Flu pandemic: Prepare for the possibility

General Article

Emergency Management Council members develop the Center's strategic action plan in the event of pandemic influenza

By now, most people have heard about a possible flu pandemic. In the last century, there have been three flu pandemics of varying severity. No one knows for certain when another influenza pandemic might hit, but health experts are concerned that the current outbreak of avian influenza (AI) — or bird flu — in Asia and parts of Europe will give rise to the next pandemic.

Considering that most people would not have immunity to a new pandemic virus, and that the seasonal flu virus strikes 5 percent to 20 percent of the population each season, experts suggest planning for flu infecting 20 percent to 40 percent of the population.

How would the Hutchinson Center operate if such a large percentage of its staff were out sick or caring for other family members? Resources may be difficult to obtain and utilities may be interrupted since all businesses will be affected. How will we continue to conduct research? What critical services and supplies at the Center will be needed? Do we need to cross-train to cover some services?

These are some of the questions that members of the Center's Emergency Management Council (EMC) seek to answer. The group includes division administrators, incident commanders, section chiefs, infectious-disease experts and others. Their efforts will enhance the Center's overall Comprehensive Emergency Management Plan and help develop a useful strategy for responding to a pandemic.

Supervisors should discuss these issues with their staff and begin to develop departmental plans for the following two scenarios:

1) Center is open but with high absenteeism (20 percent to 40 percent) for an extended period of about four to six weeks with potentially more than one period or wave of high absenteeism.
Direct your staff to stay home when sick, and develop plans for telecommuting when necessary. How will your department function with a reduction in staff (also, potentially a reduction in requests since others will be out, too)? Is your department prepared to continue in your absence (you may be sick, too)? Take time at a staff meeting to review the prevention measures in this article and discuss how high absenteeism will affect your department and options for working under these conditions.

2) Center is closed and only essential staff will be allowed on campus.
If the Center closes due to a severe pandemic, most departments will not have essential staff. Departments that have been identified as having essential staff under these conditions include the following: Shared Resources (to maintain animal-health resources), Facilities Engineering (to maintain buildings), Security, Purchasing, Human Resources and Finance. Researchers should limit their need to come in for those scientific activities that are considered absolutely critical and would require extensive time and resources to replace or repeat if left unattended. Much of the research here may need to be delayed for a period of time and restarted when conditions allow. Division administrators, vice presidents and section chiefs will determine essential staff. Be sure your staff understand whether they are essential or not under these conditions.

Remind staff of the Center's emergency hotline number, (888) 667-2020. This number in addition to the Web site http://status.fhcrc.org will be used to communicate the status of the Center to staff.

Travel information

According to the World Health Organization, as of Feb. 27, 2006, there were 174 confirmed human cases of AI and 94 deaths in the following countries: Cambodia, China, Indonesia, Thailand, Iraq, Vietnam and Turkey, with the most recent outbreaks occurring in China, Indonesia, Turkey and Iraq. Many more countries have been affected by outbreaks of bird flu in wild and domestic birds, and the virus continues to spread to new countries. In February alone, 13 additional countries, including Nigeria, Austria, Germany, Egypt and France detected the H5N1 virus in either wild and/or domestic birds for the first time.

If you are traveling to any of these countries, be sure to check the U.S. Centers for Disease Control and Prevention (CDC) travel notices (see the sidebar for the link). These notices change frequently and have been updated nine times since initially released Sept. 23, 2005.

As of Feb. 17, 2006, the CDC does not recommend avoiding travel to any of these countries. However, if visiting, there are measures that you can take to reduce your risk such as:

• Avoid all direct contact with poultry, including those that appear healthy.
• Clean your hands with soap and water frequently.
• Influenza viruses are destroyed by heat, so be sure all poultry, eggs and poultry blood products are thoroughly cooked.
• If you become sick with flu symptoms or other illness requiring medical attention, contact the U.S. consulate to help you locate appropriate medical services and inform your family and friends.
• Upon your return home, monitor your health for 10 days and if you develop a fever and other flu symptoms during this period, consult a health-care provider.

Prevention measures

Seasonal flu is a viral respiratory illness, believed to be transmitted by large respiratory droplets. This means that the virus rarely spreads beyond three feet of an infected person.

Influenza typically does not remain viable on environmental surfaces for more than 48 hours. People are typically contagious from one day before the onset of symptoms up to five days after (and maybe longer in children or persons with damaged immune systems). It can cause mild to severe illness, and at times can lead to death. Every year in the United States, on average 5 percent to 20 percent of the population contracts the flu, more than 200,000 people are hospitalized from flu complications, and about 36,000 people die from the flu. Deaths occur mostly in children, the elderly and those with compromised immune systems. Pandemic flu has similar but more severe symptoms and can affect any segment of the population.

In addition to vaccination, the following simple actions can help decrease the spread of respiratory illnesses like the flu. These same simple steps apply to pandemic outbreak of influenza, as well, and should be practiced by both those who are sick and those trying to stay well:

• Do not come to work if you are sick.
  When you are sick or have flu symptoms, stay home, get plenty of rest, and check with a health-care provider as needed. Symptoms include fever, coughing, sneezing, aches and pains, headache and severe fatigue.



• Avoid close contact with people who are sick.
  When you are sick, keep your distance from others to protect them from getting sick, too.



• Cover your mouth and nose.
  Cover your mouth and nose with a tissue or your shirt sleeve when coughing or sneezing. It may prevent those around you from getting sick.



• Clean your hands often.
  Washing your hands often will help protect you from germs. Wash with warm soap and water long enough to sing the "Happy Birthday" song twice. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. Rub hands until sanitizer has dried. Wash your hands before eating or after touching your eyes, nose or mouth. If caring for someone who is sick, wash after assisting the person in any way.



• Don't share those items that can easily transmit illness.
  This includes towels, toothbrushes, food, drinks, utensils and makeup, including lip balm.



• Discard used tissues in the trash as soon as possible.
  Placing used tissues on a counter will help spread the virus.



• Avoid touching your eyes, nose or mouth.
  Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose or mouth.



• Eat healthy, drink plenty of fluids, and get enough rest and exercise.
  Practicing healthy habits keeps your immune system strong so that your body can fight off illnesses.



• Practice social-distancing strategies in the event of a pandemic.
  These include avoiding crowded places and public transportation, keeping a distance of three feet between people when meeting, and, if possible, using the phone or e-mail instead of meeting in person. Avoid contact with those who are known to be ill.



• Stock up on food and water.
  The most common recommendation is to keep a four-to six-week supply of nonperishable food and water, as well as prescription medicines and toiletries. Keeping cash on hand for supplies is also suggested.

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To learn more about pandemic flu

Visit the Environmental Health and Safety Web site or the following links for the most reliable and up-to-date information on the avian influenza and potential pandemic.

• What are the differences between seasonal influenza and pandemic influenza? See the chart at www.pandemicflu.gov/season_or_pandemic.xml.



• Centers for Disease Control www.cdc.gov/flu/pandemic/.



• Link to travel information at www.cdc.gov/travel/other/avian_influenza_se_asia_2005.xml.



• World Health Organization www.who.int/csr/disease/avian_influenza/avian_faqs/en/index.xml. WHO is the front-line organization verifying and tracking AI in birds and humans.



• United States Department of Health and Human Services www.pandemicflu.gov/. The DHHS site includes an influenza-planning guide for families.



• King County Public Health Department, www.metrokc.gov/health/. The site will have the most up-to-date local information locally and includes travel advisories.

We are midway through the flu season for the Northwest, and it is not too late to get vaccinated for the seasonal flu. Visit the EH&S Web site at https://centernet.fhcrc.org/CN/depts/ehs/occupational_health to find out when the next clinic is scheduled, or stop by J3-104 any Wednesday from 10 a.m.-noon.

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