Pandemic Information
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A pandemic is a global disease outbreak. A flu pandemic occurs when a new influenza virus emerges for which people have little or no immunity, and for which there is no vaccine. The disease spreads easily person–to–person, causes serious illness, and can sweep across the country and around the world in very short time. The federal government and all states and territories are required to have pandemic–flu plans in place that go into effect in the event a pandemic flu strikes. These plans are to ensure that government services continue and to help manage public communications and guidance.
Current
INFLUENZA – H1N1 Flu – The World Health Organization (WHO) predicts that the H1N1 virus will infect 2 billion people over the next two years.
California
CalPanFlu.org is California’s H1N1 Vaccine Website: The 2009 Influenza A (H1N1) flu vaccine is being made available in California through the California Department of Public Health in partnership with local health departments. Healthcare providers and organizations interested in providing this vaccine can use this site to pre–register to receive vaccine, place their initial vaccine request, and report doses used. The 2009 Influenza A (H1N1) flu vaccine cannot be ordered through private organizations.
- California Department of Food and Agriculture: Swine Health (CDFA)
- California Department of Public Health (CDPH) Hotline: (888) 865–0564
- H1N1 Influenza 2009 (CalEMA)
Federal
- Centers for Disease Control and Prevention (CDC)
- H1N1 Influenza Virus (NIOSH) Provides occupational health technical guidance for workers for whom job–related questions about exposure or infection may be an occupational concern.
- H1N1 Virus Biosafety Guidelines for Laboratory Workers who may be processing or performing diagnostic testing on clinical specimens from patients with suspected H1N1 virus infection, or performing viral isolation.
- National Emergency Declaration on H1N1 10.24.09 This declaration gives authority for the Department of Health and Human Services (HHS) to waive certain regulatory requirements for healthcare facilities in response the ongoing pandemic. Specifically, healthcare facilities will be able to submit waivers to establish alternate care sites, and modified patient triage protocols, patient transfer procedures and other actions that occur when they fully implement disaster operations plans. Official H1N1 Declaration 10.24.09 (White House)
- PandemicFlu.gov
- United States Department of Agriculture (USDA)
International:
Influenza A H1N1 (World Health Organization – WHO)
One Health Initiative A movement to forge co–equal, all inclusive collaborations between physicians, veterinarians, and other scientific–health related disciplines. It has been endorsed by various major medical organizations and health agencies, including the AVMA, the AMA, the American Society of Tropical Medicine and Hygiene, the American Society for Microbiology, and the CDC.
Guides
Pandemic Influenza Agriculture Planning Toolkit 3.2008 (Fla) .pdf Every level of agricultural production, from the materials supplied to farms to the commodities sold at retail, should be considered when developing a comprehensive plan to deliver food to the tables of consumers. This document is meant to be a template or outline for small businesses to incorporate their own business practices so they can participate and assist in a comprehensive preparedness plan.
A worldwide influenza pandemic could have a major effect on the global economy, including travel, trade, tourism, food, consumption and eventually, investment and financial markets. Planning for pandemic influenza by business and industry is essential to minimize a pandemic's impact. Companies that provide critical infrastructure services, such as power and telecommunications, also have a special responsibility to plan for continued operation in a crisis and should plan accordingly. As with any catastrophe, having a contingency plan is essential. Information about planning and preparation is available at Workplace Planning.
Avian Influenza: Highly pathogenic H5N1 avian influenza (HPAI H5N1) is primarily a bird disease particular to domestic poultry, although it can infect most other domestic and wild birds. It is only one of several types of influenza viruses that infect birds. There is no evidence of HPAI H5N1 in North America. However, it could eventually arrive via migratory wild birds, illegal importation of infected poultry, from captive exotic birds, from infected travelers, or from their contaminated belongings entering California on direct flights from regions where the HPAI H5N1 virus is prevalent.
H5N1 – Health professionals are concerned that the continued spread of a highly pathogenic avian H5N1 virus across eastern Asia and other countries represents a significant threat to human health. The H5N1 virus has raised concerns about a potential human pandemic because:
- It is especially virulent
- It is being spread by migratory birds
- It can be transmitted from birds to mammals and in some limited circumstances to humans, and
- Like other influenza viruses, it continues to evolve.
- Scenario–Based State Agency Review: Public Health Considerations for Detection of Avian Influenza in Birds (HPAI H5N1) 3.2007 (CDFA) – Describes multi–agency planning considerations – and current thinking on human health consequences – should H5N1 be detected in any bird species in California. This should serve as a reference for local governments should California experience an avian influenza outbreak. guidance (PDF)
California State & Local Pandemic Planning & Response Activities contains:
- State pandemic planning information
- State Agriculture, Health & Wildlife contact information
- Federal funding assistance for states
- Links to state pandemic Web site information
- Federal/state summit information and Memoranda of Understanding (MOUs)
- 1918 flu historical information
Integrating Veterinarians and Other Animal Health Professional in Public Health Emergency Preparedness Planning (2007) Presentation outlining regional collaboration, interdisciplinary communication, joint training, and development of 'pushpacks' related to pet health/care issues during emergencies.
Avian Influenza:
- Interim Avian Influenza (AI) Response Plan DRAFT 3.2006 (USDA) Avian influenza (AI) is a viral infection of birds caused by a group of viruses known as type A influenza. AI viruses are classified as either highly pathogenic AI (HPAI) or low pathogenic AI (LPAI), based on the genetic features of the virus and the severity of disease in poultry. While most AI viruses are LPAI and usually result in mild or asymptomatic infections, HPAI viruses are associated with very high morbidity and mortality rates in poultry, up to 90 to 100 percent. Of primary concern is H5N1, a type of AI virus that has mutated into dozens of highly pathogenic varieties and has infected humans. This particularly virulent strain of AI emerged in Asia in late 2003. In addition to poultry, mortality from H5N1 has been reported in nearly 60 wild bird species worldwide. While there are no reported cases of humans becoming infected from migratory birds, humans have been infected through contact with domestic poultry or poultry products. To date H5N1 has not been detected in North America.
Centers for Disease Control (CDC) Interim Pre–pandemic Planning Guidance
FDA Pandemic Influenza Preparedness Strategic Plan (FDA)
HHS Draft National Pandemic Influenza Preparedness & Response Plan 8.2004 (HHS)
Interim Guidance on Cleaning Transit Vehicles & Facilities during a Pandemic 3.23.09 Guidance for cleaning aircraft, passenger railway cars, international points of entry, and EMS (emergency medical services) transport vehicles.
National Strategy for Pandemic Influenza: Implementation Plan (DHS) PDF format, 4.11MB, Homeland Security Council, May 2006.
Pandemic Influenza Best Practices & Model Protocols 4.2007 (DHS) Describes practices on pandemic influenza prevention and containment for all service agencies, including fire, police, EMS, public works, 911 call centers, and emergency management.
Pandemic Influenza Preparedness, Response, and Recovery Guide for Critical Infrastructure and Key Resources 9.19.06 (DHS)(PDF) Guide provides contingency planning process for a pandemic. Also provides business planners with sector–specific and common pandemic information planning variables keyed to escalating disaster phases.
Pandemic Preparedness for Veterinarians (AVMA)
Preparing for A Pandemic Influenza: A Primer for Governors & Senior State Officials (NGA) Included are discussions of how officials must control the outbreak despite a lack of fully functioning infrastructure in the “food, energy, and health care” industries, and the importance of the testing of pandemic flu emergency plans on both the state and federal levels.
North American Plan for Avian and Pandemic Influenza 8.2007 (pdf) Outlines how Canada, Mexico and the United States intend to work together to combat an outbreak of avian influenza or an influenza pandemic in North America. The Plan complements national emergency management plans and builds upon the core principles of the international Partnership on Avian and Pandemic influenza, the standards and guidelines of the World Organization for Animal Health (OIE), the World Health Organization (WHO)–including the revised International Health Regulations, as well as the rules and provisions of the World Trade Organization (WTO) and the North American Free Trade Agreement.
Responding to the Avian Influenza Pandemic Threat: Recommended Strategic Actions 8.2005 (WHO) This document sets out activities that can be undertaken by individual countries, the international community, and WHO to prepare the world for the next influenza pandemic and mitigate its impact once international spread has begun. Recommended activities are specific to the threat posed by the continuing spread of the H5N1 virus. Addressed to policy–makers, the document also describes issues that can guide policy choices in a situation characterized by both urgency and uncertainty. Recommendations are phase–wise in their approach, with levels–of–alert, and corresponding activities, changing according to epidemiological indicators of increased threat. In view of the immediacy of the threat, WHO recommends that all countries undertake urgent action to prepare for a pandemic. Advice on doing so is contained in the recently revised WHO global influenza preparedness plan and a new WHO checklist for influenza pandemic preparedness planning. To further assist in preparedness planning, WHO is developing a model country plan that will give many developing countries a head start in assessing their status regarding preparedness, and identification of priority–needs. Support for rehearsing these plans during simulation exercises will also be provided. As the present situation continues to evolve towards a pandemic; countries, the international community, and WHO have several phase–wise opportunities to intervene, moving from a pre–pandemic situation, through emergence of a pandemic virus, to declaration of a pandemic and its subsequent spread.
WHO Clinical Guidelines: H5N1 (2006)
Training
CDC:
Emergency Use Authorization Online Course (CDC & FDA) Provides public health officials, emergency managers, or Strategic National Stockpile coordinators with an introduction to the Emergency Use Authorization of medical products
Public Health Emergency Law & Forensic Epidemiology: Course v3 CDC – Forensic Epidemiology is designed to help public health and law enforcement agencies strengthen coordination of responses to pandemic influenza and similar threats. Materials include a new CDC–developed case study on pandemic influenza.
- Materials include a new CDC–developed case study on pandemic influenza Materials include three lecture units with PowerPoint slides, an interactive case study, and a Course Manager's Guide. Notes for instructors and other supplemental information.
- Order a free CD–ROM – https://www.securemcking.com/FE–PHEL_CD_Request/ CD–ROM elf–contained training packages developed by for use by instructors in any jurisdiction in the U.S. who provide public health preparedness training to front–line practitioners.
- More information, e–mail: FE–PHEL@mcking.com
- Pandemic Preparedness: for Businesses course (EDEN) Designed for Land Grant University specialists, Cooperative Extension Service educators and/or volunteers located in counties around the United States. Intended for people interested in helping small– & medium–sized businesses survive a potential pandemic. Classroom materials are available free, on–line. Designed for Land Grant University specialists, Cooperative Extension Service educators, and volunteers located in counties around the U.S. Intended to help small– and medium–sized businesses survive a potential pandemic.
- Pandemic Preparedness: Faith–Based Organizations & NGOs course (EDEN) Enables congregations, synagogues, mosques, et al(1) protect the health of their staff and the communities in which they serve, and (2) fulfill their mission during an influenza pandemic.
- Ready Business: Resources to Prepare a Disaster Plan course (EDEN)
FEMA: FEMA EMI Independent Study Courses The Federal Emergency Management Agency’s (FEMA) Emergency Management Institute (EMI) offers self–paced courses designed for the general public and for people who are interested in or have emergency management responsibilities. There are many more available. Most are offered on–line, free–of–charge:
- CDP 01-006 Pandemic Influenza Planning & Preparedness (PIPP) (CDP) on–campus
- E–430 EMAC Train–the–Trainer (FEMA) on–campus
- IS–10 Animals in Disaster, Module A: Awareness and Preparedness
- IS–11 Animals in Disaster, Module B: Community Planning
- IS–26 Guide to Points of Distribution
- IS–100.a Introduction to Incident Command System
- IS–200.a ICS for Single Resources and Initial Action Incidents
- IS–111 Livestock in Disasters
- IS–197 Special Needs Planning Considerations for Emergency Management
- IS 546 Continuity of Operations (COOP) Awareness Course
- IS 547 Introduction to Continuity of Operations (COOP)
- IS–548 Continuity of Operations (COOP) Program Manager
- IS–700.a National Incident Management System (NIMS) An Introduction
- IS–806 Emergency Support Function (ESF) #6 – Mass Care, Emergency Assistance, Housing, and Human Services
- IS–821, Critical Infrastructure & Key Resources Support Annex – focuses on the integration of CIKR protection as a key element of the nation’s unified approach to domestic incident management
- IS–860.a National Infrastructure Protection Plan (NIPP) – provides an introduction to the National Infrastructure Protection Plan.
Continuity for Business 43% of all businesses that close after a disaster fail to reopen. Information on contingency planning, outside sources for storing of vital information and documents, and meeting employee needs.
Public Health Courses:
- Impact of Pandemic Influenza on Public Health course (Johns Hopkins Ctr for Public Health Preparedness) This on–line training course examines the path of the avian influenza and examines how it could impact world health. This course has 6 modules and takes approximately 2 hours to complete. No prior knowledge of the subject is required or assumed. Upon successful completion of the course a certificate is issued.
- Preparedness & Community Response to Pandemics course (U Albany Ctr. for Public Health Preparedness) This on–line course is intended for public health workers. After taking this course, public health professionals will be able to describe the public health role in emergency response during a pandemic. Information provided is very detailed. A Pandemic Influenza Tabletop Exercise Package is included. This course has 6 modules and takes approximately 8 hours to complete. No prior knowledge of the subject is required or assumed. Upon successful completion of the course a certificate can be issued.
RKB (Responder Knowledge Base):
Continuity for Business 43% of all businesses that close after a disaster fail to reopen! Will your business survive? Have you thought about a contingency plan? An outside source for storing of vital information and documents? Have you met the needs of your employees?
Tools:
CDC – New (7.2009) preparedness and response tools that can be downloaded and installed for free
- Framework for Improving Cross–Sector Coordination for Emergency Preparedness & Response: Action Steps 7.2008 (CDC/DOJ) Action steps for achieving inter–disciplinary participation with Public Health, Law Enforcement, the Judiciary, Corrections, et al
- Med/Con: Pre–Event Tool to Estimate Population at Risk of Medical Consequences in a Disaster (CDC) Intended users are public health preparedness planners at local, state, and federal levels involved in addressing the large scale medical care requirements resulting from man–made and natural disasters.
- VacStockpile: Tool to Estimate Potential Impacts for Stockpiling Vaccines for Vaccine Preventable Diseases (CDC) Although designed for use in the U.S., it can be applied to other situations or locations where vaccine stockpiles are being maintained or considered.
Continuity Assistance Tool (CAT): Continuity Assistance for Non–Federal Entities 7.2009 (FEMA) .pdf Provides guidance and assistance for States, Territories, Tribal and Local Government Jurisdictions, and Private Sector Organizations (“organizations”) to identify continuity program strengths and areas for improvement.
Crisis Emergency Risk Communications (CERC) – Effective communication during a crisis or emergency is just as critical to emergency response operations as the actual physical response. During an emergency situation, response operations and community relations can sometimes clash because of poor communication. A poorly managed crisis can damage an organization’s credibility and potentially expose that organization to costly litigation. Effectively communicating response actions, possible health effects, and controlling rumors can enhance emergency operations and create a quicker recovery.
- Crisis and Emergency Risk Communication Tool Kit [Calif Dept of Public Health (CDPH)] The California Tool Kit is a complimentary resource that should be used in conjunction with an agency’s or organization’s own emergency response plan.
- Crisis and Emergency Risk Communication: Pandemic Influenza (186 pages) Provides vital communication tools and concepts for preparing and responding to a pandemic influenza event in the United States
- Quick Guides (185K, 1 page) The Pandemic Flu CERC “Quick Guide” is a condensed version of the “CERC Pandemic Flu Course Book”. The guide is a handy reference that contains the most pertinent information from the larger course book. The booklet has 36 pages
- Request materials at mailto:CERCrequest@cdc.gov
National HPAI Early Detection Data System: National Avian Influenza Surveillance Information [website] Alternate Title: National Highly Pathogenic Avian Influenza Early Detection Data System: National Avian Influenza Surveillance Information [website] This website details the latest national avian influenza surveillance information. It contains detailed H5N1 results tables and samples tested by each State. You can also view earlier surveillance data, news on national HPAI surveillance, and related news from the USGS National Wildlife Health Center.
Simulation Games:
Coral Cross When the H1N1 'swine flu' outbreak occurred in late April 2009, it was funded by the US Centers for Disease Control and Prevention (CDC), and designed to support real–life needs against a backdrop of current events.
Flu Pandemic Game: A business continuity training resource (6.23.09) For 3 to 12 players (teams may be formed if there are more participants), in a choice of two electronic versions – medical, and other
The Great Flu Practice your emergency disease management skills and abilities to control a pandemic virus using tools such as research, antivirals, vaccination, movement control, PPE, quarantines, & public outreach, while keeping within an allotted budget. Monitor progress on a score board that shows # of cases, # of deaths, countries effected, and money spent. Select virus agent and its degree of virulence from mild to deadly. Free
Resources
Integrating Veterinarians and Other Animal Health Professional in Public Health Emergency Preparedness Planning (2007) Presentation outlining regional collaboration, interdisciplinary communication, joint training, and development of 'push packs' related to pet health/care issues during emergencies.
National Veterinary Stockpile (NVS, USDA–APHIS) – The National Veterinary Stockpile (NVS) is the nation’s repository of supplies, vaccines, equipment, and other critical veterinary resources. Established by Homeland Security Presidential Directive 9, and operational in 2006, it enables deployment of large quantities of veterinary resources anywhere in the continental U.S. It also contains PPE for food, animal, and agriculture responders.
One Health Initiative A movement to forge co–equal, all inclusive collaborations between physicians, veterinarians, and other scientific–health related disciplines. It has been endorsed by various major medical organizations and health agencies, including the AVMA, the AMA, the American Society of Tropical Medicine and Hygiene, the American Society for Microbiology, and the CDC.
Pandemic & All–Hazards Preparedness Act (S.3678) 2006 A bill amending the Public Health Service Act with respect to public health security and all–hazards preparedness and response. Authorizes more than $1 billion a year in federal funding for HHS grants for public health and medical preparedness and requires states by 2009 to provide a 5% match of federal funding and a 10% match beginning in 2010.
Public Sector Preparedness & Business Continuity Standards 10.23.09 (Continuity Central) .html The US Department of Homeland Security recently announced its intention to propose three business continuity standards for adoption as part of its Public Sector Preparedness (PS–Prep) program. The three standards address similar aspects of the same issue: keeping businesses operational and resilient:
- US standard NFPA 1600 – when introduced had an emergency management focus but subsequently added a business continuity and disaster recovery component.
- British Standard BS 25999, Parts 1 and 2 – was designed exclusively for business continuity – not disaster recovery – and features a ‘management system’ approach to coordinating all elements of a business continuity program. This approach is consistent with many global standards, particularly those from the International Organization for Standardization (ISO), but rarely seen in US standards.
- ASIS document (SPC.1–2009) – created a business continuity guideline in 2005, parts of which can be found in the existing ASIS document (SPC.1–2009). The ASIS document also endorses the Plan–Do–Check Act (PDCA) model which is found in many ISO standards, as well as BS 25999, so in that regard it differs from most existing US standards.
Articles
Agricultural Economic Impacts:
- FAS (Foreign Agricultural Service) Overseas Attache Reports (U.S. Department of Agriculture) Provides information on the impact of avian influenza on overseas trade.
- Impact Worksheets on Animal Health Events (USDA Animal & Plant Health Inspection Service) Find out how an effected country's production and trade in the livestock and livestock products is likely to be effected by the disease.
How can we prepare? Is there an effective vaccine?
What impact would a pandemic influenza outbreak have in the United States?
What is the connection between pandemic influenza & avian or bird flu?
Brochures & Factsheets
How Does Seasonal Flu Differ From Pandemic Flu? (Flu.gov)
Fact Sheet – 2009–H1N1, Pandemic Influenza, and H5N1 (Dept. of State)
National Veterinary Stockpile (NVS) Brochures & Fact Sheets:
Websites
Centers for Disease Control (CDC)
Framework for Improving Cross–Sector Coordination for Emergency Preparedness & Response: Action Steps 7.2008 (CDC/DOG) Guide to achieving interdisciplinary participation.
PandemicFlu.gov Official U.S. Government Site for Information on Pandemic & Avian Influenza
Pandemic Influenza Planning – Department of Transportation (DOT)
Last update: 10.27.09