million. There are reports of people waking up well in the morning but dying by nightfall - so rapid was the disease process. The attack rate and mortality rates were highest among healthy adults (20-40 years old).

‘Asian’ Flu The "Asian flu" was a pandemic outbreak of avian influenza that started in China in February 1957 and spread worldwide that same year, lasting until 1958. Within 6 months, the pandemic spanned the entire globe. In Europe the epidemic coincided with the September return to school. Cases were concentrated in school-aged children and those crowded together, but in the UK the impact on mortality was in the elderly. The mortality rate was estimated at approximately 1 in 4000. Thus, the total death toll probably exceeded 1 million people. Infection spread to India, Australia, and Indonesia by May; to Pakistan, Europe, North America and the Middle East by June; to South Africa, South America, New Zealand and the pacific Islands by July; and to Central, West and East Africa, Eastern Europe and the Caribbean by August. By the end of 1957, the worst seemed to be over. However, a second wave of infection was observed early in 1958, which broke out in numerous regions including Europe (but not in UK), North America, the former USSR and Japan. This wave caused high rates of illness and increased fatalities. Quarantine measures were generally found to be ineffective, at best merely postponing the transmission by weeks.

‘Hong Kong’ Influenza As in 1957, the 1968 influenza pandemic arose in Southeast Asia. Half a million cases were reported in Hong Kong in just two weeks. The Hong Kong influenza reached the USA in September 1968, via US Marines returning from service in Vietnam. In the United Kingdom the epidemic began in December, However, the number of fatalities due to influenza sharply increased in Europe one year later, during the 1969-1970 season. Finally, the virus reached South America and South Africa in mid-1969. Vaccine manufacture began within two months of the virus being isolated. Estimates of victims of the 1969 pandemic show a range of 1-3 million fatalities, of which over 30,000 were from the United Kingdom. This virus is known as the "Hong Kong Influenza". However, this outbreak began in China in July 1968, spreading to Hong Kong that same month, from where it spread rapidly to the whole world The virus was rapidly identified as a novel influenza A subtype, H3N2, and in August 1968 WHO warned about the emergence of a possible pandemic. Further spread occurred rapidly throughout most of South-East Asia. However, a significant epidemic did not occur in Japan until January 1969. By December the illness was widespread and morbidity and mortality was as high as in the 1957-1958 pandemic. In Europe the disease was diagnosed from September 1968 onwards; symptoms were mild and excess deaths negligible However, only 20 million doses were ready by the time the epidemic peaked in the United States.

More recently An epidemic of influenza-like illness of unknown causation occurred in Mexico in March–April 2009. On 24 April 2009. The WHO issued a statement on the outbreak of "influenza like illness" The disease spread rapidly through the rest the spring, and by 3 May, a total of 787 confirmed cases had been reported worldwide. On 11 June 2009, the ongoing outbreak of Influenza A/H1N1, referred to as "swine flu", was officially declared by the WHO to be the first influenza pandemic of the 21st century It is thought to be a mutation of four known strains of influenza A virus In 1 November 2009 WHO stated that "199 countries and overseas territories/communities have officially reported a total of over 482,300 laboratory confirmed cases that included 6,071 deaths. confirmed cases of A/H1N1 influenza had been reported in Mexico and USA subtype H1N1: one endemic in humans, one endemic in birds, and two endemic in pigs (swine).[44]

Influenza A H1N1 WHAT IS IT? The official designation is A(H1N1) influenza or "Swine flu" is the name commonly given to a new form of flu. From a first known case in Mexico, the outbreak has spread at exceptional speed, prompting the UN's World Health Organisation (WHO) to declare a pandemic on June 11 2010. Read slide out aloud

Influenza A H1N1 WHY THE ALARM? People had no or little immunity against this new virus. Three times in the past century, brand-new flu strains have spread around the world, killing millions of people. To date A(H1N1) is contagious but relatively mild. Its effects are comparable to those of ordinary, or "seasonal", flu. But the worry is that it could mutate making it as lethal as past pandemic viruses.

Influenza A H1N1 WHAT IS THE TOLL? More than 700 people have been killed by A(H1N1), according to the WHO. It stopped issuing a tally of infections in July 2010, when recorded cases neared the 100,000 mark. By comparison, between 250,000 to 500,000 people around the world die of regular seasonal flu every year. Read slide out aloud

Influenza A H1N1 HOW DOES A(H1N1) SPREAD? Swine flu spreads like ordinary flu, i.e. in viral particles expelled in coughs and sneezes that are then breathed in by someone nearby, or deposited on surfaces that are then touched by the hand and transmitted to the mouth, nose or eyes. People with the virus may be able to infect others beginning a day before symptoms develop, and up to seven days or more after becoming sick. Young children may be contagious for somewhat longer. 40,000 droplets can be produced by a sneeze

Statistics of ‘Flu like’ illness throughout the UK Re-iterate the point in the title ‘flu like’ illness

Statistics of ‘Flu like’ illness throughout the UK

Pandemic Alert Phases The World Health Organisation (WHO) has defined six phases in the evolution of an influenza pandemic which define a staged approach to preparedness planning and response, leading up to the declaration of the onset of a pandemic. The UK Government has identified four additional UK alert levels (within WHO Phase 6) to define the extent of the pandemic within the UK. The WHO phases and UK alert levels are as follows: Read slide aloud

World Health Organisation (WHO) Pandemic Influenza Alert Phases Pandemic Alert Phases World Health Organisation (WHO) Pandemic Influenza Alert Phases Phase Title Phase Description WHO Phase Inter-pandemic phase New virus in animals, no human cases Low risk of human cases 1 Higher risk of human cases 2 Pandemic alert New virus causes human cases No or very limited human-to-human transmission 3 Evidence of increased human-to-human transmission 4 Evidence of significant human-to-human transmission 5 Pandemic Efficient and sustained human-to-human transmission 6 Explain at what stage WHO class the pandemic at present

UK Pandemic Influenza Alert Levels UK Alert Levels WHO Phase Alert Level Description UK Alert Level 3, 4, 5 No cases of efficient human-to-human transmission in the world 6 Virus/cases only outside the UK 1 New virus isolated in the UK 2 Outbreak(s) in the UK 3 Widespread activity across the UK 4 Explain what UK pandemic alerts are at present.

A guide on How too Protect Yourself in the Workplace during a Pandemic If you are developing symptoms and you have followed the Guidelines for reporting the illness request sick leave. Wash your hands frequently with soap and water for 20 seconds or with a hand sanitizer if soap and water are not available. Avoid touching your nose, mouth and eyes. Cover your coughs and sneezes with a tissue. Dispose of tissues in appropriate waste bins. Wash your hands or use a hand sanitizer after coughing, sneezing, or blowing your nose. Avoid shaking hands and always wash your hands after physical contact with others. If wearing gloves, always wash your hands after removing them.

A guide on How too Protect Yourself in the Workplace during a Pandemic Keep frequently touched common surfaces (i.e. telephones, computer equipment, etc.) clean. Try not to use other workers' phones, desks, offices, or other work tools and equipment. Minimize group meetings; use e-mails, call and video conferencing and text messaging. If meetings are unavoidable, avoid close contact with others and ensure that the meeting room is properly ventilated. Limit unnecessary visitors to the workplace. Maintain a healthy lifestyle; attention to rest, diet, exercise and relaxation helps maintain physical and emotional health.

Look for any symptoms in YOU and in OTHERS

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