Pandemic Influenza Planning and

Preparedness in Contra Costa County

Special thanks to the following for the use of their slides:

Howard Backer, MDChief, Immunization Branch, California Department of Health Services

Michael T Osterholm PhD, MPHDirector, Center for Infectious Disease Research and Policy and Associate Director, DHS National Center for Food Protection

•The difference between:

Seasonal influenza

Avian influenza

Pandemic influenza

•What you can do to get prepared

Overview

A Modern World View of Pandemic Influenza

The Truth

•Seasonal Influenza• Respiratory illness characterized by fever,

headache, tiredness, dry cough, sore throat, runny nose, etc.

• Complications occur mostly among “high risk” including those with congestive heart disease, asthma and diabetes

Seasonal Influenza High infectivity High infectivity Short incubation periodShort incubation period Clinical illness is non-specificClinical illness is non-specific Easily transmittedEasily transmitted

Routes of transmission Large droplets (sneezing, coughing, contact Large droplets (sneezing, coughing, contact

with saliva)with saliva) Fomites: doorknobs, Kleenex, etc.Fomites: doorknobs, Kleenex, etc. Rarely airborne over long distanceRarely airborne over long distance

Average Impact of Seasonal Influenza in US

• 5-20% infected

• Over 200,000 hospitalized– About half in 65+

• 36,000 deaths

– >90% in 65+

Avian Influenza

(Bird Flu) is an infectious disease of birds

The disease occurs worldwide.

Many wild bird species carry these viruses with no apparent signs of harm.

Other bird species, including domestic poultry, develop disease when infected with avian influenza viruses.

Avian influenza in poultry has a mortality rate that can approach 100% within 48 hours.

Approximately 150 million birds have been culled (destroyed).

Avian Flu and People

As of October 12, 2007, 331 people in 12 countries have been infected with H5N1 (avian influenza) and 202 have died of the disease.

Most were infected by close contact with infected birds.

How could avian flu become easily transmissible from person to person?

•If an avian virus and human-adapted virus “swap genes” in a co-infected cell of an animal or human, a “third virus” would result that could be readily transmitted by and between humans.

HumanHuman virusvirus

ReassortantReassortantvirusvirus

Non-humanNon-humanvirusvirus

Mechanisms of Influenza Virus Antigenic Mechanisms of Influenza Virus Antigenic “Shift”“Shift”

DIRECTDIRECT

Definition of an Influenza Pandemic:

•a new (novel) influenza virus subtype in humans causing serious illness;

•little or no immunity in the population; and,

•it spreads easily from person to person.

Pandemic influenza is different from the current

avian influenza.

Influenza pandemics are recurring events.

YearsYears Flu Flu VirusVirus MortalityMortality

1918-19191918-1919 “Spanish” “Spanish” Type A (H1N1) Type A (H1N1) 20 million worldwide20 million worldwide550,000 US550,000 US

1957-19581957-1958 “Asian” “Asian” Type A (H2N2) Type A (H2N2) 70,000 US70,000 US

1968-19691968-1969 “Hong Kong” “Hong Kong” Type A (H3N2)Type A (H3N2)34,000 US34,000 US

Glezen WP. Epidemiol Rev. 1996;18:65.Centers for Disease Control and Prevention. Influenza Prevention and Control. Influenza. Available at:http://www.cdc.gov/ncidod/diseases/flu/fluinfo.htm.

Influenza Pandemics in the 20th Century

Pandemic Severity Index

Planning Assumptions: Contra Costa County Total Over 18

months

Infected Infected 337,630 337,630 Outpatient Outpatient 168,815 168,815 Hospital Hospital 16,882 16,882 ICU ICU 3,022 3,022 Ventilator Ventilator 1,519 1,519 Deaths Deaths 3,950 3,950

Things you can do this flu season:

•Promote hand washing and respiratory etiquette (cover your cough)

•Provide hand sanitizers at work stations•Provide gloves to money handlers

•Get a flu shot•Clean shared equipment such as phones and keyboards regularly•Contact Health Services about

becoming a Point of Dispensing Push site

Our website cchealth.org contains information about pandemic flu preparedness including a Tool Kit for schools and childcare centers and checklists for business, law enforcement, etc.

For up-to-date health emergency information in

Contra Costa call:1-888-959-9911

Thank You!