Summit on Avian InfluenzaSummit on Avian Influenza

Presented by: NJ Department of Health & Senior ServicesPresented by: NJ Department of Health & Senior Services

August 31, 2006August 31, 2006

OverviewOverview

• FLU FACTS: To understand the difference FLU FACTS: To understand the difference between the terms seasonal, avian and between the terms seasonal, avian and pandemic influenza, and the impact of a pandemic influenza, and the impact of a pandemicpandemic

• FLU PREP: To identify ways that NJ is FLU PREP: To identify ways that NJ is preparing for an influenza pandemicpreparing for an influenza pandemic

• FLU & YOU: To identify steps people can FLU & YOU: To identify steps people can take to protect themselvestake to protect themselves

What is Influenza?What is Influenza?

• Primarily infection of upper respiratory tractPrimarily infection of upper respiratory tract• Incubation period: 1-3 daysIncubation period: 1-3 days• Infectious period: Infectious period:

24 hours 24 hours beforebefore symptom onset symptom onset

and up to 5 days after and up to 5 days after

symptom onsetsymptom onset

What causes Influenza?What causes Influenza?

Three types of influenza viruses: A, B & CThree types of influenza viruses: A, B & C

Type AType A Can infect humans and other animalsCan infect humans and other animals 144 potential strains (H-16; N-9)144 potential strains (H-16; N-9) Wild birds are the natural reservoirWild birds are the natural reservoir Most likely to cause epidemics and Most likely to cause epidemics and

pandemicspandemics

(cont.)(cont.)

Types of InfluenzaTypes of Influenza

Type BType B Humans onlyHumans only No subtypesNo subtypes Can cause epidemics, not pandemicsCan cause epidemics, not pandemics

Type CType C Humans and swineHumans and swine No subtypesNo subtypes Mild illness; does not cause epidemicsMild illness; does not cause epidemics

Seasonal Influenza in the USSeasonal Influenza in the US

Occurs annually – October through AprilOccurs annually – October through April More than 36,000 deathsMore than 36,000 deaths More than 200,000 hospitalizationsMore than 200,000 hospitalizations Elderly, young children and people with Elderly, young children and people with

certain health conditions are most certain health conditions are most vulnerablevulnerable

Largely preventable through vaccineLargely preventable through vaccine

Prevention & TreatmentPrevention & Treatment

PreventionPrevention• Annual flu vaccinationAnnual flu vaccination• Respiratory hygieneRespiratory hygiene• Social distancingSocial distancing

TreatmentTreatment• Fluids, fever reducing medication, bed restFluids, fever reducing medication, bed rest• Antiviral medication – not a cure!Antiviral medication – not a cure!

Why a flu shot each year?Why a flu shot each year? ShiftShift (Type A only) (Type A only)

• Major changes new Major changes new subtypesubtype

• Exchange of gene Exchange of gene segmentssegments

• May cause pandemicMay cause pandemic• Example: H3N2 replaced Example: H3N2 replaced

H2N2 in 1968H2N2 in 1968

Occurs infrequentlyOccurs infrequently

DriftDrift (Types A and B) (Types A and B)• Minor change, within Minor change, within

subtypesubtype• Gradual accumulation of Gradual accumulation of

amino acid changes in HA amino acid changes in HA and/or NAand/or NA

• May cause epidemicMay cause epidemic• Example: drifted Example: drifted

A/H3N2/Fujian circulated A/H3N2/Fujian circulated A/H3N2/Panama (vaccine A/H3N2/Panama (vaccine strain 2003/4)strain 2003/4)

Occurs continuouslyOccurs continuously

Cox NJ, Subbarao K. Lancet 1999;354:1277-82

What about Avian Influenza?What about Avian Influenza?

AKA: Bird FluAKA: Bird Flu • Type A, H5N1Type A, H5N1• Carried by migratory waterfowlCarried by migratory waterfowl• Virus passed to domestic poultryVirus passed to domestic poultry• Direct transmission Direct transmission

to humans from poultryto humans from poultry• High death rateHigh death rate

What is a pandemic?What is a pandemic?

Epidemic = community or regional Epidemic = community or regional outbreak of an infectious diseaseoutbreak of an infectious disease

Pandemic = global epidemicPandemic = global epidemic

What causes a Flu Pandemic?What causes a Flu Pandemic?

New strain of virusNew strain of virus

Ability to cause serious disease and death Ability to cause serious disease and death in humansin humans

Easy person-to-person spreadEasy person-to-person spread

Pandemic Impact

ChallengesChallenges

Health CareHealth Care SocialSocial PersonalPersonal

Health Care ChallengesHealth Care Challenges

Don’t know which people the virus will Don’t know which people the virus will affect the mostaffect the most

Vaccines will not be available in the early Vaccines will not be available in the early stages of pandemicstages of pandemic

Antivirals, if available, may be ineffectiveAntivirals, if available, may be ineffective Health care workforce will be sick along Health care workforce will be sick along

with everyone elsewith everyone else Health care system will be overwhelmedHealth care system will be overwhelmed

Societal ChallengesSocietal Challenges Maintaining essential governmentMaintaining essential government

services and businessservices and business ImplementingImplementing

social distancingsocial distancing Distributing limited Distributing limited

amounts of medicationsamounts of medications

and vaccinesand vaccines Maintaining civil orderMaintaining civil order

Personal ChallengesPersonal Challenges

Protecting self and familyProtecting self and family Attending school/work Attending school/work Obtaining goods, services and necessitiesObtaining goods, services and necessities Maintaining daily life activitiesMaintaining daily life activities Obtaining medical careObtaining medical care TravelingTraveling Obtaining reliable informationObtaining reliable information

Worldwide WatchWorldwide Watch

Governmental PreparednessGovernmental Preparedness

The Centers for Disease Control & Prevention The Centers for Disease Control & Prevention and the US Dept. of Human Servicesand the US Dept. of Human Services

NJ Dept. of Health & Senior Services and the NJ Dept. of Health & Senior Services and the Office of Homeland Security & PreparednessOffice of Homeland Security & Preparedness

Local and regional health depts.Local and regional health depts.• www.njmrc.nj.govwww.njmrc.nj.gov

Healthcare System Healthcare System PreparednessPreparedness

Developing preparedness plansDeveloping preparedness plans Enhancing infection control proceduresEnhancing infection control procedures Stockpiling suppliesStockpiling supplies Cross training staffCross training staff Conducting exercisesConducting exercises

Personal PreparednessPersonal Preparedness Keep a supply of food, water Keep a supply of food, water

and medical suppliesand medical supplies Start now to develop healthy Start now to develop healthy

habitshabits• Respiratory hygieneRespiratory hygiene• Hand hygieneHand hygiene• Stay home if sickStay home if sick

Know where to get reliable Know where to get reliable health informationhealth information

Follow instructions provided Follow instructions provided by governmental public health by governmental public health authoritiesauthorities

SummarySummary

Flu pandemics are unpredictableFlu pandemics are unpredictable We don’t know if the avian H5N1 virus will We don’t know if the avian H5N1 virus will

cause the next flu pandemiccause the next flu pandemic Flu pandemics can have serious impact on Flu pandemics can have serious impact on

us, society, businesses and the health us, society, businesses and the health care systemcare system

NJ governmental agencies are preparing NJ governmental agencies are preparing for a potential flu pandemicfor a potential flu pandemic

ResourcesResources

NJ Dept. of Health & Senior ServicesNJ Dept. of Health & Senior Services• www.nj.gov/health/fluwww.nj.gov/health/flu• Ready Together NJReady Together NJ

US Centers for Disease ControlUS Centers for Disease Control• www.cdc.gov/fluwww.cdc.gov/flu• www.pandemicflu.govwww.pandemicflu.gov• Planning Checklists: Planning Checklists:

http://www.pandemicflu.gov/plan/checklists.htmlhttp://www.pandemicflu.gov/plan/checklists.html

Contact InformationContact Information

Sylvia H. Bookbinder, MPH, CHESSylvia H. Bookbinder, MPH, CHES

Infectious & Zoonotic Disease ProgramInfectious & Zoonotic Disease Program New Jersey Department of New Jersey Department of

Health & Senior ServicesHealth & Senior Services

609-588-7500609-588-7500 Sylvia.Bookbinder@doh.state.nj.usSylvia.Bookbinder@doh.state.nj.us