Preparation for Pandemic Influenza in
Oshkosh and Surrounding Areas
Adams, I.; Graf, E.; Reid, B.; Stone, E.; and Strosahl, C.
Department of Biology and Microbiology
University of Wisconsin-Oshkosh
INDIVIDUAL CHECKLIST
Individual preparedness is essential during the time of a pandemic. There are five basics
areas of supplies that are necessary to properly prepare residents of Oshkosh during a
time of crisis14, 15. The supplies are as follows:
Water
 1 gallon of water per person per day
 Minimum water supply for at least 1-2 weeks (Avoid storing water in containers
that can easily decompose or break. Water should be stored in plastic containers.)
 Water purification kit (available at most sports or outdoor/adventure stores)
Food
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Minimum food supply for 4 weeks
Ready to eat canned meats, fruits, and vegetables
Dried Meats (e.g. Beef Jerky)
High energy foods (e.g. protein bars and nuts)
Staples (e.g. sugar, spices, pepper, etc.)
Vitamins and other supplements
Canned juices
Fluids with electrolytes
Food for infants
Flu Care Kit
 Tylenol or other pain reliever
 Ibuprofen
 Cough syrup
 Nasal decongestant
 Disposable ice packs
 Medical grade latex (or non-latex) gloves
 Masks (Recommended: 3M™ Particulate Respirator 8210, N95 masks. Can be
ordered online for $27.95 for a box of 20. Minimum supply should consist of one
mask per person per day for 2-3 weeks).
 Medicine dropper
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Other prescription medications as needed (e.g. Tamiflu® if available)
General Kit
 Cash
 Chlorine Bleach
 10% Bleach and water solution in a spray bottle (or other disinfectant)
 Rags or paper towel
 Kleenex
 Battery operated radio
 Flashlight
 Batteries
 Non-electric can opener
 Utility knife
 Matches
 Soap or other liquid detergent
 Medical grade latex (or non-latex) gloves (for general purpose)
 Other special items required by infants, disable, or the elderly
What to pack if you must move to the hospital or other restricted area for treatment
 Documents (identification, health insurance, etc.)
 Extra clothes
EMERGENCY WORKKFORCE TEAM AND ROLE OF
EMERGENCY WORKERS
Emergency Preparedness Council for the City of Oshkosh includes12, 13:
City Manager: Heads Emergency Preparedness Council (EPC) and acts as liaison
between the city council and the EPC.
City of Oshkosh Fire Chief: Coordinates efforts of the fire department as
described below.
City of Oshkosh Chief of Police: Coordinates efforts of the police department as
described below.
City of Oshkosh Health Director: Maintains communication with area hospitals
and coordinates efforts of healthcare workers as described below;
determine risk levels of specific health care tasks (e.g. surgery, emergency
room care)
City of Oshkosh Director of Public Works: Apprises council of city services and
determines level of need during quarantine; also acts as liaison between
EPC and other departments of public works (e.g. sanitation, water
distribution, etc.)
Oshkosh Community Access Television director:
Provides important
preparedness and quarantine information via public access.
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President of the Chamber of Commerce: Will need to determine essential
businesses to remain open during a city wide pandemic and prepare for
business closings as well as enforce immediate sick leave legislation.
President of the Oshkosh Board of Education: Provides information on school
closings and may work with healthcare workers during Hospital overflow
situations; can also disseminate information through school district.
City of Oshkosh Transportation Director: Provide information on street closings
due to quarantine; assist police chief with quarantine operations.
County Deputy: Coordinates efforts of county level police department in similar
fashion to which is described below.
County Coroner: Manages disposal of bodies and post-mortem disease spread.
Role of Health Care Workers:
During an influenza pandemic, healthcare workers in the city of Oshkosh will be
expected to perform routine procedures as indicated by the health director.
Health care workers will assist in the identification of potential outbreaks,
test for the presence of H5N1 influenza virus, and treat infected patients.
If an outbreak occurs within the city limits, health care workers will assist
the City of Oshkosh Health Director in determining quarantine size.
Health care workers will also need to be prepared to mobilize to
quarantine sites to treat infected patients.
Role of Police:
Police will maintain a presence at all times during the initial stages of a pandemic
to reduce looting and panic. Within the city limits, the Oshkosh Police
Department will maintain all quarantine zones, and prevent traffic
movement into or out of these areas. Highway access into and out of the
city will also be monitored by police officers. Minimal traffic movement
will be allowed in the city. Police officers will be permanently on call. If
necessary, the Oshkosh Auxiliary Police (volunteer PD) will be called
upon to assist.
Role of Fire Departments:
Fire departments will also assist in the prevention of looting and arson during a
pandemic. Fire Departments must be prepared to respond to a high
volume of emergency calls that will require EMTs and ambulances. As
the Oshkosh Fire Department provides support to surrounding
communities, they will be asked to assist with county preparedness plans.
HAZMAT teams will also be used (in effected areas) to train police teams,
provide security, and maintain quarantine protocols within quarantine
zones. However, HAZMAT is regional and will most likely be stretched
extremely thin. The Fire Department must be prepared to fill this void12,13.
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MEDIA
Radio:
The mayor of Oshkosh will contact the State Emergency Operation Center in
Madison. Information about the pandemic will be relayed to the public
via the National Warning System (NAWAS) based in Madison. The
NAWAS has several branches in the state of Wisconsin. The East Central
branch includes the radio stations 90.3 WRST and 99.5 WPKR, both of
which are located in Oshkosh. Important local (city/county) information
will be broadcast. These radio stations will be a primary means of relaying
information because only two employees are necessary per station to
broadcast information9.
Television:
The television stations OCAT, WLUK channel 11 and WGBA channel 26 will
also be used to relay pertinent information.
Internet:
Information will also be posted on a pandemic website, which will be a link to
the City of Oshkosh website. The websites of the radio and television
stations mentioned above will also have links to this pandemic website.
Schools and Local Businesses:
In addition to radio and television, school and business closings will be
announced via email and phone. The mayor will contact the Oshkosh
School Superintendent and the Chairperson of the Oshkosh Chamber of
Commerce who will in turn contact the schools and businesses.
All sources of information will be interconnected. The radio/television
stations and the website will contain the same information so that the
public has multiple sources for important local information. Schools and
businesses will still be encouraged to provide information via email and
phone to students, and employees.
Hotline:
A Flu-HOTLINE will also be set up by the city Health Department. The hotline
will be used to report new flu cases.
General Information:
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We realize that the Fox Valley has large Hmong, Hispanic, and Bosnian
communities; therefore all information will also be delivered in Hmong,
Spanish and Bosnian.
Information that will be provided through media sources will be as follows:
Number of flu cases
Quarantine measures
Curfew
Business and school closings
Cough etiquette
Information about the proper use of masks
Disinfecting tips
COMMUNITY COMMUNICATION
In the city of Oshkosh, the movement and protection of critical supplies will be vital to
maintaining order. Critical supplies are defined as:
Food
Water
Medicine
 Insulin
 Vaccines
 Tamiflu®
 Tylenol (or other pain reliever)
 Cough Syrup
 Nasal Decongestant
 Blood (if necessary because lack of transportation)
Medical Supplies
 Respirators
 Linens
 Disposable ice packs
 Syringes Cotton Balls
 Medical grade masks
 Medical grade latex gloves
Disinfectants
Gasoline and Propane
Wood
Body bags
The movement of these critical supplies will be provided by:
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Transportation Workers (i.e. Truck drivers, and if public transportation is shut
down, Bus and Taxi Drivers)
Oshkosh Public Health Workers
Police and Fire Department officials
Volunteers
The protection of critical supplies is essential to maintaining self sufficiency of our
community. Protection of supplies will be overseen by:
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Local Police
Public Health Workers
Volunteers (if necessary)
Of all of the critical supplies, all medical equipment and medicine will require the
heaviest security levels. This will be overseen by:
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Fire Department
County and State Police Officials
National Guard (if available)
QUARANTINE MEASURES
In the event that an avian flu outbreak occurs, various measures of isolation of exposed
persons and quarantine of persons possibly exposed will be undertaken to reduce the
transmission of the flu. In the initial stages of a pandemic outbreak, hospital beds will be
available for isolation of those afflicted. If the spread of the flu continues, isolation wards
at outlying facilities away from the hospitals will be established.
Those exposed but not showing signs of infection will need to be quarantined for ten days
to insure that they will not further increase the spread of the flu. In the initial stages of
outbreak quarantine, this may be accomplished by requiring patients to remain in their
homes. In the latter stages of an outbreak, it may be necessary to quarantine entire city
blocks or neighborhoods.
In the case that those exposed are medical personnel, unless they show signs of exposure,
they may be allowed to continue to work at the facility where they were exposed. Work
quarantine may also be used for those who are employed in areas crucial to the
functioning of the cities infrastructure, i.e. power plants, water treatment facilities, police
and fire departments.
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In the case of an outbreak, a state of emergency may be declared by the governor
under s.166.03(1)(b)1, as per request of local authorities. This allows local authorities to
run all emergency programs and request assistance of various other community, state and
federal assets.
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If the flu outbreak remains on a small scale, city and county police will be
responsible for ensuring quarantine conditions are met.
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In the case of a larger outbreak, it may be necessary to bring in National Guard
troops to maintain order.
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In the case of wide-spread infection, it is possible that access to Oshkosh will be
limited to only those delivering needed supplies and/or health care specialists.
PUBLIC GATHERINGS POLICIES
Public gatherings will be prohibited after there are 50 confirmed cases of avian flu, and if
these cases are not localized. The Department of Public Health will make this decision.
All public and private schools, colleges and universities, and non-essential businesses
will be closed8. This includes, but is not limited to:
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The Public Library
Museums
Theaters (cinema and stage)
Church services
Sport events
Public meetings (i.e. town hall meetings)
Office buildings (i.e. Oshkosh City Center and the Washington Building at 105
Washington Blvd.)
Shopping malls
Department stores (i.e. Shopko, Target) we realize that stores such as Shopko
have pharmacies; therefore the inventories of department store pharmacies
will be transferred to other pharmacies, clinics and hospitals.
Restaurants
Some examples of businesses that will remain open, but with minimal staff if possible
include:
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Stand Alone Pharmacies (i.e. Morton’s or Walgreens)
Groceries
Gas stations
Power plants
Water treatment plants
Radio/Television stations
Clinics will remain open to filter out less severe flu patients, and to provide care
for non-flu related illnesses and injuries.
Public transportation will also be suspended. The public will be encouraged to stay
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home. The CDC recommends that persons who show flu symptoms or have been
exposed to the flu not go to groceries or pharmacies, but to ask other persons such as
neighbors of family for home delivery if possible8.
HOSPITALS
During the event of an avian influenza pandemic, several precautionary guidelines will be
followed by hospitals in the City of Oshkosh, and Winnebago County. Local hospitals
have general emergency plans implemented for response to disasters in their community.
Most protocols follow the Incidence Command System that is overseen by FEMA. In a
typical disaster, all hospitals fall under the umbrella of command of FEMA.
Unfortunately, in the event of an avian influenza pandemic, FEMA may not be able to
respond and assist the City of Oshkosh residents if the reported number of incidences are
wide spread. As a result, it will be essential for area hospitals to cooperate, and follow
the direction that is provided by the Winnebago County Public Health Director14,17,18.
Phase I
For suspected cases of avian influenza, patients should be quarantined in negative
pressure isolation rooms. Criteria for suspected cases include:
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Signs and symptoms of influenza
Recently returned from travel to Southeast Asia, Iraq, or Turkey within 10 days
prior to onset of symptoms
At Mercy Medical Center, there are 12 designated Isolation Rooms that are equipped to
have negative pressure. At Aurora Hospital there are 13 negative pressure isolation
rooms. These rooms limit and control aerosol transmission of the virus.
Collection of specimens will be sent to the Wisconsin State Laboratory of Hygiene
(WSLH). All specimens must arrive at the WSLH within 24 hours. Specimen collection
will include:
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1 oro/nasal pharyngeal swab in viral transport media (for virus isolation)
1 oro/nasal pharyngeal swab in no media (for PCR testing)
Based on the condition of patients, those with symptoms that do not require
hospitalization will be asked to return home and remain under quarantine until laboratory
results are available. Those that require critical care will remain in the hospital in the
negative pressure isolation room.
If results determine that a patient has contracted the avian influenza virus, the County
Department of Public Health will identify individuals that have had face-to-face contact
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with the infected patient. These identified individuals will be requested to remain at
home under quarantine, and will also be tested for the avian influenza virus.
In the event that more than 12 cases of confirmed avian influenza are identified, and
require hospitalization, Mercy Medical Center is equipped to convert the 5th floor of the
hospital into a negative pressure isolation ward. This would accommodate approximately
50 patients14,17,18.
Phase II
When more than 50 cases of avian influenza are confirmed, public gathering and other
quarantine measures will be implemented for the city of Oshkosh. Area hospitals will
seize emergency room activity, and surgeries. Local clinics will remain open to service
all non-flu related health issues. Hospitals will service all avian influenza suspected
cases. Local hospital capacity is as follows:
Hospital
Mercy Medical Center
Aurora
Winnebago Mental Health
Theda Clark
St. Elizabeth Hospital
Licensed Beds
157
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315
250
352
During a disaster, FEMA typically distributes patients requiring hospitalization evenly
among area hospitals. Communication between area hospitals will be pertinent to
maintain a balance between the number of patients, hospital beds open, ventilators
accessible, and medical staff currently available to work. Patients that require
hospitalization will be admitted, while cases that are less severe will be asked to return
home.
Due to limited number of medical staff available for working, volunteers will be
requested from the community to assist in basic care of patients. The American Red
Cross would organize the training of 1st Aid, and CPR to willing volunteers14,17,18.
Phase III
In the event that the number of patients requiring hospitalization exceeds the capacity of
all hospitals, the Grudenhagen Conference Center located on the University of Wisconsin
Oshkosh campus will be commandeered as a 2nd hospital. All patients that are in critical
condition will remain at the hospital. Patients that are less severe will move into
Grudenhagen. All patients will still be initially screened at the hospital, and medical staff
will determine the appropriate accommodation for each patient.
Medical supplies/equipment, and medical staff will be available in limited quantities due
to the overwhelming number of cases. Medical care will be provided to the best of
ability, and will mainly consist of basic care. Equipment possibly available will include:
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Heart Rate monitors
IV
Blood pressure monitors
PHARMACIES/HEALTH PLAN
High Risk Groups for Drug shortage:
During a flu pandemic, there are many people who will need drugs on a daily basis.
These individuals will either need to start stockpiling medicines themselves now, or at the
time of pandemic, need to rely solely on state and municipal health services to provide
them with the needed medications. At the moment many of the states prescription drugs
have been outsourced to Canada to reduce price, as the cost of U.S. produced drugs is
rising. To combat the fact that there will be fewer drugs produced in the U.S. Oshkosh,
health care organizations must begin to stock pile essential drugs. According to the State
prescription drug resource, many smaller prescription orders could be filled in as few as
two weeks. These drugs could then be distributed to high risk groups6. Those at the
highest risk for drug shortages during a crisis include:
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The elderly - Nursing homes and pharmacies need to have medications for heart
disease, high blood pressure, and other chronic issues often associated with age.
Patients with Diabetes - Insulin will also be a high demand drug.
Immunocompromised patients - Patients suffering from AIDS, organ transplant
patients, or patients in the middle of chemotherapy treatment for cancer will be
especially susceptible to drug shortages.
Those already infected with the flu - As we learned with the 1918 flu pandemic,
flu patients are extremely susceptible to secondary bacterial infections, and we
will need to have antibiotics on hand.
Other patients with chronic illnesses and other medical needs – Other
medications need to be stock piled for asthma, allergies, birth control, and mental
health related illnesses.
Groups to Contact:
Due to the need for prescription drugs in the state of Wisconsin, and in particular our
municipalities, we need to begin stocking drugs that are essential. The need to stock pile
medications is necessary to ensure the welfare of the entire community. To resolve these
underlying issues, groups that should be contacted to assess their preparedness include:
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Local hospitals- Aurora Medical Center, Mercy Medical Center
Pharmacies- Morton’s, CVS, and Walgreen’s
Health Clinics (Affinity and Aurora affiliates)
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 Police and Fire Departments (responsible for protecting the drug supply routes)
 Nursing homes
 Winnebago County Dept of Human Services
To help prevent a lack of coverage by healthcare and insurance organizations, it will be
necessary to keep the local Winnebago County Dept of Human Services Financial Aid
Division open to continue to determine eligibility for medical assistance.
Local medical organizations should be preparing for a pandemic by stockpiling
medications. Although some individuals may turn to resources outside the United States,
there is the possibility that additional sources may no longer be available. Currently
individuals who are seeking discounts on medications can order drugs from Canada
through the State of Wisconsin Prescription Drug Resource website6.
Flu Medications:
Medications like Tamiflu®, although not necessarily found effective, may be a possible
preventative measure for the disease. Therefore, local healthcare organizations
absolutely need to stockpile these drugs to distribute to vital workers. Any means to
break the cycle of infection should be taken, whether guaranteed effective or not6.
Essential Drugs:
Our local municipalities also need to begin to stock pile essential medications such as
insulin, heart medications, chemotherapies, HIV medications, general vaccinations,
immunosuppressive drugs, etc to be able to continue treatment of common health issues.
In addition, antibiotics and antivirals will also be necessary to stock pile to combat both
bacterial and viral diseases that will occur due to opportunistic infections. Possible
secondary infections of influenza patients will include pneumonia and meningitis
infections6.
TREATMENT PROTOCOL FOR PATIENTS IN LONGTERM CARE
The only drugs that have been shown to be effective in killing the avian influenza virus are
oseltamivir (Tamiflu®) and zanamivir (Relenza). Both of these drugs are neuraminidase
inhibitors. They stop the virus from spreading by interfering with the virus’ ability to
detach from cells and then spread throughout the body. Due to the shortage of anti-viral
drugs that are effective against H1N5 influenza, these drugs will be rationed, and given to
first priority groups.
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In order to insure stability, health care personnel will be given antivirals if they
appear to have contracted the flu. As noted before, these personnel will be allowed
to continue to work in their areas as long as they are not showing signs of infection.
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Antiviral medications will also be reserved for personnel essential to the continued
functioning of the city, these include: police, firefighters, those involved in
logistical supply efforts and power and water workers.
After doses of antiviral drugs have been earmarked for key personnel, further doses
will be given in triage fashion. The most vulnerable patients and those who are in
situations whereby the spread of the disease may be facilitated will be treated.
These patients include those in nursing homes and long-term care facilities.
Emergency personnel involved in food distribution will create a phone list in order
to maintain contact with the elderly and others who are house bound.
PRIORITY LIST OF PANDEMIC VACCINATION
The establishment of priorities for vaccination should be decided early in the pandemic
period to obtain a consistent immunization strategy, and may need to be adjusted based
on the effects of the specific virus. Personnel establishing the list should consider the
impact the vaccine will have on: reducing morbidity and mortality through health service
responses and individual protection of high risk groups and obtaining minimal disruption
of the society to allow the maintenance of the society. Vaccine eligibility should be
defined based on work/duties of the individual rather than position.
Priority Groups
1. Health Care Workers
Rationale: To maintain health service and the vaccination program to help reduce
morbidity and mortality. Health service workers to be considered for the
vaccination group:
 Acute care hospitals
 Long term care facilities/ nursing homes
 Private physician's offices
 Home care and community care facilities
 Public health workers
 Ambulance and paramedic services
 Pharmacy workers
 Laboratories
2. Essential Service providers
Rationale: To maintain essential community services. The individuals that are
essential to uphold these services consist of:
 Police and fire-fighters
 Armed forces
 Key emergency response decision makers
 Utility workers
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Funeral service/mortuary personnel
Workers of institutionalized populations
Public and goods transportation workers
3. Persons at high risk for a severe infection
Rationale: To meet the goal to decrease morbidity and mortality in the community.
These individuals status on the list may change due to type of virus.
 Healthy adults (18-40 years of age)
Although this is not the typical pandemic flu procedure, the bird flu is
known to target healthy individuals so their immune system overreacts.
 Pregnant Women
In bird flu pandemics, studies have shown that a large amount of pregnant
women were severely affected by the virus.
 Persons in nursing homes, long-term care facilities, homes for the elderly
 Persons over the age of 65 living independently
 Persons with medical conditions
 Children 6 months to 23 months in age
 Children 24 months to 18 years in age
CITY ISSUES
Primary Business/Organizations
During Phase 3 (50 or more reported cases) of an avian influenza pandemic, the majority
of local businesses/organizations will be required to close. However, it will be necessary
to allow a small number of businesses/organizations to remain open, as well as continue
operations of many city and county departments.
Oshkosh City and Winnebago County jobs that must continue to operate to maintain the
infrastructure of the community will include:
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Emergency Management Team
Winnebago County Solid Waste Management
Winnebago County Coroner’s office
Winnebago County & Oshkosh City Health Department
Oshkosh City Cemetery
Oshkosh City Public Works & Sanitation
Winnebago County & Oshkosh Police & Fire Departments
Park View Health Center
Winnebago County Dept of Human Services
Private businesses/organizations that provide basic support for the community, that must
also remain open with minimal staff include:
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Wisconsin Public Service & WE
SBC Communications, CenturyTel, TDS metrocom, etc.
Stand Alone Pharmacies (i.e. Morton’s or Walgreens)
Groceries
Gas stations
Local Radio/Television Stations
Clinics
American Red Cross/Salvation Army/Father Carr’s
Infection-Control Supplies
Due to the lack of current preparation, neither the City of Oshkosh nor Winnebago
County will be able to provide infection-control supplies to residents. Infection control
supplies include masks, gloves, disinfectants, and other tissue products. Oshkosh
residents will need to take a pro-active approach, and obtain the necessary supplies from
alternative sources. These items are listed in the INDIVIDUAL CHECKLIST section of
this report.
Residents that fall below or at the poverty level may not have the financial means to
purchase such items. Many of these products can currently be made available through
referrals to the American Red Cross/Salvation Army/Father Carr’s or the City Nurse.
During a pandemic, supplies will run short, and all residents must prepare ahead of time.
Until further preparation is implemented, residents must take a pro-active approach
because the local government will be ineffective in making available infection-control
supplies.
Winnebago County Solid Waste Management
During an avian influenza pandemic, the collection of garbage will be necessary to
maintain the sanitary conditions of our city. Most of Winnebago County garbage
collection services are contracted out to private businesses (e.g. Onyx). It will be vital to
maintain these weekly services.
Oshkosh City Public Works & Sanitation
The city of Oshkosh obtains the water supply for local residents from Lake Winnebago.
The water that is pumped in must be filtered, treated with chemicals, and then
disinfected. The Oshkosh facility has an additional disinfection process prior to water
distribution. Currently, the Oshkosh water treatment plant is capable of filtering 16
million gallons per day with an average daily pumping rate of 7.5 million gallons per day.
The Oshkosh facility has four elevated storage tanks, and an additional station to meet
water usage demands and pressure requirements1,2,3,16.
The following is a list of treatments necessary for water purification:
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Description
Chloramines
Fluoridation
Hypochlorination
Inhibitor, Polyphosphate
Ozonization
(3)
Objectives
Disinfection
Other
Disinfection
Corrosion Control
Disinfection
Currently, the Oshkosh treatment has an average inventory of chlorine of a total of 8 2,000 pound (1-ton) tanks, for a total of 16,000 pounds (8-tons). However, the facility is
capable of storing up to a total of eighteen - 2,000 pound (1-ton) tanks (a total of 36,000
pounds of chlorine). In addition, the facility has an inventory of anhydrous ammonia
(chloramines) of two - 2,000 gallon tanks, for a total of 22,720 pounds1,2,3,16.
On average, water treatment facilities are required to treat with 4.0 mg of chlorine/liter
and 4.0 mg chloramines/liter. Based on the provided data, on average the Oshkosh water
treatment facility utilizes approximately 250.5 pounds per day of chlorine and
chloramines. With storing the maximum amount of chlorine, the city of Oshkosh will be
able to effectively disinfect incoming lake water with chlorine for 4 ½ months and with
chloramines for 3 months1,2,3,16.
If water purification does not occur, it will become necessary for residents to purify water
at home. The American Red Cross recommends the following:
1. Filter the water using a piece of cloth or coffee filter to remove solid particles.
2. Bring it to a rolling boil for about one full minute.
3. Let it cool at least 30 minutes. Water must be cool or the chlorine treatment
described below will be useless.
4. Add 16 drop of liquid chlorine bleach per gallon of water, or 8 drops per 2-liter
bottle of water. Stir to mix. Sodium hypochlorite of the concentration of 5.25% to
6% should be the only active ingredient in the bleach. There should not be any
added soap or fragrances. A major bleach manufacturer has also added Sodium
Hydroxide as an active ingredient, which they state does not pose a health risk for
water treatment.
5. Let stand 30 minutes.
6. If it smells of chlorine, you can use it. If it does not smell of chlorine, add 16
more drops of chlorine bleach per gallon of water (or 8 drops per 2-liter bottle of
water), let stand 30 minutes, and smell it again. If it smells of chlorine, you can
use it. If it does not smell of chlorine, discard it and find another source of
water14.
Coroner
We are unsure of the death toll as a result of an avian influenza pandemic; however, we
can predict that there will be an increase in deaths in Winnebago County. In 2004,
Winnebago County had a total of 1247 deaths4,5. The break down of death rates via
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location in Winnebago County were:
City/Township
Algoma
Appleton
Clayton
Menasha
Neenah
Omro
Oshkosh
Total # of Deaths
20
37
14
220
309
41
599
Oshkosh’s current population estimate is 62,000. Based on the death rate in Winnebago
County, our county is prepared to deal with a maximum of 1-2000 deaths per year.
During a pandemic, this death rate will most likely to be exceeded, and the local
Coroner’s office overwhelmed4,5.
In the state of Wisconsin coroners, medical examiners, deputy coroners/medical
examiners, physicians, and registered nurses (licensed in Wisconsin) are capable of
pronouncing death. Our community will need to draw from each of these sources to deal
with the death toll. In addition, approximately 58.3% of Wisconsin residents are buried
each year, and 33.1% are cremated. Due to the lack of body bags and burial plots
necessary to deal with an increase in the death rate, many more families will need to rethink their position regarding the disposition of a dead body. Cremation will be highly
recommended. All alternative means will be used to prevent having to create mass
graves4,5.
WINNEBAGO COUNTY HEALTH DEPARTMENT’S
BOARD OF HEALTH AND THE OSHKOSH BOARD OF
HEALTH’S ROLE
In the event of a pandemic, the Oshkosh Board of Health will make decisions similar to
decisions made in 1918, i.e. when to quarantine, when to close schools. Surveillance of
the H5N1 strain is the responsibility of heath care workers who report to Public Health
officials. Therefore, the Oshkosh Health Department and the Winnebago County Health
Department’s Board of Health will be among the first public officials to know of H5N1
cases in Winnebago County. The City of Oshkosh Health Director is a member of the
Emergency Preparedness Council, and will relay to the Council the Board of Heath’s
decisions.
Currently, Oshkosh has good emergency plans, but is still developing a local flu plan
based on the Wisconsin Pandemic Influenza Preparedness plan. The Oshkosh Board of
Health is encouraging businesses to design their own flu plans, promoting hand washing,
16
and individual stockpiling. Moreover, the Oshkosh Board of Health is stressing that
people stay home if they are sick.
The Winnebago County Department of Health is responsible for rural areas. It will make
decisions similar to the Oshkosh Board of Health, but will coordinate containment efforts
with Oshkosh, Neenah and Menasha. If a pandemic occurs, the Winnebago County
Department of Heath’s Board of Heath will be working closely with the Oshkosh Board
of Health, as well as Menasha, and Neenah (for example, movement of supplies and
determining which patients need hospitalization).
Winnebago County Health Department’s Board of Health19








Chairman: Jim Koziczkowski
Vice Chair: Joanne Sievert
Steve Arne
Dr. Joseph Bachman
Nancy Barker
Jill Collier, RN, MSN
Bernard Egan
Tom LaFuze
Health Officers
 Menasha: Sue Nett
 Neenah: Judy Crouch-Smolarek
 Oshkosh: Paul Spiegal
 Winnebago County: Doug Gieryn
Oshkosh Board of Health The Oshkosh Board of Health consists of four members, two
alternates, and one City Council member12. The current Board of Health members are,
 Dr. Barbara Strand - Chair, Affinity Medical Group
 Jamie Bonell - CFNP, APNP, Aurora Medical Group
 Burk Tower – Council Representative
 Christine Kniep – UW-Extension
 Susan Panek – United Way
 Stan Kline – Alternate
 Mardell Sowers – Alternate
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References
1.
“Oshkosh Wastewater Treatment Plant Process Guide”. University of Wisconsin:
Oshkosh. Last viewed 05/02/2006.
<http://www.uwosh.edu/environmentalaudit/documents/water/waterPDFS/treatm
entGuide.pdf>.
2.
“City of Oshkosh Drinking Water Quality Report 2005” City Of Oshkosh, WI. Last
Viewed 05/02/2006.
<http://www.ci.oshkosh.wi.us/Public_Works/PDF_Files/Consumer_Confidence_
Water_Report.pdf>.
3.
Pontius, F. “Drinking Water Disinfection with Chlorine: An Effective Public Health
Practice”. Chlorine Chemistry Council. Last Viewed 05/02/2006.
<http://c3.org/news_center/third_party/disinfection.html>.
4.
Wisconsin Department of Health and Family Services, Division of Public Health,
Bureau of Health Information and Policy. Wisconsin Deaths 2004 (PPH 536404). August, 2005.
5.
Missfeldt, Marianne. “Pronouncement of Death Regulations Update due to 2003
Wisconsin Act 273 Hospice Nurse Pronouncement of Death”. Last Viewed
05/02/2006. <http://dhfs.wisconsin.gov/rl_DSL/Publications/pdfmemos/04019.pdf>.
6.
“State of Wisconsin Prescription Drug Resource” Office of the Governor: State of
Wisconsin. Last Viewed 05/02/2006. <http://www.drugsavings.wi.gov/>.
7.
Schultz, Cathy. Telephone interview. “Conversation with Cathy Schultz (Trauma
Team Manager at Mercy Medical)”.
8.
“Influenza (Flu)”. Centers for Disease Control. Last viewed 05/02/2006.,
<www.cdc.gov/flu/pandemic/>.
9.
“Wisconsin Emergency Management”. State of Wisconsin Emergency Management.
Last viewed 05/02/2006. <http://emergencymanagement.wi.gov/>.
10.
“Oshkosh Fire Department” City of Oshkosh, WI. Last viewed 05/02/2006.
<http://www.ci.oshkosh.wi.us/Fire/>.
11.
“Oshkosh Police Home Page”. City of Oshkosh Police Department. Last viewed
05/02/2006. <http://www.oshkoshpd.com/>.
12.
“ City of Oshkosh on the Water”. City of Oshkosh, WI. Last viewed 05/02/2006.
<http://www.ci.oshkosh.wi.us/>.
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13.
“Members: Board of Education”. Oshkosh Area School District. Last viewed
05/02/2006. <http://www.oshkosh.k12.wi.us/aboutus/boe_members.cfm>.
14.
“American Red Cross” American Red Cross. Last Viewed 02/09/2006 &
05/02/2006. <http://www.redcross.org >.
15. “Bird Flu Protection”. Bird-Flu-Kits.com. Last Viewed 02/09/2006 & 05/02/2006.
<http://www.bird-flu-kits.com>.
16. Oshkosh Water Filtration Plant. “RMP Executive Summary”. Last viewed
04/12/2006. <http://www.rtknet.org/rmp/sum7/WI/fac100000140411>.
17. Dept of Health and Family Services, Division of Public Health. “Memo: Update on
Human Cases of Avian Influenza Worldwide”. Last viewed 03/02/2006.
<http://www.slh.wisc.edu/comdis/documents/DPH_Avian_update_020606.pdf >.
18.
FEMA. Last viewed 03/02/2006 <http://fema.gov/>.
19.
Wisconsin Local Public Health Department Listings. Last viewed 04/20/06 &
05/09/06. <http://dhfs.wisconsin.gov/localhealth/. >
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