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Be Prepared IF Bird Flu Hits

Local Efforts Paramount

IF Bird Flu Pandemic Hits -- March 1, 2006

Flu Pandemic - Local Efforts Paramount

If the bird flu turns into a pandemic, Columbus is on its own. That timely
reminder is the most valuable piece of information to come out of Ohio’s
flu-preparedness summit on Feb. 17, when Michael Leavitt, U.S. secretary
of Health and Human Services, laid out the scenario for state leaders.

The federal government will do everything it can to help, but, unlike
Hurricane Katrina, a flu disaster would not be localized; hundred of
cities would be in the same dire straits at the same time.

Pandemics have hit 10 times in the past 300 years, the last being the Hong
Kong flu 38 years ago. And if bird flu were to be on par with the 1918
Spanish flu pandemic, which also originated from birds, 90 million
Americans might become ill, 45 million of them might require serious
treatment and 2 million might die.

Humans have no immunity to the strain, so recipients of a vaccine would
need two doses 30 days apart for protection. But any vaccine would take at
least six to eight months to develop once the virus is identified.

With federal manpower and resources stretched thin, the most Ohioans
should expect from the federal government would be to ensure that states
are cooperating and to track the virus' spread.

Counties, cities, universities, school districts, public utilities,
emergency services and businesses should develop a comprehensive plan for
what they would do in that situation. They should know how they would
operate if key workers were absent for long periods or if the businesses
don't receive needed supplies.

In September, the Ohio Department of Health published the state's
pandemic-response plan, which gives a straightforward description of what
agencies and residents can expect. Shortages are likely in drugs, hospital
equipment, hospital beds, space in morgues and "perishable resources" such
as food.

Leavitt's department has warned that people might be ordered to stay in
their homes and avoid public places; public transportation, schools and
day-care centers might be closed and events might be canceled.

Even if someone ventures out to a store, shelves might be bare if
deliveries can't be made. Gasoline might run low. Electricity, phone and
water service, banks and the U.S. mail might be disrupted.

A large concern is the psychological impact on health-care workers of
seeing masses of people, especially children, die. The median age of the
flu's few victims around the world so far is 12.5. In 1918, the flu killed
a disproportionate number of people ages 20 to 40..

While there is plenty of cause for planning, there is no cause for panic
because the virus might never mutate into a form that can pass easily
between people. And even if it does, the strain might be significantly

So far, the H5N1 strain has been found in Asia, Europe and Africa, killing
at least 93 people out of the estimated 170 who have contracted it since

The latest victim, a 27-year-old Indonesian woman, died on Feb. 22. Last
week, the virus was detected in a turkey farm in France and also in birds
in Germany, near the Polish border. India had finished culling hundreds of
thousands of birds when the virus emerged in its west-central region.

Just as government, hospitals and businesses should develop plans, so
should individuals. Throwing an extra pack of batteries into the grocery
cart one week and a manual can opener the next wouldn't hurt. If people
stock up gradually, shortages and panic can be minimized.

A list of useful supplies appears on the Health and Human Services Web
site: under the link "Planning Checklists." It's not
paranoia to start thinking about such things and, besides, these items
come in handy during any emergency, from blizzards to summer blackouts.

****Frequently Asked Questions****

What is influenza?

Influenza, or the "flu", is an infection of the respiratory tract (breathing tubes and lungs), caused by the influenza virus. In some persons, complications of influenza can be severe, including pneumonia.

What is pandemic influenza?

Pandemic influenza is a global outbreak of disease from a new influenza A virus that is unlike past influenza viruses. Because people have not been infected with a similar virus in the past, most or all people will not have any natural immunity (protection) to a new pandemic virus.

How is a pandemic different from regular flu season?

A flu pandemic has little or nothing in common with the annual flu season. Pandemic flu would be a new strain and a much more serious and contagious flu virus. Humans would have no natural resistance to a new strain of influenza. Also, there is a vaccine for seasonal flu, but there is no vaccine available at this time for pandemic flu.

Why is pandemic influenza so serious?
Because most or all people would not have immunity to a new pandemic virus, large numbers of persons around the world can be infected. If the pandemic virus causes severe disease, many people may develop serious illnesses.

Once a pandemic virus develops, it can spread rapidly causing outbreaks around the world. The U.S. Centers for Disease Control and Prevention (CDC) predicts that as much as 25% to 30% of the US population could be affected.

Can pandemic flu be prevented?

The Ohio Department of Health Services is working with federal and local government agencies to respond to pandemic influenza if an outbreak should occur. The ODHS Pandemic Flu Plan identifies Ohio-specific activities that may occur during a flu pandemic. Governments around the world are preparing for the possibility of a pandemic outbreak under the leadership of the World Health Organization.

It may not be possible to prevent or stop a pandemic once it begins. A person infected with influenza virus can be contagious for 24 hours before the onset of symptoms, and for seven days thereafter, making it extremely easy for the virus to spread rapidly to large numbers of people.

Although the federal government is stockpiling medical supplies and antiviral drugs, no country in the world has enough antiviral drugs to protect all its citizens. Antiviral drugs may be used to treat severe cases or prevent additional cases as long as supplies are available. Antiviral drugs might also be prioritized for people who work in essential occupations, such as health care workers.

There currently is no vaccine to protect humans against a pandemic influenza virus because we do not know which virus will spark the next pandemic. However, vaccine development efforts are under way to protect humans against a pandemic influenza virus that might develop from the current bird flu virus in Asia, A/H5N1. (See information on bird flu below).

When is pandemic influenza expected?

Influenza pandemics occur naturally. There were 3 pandemics in the 20th century. The pandemic of 1918-19 was the most severe pandemic on record, in which 50 million or more persons around the world died, including approximately 650,000 Americans.

It is not possible to predict accurately when influenza pandemics will occur or how severe they will be. However, the current outbreak of avian influenza in Asia has influenza experts concerned that a pandemic could be developing.

Do businesses and schools need to plan for a pandemic?

Yes. In the event of pandemic influenza, businesses will play a key role in protecting employees’ health and safety as well as limiting the negative impact to the economy and society. Planning for pandemic influenza is critical. To assist you in your efforts, the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) have developed this checklist for businesses. It identifies important, specific activities large businesses can do now to prepare, many of which will also help you in other emergencies.

Why does the current bird flu outbreak in Southeast Asia pose a risk of causing a pandemic influenza A outbreak in humans?

New human influenza viruses arise from bird influenza viruses that then change to a form that can infect humans and spread readily from person to person. The current bird flu outbreak in Asia is caused by a type of influenza A virus called “H5N1.” The H5N1 outbreak among domestic chickens and ducks in Asia is widespread and uncontrolled. Human infections and deaths due to the avian H5N1 virus have occurred, although the virus has at this time not developed the ability to pass easily from person to person and cause outbreaks in humans.

What are the symptoms of bird flu in humans?

The reported symptoms of bird flu in humans have ranged from typical influenza-like symptoms (e.g., fever, cough, sore throat, and muscle aches) to eye infections (conjunctivitis), pneumonia, acute respiratory distress, viral pneumonia, and other severe and life-threatening complications.

What can the public do to reduce the risk of pandemic influenza?

* Stay informed.
Regularly updated information about bird flu and pandemic flu:
World Health Organization
Centers for Disease Control and Prevention (CDC):
o Spread of Avian Influenza Viruses among Birds
o Avian Influenza Vaccines
o Avian Influenza A Viruses

Information on the vaccine development process:
National Institutes of Health
* Stop germs from spreading.
Cover your mouth and nose with tissue when coughing and sneezing.
Wash your hands often.
Stay home when you are sick.

* If traveling to Southeast Asia, visit the CDC Travelers' Health website.

* For more information visit the official U.S. government Web site for information on pandemic flu and avian influenza.

Flu pandemic deemed inevitable--Communities will be on their own
COLUMBUS - An influenza pandemic is inevitable and local communities will be on their own when it hits because federal and state governments will have their hands full, U.S. Health and Human Services Secretary Mike Leavitt warned yesterday.

The worst-case scenario suggests as many as 2 million Americans could die.

Whether it's the so-called bird flu or a virus not yet on the radar screen, Mr. Leavitt urged more than 500 health officials, doctors, nurses, law enforcement officers, and others attending Ohio's first flu pandemic summit to start the "buzz" now to prepare for what will surely come.

"Pandemics happen," he said. "They've been happening for centuries. There's no reason to believe the 21st century will be markedly different."

There were three global pandemics in the 20th century, the worst in 1918, killing an estimated 500,000 Americans. The last, in 1968, was tame by 1918 standards.

"If we were to have a pandemic of equal proportion to the one that happened in this country in 1918, we would see 90 million Americans contract the disease," said Mr. Leavitt, a former Utah governor.

"We would see half of them, over 45 million people, who would become sick enough that they would require serious medical attention," he said. "Regrettably, if we have a pandemic of similar proportion as in 1918, nearly 2 million of our citizens will die."

Mr. Leavitt came with the promise of $3.2 million in federal aid for Ohio to help state and local planning efforts, part of $100 million that has been appropriated nationwide by Congress from $350 million President Bush has requested.

Similar summits are happening in states across the nation.

Lucas County Deputy Health Commissioner Larry Vasko, who attended the summit, said he has never seen as much government money reaching local efforts for planning.

But he said he understands Mr. Leavitt's point about local communities being largely on their own in a worst-case scenario in which the number of deaths could be "staggering."

"If everybody is struggling with the same crisis, natural or man-made, they're aren't enough people to go around," he said. "That's a major concern, but you've got no other choice. When you look at some of what we've done over the last four or five years, whether its with hurricanes, anthrax, or smallpox, it shows that it's important to have a good public health infrastructure."

Some of those in attendance, however, questioned government's commitment.

"We're talking about having more surveillance, but at the same time they're not giving the local school boards and districts the support they need to be able to keep their school nurse staffing levels," said Deborah Strouse, central Ohio representative for the Ohio Association of School Nurses.

"You can expect the highest incidents to be in school-age children, and that will probably be at a rate of about 40 percent, and we're usually going to see them before they're sick enough to go to the hospital," she said.

The Ohio Department of Health adopted a Pandemic Flu Preparedness Study two years ago and has since updated it. The 59-page document provides instructions on such things as communications during a crisis and how to prioritize who gets a newly created vaccine while it remains in short supply.

Families are encouraged to keep a stock of food, water, and other supplies in case they have to quarantine themselves for perhaps weeks at a time.

Marjorie Broadhead, Seneca County's health commissioner, said Ohio is probably better prepared than most states.

But even as it prepares for a pandemic threat for which there may be no vaccine, she said the federal government could do a better job encouraging for the elderly to take pneumococcal vaccine now to reduce the chances of a fatal secondary infection attacking weakened flu victims.

"This is something that we can physically do for preparation, because so many times people die of the secondary infection, which is pneumonia from flu," she said. "If we can immunize people against pneumonia, doesn't it make sense to do that? We have that vaccine now."

Health chief tells of flu preparation
COLUMBUS | — U.S. Health and Human Services Secretary Mike Leavitt made a stop in Columbus on Friday as part of a nationwide tour to discuss how state and local governments can prepare for a potential influenza outbreak that could kill up to 2 million Americans.
"The H5N1 avian influenza, also known as bird flu, has reawakened Ohio, the United States and the world community to the very real possibility of another influenza pandemic," said Gov. Bob Taft at the Ohio Pandemic Flu Preparedness Summit at the Columbus Convention Center. More than 500 Ohio leaders attended.
As of Monday, there had been 169 confirmed cases of the bird flu since 2003, 91 resulting in deaths, according to the World Organization of Health. All cases have been in Southeast Asia or the Middle East.
The virus cannot be transmitted from person to person. A human can be infected only by a bird with the virus, but there is concern a mutation could cause a pandemic.
In the past 300 years there were 10 flu pandemics, Leavitt said.
"If it's not the H5NI virus, then it will ultimately be another because pandemics happen," Leavitt said.
Ohio will receive $3.2 million federal dollars for local pandemic planning, part of $350 million to be distributed throughout the country, said Doug O'Brien, a regional director for HHS. The preparations include stockpiling medication and researching vaccines.
"All of this seems alarmist before the fact, but after it happens, it seems inadequate," Leavitt said.

Posted by sslaughter on 03/25/2006
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