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Summit on Avian InfluenzaSummit on Avian Influenza
Presented by: NJ Department of Health & Senior ServicesPresented by: NJ Department of Health & Senior Services
August 31, 2006August 31, 2006
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OverviewOverview
• FLU FACTS: To understand the difference FLU FACTS: To understand the difference between the terms seasonal, avian and between the terms seasonal, avian and pandemic influenza, and the impact of a pandemic influenza, and the impact of a pandemicpandemic
• FLU PREP: To identify ways that NJ is FLU PREP: To identify ways that NJ is preparing for an influenza pandemicpreparing for an influenza pandemic
• FLU & YOU: To identify steps people can FLU & YOU: To identify steps people can take to protect themselvestake to protect themselves
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What is Influenza?What is Influenza?
• Primarily infection of upper respiratory tractPrimarily infection of upper respiratory tract• Incubation period: 1-3 daysIncubation period: 1-3 days• Infectious period: Infectious period:
24 hours 24 hours beforebefore symptom onset symptom onset
and up to 5 days after and up to 5 days after
symptom onsetsymptom onset
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What causes Influenza?What causes Influenza?
Three types of influenza viruses: A, B & CThree types of influenza viruses: A, B & C
Type AType A Can infect humans and other animalsCan infect humans and other animals 144 potential strains (H-16; N-9)144 potential strains (H-16; N-9) Wild birds are the natural reservoirWild birds are the natural reservoir Most likely to cause epidemics and Most likely to cause epidemics and
pandemicspandemics
(cont.)(cont.)
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Types of InfluenzaTypes of Influenza
Type BType B Humans onlyHumans only No subtypesNo subtypes Can cause epidemics, not pandemicsCan cause epidemics, not pandemics
Type CType C Humans and swineHumans and swine No subtypesNo subtypes Mild illness; does not cause epidemicsMild illness; does not cause epidemics
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Seasonal Influenza in the USSeasonal Influenza in the US
Occurs annually – October through AprilOccurs annually – October through April More than 36,000 deathsMore than 36,000 deaths More than 200,000 hospitalizationsMore than 200,000 hospitalizations Elderly, young children and people with Elderly, young children and people with
certain health conditions are most certain health conditions are most vulnerablevulnerable
Largely preventable through vaccineLargely preventable through vaccine
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Prevention & TreatmentPrevention & Treatment
PreventionPrevention• Annual flu vaccinationAnnual flu vaccination• Respiratory hygieneRespiratory hygiene• Social distancingSocial distancing
TreatmentTreatment• Fluids, fever reducing medication, bed restFluids, fever reducing medication, bed rest• Antiviral medication – not a cure!Antiviral medication – not a cure!
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Why a flu shot each year?Why a flu shot each year? ShiftShift (Type A only) (Type A only)
• Major changes new Major changes new subtypesubtype
• Exchange of gene Exchange of gene segmentssegments
• May cause pandemicMay cause pandemic• Example: H3N2 replaced Example: H3N2 replaced
H2N2 in 1968H2N2 in 1968
Occurs infrequentlyOccurs infrequently
DriftDrift (Types A and B) (Types A and B)• Minor change, within Minor change, within
subtypesubtype• Gradual accumulation of Gradual accumulation of
amino acid changes in HA amino acid changes in HA and/or NAand/or NA
• May cause epidemicMay cause epidemic• Example: drifted Example: drifted
A/H3N2/Fujian circulated A/H3N2/Fujian circulated A/H3N2/Panama (vaccine A/H3N2/Panama (vaccine strain 2003/4)strain 2003/4)
Occurs continuouslyOccurs continuously
Cox NJ, Subbarao K. Lancet 1999;354:1277-82
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What about Avian Influenza?What about Avian Influenza?
AKA: Bird FluAKA: Bird Flu • Type A, H5N1Type A, H5N1• Carried by migratory waterfowlCarried by migratory waterfowl• Virus passed to domestic poultryVirus passed to domestic poultry• Direct transmission Direct transmission
to humans from poultryto humans from poultry• High death rateHigh death rate
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What is a pandemic?What is a pandemic?
Epidemic = community or regional Epidemic = community or regional outbreak of an infectious diseaseoutbreak of an infectious disease
Pandemic = global epidemicPandemic = global epidemic
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What causes a Flu Pandemic?What causes a Flu Pandemic?
New strain of virusNew strain of virus
Ability to cause serious disease and death Ability to cause serious disease and death in humansin humans
Easy person-to-person spreadEasy person-to-person spread
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Pandemic Impact
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ChallengesChallenges
Health CareHealth Care SocialSocial PersonalPersonal
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Health Care ChallengesHealth Care Challenges
Don’t know which people the virus will Don’t know which people the virus will affect the mostaffect the most
Vaccines will not be available in the early Vaccines will not be available in the early stages of pandemicstages of pandemic
Antivirals, if available, may be ineffectiveAntivirals, if available, may be ineffective Health care workforce will be sick along Health care workforce will be sick along
with everyone elsewith everyone else Health care system will be overwhelmedHealth care system will be overwhelmed
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Societal ChallengesSocietal Challenges Maintaining essential governmentMaintaining essential government
services and businessservices and business ImplementingImplementing
social distancingsocial distancing Distributing limited Distributing limited
amounts of medicationsamounts of medications
and vaccinesand vaccines Maintaining civil orderMaintaining civil order
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Personal ChallengesPersonal Challenges
Protecting self and familyProtecting self and family Attending school/work Attending school/work Obtaining goods, services and necessitiesObtaining goods, services and necessities Maintaining daily life activitiesMaintaining daily life activities Obtaining medical careObtaining medical care TravelingTraveling Obtaining reliable informationObtaining reliable information
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Worldwide WatchWorldwide Watch
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Governmental PreparednessGovernmental Preparedness
The Centers for Disease Control & Prevention The Centers for Disease Control & Prevention and the US Dept. of Human Servicesand the US Dept. of Human Services
NJ Dept. of Health & Senior Services and the NJ Dept. of Health & Senior Services and the Office of Homeland Security & PreparednessOffice of Homeland Security & Preparedness
Local and regional health depts.Local and regional health depts.• www.njmrc.nj.govwww.njmrc.nj.gov
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Healthcare System Healthcare System PreparednessPreparedness
Developing preparedness plansDeveloping preparedness plans Enhancing infection control proceduresEnhancing infection control procedures Stockpiling suppliesStockpiling supplies Cross training staffCross training staff Conducting exercisesConducting exercises
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Personal PreparednessPersonal Preparedness Keep a supply of food, water Keep a supply of food, water
and medical suppliesand medical supplies Start now to develop healthy Start now to develop healthy
habitshabits• Respiratory hygieneRespiratory hygiene• Hand hygieneHand hygiene• Stay home if sickStay home if sick
Know where to get reliable Know where to get reliable health informationhealth information
Follow instructions provided Follow instructions provided by governmental public health by governmental public health authoritiesauthorities
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SummarySummary
Flu pandemics are unpredictableFlu pandemics are unpredictable We don’t know if the avian H5N1 virus will We don’t know if the avian H5N1 virus will
cause the next flu pandemiccause the next flu pandemic Flu pandemics can have serious impact on Flu pandemics can have serious impact on
us, society, businesses and the health us, society, businesses and the health care systemcare system
NJ governmental agencies are preparing NJ governmental agencies are preparing for a potential flu pandemicfor a potential flu pandemic
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ResourcesResources
NJ Dept. of Health & Senior ServicesNJ Dept. of Health & Senior Services• www.nj.gov/health/fluwww.nj.gov/health/flu• Ready Together NJReady Together NJ
US Centers for Disease ControlUS Centers for Disease Control• www.cdc.gov/fluwww.cdc.gov/flu• www.pandemicflu.govwww.pandemicflu.gov• Planning Checklists: Planning Checklists:
http://www.pandemicflu.gov/plan/checklists.htmlhttp://www.pandemicflu.gov/plan/checklists.html
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Contact InformationContact Information
Sylvia H. Bookbinder, MPH, CHESSylvia H. Bookbinder, MPH, CHES
Infectious & Zoonotic Disease ProgramInfectious & Zoonotic Disease Program New Jersey Department of New Jersey Department of
Health & Senior ServicesHealth & Senior Services
609-588-7500609-588-7500 [email protected]@doh.state.nj.us