Understanding the Threat
of an Influenza Pandemic
Introduction to Pandemic Planning
and Response
• What are seasonal, avian, and pandemic influenza,
and how do they differ from each other?
• What are the symptoms of influenza?
• How is influenza transmitted, and how is it treated?
• How will a pandemic start in my municipality?
• What will life be like during a severe pandemic?
• How can municipalities be prepared?
What is Seasonal Influenza ?
• The breathing sickness that affects people every year,
usually during the cold season.
• It makes many people sick, but not as sick as
pandemic influenza because our bodies can fight it
better than pandemic influenza.
• Seasonal influenza is similar to the pandemic influenza
but is less severe.
What are the Symptoms of influenza?
One or more of these
symptoms may mean influenza:
• Fever
• Muscle aches and pains
• Tiredness
• Coughing
• Sneezing
• Shortness of breath
• Sore throat
• Runny or stuffy nose
More Symptoms—Especially in Children
• Nausea and vomiting
• Stomach cramps
• Diarrhea
(all of these symptoms
can also be caused by
other diseases)
What is Pandemic Influenza?
• Pandemic influenza is a respiratory (or breathing)
illness that is new to humans and can make them
very sick.
• It happens about 3 times per century and spreads
around the world, killing many people and making
many people sick.
• Pandemic influenza also causes many serious
problems in municipalities, such as problems with
food, water, and electricity.
What is Avian Influenza (Bird Flu)?
• It is a disease that spreads from bird to bird, causing
some birds to become very sick or die.
• It can spread from birds to humans, but not easily.
• It is not yet capable of spreading from human to
human except in very rare cases.
• There is a risk that it could become pandemic
influenza, but this has not happened yet with the type
of bird flu that has recently killed so many chickens.
What is Swine Influenza?
• An influenza A virus that causes illness predominately
in pigs
• The disease is spread from pigs to pigs
• Like avian influenza in birds, it can sometime infect
humans in close contact with infected pigs, but
humans cannot transmit it to other humans
What is H1N1?
• A new virus that emerged in 2009 in Mexico City and
quickly spread across the globe
• H1N1 declared a pandemic in June 2009
• Initially referred to as “swine” influenza because the
virus was found to contain genetic material from swine
influenza A strains, as well as avian and human strains
• A human virus, and people get it from people – not
from pigs
How Do Seasonal and
Pandemic Influenza Spread?
They are spread
through the air
when infected
people cough,
sneeze, or talk,
and healthy
people then
breathe in
the virus.
How Do Seasonal and Pandemic
Influenza Spread? (2)
• They are also spread when healthy people touch
things that are contaminated with the virus (like door
knobs, light switches, and table tops) and then touch
their eyes, nose, or mouth.
• They could be spread by people who do not feel or
look sick.
• They spread most quickly in crowded places—
especially indoors.
What Have We Learned from Past
Pandemics of Influenza?
• In 1918, tens of millions of people died all over the
world from pandemic influenza.
• Local outbreaks last about 6–12 weeks.
• A pandemic can happen in the same municipality 2 or
3 times in 1–2 years (in waves).
• Pandemics can vary in severity.
• Hospitals and clinics will become completely
overloaded, and most people will have to be treated
at home.
What Have We Learned from Past
Pandemics of Influenza? (2)
• Services may be interrupted when many people are sick—
including police, water, electricity, food supplies, banks,
telephones, etc.
• Outside help will probably not come because many people will
be sick everywhere.
• Some families may need community help if everyone in the
family is sick.
• Schools, churches, and some workplaces may need to close
during the pandemic to try to decrease the spread of the disease
and minimize the number of people who get sick or die.
What Can Be Done to Slow or Decrease the
Impact of a Severe Pandemic?
• Municipalities can prepare before the pandemic starts
or before it reaches them.
• Municipalities can help their residents understand how
to protect themselves.
• Municipalities can implement “social distancing”
policies and actions.
How Will a Pandemic Start
in My Municipality?
• The pandemic will probably start somewhere else in the world.
• It will probably arrive in this country through infected humans, not
infected birds.
• Municipalities need to be prepared to communicate that the
pandemic has not entered the country, and that people should
continue daily life as usual.
• Once cases have been confirmed in the country, the government
will enact its alert and response system. At that time,
municipalities should implement their response plans.
WHO Phases
WHO Pandemic Phases
and Currently Circulating Novel Viruses
• H1N1
– April 25, 2009: Declaration of a Public Health Emergency of
International Concern
– April 28, 2009: WHO declares Phase 4
– April 29, 2009: WHO declares Phase 5
– June 11, 2009: WHO declares Phase 6
• H5N1
– First human cases reported 1997
– Increase in reports of human cases began in 2003
– WHO Phase 3
What Will Life Be Like in a Severe Pandemic?
Shortages of Essential Goods
• Lost work days (absenteeism) will result in decreased production,
reduced international and national cargo transports, and missed
deliveries to local areas.
• The supply chain will be very vulnerable.
• Shortages of essential goods may occur—including food, water,
fuel, medicines, and many more.
• Available goods may be subject to personal consumption, looting,
and hoarding.
• Hostilities may break out over scarce resources.
• Locally available goods and stockpiles may be needed to sustain
the population.
Disruption in Routine Services
• Schools, government offices, and the post office
may be closed.
• Electricity, telephone service, the Internet, and
commercial radio and TV broadcasts could also be
interrupted if the electric power grid falters or fails.
• Local automated teller machines (cajeros automaticos)
and banks may be shut down, and cash will be in
short supply.
Changes in Public Transportation
and Other Municipal and Private Services
• Buses, taxis, and other
transportation services
may be stopped or
limited.
• Gasoline supplies may
be limited or unavailable.
• Trash removal, road
repair, water, and other
services may be limited.
• Utility service and
repairs may be delayed.
Restrictions of Personal Movement
• Travel may be restricted.
• Restrictions on public
gatherings—such as
funerals, parties, and
other events—may be
necessary.
• Schools and markets
may be closed.
• Isolation and quarantine
may be necessary.
How Can Municipalities Be Prepared?
• Municipalities need to be able to rely on their own
resources to care for sick people, provide essential
services, and maintain social order.
• Municipalities must understand the likely local impact
and develop plans to address it.
• Municipalities must have a good response team
who knows what has to be done before a severe
pandemic hits.
• Strong leadership is critical!
Who would you rather be like—the mayor of
Philadelphia from 1918 or the Mayor of Saint Louis
from 1918?
Death Rates / 100,000 Population (Annual
Basis)
1918 Death Rates: Philadelphia v St. Louis
16000
Philadelphia
14000
St. Louis
12000
10000
8000
6000
4000
2000
0
Date
PREPAREDNESS CAN MAKE ALL THE DIFFERENCE!
SOURCES
•
CDC (Centers for Disease Control and Prevention). Pandemic influenza planning
checklists. www.pandemicflu.gov,
http://pandemicflu.gov/plan/states/statelocalchecklist.html
•
CDC. Risk communication. http://www.pandemicflu.gov
•
CDC. 2007. Interim pre-pandemic planning guidance: Community strategy for pandemic
influenza mitigation in the United States. Atlanta, GA: CDC.
http://pandemicflu.gov/plan/community/community_mitigation.pdf
•
WHO (World Health Organization). 2004. WHO influenza pandemic preparedness
checklist. Geneva: WHO. http://www.wpro.who.int/NR/rdonlyres/25885074-7A3B-442A834E-E96484D14D69/0/WHOInfluenzaPandemicPreparednessChecklist.pdf
•
WHO. 2009. Pandemic Influenza Preparedness and Response.
http://www.who.int/csr/disease/influenza/PIPGuidance09.pdf
•
WHO. 2008. Pandemic influenza preparedness and mitigation in refugee and displaced
populations. 2nd ed. WHO/HSE/EPR/DCE/2008.3. Geneva:
WHO.http://www.who.int/diseasecontrol_emergencies/guideline/en/index.html
•
WHO. 2009. WHO guidelines for pandemic preparedness and response in the nonhealth sectors. Geneva: WHO. http://www.unpic.org/pic/web/documents/english/WHO%20WOS%20Pandemic%20Readiness%2020
09-05-05.pdf