The
Influenza Pandemic is Coming
During the next influenza pandemic, 80,000 to 300,000 people will
die in the United States according to Centers for
Disease Control and Prevention (CDC) estimates. This
could include 1,760 to 6,600 deaths in Indiana.
Historically, influenza pandemics have occurred every
10-30 years, and it has been more than 30 years since
the last pandemic. Influenza pandemics have occurred
periodically for over 300 years. Many experts consider
influenza pandemics inevitable--yet, no one knows when
the next one will occur.
 Three
major pandemics have occurred this century. In
1918-1919, the "Spanish Flu", H1N1 strain, caused
more than 500,000 deaths in the United States (more than
all the wars in the 20th century) and more
than 20 million deaths worldwide. In 1957-1958, the
"Asian Flu" (H2N2 strain) killed 70,000 in the U.S., and
in 1968-1969, the "Hong Kong Flu" (H3N2 strain) killed
36,000.
Influenza
Viruses
Three types of influenza viruses affect people each
year. Some cause major illness and disease, while others
can be asymptomatic or cause only mild illness.
Type A infections are usually the most severe and
are often associated with epidemics and pandemics.
Type B infections are of mild to moderate severity,
but can be associated with epidemics. Type C
infections are very mild and may cause minor respiratory
illness or no symptoms. Type C infections are not
associated with epidemics. Therefore, efforts to control
the impact of influenza are aimed at types A and B
because of the severe public health threat they pose.
Influenza viruses continually undergo frequent
genetic mutations (antigenic drift). These changes
enable the virus to evade the immune system causing
people to remain susceptible to influenza virus
infection. For this reason, a new vaccine must be
developed annually to match the new circulating strains.
Every 20-30 years, type A viruses
undergo a major genetic change (antigenic shift), which
are associated with epidemics and pandemics. An
antigenic shift can lead to a pandemic if it results in
the emergence of a new virus (novel virus) to which the
overall population has no immunity.
Preparation for
the Next Pandemic
In 1993, a national working
group on influenza pandemic preparedness and emergency
response created a comprehensive conceptual "Influenza
Pandemic Preparedness Plan" that outlined critical areas
that need to be addressed to minimize the burden of a
pandemic. Draft state and local guidelines were
developed by January 1997 and 5 states (Connecticut,
Missouri, Maine, New Mexico, and New York) were selected
to pilot test the draft guidelines. In 1998, the
conceptual plan became the framework for enhancing
pandemic preparedness efforts at the national and state
level. Indiana, along with Florida, New Hampshire, New
Jersey, and Massachusetts were the second group of
states selected to develop state plans.
The key objectives for Indiana’s influenza pandemic
planning process will be to:
- Develop a state and local
plan in conjunction with our Bioterrorism plan;
- Ensure that all
relevant organizations in the public and private
sectors actively participate in the planning
process;
- Build
collaborative networks between the public health and
emergency response communities;
- Understand
relationships, responsibilities, and communication
frameworks among various organizations at the
national, state, and local levels;
- Focus on
actions that are most crucial to effective planning,
response, and mitigation at the state and local
level.
In this early phase of the planning
process, we are taking into consideration that each
jurisdiction must assume responsibility for deciding how
specific aspects of the plan are actually implemented.
Also, note that a number of actions taken by state and
local agencies will be contingent upon the development
of national policies and procedures, many of which are
presently under development.
Research to better understand the evolution of influenza
viruses, their complex epidemiology, and
vaccine/antiviral interventions are a priority in
preparing for the next pandemic. Implementation of new
strategies to enhance adult immunization against
influenza and pneumococcus will provide much of the
needed infrastructure to deliver immunoprophylaxis in
the event of a pandemic.
Information was provided by:
Stephanie Fang, RN. BSN.
ISDH Communicable Disease |
|
|
|
