Pandemic Influenza
THIS IS AN EXERCISE. THIS IS NOT A REAL EVENT.
Updated: July 2006
Frequently Asked Questions
- General Questions
- H5N1 Avian (Bird) Influenza
- Flu Vaccine
- Antiviral Medications
- Preparing for an Influenza Pandemic
- Questions About Quarantine
THIS IS AN EXERCISE: THIS IS NOT REAL
General Questions
What is a pandemic?
A pandemic is a worldwide outbreak of disease that happens when a new virus emerges and infects people, causes severe illness and death, and spreads easily from person to person.
In the last century, there have been three influenza pandemics: in 1918, 1957 and 1968. The 1918 pandemic (also called "Spanish Flu") was severe.
What’s the difference between pandemic and seasonal flu?
Influenza pandemics are caused by the emergence of a virus that is “novel” (brand new) or radically different from flu viruses that have spread in the past. Because people have little or no resistance to the new virus, and there is no vaccine ready-made to match the new virus, a pandemic results in more severe illness and more death than the common flu we are used to.
Seasonal flu outbreaks are caused by small changes in common influenza viruses. Even though these viruses may change slightly from one year to the next, many people have some immunity. Because similar flu viruses have been around in the past, vaccine can be made to match as closely as possible the flu virus that is expected for the next flu season – before the flu season starts.
When will the next pandemic occur?
No one can predict when a pandemic might start, but scientists and public health experts are watching the H5N1 bird flu situation in Asia, Australia, Europe, Canada and the United States very closely. Governments around the world are preparing for the possibility that this virus may spread more easily from person to person.
The Vermont Department of Health and other agencies around the country are aggressively monitoring human cases of avian flu. To date there have been a several confirmed cases reported in the U.S.
H5N1 Avian Influenza
Is the H5N1 bird flu a pandemic?
No. The current outbreak of H5N1 bird flu is a disease of birds that has made some people sick, but it is not a human pandemic.
Why is the H5N1 bird flu such a concern?
Although scientists cannot predict when the next pandemic will start, or what strain of flu virus will cause it, the continued spread of the H5N1 strain of avian influenza in birds across Asia, Australia into Europe is being closely watched, as well as several confirmed cases in humans in the United States and Canada.
H5N1 is a serious concern because:
- The virus is widespread in poultry overseas.
- It has spread from poultry to some people and other mammals.
- People confirmed to be infected with the H5N1 virus have become severely ill, and about half of them have died.
- The H5N1 virus, like other influenza viruses, is continuing to change.
- The H5N1 virus circulating in California is a form that spreads easily from person to person.
Is H5N1 bird flu virus the only avian influenza of concern?
Right now, the H5N1 virus is the greatest threat for pandemic. However, other strains of bird flu have also infected people in recent years and have the potential to cause to a pandemic.
Will the H5N1 bird flu virus cause the next pandemic?
Scientists cannot predict whether the H5N1 avian influenza virus will cause a pandemic. But federal, state and local health officials are working with their counterparts throughout the world to track H5N1 as it occurs in birds, and are aggressively monitoring human cases.
Vaccine
Is there a pandemic influenza vaccine?
Yes. Federal officials have contracted with a manufacturer to produce a small supply of human vaccine against the H5N1 strain of bird flu. The vaccine might not be effective if the H5N1 virus changes to a form that more easily infects humans, and H5N1 may not become pandemic influenza.
Why isn’t there a large supply of vaccine available?
Large amounts of vaccine cannot be made before knowing exactly which virus would be the cause of a pandemic. Production of new vaccine takes about six months.
Can a regular flu shot protect you from bird flu or pandemic flu?
No. Current flu vaccines will not protect against a new pandemic strain of influenza virus.
Can I get the pandemic influenza vaccine once it is developed?
Very few people would be able to get vaccinated at first. If a pandemic starts, federal, state and local governments will work with partner groups to make specific recommendations on the early use of vaccine.
Current recommendations are to use limited vaccine supplies for health care workers and people at highest risk of death. Over time, as more vaccine is produced, more people would be vaccinated.
Antiviral Medications
What are influenza antiviral medications?
These are prescription drugs that can make symptoms less severe and shorten the length of time people are sick. The drugs may also make a person less likely to spread influenza to others. To be effective, they must be taken within two days of becoming sick. Some antiviral medications may also be used to prevent influenza.
Which antiviral medications would be used if the H5N1 bird flu became a human pandemic?
At this time, Tamiflu and Relenza are the most likely antiviral medications to be used in a pandemic caused by the H5N1 virus. The effectiveness of these antivirals would vary depending on how resistant the virus is to one or more of the medications.
Are there enough antiviral medications for everyone if a pandemic happened now? If not, who will get them?
Although the government is stockpiling antiviral medications, at this time there are not enough for everyone. The federal government has made recommendations about who will be the first to get antiviral medications based on their risk, their role in fighting the pandemic, and the severity of the illness. Discussion continues about the best way to allocate these medications.
The Health Department has restricted the use of antiviral medications by Vermont hospitals and clinics, in case the antivirals are needed by someone admitted with suspected H5N1 infection.
Preparing for an Influenza Pandemic
What effect would a pandemic have on our communities?
The effects of a pandemic could be severe. Many people could be sick at the same time and be unable to go to work. Many people might have to stay at home to care for sick family members. Schools and businesses might close for a time to try to reduce the spread of disease. Basic supplies, medications and services could be limited. Large group gatherings might be canceled. These are examples of challenges that must be considered as we plan for a pandemic response.
What can I do to prepare for a possible pandemic?
Plan ahead for situations in which you might have to take care of yourself and your family without leaving home. Think about essential supplies, like food and medicine, that you and your family might need. The more you know now, the more you can help your family and community prepare. Individual and family preparedness guides and planning checklists are available to help you get started.
What can I do to keep from getting or spreading flu?
We can all learn to decrease the spread of disease by taking a few simple precautions every day, and by reinforcing these behaviors among family and friends.
- Wash your hands often and well
- Cover your mouth every time you cough or sneeze
- Teach your children to do the same
- Stay home when you are sick
- Keep sick children out of school or day care
- If you are going overseas, check information for travelers at virtual_pandemicflu.gov
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Quarantine Questions
What is “quarantine?”
“Quarantine” refers to any situation in which a person or group of persons thought to have been exposed to a dangerous communicable disease agent is kept apart from others (“quarantined”) to prevent disease spread.
What are “quarantine measures?”
People who have been exposed to a communicable disease may be asked to remain at home or another location to prevent further spread of infection. This public health measure may be compared with ‘snow days,’ when travel is temporarily restricted and inconveniences are tolerated. The concept may also be referred to as ‘shelter in place’ or quarantine.
Who can impose a quarantine?
Quarantine may be undertaken voluntarily or compelled by public health authorities.
Why are quarantine measures implemented?
Stopping an outbreak of disease sometimes requires the use of the most rapid and effective public health tools available. One of those tools is quarantine–restricting the movement of people who may have been exposed to infection to prevent them from infecting others. When most members of a population lack immunity to a contagious disease, quarantine of exposed persons may be the best initial way to prevent uncontrolled spread, especially when combined with other health strategies.
What are the duration and scope of quarantine measures?
The duration of quarantine measures may vary widely, depending on their purpose and what is known about the incubation period of the infectious agent.
What are some examples of quarantine measures?
- A few hours for assessment. Passengers on a plane believed to carry a person infected with a dangerous contagious disease might be delayed for a few hours while health authorities determine the threat. Alternatively, passengers may be asked to provide contact information and then released, while the ill person is transported for medical attention.
- Enough time to provide prophylactic treatment or other intervention. If public health authorities determine a plane passenger is sick with a dangerous contagious disease, the other passengers may be quarantined in a designated facility where they may receive prophylactic treatment and be monitored for signs of side effects or illness.
- For the duration of the incubation period. If public health officials determine that a plane passenger is infected with has a contagious disease, and the passengers sitting close to him may have had close contact with the infected passenger, these passengers might be quarantined in a designated facility where they can be monitored for signs of illness and cared for under isolation conditions if they become ill.
Who has authority to implement quarantine?
States generally have authority to invoke and enforce quarantine within their jurisdictions. This authority derives from the states’ “police power:” the inherent authority of governments to enact laws and promote regulations to safeguard the health and welfare of its citizens. Other public health actions that can be compelled by state health authorities include school immunization and tuberculosis treatment laws.
What is the federal authority?
CDC’s authority to implement quarantine measures, is derived from Section 361 of the Public Health Service Act (42 U.S.C. 264), as amended.
Have quarantine measures been implemented recently? If so, when?
Health officials in Singapore, Hong Kong, and Ontario have implemented population-based quarantine and isolation measures to limit the spread of SARS. In the United States in modern times, most quarantine measures have been imposed on a small scale, typically involving small numbers of travelers (airline or cruise ship passengers) who have curable diseases such as infectious tuberculosis or cholera. In fact, no instances of large-scale quarantine have occurred in the United States since the “Spanish Flu” pandemic of 1918–19