pandemic influenza




Influenza
Guidance





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SUMMARY

Outbreaks of the new pandemic influenza A(H1N1) virus are accelerating in the Southern Hemisphere and tropics as the peaks of their flu seasons approach. Chile, Argentina, Australia and New Zealand are already reporting significant outbreaks, and the novel influenza virus is now responsible for the majority of influenza illnesses in those countries. This strain will likely predominate throughout the Southern hemisphere's flu season, and highlights the need for a new H1N1 influenza vaccine.

pandemic H1N1 2009

Scientists are also concerned that Pandemic (H1N1) 2009 outbreaks could worsen in the Northern Hemisphere beginning in the fall, but genetic studies of the virus have shown no indication that it is evolving to a more lethal form.

Early data from Mexico and the U.S. indicates that the H1N1 swine influenza strain is transmitted efficiently from person-to-person. Public health officials say that the incubation period (time from exposure to onset of symptoms) might be up to eight days, but is most commonly two to three days. U.S. officials say the percentage of patients requiring hospitalization appears to be higher than would be expected during a typical influenza season. Groups at high risk of severe disease include asthmatics, pregnant women and people with chronic diseases. Persons younger than 60 years appear to be at greatest risk for infection and serious illness. This pattern is typical of pandemic influenza.

FREQUENTLY ASKED QUESTIONS

What is pandemic influenza?

Pandemic influenza is a new, or novel, influenza virus. Since this is a new strain of influenza, people will likely have little or no natural immunity to protect against the virus. The current pandemic flu virus is known in medical nomenclature as influenza A(H1N1) 2009, but is most easily recognized as “swine flu”.

What are the symptoms of pandemic influenza infection?

Symptoms of pandemic flu are similar to those of seasonal influenza: sudden onset of fever, cough, sore throat, headache, malaise and a runny nose. Unlike seasonal influenza, pandemic influenza sometimes causes nausea, vomiting and diarrhea. The vast majority of people who contract pandemic influenza recover completely within a week without the aid of medications. A small percentage of people - five percent or less - develop pneumonia and severe disease.

How is pandemic influenza transmitted from person to person?

Pandemic influenza is transmitted through coughing, sneezing and direct contact with surfaces contaminated with infectious secretions. Touching something with flu viruses on it and then touching the mouth or nose could cause infection. People within six feet of a person sick with pandemic influenza are at risk of infection through infectious droplets caused by coughs and sneezes. People can develop symptoms from 1-7 days after exposure to the virus. Many people worry about the risk of contracting influenza in airplane cabins - a crowded and closed setting. The people in rows nearest the infected person are at greatest risk. Beyond six feet, the risk goes down considerably. Nevertheless, if the ill person moves about the cabin or uses the restroom, he/she could spread illness further and contaminate surfaces with his/her hands. In general, however, the risk of contracting influenza during air travel is no greater than the risk in any other relatively crowded setting.

Who is at risk for severe disease?

People at greatest risk for severe illness include people with underlying conditions that include asthma, diabetes, immune disorders, obesity, pregnancy, cardiovascular disease and other chronic diseases. These conditions make it harder for the body to fight off a pandemic flu infection, allowing the virus to replicate more and cause more serious disease. This virus, as with previous pandemic flu viruses, seems to cause severe disease and death mostly in young and middle age people. This differs from seasonal influenza, which normally causes severe disease in those over 65 and younger than 5 years. Among the first few hundred people hospitalized in the US with pandemic influenza, the median age was 19 years; the median age of deaths is 37 years.

While illness caused by pandemic flu resembles seasonal flu in most cases, the new form can sometimes lead to hospitalization or death in otherwise healthy young and middle-age people. The reason for this is not clear, but it is typical of pandemics and may be related to young people's strong immune response to the virus that causes excessive inflammation and damage to the lungs.

How can I protect myself from getting pandemic flu?

This advice may sound simplistic, but it can’t be emphasized enough: After visiting public places, wash your hands thoroughly with soap and warm water, or use hand sanitizer. This is particularly difficult for students, but avoid crowds - or crowded public transportation – if at all possible.

What should I do if I get sick?

As noted, this flu is different from typical seasonal influenza, so habits must change as well. If you become ill with the typical symptoms of influenza, stay home so you do not infect others. If you have a condition, for example asthma, that puts you in a high-risk group for severe disease, promptly seek medical advice. Treatment with antivirals can reduce the severity of disease and prevent complications and deaths. Anyone who develops signs of severe disease, such as shortness of breath and difficulty breathing should seek prompt medical attention.

What should I consider before traveling during a pandemic?

The most important consideration is your health. Do you have a condition that puts you at high risk for severe disease associated with pandemic influenza? If so, you need not cancel your trip, but consult with your doctor before travel, and be sure adequate medical treatment would be available at your destination.

There are important questions to consider for all travelers:
• How good is the healthcare system at your destination?
• Are basic pharmaceuticals and antivirals available?
• Who would you call in case of emergency?
• Will I be quarantined?

Remember, if you fall ill with pandemic influenza, you will likely have to remain in that country until you recover. Some countries isolate sick people in hospitals or other facilities without access to visitors or personal physicians. In addition, as pandemic influenza spreads globally, the chance of becoming ill away from home will increase.

Travelers, especially those with short itineraries, might also consider the destination country's policies regarding quarantining and isolation, as these can cause significant disruptions to travel. (The term quarantine refers to healthy persons, while isolation refers to sick individuals.)

As pandemic influenza has spread across the world, countries have responded in varying ways. Numerous countries have active surveillance at entry points to look for people who might be infected with the new flu. Be prepared to fill out health questionnaires and have your temperature taken. Some countries, especially those in Asia that were hit hard by SARS, quarantine close contacts of people who have fever or are suspected to be ill with pandemic influenza. Travelers should be prepared to be quarantined if they are unlucky enough to sit near or travel with someone who has symptoms of the flu or develops fever. All travelers should adhere to quarantine procedures, which may vary slightly from country to country. Failure to do so can result in fines or imprisonment.

Source :
IJET Threat Assessment – University of California: Pandemic Influenza Guidance
July 2009.
iJET® Intelligent Risk Systems (www.ijet.com) is a leading provider of global intelligence and business resiliency services, helping multinational corporations and government organizations monitor, protect against and respond to global threats. Integrating world-class open source intelligence with patented technology, iJET’s award-winning Worldcue® solutions help clients monitor and assess global threats relative to their key people, facilities and supply chain assets; automatically track and communicate with travelers and expatriates; and deploy emergency response services throughout the world at a moment's notice. Providing a unified view of threats to assets, iJET enables clients to mitigate risks, reduce corporate liability and prepare for and respond to crises.

SWINE INFLUENZA
What is swine influenza?
Influenza Defined
Influenza Viruses - Types, Subtypes, and Strains
What is pandemic influenza A(H1N1) 2009 virus?
Definitions for identification of pandemic influenza A(H1N1) 2009
Case Management & Infection Control
Who should be tested?
Step-by-step guide for specimen collection, storage and transportation
Doctors/Nurses directions to Patients/Parents
How Influenza Viruses Change: Drift and Shift
The 2009 Influenza Pandemic
International Health Regulations
Vaccine Development and Use
Naming the Virus Strain
Information for Families and Visitors
New Pandemic Influenza A (H1N1) 2009
Pandemic (H1N1) 2009 Influenza Guidance
Recent Results from Studies with the new 2009 A/H1N1 Influenza A Virus
Continued pandemic influenza virus detections across Europe with increased activity in the UK (Northern Ireland)
Highly Pathogenic Avian Influenza Virus H5N1 and Wild Birds