Pandemic Influenza Planning

Impact of Pandemic Influenza

If a new and severe strain of flu were to begin spreading across the globe, Virginia would not be spared from its impact. The severity of the next pandemic cannot be predicted, but modeling studies suggest that its effect in the United States could be severe. In the absence of any control measures (vaccination or drugs), it has been estimated that in the United States a "medium-level" pandemic could cause:

• 89,000 to 207,000 deaths
• 314,000 to 734,000 hospitalizations
• 18 to 42 million outpatient visits
• 20 to 47 million people becoming sick
• An economic impact ranging between $71.3 and $166.5 billion

In Virginia, pandemic flu impact estimates include:

• 2,700 to 6,300 deaths
• 12,000 to 28,500 hospitalizations
• 575,000 to 1.35 million outpatient visits
• 1.08 million to 2.52 million people becoming sick

Flu pandemics are different from many of the threats for which public health and the health-care system are currently planning:

• The pandemic will last much longer than most other emergency events and may include waves of flu activity separated by months (in 20th century pandemics, a second wave of flu activity occurred three to 12 months after the first wave).
• The numbers of health-care workers and first responders available to work can be expected to be reduced as they will be at high risk of illness through exposure in the community and in health care settings, and some may have to miss work to care for ill family members.
• Resources in many locations could be limited because of how widespread a flu pandemic would be.

Seasonal Flu vs. Pandemic Flu

Seasonal Flu	Pandemic Flu
Outbreaks follow predictable seasonal patterns; occurs annually, usually in winter, in temperate climates	Occurs rarely (three times in 20th century - last in 1968)
Usually some immunity built up from previous exposure	No previous exposure; little or no pre-existing immunity
Healthy adults usually not at risk for serious complications; the very young, the elderly and those with certain underlying health conditions at increased risk for serious complications	Healthy adults may be at increased risk for serious complications
Health systems can usually meet public and patient needs	Health systems may be overwhelmed
Vaccine developed based on known flu strains and available for annual flu season	Vaccine probably would not be available in the early stages of a pandemic
Adequate supplies of antivirals are usually available	Effective antivirals may be in limited supply
Average U.S. deaths approximately 36,000/yr	Number of deaths could be quite high (e.g., U.S. 1918 death toll approximately 675,000)
Symptoms: fever, cough, runny nose, muscle pain. Deaths often caused by complications, such as pneumonia.	Symptoms may be more severe and complications more frequent
Generally causes modest impact on society (e.g., some school closing, encouragement of people who are sick to stay home)	May cause major impact on society (e.g. widespread restrictions on travel, closings of schools and businesses, cancellation of large public gatherings)
Every year in the United State, on average: 5% to 20% of the population gets the flu More than 200,000 people are hospitalized from flu complications About 36,000 people die from flu.	The effects of a severe pandemic could be much more damaging than those of a regular flu season. It could lead to high levels of illness, death, social disruption, and economic loss. Everyday life could be disrupted because so many people in so many places become seriously ill at the same time. Impacts could range from school and business closings to the interruption of basic services such a public transportation and food delivery.

Prevention

Protect yourself against the spread of the flu and other germs and viruses:

• Cover your nose and mouth with a tissue when coughing or sneezing
• Wash hands thoroughly and often
• Avoid touching eyes, nose or mouth
• • Stay home when you are sick

Cold vs. Flu

Symptoms	Cold	Flu
Fever	Rare in adults and older children. Can be up to 102 F in infants and small children.	Usually 102 F. Can go up to 104 F. Usually lasts 3-4 days.
Headache	Rare	Sudden onset. Can be severe.
Muscle Aches	Mild	Usual. Often severe
Tiredness & Weakness	Mild	Often extreme. Can last 2 or more weeks.
Extreme Exaustion	Never	Sudden onset. Can be severe.
Runny Nose	Often	Sometimes
Sneezing	Often	Sometimes
Sore Throat	Often	Sometimes
Cough	Mild hacking cough	Usual. Can become severe.

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