How would state health officials respond to pandemic?


Published: Tuesday, November 1, 2005 at 6:01 a.m.
Last Modified: Monday, October 31, 2005 at 10:39 p.m.

Facts

Challenges of a pandemic

  • A pandemic will last much longer than most public health emergencies and may include "waves" of influenza activity separated by months.
  • The numbers of health care workers and first responders available to work can be expected to be reduced. They will be at high risk of illness through exposure and some may have to miss work to care for ill family members.
  • Resources in many locations could be limited, depending on the severity and spread of an influenza pandemic.
    - Centers for Disease Control and Prevention

  • Today, President Bush is expected to spell out the administration's game plan for dealing with the next flu pandemic in the United States - whether it arises from the bird flu in Asia or some other super-strain of influenza.
    A possible avian flu epidemic is being compared to the deadly 1918 Spanish flu that claimed more than 500,000 lives in the United States.
    The federal Centers for Disease Control and Prevention is advising state and local health departments that the risk of people contracting avian flu is low. But in September the Florida Department of Health updated its disaster plan to handle a widespread outbreak of flu - avian or otherwise.
    "We've had a pandemic plan for years; this isn't something that just came up with avian flu," Department of Health spokesman Doc Kokol said Monday.
    When they do occur, influenza pandemics infect 20 percent to 40 percent of the world's population in a single year; the last such pandemic was 37 years ago.
    If the world were swept with an epidemic of flu virus as deadly as the Spanish flu, the CDC estimates that about 90 million Americans would be struck by the illness and about 200,000 would die. The direct health care cost of such a pandemic would be $166 billion.
    If the CDC's estimates are on target, then Florida must be prepared to treat 3.4 to 6.8 million cases of influenza in a pandemic. According to the Department of Health's report, the state can "cautiously plan" to receive 120,000 treatment courses of Tamiflu, the prescription antiviral flu treatment, from the CDC's strategic national stockpiles.
    Florida health officials have not yet been given federal guidance on which groups would receive the flu treatment - would it be the elderly, other high-risk populations, seasonal tourists? No matter who received the treatment, it would not be enough to control the spread of the disease, the DOH working group concluded.
    Furthermore, any quantities of flu vaccine allocated to the state would not be enough to stop or quickly alter the course of a pandemic.
    So how would public health officials in Florida respond?
    The Secretary of the Department of Health has the authority to declare a quarantine to protect the public. However, isolation of flu patients in hospitals or at home is a more likely first response. People will be asked to voluntarily stay home from school or work when they become sick to cut down the risk of exposing others.
    Kokol said that EMS, physicians and emergency room personnel have been part of an outreach program to step up their surveillance of disease outbreaks, not just in the event of a flu pandemic or some other emergency event.
    "Historically, these flu pandemics come along every so often, and the next one may not be avian flu," he said. "But we can't take the chance, so we have to increase our surveillance. We want to identify the infected persons, isolate them and treat them so that it doesn't become a pandemic."
    The state health official offered some practical advice for those reading about the potential threat of avian flu.
    "If you look at the number of deaths from the Hong Kong flu pandemic, it killed 34,000 people in the United States," he said. "Our seasonal flu will kill 30,000 people this year, just as it does every year."
    He advised residents to get a flu shot now, before the flu season - which traditionally hits North Central Florida in late November - gets started.
    "It's something you can control, and you'll help yourself, your neighbors and your community," Kokol said.
    Diane Chun can be reached at (352) 374-5041 or chund@gvillesun.com
    Pandemics and the challenges they present

    20th century flu pandemics

  • In 1918-19, "Spanish flu," A (H1N1), killed more than 500,000 people in the United States. Up to 50 million people may have died worldwide. Nearly half of those who died were young, healthy adults. Influenza A (H1N1) viruses still circulate today after being introduced again into the human population in 1977.
  • The "Asian flu," A (H2N2), caused about 70,000 deaths in the United States in 1957-58. First identified in China in late February 1957, the Asian flu spread to the United States by June of that year.
  • "Hong Kong flu," A (H3N2), caused about 34,000 deaths in the United States in 1968 and 1969. Influenza A (H3N2) viruses still circulate today.
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