What is Pandemic Influenza?

Pandemic Influenza

• A global outbreak of disease that occurs when a new influenza virus appears or “emerges” in the human population, causes illness, and then spreads easily from person-to-person worldwide

Influenza Virus

• Hemagglutin

• Neuraminidase

Pandemic StrainHow does it begin?

Virus Transmission

Recent History

Avian Influenza (H5N1)

Swine Flu (H1N1)

Today – Pandemic (H1N1) 2009 Influenza• Pandemic (H1N1) 2009 influenza is a

respiratory illness that causes symptoms similar to those of seasonal flu (fever, fatigue, lack of appetite, coughing, body aches, and sore throat).

• The virus had its origins in pigs.

The Spread of H1N1

• Similar to seasonal influenza• Respiratory droplets from an

infected person are released into the air through coughing and sneezing• inhaled by others

• land on surfaces that are touched by the hands and then spread by contaminated hands to the nose and mouth

Global Spread of H1N1

Looking to the Past to Predict the Future

• 1918-19 Spanish Flu (~21 million deaths)

• 1957-58 Asian Flu (~1-4 million deaths)

• 1968 Hong Kong Flu (~1 million deaths)

Modeling the Impact of Influenza Pandemic: Ontario• 4,440,443 may be ill

• 3,397,536 may seek outpatient care

• 81,655 may require hospitalization• 67,387 may recover

• 20,383 may die

Taken from 2008 Ontario Health Plan for an Influenza Pandemic. Based on a 1968-like virus, numbers shown are based on the worst case scenario.

Impact of Influenza Pandemic: Sudbury & Manitoulin Districts• 69,000 may be ill enough to remain

home

• 52,963 may seek outpatient care

• 1,318 may require hospitalization

• 333 may die

Taken from 2008 Ontario Health Plan for an Influenza Pandemic. Based on a 1968-like virus, numbers shown are based on the worst case scenario.

Slowing the Spread

• Infection control• Social distancing• Enhanced environmental cleaning• Screening and surveillance• Staying home when ill• Antivirals• Vaccine

Infection Control

Hand hygiene

Cover Your Cough!• To minimize the spread of germs, cough and sneeze

into the fabric of your clothing in the elbow area.• Cover your mouth and nose with a disposable tissue

when coughing or sneezing and discard the tissue

immediately.• Wash your hands after handling

tissues.

Infection Control Hygienic measures

Are Masks Effective?

The Public Health Agency of Canada does not recommend that members of the general public wear surgical masks to protect against contracting influenza. Incorrect use of masks can actually increase the risk of infection.

What Are Antivirals?

• Medication prescribed to either treat a person who is ill or to prevent illness in a person who was exposed to someone who was ill.

• Antivirals must not be overused or the influenza virus may become resistant to them.

How Are Antiviral Medications Made Available? • Antivirals are prescription drugs.

• Currently physicians are advised to only prescribe antivirals for people with influenza like illness requiring hospitalization or for whom there is a risk of complicated disease. Treatment must start within 48 hours of illness onset to be effective.

• Canada has a National Antiviral Stockpile that contains 55 million doses of antivirals, made up primarily of oseltamavir (Tamiflu®). The federal stockpile of antivirals will be distributed to provinces and territories on an as-needed basis.

What Are Influenza Vaccines?

Is There a Pandemic (H1N1) 2009 Influenza Vaccine?

• Canada has a contract with Glaxo-Smith Kline for vaccine production.

• An H1N1 vaccine is expected to be available in early 2010.

• The contract in place covers the production of enough pandemic vaccine for all Canadians.

Pandemic InfluenzaPlanning and Response

Pandemic Influenza Planning: Collaborative Process

World Health Organization

Federal Government

Provincial Government

Local Public Health Unit

Goal of Influenza Pandemic Planning, Preparedness and Response

1. To minimize serious illness and overall deaths.

2. To minimize societal disruption among Canadians as a result of an influenza pandemic.

Challenges Anticipated With Pandemic Influenza • Young healthy individuals will be

affected.

• There will be a shortage of medical resources, equipment, and personnel.

• Essential services will be disrupted due to absenteeism.

• All areas of the province will be affected simultaneously.

WHO Pandemic Periods and Phases

Period Phase Description

Interpandemic 1

2

NO new influenza virus subtype in humans

Circulating animal influenza - substantial risk to humans

Pandemic alert 3

4

5

NO human-to-human spread

Small clusters – human-to-human

Larger clusters, still clusters

Pandemic 6 Increased and sustained in populations

Post pandemic Return to Interpandemic period

Timing Of Public Health Measures

Pandemic Influenza Preparedness: Public Health Role

• Surveillance, reporting and investigation

• Liaison with community partners• Assessment of local health services

capacity• Confirming pandemic activity locally• Mass immunizations and distribution of

vaccines, antiviral meds and supplies• Collaborating with province to deliver

public information/education programs

The SDHU Pandemic Plan Is on www.sdhu.com

Components of the plan:

Preparedness Surveillance Vaccines Antivirals Health services Emergency response Public health measures Communications Response

Linkages

Community Agency Plans

SDHU Plan

Health Agency Plans

Municipal Plans

Do You Have a Plan?• Personal preparedness

• Create your own family/personal pandemic influenza plan.

• Identify strategies that you can take to address personal and family issues if you are ill or if you have to go to work.

• List of supplies you should consider having in the event of an emergency.

• Ways that you may be able to provide assistance to others.

“The only thing harder than planning for an

emergency is explaining why you

didn’t.”

This presentation was prepared by staff at the Sudbury & District Health Unit. This resource may be reproduced, for educational purposes, on the condition that full credit is given to the Sudbury & District Health Unit.

This resource may not be reproduced or used for revenue generation purposes.

© Sudbury & District Health Unit, 2009