Personal Pandemic Planning
What is Influenza?-The “Garden Variety” Flu
Influenza (the “flu” ) is a common viral illness. It circulates in the human population in an annual, cyclic fashion. In any given year approximately 10-20% of the population becomes ill with influenza. Influenza is responsible for an average of 200,000 hospitalizations and 36,000 deaths in the United States each year. Because it is caused by a virus, flu cannot successfully be treated with antibiotics. Special drugs called antivirals are used to reduce the symptoms and duration of the illness; or to help prevent symptoms (prophylaxis). Vaccination can also prevent or reduce the symptoms of flu.
Compared to most viruses influenza mutates, or changes its genes and external structure, very rapidly . This rapid change of its protein coat allows the virus to fool the immune system into not recognizing it as an invader, even though you’ve had a different strain of flu before, or been vaccinated in the past. To be effective the vaccine that is used to prevent flu must change to reflect the unique strains predominating each year.
When a person is infected with the flu, the virus begins to rapidly reproduce within the infected persons (host) tissues. Most influenza strains reproduce rapidly in lung and intestinal tissue. When a host coughs, sneezes or breathes out moist air, large amounts of the virus is released (shed) back out into the environment. It can also be shed in stool and other body fluids.
Researchers believe the most common way to be infected with the flu is by breathing in the flu virus. Virus floats in the air in droplets created by coughs and sneezes. Invisible to the human eye, those tiny droplets can remain suspended in the air for many hours after they are produced. Contact with other infected body secretions, such as stool containing live virus, can also cause an infection. The virus can live in the environment on hard surfaces for days. People touching those surfaces can be infected when they transfer the virus from their hands to the mucous membranes of their mouth, nose or eyes.
About two days after infection (up to four days), symptoms begin. In most common flu types, a headache and fever are often the first signs. The oral temperature usually runs from 101 degrees to 103 degrees Fahrenheit. Respiratory symptoms then start-cough, congestion, sneezing and some shortness of breath are common to most infections of flu. Even before symptoms are apparent- about a day after infection, the host begins shedding virus. Many victims catch the flu from people who do not yet appear ill.
Cold symptoms are often mistaken for the flu, but cold bugs do not usually cause the high fever and profound weakness common to influenza. Some strains also cause gastrointestinal symptoms, such as nausea, diarrhea and vomiting. Additional flu symptoms include severe aching of muscles and joints, headache, sore throat, decrease or loss of appetite and profound lethargy and tiredness. These symptoms continue for about three or four days. The victim experiences overwhelming tiredness and generalized discomfort for about 3 or 4 more days. Although acute symptoms usually last about a week, it may take several more weeks or even months until the victim regains usual levels of stamina.
There are many possible complications of influenza infection. People most at risk of complications are the elderly. Our immune systems function less effectively as we age, so flu mortality is high in persons over age 65. Risk is also high in the very young-the immune systems of infants and young children sometimes isn’t developed enough to effectively fight off the flu virus. Both groups are also prone to life-threatening dehydration from the high fever, vomiting and diarrhea. Other special risk groups include those with chronic illnesses, such as diabetes, lung problems, those taking steroids for autoimmune diseases, and persons with HIV. If you have a chronic illness you should check with your physician to see if you may be at higher risk of complications from the flu.
The immune system becomes exhausted when fighting off an infection like flu- leaving you more susceptible to other infections. Bronchitis and sinus infections are common, especially among smokers. Another common flu complication is called “secondary pneumonia”. A different pathogen takes advantage of the weakened immune system and causes pneumonia- the usual culprit is a bacteria. Bacterial pneumonias are usually treated with antibiotics. Secondary pneumonias are suspected when a person initially recovers form the flu symptoms, but then days or weeks later becomes ill again with a fever and cough. Pneumonia is considered the most common cause of mortality (death) attributed to the usual human flu infection.
Aditional but more rare complications of the normal flu include neurological disease (encephalitis and meningitis) that occurs when the brain tissues become infected. Infections of the heart muscle (myocarditis) can also occur. Children are especially susceptable to croup and Reyes syndrome. Never give aspirin or aspirin containing products to children, as that is assosciated with Reyes syndrome.
For more influenza facts and statistics, see: http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=316591
Pandemic Influenza
We most commonly think of flu as a human disease. But, different strains of influenza circulate in animal populations as well. Birds, especially wild waterfowl; are reservoirs of flu strains.
Usually, the human and avian strains are separate- a person does not normally contract the influenza strain and become ill when exposed to an avian influenza virus. That is because the strains that birds carry lack the protein configuration on the outside of the virus that act as a key to “unlock” human cells and allows the virus to enter, multiply and cause illness. That is why some influenza strains are referred to as “Avian Flu” -they are specific for the cells of birds, and don’t adapt to human cells.
Occasionally, an avian flu strain mutates and gains the ability to infect humans. This may cause sporadic cases of human illness, but the virus has trouble efficiently passing from human to human. If the virus mutates to develop human infectivity or meets up with another flu virus in host with dual infections, and shares the genes with it that allow efficient human to human transmission (H2H), a new strain may begin to spread among people. A small outbreak of influenza is called a cluster. If the clusters become more common and frequent, then the chances of an influenza epidemic or pandemic increase. An epidemic is recognized when infection spread in large geographic region like country or continent.
A pandemic is characterized by the rapid and efficient transmission of the virus within the human population, worldwide. Because it is an entirely new strain, there is no immunity to new virus in the human population. More of the people who are exposed to the virus develop influenza illness. During a pandemic it is estimated that about ¼ to1/3 of the population will become ill from the pandemic strain. That is called the “attack rate”.
Besides a high attack rate, a pandemic has historically had another significant characteristic- the severity of human illness the pandemic strain causes. Three significant influenza pandemics occurred during the 20th century. All three of those pandemic flu strains are believed to have originated in birds, and become adapted to humans. The most serious and deadly pandemic we have any data on occurred during WW1-the Spanish Flu.
The Spanish flu began causing serious illness in 1918. It spread throughout the world in three waves- periods of time when the virus was very active. Estimates vary, but it believed that up to 1/3 of the world population suffered influenza during one of the three pandemic waves, and between 2.5 and 5% of those who became ill died of the flu or its complications (mortality rate). The human death toll is believed to have been anywhere from 20 to 100 million people.
Pandemic strains may also cause different symptoms and affect different body systems then the usual annual flu virus. Some pandemic strains cause unusually high rates of neurological illness, result in primary viral influenza pneumonia, or uncontrolled bleeding (hemorrhagic strains). Another possible cause of high mortality (death rates) of pandemic flu occurs when the strain triggers a hyperactive response of the immune system, flooding the lungs with white blood cells and fluids, essentially drowning the victim in their own secretions (cytokine storm).
For more information on the Spanish Flu Pandemic see:
http://www.stanford.edu/group/virus/uda/
http://www.pbs.org/wgbh/aso/databan...ies/dm18fl.html
http://www.curevents.com/vb/showthread.php?t=9633
http://en.wikipedia.org/wiki/Spanish_Flu
The Current Risks of a New Influenza Pandemic
By June of 2005, international medical experts have realized that a novel, rapidly spreading and endemic (entrenched in the population) type of Avian Flu (H5N1) may result in a human influenza pandemic sometime in the near future. Without accurate scientific records from previous severe pandemics, it is impossible to be certain that the behavior of the virus indicates that a human pandemic is inevitable. Expert concern has recently reached new highs due to new outbreaks in Vietnam and China because analysis of the changing behavior and structure of the virus appears to indicate it may be adapting to efficient human transmission.
http://www.curevents.com/vb/showthread.php?t=16991
http://www.recombinomics.com/News/0...c_Timeline.html
The H5N1 flu has caused the death by infection or culling of millions of domestic fowl in Southeast Asia and China. It appears to spread by wild migratory birds and waterfowl, and has recently developed the ability to exist in some birds (ducks) without causing illness. Approximately 100 cases of human illness and over 50 deaths have resulted, (as of mid-June, 2005) most from contact with infected birds. Some human clusters have been identified in which limited human to human transmission has apparently occurred. Several different subtypes of the virus have been identified, and the mortality rate of human H5N1 flu infections has been close to 50% of the total known infected.
Mortality rates vary by strain- some recent (2005) strains in Vietnam have mortality rates as low as 20%, others closer to 80%. The current true mortality rate may be unknown, as many observers are uncertain if milder cases are cirulating in the public and not being identified and counted in the current totals.
It is difficult to predict the mortality rate of a pandemic strain of H5N1. It is believed that as the virus continues to adapt and mutate, that the ability to cause illness resulting in death of the victim will decrease. Some experts apparently consider the mortality rate of a worst case pandemic of H5N1 to be similar to the Spanish Flu.
But, That was Then...
In 1918, the medical community did not know the virus caused the disease. They had no influenza vaccines to lower the attack rate, antibiotics to treat secondary infections, personal protective equipment like N95 masks and medical gloves as an effective barrier to prevent infection. There was no sophisticated medical equipment like ventilators to support patients who experienced respiratory failure. It seems logical to assume that with modern medical care many people who died in 1918 from the flu or its complications would survive a similar illness today-and so a pandemic occuring now would not be as serious.
But the risks of a pandemic today are not as insignificant as it may seem, even considering the many benefits we have in 2005 compared to 1918. The sheer, overwhelming numbers of ill people in a pandemic may cancel out many of those benefits. If 10% of the population is ill at any one time, the entire medical system will become seriously overloaded. In a normal flu season with the average type of flu bug, hospital bed availability is already stressed.
In a pandemic, there may be nowhere near enough beds or medical staff available to treat the number of patients who may need their help. Even with personal protective equipment (PPE) that is currently available, it is assumed that healthcare workers will experience a high rate of infection. Increased staff absenteeism combined with increased patient census means less beds available for sick people.
Availability of medical equipment and medicines is also a concern. Mask, gloves, gowns, respiratory equipment, disposable patient care items, and other items like this are manufactured with little extra available for immediate increased (surge) need. During the recent SARS epidemic, much of this equipment became so backordered that hospitals were unable to obtain what they needed fast enough, even with manufacturers going to 24 hour production and rush shipments.
The SARS epidemic affected a very small area compared to a worldwide flu pandemic. The needed volume of equipment and supplies would be many times higher then the needs that we experienced during SARS.
If the pandemic strain causes severe illness (referred to as a virulent strain); hospitals, clinics and medical offices will become quickly overwhelmed. Ventilators and other sophisticated medical support devices will be in short supply- and not everyone who will need one will find one available. The medical system does not have the surge capacity in either equipment, supplies, physical beds or medications to meet the anticipated demand of a 1918 style pandemic. The mortality rate will increase if our ability to deliver sophisticated care is diminished.
An effective pandemic influenza vaccine is considered the best response to a pandemic situation. It would protect healthcare workers and reduce the absenteeism due to illness. If large numbers of the public are vaccinated, the number of people with serious illness will decrease, easing some of the strain on the system.
But in order to create an influenza vaccine, manufacturers need to have samples of the strain that’s circulating to produce it. We may not have samples of a strain close enough to the pandemic strain to create an effective vaccine until after the pandemic begins. Using current vaccine technology, it takes approximately six months to create a seed vaccine for a new influenza strain.
In a pandemic, we would need many times the number of influenza vaccine doses then we normally produce each year. It is anticipated that using current manufacturing techniques that the production of a pandemic vaccine in sufficient quantity to immunize the general public may not be possible for up to one year after the pandemic begins. Initial production runs will probably be used to immunize healthcare workers and essential service personnel, and then the high risk groups. http://www.asianewsnet.net/level3_t...5&news_id=41244
Antiviral medications offer some hope to decrease the severity of illness in the affected. They may also be used prophylacticly, to help reduce the chance of infection. But H5N1 is resistant to the commonly used oral tablet flu antivirals, except for oseltamivir (Tamiflu). Unfortunately the availability of Tamiflu is limited due to a long production time and the expense of the medication. There will not be enough Tamiflu available if a pandemic occurs in the next year or two to protect even essential service personnel. http://www.curevents.com/vb/showthread.php?t=17044
The Possible Secondary, Social Effects of a Pandemic
Healthcare may not be the only system in our society strained to the breaking point by a pandemic.
The Spanish flu pandemic came in three distinct waves, of approximately 12 weeks each. Anywhere from 5- 15% of the population was ill during each wave. Quarantines were declared to reduce gatherings that allowed the illness to spread. Schools, churches and non essential businesses closed for weeks or months- sometimes permanently. Hundreds of thousands of workers were temporarily unemployed as the waves spread across the continents.
Early in 2005, President Bush signed an order that allowed the use of quarantines in the event of an influenza pandemic. Quarantines are considered an essential tool to decrease the spread of the disease. Many state and local pandemic planners may declare protective quarantines if a pandemic occurs. That will have significant adverse financial implications for many wage earners. Child care resources and schools may be among he first to close, forcing many parents to remain home to care for minor children even if their employers remain open. Alternative group childcare arrangements may not be used when the parents realize the increased risk of infection that these arrangements create.
http://my.webmd.com/content/Article/104/107276.htm
Public transportation may be closed due to the ability of the virus to spread in the close confines of planes, trains and busses. Workers who depend on public transportation may not all find alternative means to get their workplaces.
Essential services must remain available even in a severe pandemic. Essential service workers are needed to continue electrical generation and supply, fuel oil and gas deliveries, and the manufacture and delivery of the supply of food, medicines and other critical items the public will need. Essential service personnel will also include fire, police, emergency service workers and the active military.
Influenza, unlike some other infectious illnesses, can be spread by an infected person before they know they experience symptoms and realize they are sick. Many essential service personnel will, like healthcare workers; be at higher risk of infection due to frequent contact with others. In the absence of an effective vaccine, and with protective equipment is short supply it is likely that illness rates in these groups may be higher then the general population.
It is possible that some essential service disruption may occur. Most grocery stores have only enough food in them for about three days, currently their inventory is replenished approximately twice a week. Disruption anywhere in the production, manufacturing, supply or distribution of foods may result in shortages. Quarantines may limit the public’s access to stores even if shortages are not severe.
http://www.ctv.ca/servlet/ArticleNe..._47/?hub=Health
http://news.yahoo.com/news?tmpl=sto...ood_shortages_1
Most pandemic waves occur during late all and winter months. Continuing supply and distribution of heating oil and natural gas will be essential to prevent illness and death due to severe weather conditions. Electrical service interruptions due to winter storms may last longer if a pandemic reduces the number of repair personnel, because mutual aid from other unaffected areas may not be available. The ability of municipalities to deal with storms, snow covered roads and other problems will be compromised if the availability of workers, equipment and supplies are affected. Police, fire and emergency personnel may not be able to respond to emergencies if road conditions can not be maintained.
In addition to the unknown human toll of death, illness and permanent disability, it is difficult to anticipate the economic toll of a severe pandemic. If millions of workers are suddenly out of work for weeks or months at a time, large numbers of business failures seem likely. Loss of income for such a large segment of the population translates to mass default on debt. Mortgage payments, utility bills, car loans and other loans may not be paid for many months. State, federal and local tax revenues will decrease even as the need for money for pandemic programs and social welfare responses increases dramatically. A severe recession seems likely to some observers, and even more serious economic effects are possible.
The possible responses of the stock markets world wide are unknown. The loss of the retirement savings of millions of baby boomers so close to retirement age seems possible. Government action may be needed to prevent total economic meltdown. Recovery from the economic effects of a pandemic may take decades.
What You Can Do To Prepare
Stay informed!
Watch the news to determine if a pandemic is about to occur. In addition to mainstream media, several internet resources can help you keep up with the latest developments. You may wish to check these resources on a regular for up to the minute information. There are currently several internet boards and blogs following the developing avian flu issue:
The Agonist Disease Outbreak Board- not specifically dedicated to flu, its members follow all emerging or significant disease outbreaks. http://discuss.agonist.org/yabbse/index.php?board=6
Effect Measure-a public health blog, a large portion of its content involves commentary and information on Avian Flu.
http://www.effectmeasure.blogspot.com/
Avian Flu- a filter site with lists of news articles dealing with flu updated daily.
http://www.sars.com.sg/birdflu/bfindex.php
The Flu Clinic- a board dedicated specifically to following and preparing for the coming pandemic.
http://www.curevents.com/vb/forumdisplay.php?f=40
Two newer boards specifically dedicated to the current flu situation:
Epidmica
http://www.epidemi.ca/
Pandemic:H5N1
http://www.pandemich5n1.com/news.php
Assess Your Risk
Consider your personal situation in case of a flu pandemic. Talk to your doctor to determine if you or othe family members are at risk of complications. Ask for a pneumonia vaccine shot to help protect against one of the most common causes of secondary pneumonia is right for you.
Consider storing extra supplies of medical equipment and medications (especially the ones you cant live without) you take on regular basis. Purchase and store over the counter medications to be used for influenza if someone in your family gets sick.
Consider what life would be like for your family in a pandemic, with possible supply shortages. If your workplace closes and your income stops, what will you need to "get through this" until the paychecks start coming again? What would you do if diapers, toilet paper, birth control and the many daily use disposable items weren't readily avialable? Estimate your needs and plan to store extra just in case. Consider indoor entertainment- books, games and handheld devices. These may come in handy if electric services are disrupted.
You may wish to consider a backup form of heat if you live in a cold climate. Kerosene heaters, generators, wood stoves and fuel, and other options may be in short supply if the public decides to purchase them when a pandemic starts. Obtaining them before the pandemic encourages increased production and availability for others before the need arises. Even if a pandemic does not occur, they are good backup for common storm and other crisis related interruptions. With careful shopping now, you may be able to obtain good used or inexpensive models that won’t be found when a crisis occurs.
Pandemic waves may last several months, and it is possible, from studying past pandemics, that several waves will occur. Begin purchasing extra storable food items each time you go shopping. Consider just how much food you will need for your family for the duration of any food supply disruptions that may occur. The goal of many people planning for the pandemic is storing 4 to 6 months worth of food for their family.
Consider your financial situation. You may wish to discuss your personal situation with your family and/ or your financial counselor.
Create a Plan
After assessing our risk, determine what you can do to mitigate it. If you have questions you may wish to join one of the boards following the flu situation for advice and support.
Estimate your food needs with a food storage calculator: http://lds.about.com/library/weekly...s/aa102201b.htm
Learn what to store and how to do so safely and effectively:
http://waltonfeed.com/grain/faqs/
Learn the basic care of person with the flu. Doctors offices and hospital emergency departments may only have room for the very sickest. Know what OTC medicines to use, and what symptoms mean you should call your doctor if things become serious. Have a working thermometer for each family member.
Make action lists:
1. “To do now”
2. “If a pandemic is imminent, I will:”
3. ”If a pandemic is declared, I will:”
Take Action!
Start with your “Do Now” list
Begin shopping for the items and supplies you have determined you should have available.
Talk to your employer. If you are an essential service worker, you may need to plan for the care and safety of your family members if you are unable to leave work or become quarantined at work.
Contact your local officials, and find out what they know about the possibility of a pandemic, and what the plans are. Share information with them if they aren’t preparing.
Help spread the word. Share this FAQ and other relevant information. The more people are prepared, the less chaos and catastrophe a flu pandemic-or any crisis-can create.
Be prepared, not scared.<!-- / message --><!-- sig -->
What is Influenza?-The “Garden Variety” Flu
Influenza (the “flu” ) is a common viral illness. It circulates in the human population in an annual, cyclic fashion. In any given year approximately 10-20% of the population becomes ill with influenza. Influenza is responsible for an average of 200,000 hospitalizations and 36,000 deaths in the United States each year. Because it is caused by a virus, flu cannot successfully be treated with antibiotics. Special drugs called antivirals are used to reduce the symptoms and duration of the illness; or to help prevent symptoms (prophylaxis). Vaccination can also prevent or reduce the symptoms of flu.
Compared to most viruses influenza mutates, or changes its genes and external structure, very rapidly . This rapid change of its protein coat allows the virus to fool the immune system into not recognizing it as an invader, even though you’ve had a different strain of flu before, or been vaccinated in the past. To be effective the vaccine that is used to prevent flu must change to reflect the unique strains predominating each year.
When a person is infected with the flu, the virus begins to rapidly reproduce within the infected persons (host) tissues. Most influenza strains reproduce rapidly in lung and intestinal tissue. When a host coughs, sneezes or breathes out moist air, large amounts of the virus is released (shed) back out into the environment. It can also be shed in stool and other body fluids.
Researchers believe the most common way to be infected with the flu is by breathing in the flu virus. Virus floats in the air in droplets created by coughs and sneezes. Invisible to the human eye, those tiny droplets can remain suspended in the air for many hours after they are produced. Contact with other infected body secretions, such as stool containing live virus, can also cause an infection. The virus can live in the environment on hard surfaces for days. People touching those surfaces can be infected when they transfer the virus from their hands to the mucous membranes of their mouth, nose or eyes.
About two days after infection (up to four days), symptoms begin. In most common flu types, a headache and fever are often the first signs. The oral temperature usually runs from 101 degrees to 103 degrees Fahrenheit. Respiratory symptoms then start-cough, congestion, sneezing and some shortness of breath are common to most infections of flu. Even before symptoms are apparent- about a day after infection, the host begins shedding virus. Many victims catch the flu from people who do not yet appear ill.
Cold symptoms are often mistaken for the flu, but cold bugs do not usually cause the high fever and profound weakness common to influenza. Some strains also cause gastrointestinal symptoms, such as nausea, diarrhea and vomiting. Additional flu symptoms include severe aching of muscles and joints, headache, sore throat, decrease or loss of appetite and profound lethargy and tiredness. These symptoms continue for about three or four days. The victim experiences overwhelming tiredness and generalized discomfort for about 3 or 4 more days. Although acute symptoms usually last about a week, it may take several more weeks or even months until the victim regains usual levels of stamina.
There are many possible complications of influenza infection. People most at risk of complications are the elderly. Our immune systems function less effectively as we age, so flu mortality is high in persons over age 65. Risk is also high in the very young-the immune systems of infants and young children sometimes isn’t developed enough to effectively fight off the flu virus. Both groups are also prone to life-threatening dehydration from the high fever, vomiting and diarrhea. Other special risk groups include those with chronic illnesses, such as diabetes, lung problems, those taking steroids for autoimmune diseases, and persons with HIV. If you have a chronic illness you should check with your physician to see if you may be at higher risk of complications from the flu.
The immune system becomes exhausted when fighting off an infection like flu- leaving you more susceptible to other infections. Bronchitis and sinus infections are common, especially among smokers. Another common flu complication is called “secondary pneumonia”. A different pathogen takes advantage of the weakened immune system and causes pneumonia- the usual culprit is a bacteria. Bacterial pneumonias are usually treated with antibiotics. Secondary pneumonias are suspected when a person initially recovers form the flu symptoms, but then days or weeks later becomes ill again with a fever and cough. Pneumonia is considered the most common cause of mortality (death) attributed to the usual human flu infection.
Aditional but more rare complications of the normal flu include neurological disease (encephalitis and meningitis) that occurs when the brain tissues become infected. Infections of the heart muscle (myocarditis) can also occur. Children are especially susceptable to croup and Reyes syndrome. Never give aspirin or aspirin containing products to children, as that is assosciated with Reyes syndrome.
For more influenza facts and statistics, see: http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=316591
Pandemic Influenza
We most commonly think of flu as a human disease. But, different strains of influenza circulate in animal populations as well. Birds, especially wild waterfowl; are reservoirs of flu strains.
Usually, the human and avian strains are separate- a person does not normally contract the influenza strain and become ill when exposed to an avian influenza virus. That is because the strains that birds carry lack the protein configuration on the outside of the virus that act as a key to “unlock” human cells and allows the virus to enter, multiply and cause illness. That is why some influenza strains are referred to as “Avian Flu” -they are specific for the cells of birds, and don’t adapt to human cells.
Occasionally, an avian flu strain mutates and gains the ability to infect humans. This may cause sporadic cases of human illness, but the virus has trouble efficiently passing from human to human. If the virus mutates to develop human infectivity or meets up with another flu virus in host with dual infections, and shares the genes with it that allow efficient human to human transmission (H2H), a new strain may begin to spread among people. A small outbreak of influenza is called a cluster. If the clusters become more common and frequent, then the chances of an influenza epidemic or pandemic increase. An epidemic is recognized when infection spread in large geographic region like country or continent.
A pandemic is characterized by the rapid and efficient transmission of the virus within the human population, worldwide. Because it is an entirely new strain, there is no immunity to new virus in the human population. More of the people who are exposed to the virus develop influenza illness. During a pandemic it is estimated that about ¼ to1/3 of the population will become ill from the pandemic strain. That is called the “attack rate”.
Besides a high attack rate, a pandemic has historically had another significant characteristic- the severity of human illness the pandemic strain causes. Three significant influenza pandemics occurred during the 20th century. All three of those pandemic flu strains are believed to have originated in birds, and become adapted to humans. The most serious and deadly pandemic we have any data on occurred during WW1-the Spanish Flu.
The Spanish flu began causing serious illness in 1918. It spread throughout the world in three waves- periods of time when the virus was very active. Estimates vary, but it believed that up to 1/3 of the world population suffered influenza during one of the three pandemic waves, and between 2.5 and 5% of those who became ill died of the flu or its complications (mortality rate). The human death toll is believed to have been anywhere from 20 to 100 million people.
Pandemic strains may also cause different symptoms and affect different body systems then the usual annual flu virus. Some pandemic strains cause unusually high rates of neurological illness, result in primary viral influenza pneumonia, or uncontrolled bleeding (hemorrhagic strains). Another possible cause of high mortality (death rates) of pandemic flu occurs when the strain triggers a hyperactive response of the immune system, flooding the lungs with white blood cells and fluids, essentially drowning the victim in their own secretions (cytokine storm).
For more information on the Spanish Flu Pandemic see:
http://www.stanford.edu/group/virus/uda/
http://www.pbs.org/wgbh/aso/databan...ies/dm18fl.html
http://www.curevents.com/vb/showthread.php?t=9633
http://en.wikipedia.org/wiki/Spanish_Flu
The Current Risks of a New Influenza Pandemic
By June of 2005, international medical experts have realized that a novel, rapidly spreading and endemic (entrenched in the population) type of Avian Flu (H5N1) may result in a human influenza pandemic sometime in the near future. Without accurate scientific records from previous severe pandemics, it is impossible to be certain that the behavior of the virus indicates that a human pandemic is inevitable. Expert concern has recently reached new highs due to new outbreaks in Vietnam and China because analysis of the changing behavior and structure of the virus appears to indicate it may be adapting to efficient human transmission.
http://www.curevents.com/vb/showthread.php?t=16991
http://www.recombinomics.com/News/0...c_Timeline.html
The H5N1 flu has caused the death by infection or culling of millions of domestic fowl in Southeast Asia and China. It appears to spread by wild migratory birds and waterfowl, and has recently developed the ability to exist in some birds (ducks) without causing illness. Approximately 100 cases of human illness and over 50 deaths have resulted, (as of mid-June, 2005) most from contact with infected birds. Some human clusters have been identified in which limited human to human transmission has apparently occurred. Several different subtypes of the virus have been identified, and the mortality rate of human H5N1 flu infections has been close to 50% of the total known infected.
Mortality rates vary by strain- some recent (2005) strains in Vietnam have mortality rates as low as 20%, others closer to 80%. The current true mortality rate may be unknown, as many observers are uncertain if milder cases are cirulating in the public and not being identified and counted in the current totals.
It is difficult to predict the mortality rate of a pandemic strain of H5N1. It is believed that as the virus continues to adapt and mutate, that the ability to cause illness resulting in death of the victim will decrease. Some experts apparently consider the mortality rate of a worst case pandemic of H5N1 to be similar to the Spanish Flu.
But, That was Then...
In 1918, the medical community did not know the virus caused the disease. They had no influenza vaccines to lower the attack rate, antibiotics to treat secondary infections, personal protective equipment like N95 masks and medical gloves as an effective barrier to prevent infection. There was no sophisticated medical equipment like ventilators to support patients who experienced respiratory failure. It seems logical to assume that with modern medical care many people who died in 1918 from the flu or its complications would survive a similar illness today-and so a pandemic occuring now would not be as serious.
But the risks of a pandemic today are not as insignificant as it may seem, even considering the many benefits we have in 2005 compared to 1918. The sheer, overwhelming numbers of ill people in a pandemic may cancel out many of those benefits. If 10% of the population is ill at any one time, the entire medical system will become seriously overloaded. In a normal flu season with the average type of flu bug, hospital bed availability is already stressed.
In a pandemic, there may be nowhere near enough beds or medical staff available to treat the number of patients who may need their help. Even with personal protective equipment (PPE) that is currently available, it is assumed that healthcare workers will experience a high rate of infection. Increased staff absenteeism combined with increased patient census means less beds available for sick people.
Availability of medical equipment and medicines is also a concern. Mask, gloves, gowns, respiratory equipment, disposable patient care items, and other items like this are manufactured with little extra available for immediate increased (surge) need. During the recent SARS epidemic, much of this equipment became so backordered that hospitals were unable to obtain what they needed fast enough, even with manufacturers going to 24 hour production and rush shipments.
The SARS epidemic affected a very small area compared to a worldwide flu pandemic. The needed volume of equipment and supplies would be many times higher then the needs that we experienced during SARS.
If the pandemic strain causes severe illness (referred to as a virulent strain); hospitals, clinics and medical offices will become quickly overwhelmed. Ventilators and other sophisticated medical support devices will be in short supply- and not everyone who will need one will find one available. The medical system does not have the surge capacity in either equipment, supplies, physical beds or medications to meet the anticipated demand of a 1918 style pandemic. The mortality rate will increase if our ability to deliver sophisticated care is diminished.
An effective pandemic influenza vaccine is considered the best response to a pandemic situation. It would protect healthcare workers and reduce the absenteeism due to illness. If large numbers of the public are vaccinated, the number of people with serious illness will decrease, easing some of the strain on the system.
But in order to create an influenza vaccine, manufacturers need to have samples of the strain that’s circulating to produce it. We may not have samples of a strain close enough to the pandemic strain to create an effective vaccine until after the pandemic begins. Using current vaccine technology, it takes approximately six months to create a seed vaccine for a new influenza strain.
In a pandemic, we would need many times the number of influenza vaccine doses then we normally produce each year. It is anticipated that using current manufacturing techniques that the production of a pandemic vaccine in sufficient quantity to immunize the general public may not be possible for up to one year after the pandemic begins. Initial production runs will probably be used to immunize healthcare workers and essential service personnel, and then the high risk groups. http://www.asianewsnet.net/level3_t...5&news_id=41244
Antiviral medications offer some hope to decrease the severity of illness in the affected. They may also be used prophylacticly, to help reduce the chance of infection. But H5N1 is resistant to the commonly used oral tablet flu antivirals, except for oseltamivir (Tamiflu). Unfortunately the availability of Tamiflu is limited due to a long production time and the expense of the medication. There will not be enough Tamiflu available if a pandemic occurs in the next year or two to protect even essential service personnel. http://www.curevents.com/vb/showthread.php?t=17044
The Possible Secondary, Social Effects of a Pandemic
Healthcare may not be the only system in our society strained to the breaking point by a pandemic.
The Spanish flu pandemic came in three distinct waves, of approximately 12 weeks each. Anywhere from 5- 15% of the population was ill during each wave. Quarantines were declared to reduce gatherings that allowed the illness to spread. Schools, churches and non essential businesses closed for weeks or months- sometimes permanently. Hundreds of thousands of workers were temporarily unemployed as the waves spread across the continents.
Early in 2005, President Bush signed an order that allowed the use of quarantines in the event of an influenza pandemic. Quarantines are considered an essential tool to decrease the spread of the disease. Many state and local pandemic planners may declare protective quarantines if a pandemic occurs. That will have significant adverse financial implications for many wage earners. Child care resources and schools may be among he first to close, forcing many parents to remain home to care for minor children even if their employers remain open. Alternative group childcare arrangements may not be used when the parents realize the increased risk of infection that these arrangements create.
http://my.webmd.com/content/Article/104/107276.htm
Public transportation may be closed due to the ability of the virus to spread in the close confines of planes, trains and busses. Workers who depend on public transportation may not all find alternative means to get their workplaces.
Essential services must remain available even in a severe pandemic. Essential service workers are needed to continue electrical generation and supply, fuel oil and gas deliveries, and the manufacture and delivery of the supply of food, medicines and other critical items the public will need. Essential service personnel will also include fire, police, emergency service workers and the active military.
Influenza, unlike some other infectious illnesses, can be spread by an infected person before they know they experience symptoms and realize they are sick. Many essential service personnel will, like healthcare workers; be at higher risk of infection due to frequent contact with others. In the absence of an effective vaccine, and with protective equipment is short supply it is likely that illness rates in these groups may be higher then the general population.
It is possible that some essential service disruption may occur. Most grocery stores have only enough food in them for about three days, currently their inventory is replenished approximately twice a week. Disruption anywhere in the production, manufacturing, supply or distribution of foods may result in shortages. Quarantines may limit the public’s access to stores even if shortages are not severe.
http://www.ctv.ca/servlet/ArticleNe..._47/?hub=Health
http://news.yahoo.com/news?tmpl=sto...ood_shortages_1
Most pandemic waves occur during late all and winter months. Continuing supply and distribution of heating oil and natural gas will be essential to prevent illness and death due to severe weather conditions. Electrical service interruptions due to winter storms may last longer if a pandemic reduces the number of repair personnel, because mutual aid from other unaffected areas may not be available. The ability of municipalities to deal with storms, snow covered roads and other problems will be compromised if the availability of workers, equipment and supplies are affected. Police, fire and emergency personnel may not be able to respond to emergencies if road conditions can not be maintained.
In addition to the unknown human toll of death, illness and permanent disability, it is difficult to anticipate the economic toll of a severe pandemic. If millions of workers are suddenly out of work for weeks or months at a time, large numbers of business failures seem likely. Loss of income for such a large segment of the population translates to mass default on debt. Mortgage payments, utility bills, car loans and other loans may not be paid for many months. State, federal and local tax revenues will decrease even as the need for money for pandemic programs and social welfare responses increases dramatically. A severe recession seems likely to some observers, and even more serious economic effects are possible.
The possible responses of the stock markets world wide are unknown. The loss of the retirement savings of millions of baby boomers so close to retirement age seems possible. Government action may be needed to prevent total economic meltdown. Recovery from the economic effects of a pandemic may take decades.
What You Can Do To Prepare
Stay informed!
Watch the news to determine if a pandemic is about to occur. In addition to mainstream media, several internet resources can help you keep up with the latest developments. You may wish to check these resources on a regular for up to the minute information. There are currently several internet boards and blogs following the developing avian flu issue:
The Agonist Disease Outbreak Board- not specifically dedicated to flu, its members follow all emerging or significant disease outbreaks. http://discuss.agonist.org/yabbse/index.php?board=6
Effect Measure-a public health blog, a large portion of its content involves commentary and information on Avian Flu.
http://www.effectmeasure.blogspot.com/
Avian Flu- a filter site with lists of news articles dealing with flu updated daily.
http://www.sars.com.sg/birdflu/bfindex.php
The Flu Clinic- a board dedicated specifically to following and preparing for the coming pandemic.
http://www.curevents.com/vb/forumdisplay.php?f=40
Two newer boards specifically dedicated to the current flu situation:
Epidmica
http://www.epidemi.ca/
Pandemic:H5N1
http://www.pandemich5n1.com/news.php
Assess Your Risk
Consider your personal situation in case of a flu pandemic. Talk to your doctor to determine if you or othe family members are at risk of complications. Ask for a pneumonia vaccine shot to help protect against one of the most common causes of secondary pneumonia is right for you.
Consider storing extra supplies of medical equipment and medications (especially the ones you cant live without) you take on regular basis. Purchase and store over the counter medications to be used for influenza if someone in your family gets sick.
Consider what life would be like for your family in a pandemic, with possible supply shortages. If your workplace closes and your income stops, what will you need to "get through this" until the paychecks start coming again? What would you do if diapers, toilet paper, birth control and the many daily use disposable items weren't readily avialable? Estimate your needs and plan to store extra just in case. Consider indoor entertainment- books, games and handheld devices. These may come in handy if electric services are disrupted.
You may wish to consider a backup form of heat if you live in a cold climate. Kerosene heaters, generators, wood stoves and fuel, and other options may be in short supply if the public decides to purchase them when a pandemic starts. Obtaining them before the pandemic encourages increased production and availability for others before the need arises. Even if a pandemic does not occur, they are good backup for common storm and other crisis related interruptions. With careful shopping now, you may be able to obtain good used or inexpensive models that won’t be found when a crisis occurs.
Pandemic waves may last several months, and it is possible, from studying past pandemics, that several waves will occur. Begin purchasing extra storable food items each time you go shopping. Consider just how much food you will need for your family for the duration of any food supply disruptions that may occur. The goal of many people planning for the pandemic is storing 4 to 6 months worth of food for their family.
Consider your financial situation. You may wish to discuss your personal situation with your family and/ or your financial counselor.
Create a Plan
After assessing our risk, determine what you can do to mitigate it. If you have questions you may wish to join one of the boards following the flu situation for advice and support.
Estimate your food needs with a food storage calculator: http://lds.about.com/library/weekly...s/aa102201b.htm
Learn what to store and how to do so safely and effectively:
http://waltonfeed.com/grain/faqs/
Learn the basic care of person with the flu. Doctors offices and hospital emergency departments may only have room for the very sickest. Know what OTC medicines to use, and what symptoms mean you should call your doctor if things become serious. Have a working thermometer for each family member.
Make action lists:
1. “To do now”
2. “If a pandemic is imminent, I will:”
3. ”If a pandemic is declared, I will:”
Take Action!
Start with your “Do Now” list
Begin shopping for the items and supplies you have determined you should have available.
Talk to your employer. If you are an essential service worker, you may need to plan for the care and safety of your family members if you are unable to leave work or become quarantined at work.
Contact your local officials, and find out what they know about the possibility of a pandemic, and what the plans are. Share information with them if they aren’t preparing.
Help spread the word. Share this FAQ and other relevant information. The more people are prepared, the less chaos and catastrophe a flu pandemic-or any crisis-can create.
Be prepared, not scared.<!-- / message --><!-- sig -->