1. Ready or Not: Preparing for Pandemic Flu

2. A flu pandemic will happen – we can’t predict when or where

3. Objectives Understand what avian flu and pandemic flu are Describe three things you can do at home to prepare and/or protect yourself and your family Describe three things you can do at work to protect yourself and others Identify where to get accurate information about pandemic flu

4. Definitions Seasonal Influenza Avian Influenza Pandemic Influenza

5. Seasonal Influenza Caused by a virus Infects humans Usually occurs during the winter Easily spreads from person to person Vaccine is available

6. Incubation period is usually 1-3 days Symptoms -Fever (often sudden), chills, headache, muscle aches, dry cough, sore throat, weakness, runny nose, may last three to five days or more -People can shed the virus without showing symptoms of infection Seasonal Influenza Seasonal Influenza

7. The virus can be spread: -Cough/Sneeze Most important (within 3 feet) -Contact Contaminated articles Seasonal Influenza Droplet Contact

8. The Burden of Seasonal Influenza 250,000 to 500,000 deaths globally/yr 36,000 deaths and > 200,000 hospitalizations/yr in U.S. $37.5 billion in economic costs/yr in U.S. related to influenza and pneumonia

9. Influenza and Other Species Influenza viruses can infect a number of different species, including humans Other species include: – Birds (Avian) – Pigs – Horses – Seals – Whales

10. Avian Influenza (“Bird Flu”) Readily infectious between birds Only rarely infects humans

11. How do humans get the bird “bird flu”? Through close direct contact with poultry Not easily passed from bird to human

12. How a new human influenza virus is created

13. Situation Report: H5N1 Avian Flu in Humans Human infections associated with close direct contact with infected poultry High mortality (above 50%) Does not transmit from human to human efficiently so far

14. What is a pandemic? Outbreak is higher than usual number of cases occurring locally Pandemic is a worldwide outbreak

15. H1 H3 H2 1918 Spanish Flu H1N1 1957 Asian Flu H2N2 1968 Hong Kong Flu H3N2 1915 1925 1935 1945 1955 1965 1975 1985 1995 2005 Flu Pandemics in the 20 th Century

16. Requirements for a pandemic A new virus must emerge (people have not been exposed to it before) Infection usually causes serious disease The virus must spread as easily as seasonal influenza—by coughing and sneezing

17. Interpandemic Pandemic AlertPandemic Phase 1 No new virus in humans Animal viruses low risk to humans Phase 2 No new virus in humans Animal viruses high risk to humans Phase 3 New virus in humans Little/no spread among humans Phase 4 Small clusters, localized Limited spread among humans Phase 5 Larger clusters, localized Limited spread among humans Phase 6 Increased and sustained spread in general human population Current Level Current Pandemic Status

18. Planning Assumptions Time from infection to symptoms: – 1-4 days (average 2 days) Infectiousness: – Greatest during the first 2 days of illness may be infectious 1 day BEFORE symptoms – Infectious for about 5 or more days, children will shed the most virus – On average, each person will transmit influenza to two others

19. Planning Assumptions In an affected community an outbreak may last 6-8 weeks Absenteeism may be as high as 40% in a severe pandemic High rates of illness may occur among school aged children

20. Things to think about during a pandemic: Need to create as safe a work place as possible Need healthy workers on the job to keep community functioning Need workers to remain home when ill Healthcare may look different during a pandemic

21. Health Protection Preparedness System Local-state-federal Domestic-international Multisector integration Public-private Non-partisan Animal-human Health protection- homeland security- economic protection Healthcare Delivery System Federal Partners Education System Business & Workers Local /State / Federal Public Health System It Takes a NETWORK!

22. National Response Development of a national response plan and checklists to help local communities plan Investment of resources into vaccine development and medication reserves Control of disease coming from outside the U.S. through isolation/quarantine

23. Local Response

24. Quarantine: Well persons exposed to an Illness are kept separate from others to reduce disease spread Isolation: Ill persons are kept separate from others to reduce disease spread with the illness

25. Community Control of Pandemic Influenza I solation of the ill Management of patient contacts Quarantine of small groups Cancellation of specific events Closure of specific facilities Snow days and self-shielding Closure of facilities and transportation Widespread community quarantine less Restrictive more

26. As an individual what can you do to protect yourself and your family?

27. Individual Activities Individual Activities Social Distancing Annual flu vaccine Hand hygiene Respiratory etiquette “Cover your cough”

28. Social Distancing Three feet from other people Limit face-to-face contact

29. Prepare for an extended stay at home: Ready-to-eat canned meats, fruits, vegetables, and soups Protein or fruit bars Dry cereal or granola Peanut butter or nuts Dried fruit Crackers Canned juices Bottled water Canned or jarred baby food and formula Pet food

30. Examples of medical, health, and emergency supplies Prescribed medical supplies Soap and water Medicines for fever Thermometer alcohol- based hand wash Batteries Portable radio Tissues, toilet paper, disposable diapers Fluids with electrolytes Garbage bags

31. Hygiene: Wash Your Hands Before, during, and after you prepare food Before you eat, and after you use the bathroom After handling animals or animal waste When your hands are dirty, and More frequently when someone in your home is sick Avoid touching your eyes, nose or mouth

32. Wash Your Hands Wash Your Hands Use soap and warm running water for At least 20 seconds OR Use an alcohol based hand sanitizer for at least 15 seconds.

33. If you become ill…

34. Sneezes and Coughs are powerful germ explosions

35. Cover Your Coughs and Sneezes Use a tissue or inside of your elbow when sneezing or coughing.

36. Stay home when you are sick Stay home if you have… A fever of 101 degrees If needed seek medical care

37. More information is available

38. Resources National Planning: www.pandemicflu.gov Bird and Animal Issues: www.usda.gov State Planning: http://www.oregon.gov/DHS/ph/acd/flu/influenza.shtml Marion County Communicable Disease Info (503) 588-5621

39. “Pandemics are global in nature, but their impact is local. When the next pandemic strikes, as it surely will, it is likely to touch the lives of every individual, family, and community. Our task is to make sure that when this happens, we will be a Nation prepared.” - Mike Leavitt, Secretary US Department of Health and Human Services