2. It is not a matter of IF this is going to happen, but WHEN… Every day you are not prepared is another day to PLAN!

3. Seasonal Flu There are thousands of flu viruses Caused by respiratory viruses Easily transmitted from person to person People may have some residual immunity to the virus A vaccine is available

5. Pandemic Causes global outbreak Highly pathogenic for humans Spreads easily from person to person worldwide Genetically unique High morbidity & mortality

6. New influenza virus Little/No immunity in human population Infects & replicates in humans Spreads easily and is sustained among humans Currently, there is No pandemic

7. Avian Flu (a.k.a. H5N1) Caused by influenza viruses that naturally infect wild birds Can be deadly for domesticated birds such as chickens, ducks, and turkeys Can be transmitted from birds to humans No human immunity or vaccine is available at this time

8. Influenza-like diseases appeared as early as 412 BC First Recorded Pandemic – 1580 19 th century- three pandemics, including the Russian Flu of 1889

9. 1918 – Spanish Flu 1957 - Asian Flu 1968 - Hong Kong Flu Library of Congress, Prints & Photographs Division, Reproduction number unknown

10. Over 500,000 U.S. deaths Up to 40 million deaths worldwide More died in one year than in four (4) years of the Black Death The most catastrophic pandemic

11. The attack rate and mortality rate was highest among young adults ages 25-50 years old. The body responds to the infection by triggering the immune system to over respond, which includes an increase in fluid in the lungs. You need to be placed on a ventilator to pump out the fluid. The government is using what happened during the Spanish Flu as an example to help plan for the next Pandemic.

12. Library of Congress, Prints & Photographs Division, Reproduction number LC-USZ62-126995 Over 70,000 U.S. deaths 1-2 million deaths worldwide Elderly had the highest rates of death

13. Library of Congress, Prints & Photographs Division, Reproduction number LC-USZ62-126995 Over 34,000 U.S. deaths 700,000 deaths worldwide Mildest of the pandemics ) *This would not have been declared a pandemic if it was not worldwide

14. Closed saloons, dance halls, and cinemas Schools were closed Banned large crowd gatherings Prohibited public funerals

15. Hong Kong Source of infection - Close contact with live poultry (sharing living quarters, contact with fecal matter, etc.) 18 humans infected; 6 deaths Prevention - 1.5 million birds were destroyed in three days to try to eradicate the virus

16. Mutates rapidly Causes severe disease in humans Since 2003 – over 300 human H5N1 cases have been reported

17. Total number of cases includes number of deaths. WHO reports only laboratory-confirmed cases. Countr y 20032004200520062007 Total cases death s casesdeathscasesdeathscasesdeathscasesdeathscasesdeaths Azerbaijan000000850085 Cambodia000044221177 China110085138212415 Djibouti000000100010 Egypt00000018101643414 Indonesia00002013554522199777 Iraq000000320032 Lao People’s Democrati c Republic 000000002222 Nigeria000000000111 Thailand0017125233302517 Turkey00000012440 4 Viet Nam332920611900009342 Total 4446329843115794428307186 High fatality rate (61% death rate) For current information go to: http://www.pandemicflu.gov/

18. More infected birds = increased chance for human infection More exposure to infected birds = increase chance of human-to-human mutated strain, which may lead to the next pandemic. This photo depicts the burying of dead birds

19. H5N1 currently transmits through birds Nasal/body secretions (saliva, mucus membranes, oils, droppings, etc.) Most human H5N1 cases have a history of prolonged contact with sick birds

20. Currently there is NO pandemic! SB County has a population of 1.9 million. –Of those approximately 30% (600,000) may become infected with H5N1. –Approximately 5% (30,000) of those infected may die We are currently in a phase 3 alert stage which means there has been no or very limited human to human transmission (as determined by the World Health Organization).

21. Resemble those of the common flu (fever, cough, sore throat, shortness of breath, eye infections, & muscle aches) Increased symptoms include pneumonia, severe respiratory diseases, and other severe and life threatening complications (multi-organ failure) Patients do not get better See your doctor for treatment

22. Adults can shed the virus 3-5 days prior to showing symptoms Children can shed the virus 5-7 days prior to showing symptoms

23. Bird Migration Illegal smuggling of birds and poultry products Travel by infected people People traveling with virus contaminated items (i.e. clothing, gloves, etc.)

24. Vaccine may take 6-9 months to develop from the time it passes from human to human Obstacles:  Limited production capacity  Only a few companies that can produce the vaccine  Long standing technology  New technology

25. Non-medical control measures: Risk Communication Pre-event During event Isolation of Cases Self-imposed (shelter-in-place) Mandated

26. Non-medical control measures: Tracing and Management of Contacts Social Distancing Schools Furloughing non- essential workers Canceling mass gatherings Limiting travel

27. Proactive Education Planning Surveillance Antiviral Medications Vaccine Development Health Care Planning Public Health Interventions

28. Promote public health efforts in your community & stay informed! Practice good health habits: *Wash hands frequently *Cover coughs and sneezes *Stay away from others when sick (follow the 3 – 6 foot rule) *Continue practicing proper handling and cooking of poultry and egg products

29. Individual Family Community Organization We need to work together!

30. pandemicflu.gov cdc.gov sbcounty.gov/pubhlth sbcounty.gov/pubhlth/prepandresponse For more information, please call the Preparedness and Response Program at: (909) 387-6280 or (800) 782-4264 THANK YOU!