Birdflu Mailing List: Fw: Pandemic preparations - Hennepin County perspective

[William Weir (weirwilliam]

Here is Hennepin County's Pandemic Health Protection perspective from Bill 
Belknap:

(Since this discussion manager does not forward attachments, I've added it 
below.)

Bill Weir
----- Original Message ----- 
From: Bill.Belknap [at] co.hennepin.mn.us<mailto:Bill.Belknap [at] 
co.hennepin.mn.us> 
To: weirwilliam [at] msn.com<mailto:weirwilliam [at] msn.com> 
Sent: Thursday, March 02, 2006 2:06 PM
Subject: Pandemic preparations



Bill -  I was forwarded your contact information and am responding to your 
request for information about the H5N1 avian influenza.

I'd encourage your to read a couple of very informative pieces about the 
current avian influenza H5N1 and the prospects of it becoming a deadly human
strain.  These include:

http://www.pandemicflu.gov/rcommunication/pre_event_maps.pdf<http://www.pandemicflu.gov/rcommunication/pre_event_maps.pdf>

And from the local Hennepin County Public Health Protection perspective, the 
following file:

(See attached file: Avian Influenza.01.30.06.doc)   

Please let me know if you need additional information.  Feel free to call, 
email or fax me.

All the best,

Bill Belknap
Public Health Emergency Preparedness
  & Environmental Health
Hennepin County Public Health Protection
1011 First Street South, Suite 215
Hopkins, MN 55343-9413
Phone: 952-351-5261
bill.belknap [at] co.hennepin.mn.us<mailto:bill.belknap [at] co.hennepin.mn.us>

"We don't see things as they are; we see things as we are."

AVIAN INFLUENZA - Talking Points

 

STILL A "BIRD FLU" 



  a.. H5N1, the closely watched avian influenza strain, is a bird virus that 
has infected hundreds of thousands of Eurasian poultry and fowl.


  b.. In the past two years, H5N1 has infected some 150 people in S.E. Asia in 
close contact with infected birds, killing 80 - in Hong Kong, Viet Nam, 
Thailand, Cambodia, Indonesia and China.  


  c.. In the past 2-3 months, the same highly virulent strain of H5N1 has been 
confirmed by WHO to have infected poultry flocks in Turkey, Ukraine and Romania 
and to have infected as many as 21 people in Turkey in close contact with 
infected birds there, killing 4.


  d.. It's often stated that 50 percent of the S.E. Asian human H5N1 cases have 
ended in death - a sobering mortality rate, though likely not accurate. (How 
many others contracted it and recovered or died, undiagnosed, won't ever be 
known.) 


  e.. The more recently recorded human mortality rate in Turkey so far has been 
significantly lower - just under 20 percent (4 of 21). Early detection and 
treatment is credited with the improved survival rate.


  f.. WHO recommends Tamiflu treatment immediately upon H5N1 diagnosis.  
 

THE PANDEMIC POTENTIAL



  a.. H5N1 is not the same virus as the one that caused the "Spanish Flu" 
pandemic of 1918 and 1919.  However, H5N1 may share certain pathogenic 
predilections with that infamous virus -- a bird flu that jumped to humans and 
infected deep into lung tissue in a way that human flu viruses typically do 
not. 


  b.. The 1918-19 influenza caused many thousands of human deaths -- attacking, 
with particular vigor, healthy young and middle-aged people with strong immune 
systems. H5N1 has the potential to do the same thing if it mutates so it 
transmits human-to-human - which it doesn't appear to have done yet.  


  c.. H5N1 may incubate for as long as two weeks (compared to 2-3 days for 
seasonal influenza) before the onset of symptoms. All human H5N1 cases have 
rapidly progressed to pneumonia (according to WHO).


 

 

A THREAT TO U.S. POULTRY?

 

  a.. Low pathogenic strains of avian influenza (LPAI) are routinely found and 
eradicated in U.S. poultry flocks, with little threat to humans. High 
pathogenic strains (HPAI) have been uncommon but, when they have appeared, have 
caused high mortality in poultry.  (1924, 1983 and 2004 -- high pathogenic 
forms of H5N2 caused deadly outbreaks in U.S. poultry -- all contained without 
human infection.)


  b.. The H5N1 HPAI virus has been shown to survive in infected bird droppings 
for more than a month at low temperatures (below 40°F) and as long as a week at 
high temperatures (above 90°F) and, as such, can readily spread H5N1 to both 
people and birds.


  c.. Only H5 and H7 strains of low pathogenic avian influenza viruses have 
been known to become high pathogenic strains in poultry. 


  d.. The USDA has H5 and H7 vaccine available to immunize U.S. poultry flocks 
when high pathogenic H5 or H7 outbreaks are detected. The H5 vaccine has been 
shown to be effective against the current H5N1 HPAI S.E. Asian strain in 
poultry.
 

  a.. If and when an HPAI is detected in the U.S., a response team from USDA is 
organized to be on-site within 24 hours (to quarantine, destroy, sanitize, 
investigate and immunize.)
 

  a.. Migratory fowl are suspected of being a means for transcontinental avian 
influenza transmission (a subject of some debate) so the USDA is conducting 
extensive surveillance of all migratory flyways into the U.S. -- with 
particular attention to the Alaskan flyway from eastern Asia. The USDA seems 
confident it'll detect the presence of H5N1 in poultry before it becomes a 
threat to humans within the U.S.
 

  a.. Even if H5N1 arrives on our shores, the chicken in our food supply will 
be safe to eat -- if cooked properly. 
 

A THREAT TO THE U.S. POPULATION?



  a.. If H5N1 becomes a human virus, its impact on our daily lives and economy 
is likely to be vast; our societal perception of infectious disease is likely 
to be forever altered.


  a.. If H5N1 becomes a human virus, our annual flu shots won't protect us 
because they won't target the specific pandemic strain. It will take several 
months to produce the right vaccine, beginning weeks after the pandemic has 
already started. Even then, the vaccine will be in short supply when it does 
become available. 


  b.. An anti-viral drug (Tamiflu) also may be effective against a pandemic 
strain, though that won't be known until there is a pandemic strain and the 
drug can be tested.  There likely won't be an adequate supply of the drug to 
dispense to most people, at least in the short-term.


  c.. So, instead of telling people, "Get a shot now before this new bug gets 
you," or "You'll get this pill and you'll get better," we'll be telling them: 
  "Stay away from others who are ill...wash your hands...don't touch your eyes, 
nose, mouth or face...report symptoms as soon as you get them...stay away from 
crowded places.isolate and quarantine, etc." 


  d.. Closing schools and canceling large events are likely elements of a 
pandemic prevention strategy.


 

ARE WE READY?

 

  a.. Ever since SARS, there's been a heightened level of awareness and 
commitment given, globally, by public health to the prospect of another 
naturally occurring large-scale disease outbreak. 


  b.. The level of cooperation by various national governments with the World 
Health Organization is tremendously improved today, compared to the denial and 
dismissive attitudes that allowed SARS to sneak up on them in 2003. Our 
attitude today is: This one's not going to sneak up on us.


  c.. WHO and the CDC, along with state and local public health agencies and 
hospitals and clinics around the world, are on the lookout for the first signs 
of a pandemic emerging so steps can be taken to contain it. 


  d.. Even as we've been preparing for acts of bioterrorism - smallpox, anthrax 
or some other deliberately released agent - we've committed to be just as 
prepared for a naturally occurring pandemic outbreak.


  e.. We know we won't have unlimited hospital beds and medical equipment. We 
also may not have an effective vaccine or an effective anti-viral drug at our 
disposal immediately or in the quantities we'd like. So our focus will be on 
containing the disease - on slowing and stopping its spread.


  f.. A newly announced "State Response to Avian and Pandemic Flu" outlines 
current statewide plans to respond to 1) an H5N1 influenza outbreak in local 
birds, 2) to a limited number of H5N1 infections in humans in the state and 3) 
to a widespread, rapidly transmitted pandemic flu outbreak in humans in the 
state.


  g.. Local Public Health and Emergency Management departments, including 
Hennepin's, continue to work closely with their state counterparts to flesh out 
the details of, and respective roles within, this "State Response" plan.


  h.. We've spent the last three years giving focused attention to this issue. 
That attention continues. With every passing month, we're more and more 
prepared. 
 



PANDEMIC PREPAREDNESS IN PERSPECTIVE 

 

  a.. Right now, it's no more dangerous to be in Bangkok than in Minneapolis, 
unless you're a bird. (Message: It's a bird flu. Wherever you go, don't get too 
cozy with birds.)


  a.. If and when H5N1 becomes a human pandemic, you'll want to avoid where it 
is and stay where it isn't. If it "makes the jump" in Bangkok, you'll want to 
get out of Bangkok before the airport is closed. (Message #1: It's still safe 
to go to S.E. Asia but be prepared to leave quickly.  Message #2: Get ready to 
hear a lot about social distancing.)  


  b.. Having a household emergency stockpile of food and water is a good idea 
in a general sense -- useful if there's a sustained power outage or a 100-year 
blizzard, not just if there's a pandemic outbreak and social distancing orders 
are imposed. In fact, as with a hurricane, with a pandemic emergency we'll 
likely have a brief prep period when we can run to the store for stuff before 
we hunker down at home.  People also should make sure they keep adequate 
supplies of maintenance medicines on hand (insulin, heart meds, etc.) (Message: 
Personal preparedness - giving careful and individualized thought to what will 
be needed to stay healthy - is just as important as public health preparedness.)


  c.. 90-plus percentage of us will survive the pandemic, even the worst-case 
scenario. The more people who follow public health advisories and take personal 
responsibility for staying healthy and safe, the higher the survival rate will 
be. (Message: Stay informed. Be ready. Stay healthy.)