Pandemic Flu Threat Update

1
Pandemic Flu Threat Update

• 28 March 2006
• Dr Susan Turnbull
• Director of Public Health for Bournemouth

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Avian Flu vs Pandemic Flu

• Avian influenza a disease of birds caused by
  influenza viruses closely related to human
  influenza viruses
• Can cause large outbreaks / high mortality in
  poultry highly pathogenic avian influenza
  HPAI
• Previous human flu pandemics combination of
  avian and human flu viruses
• new human subtype
• No one immune and no vaccine

3
Current situation

• Rapid spread of HPAI with simultaneous outbreaks
  in several countries historically unprecedented
• Rare for avian flu virus to be transmitted to
  humans
• Current H5N1 strain of HPAI - unique capacity to
  jump the species barrier
• Causes severe human disease with high mortality
  (around 50)
• Human seasonal flu currently circulating in
  parts of world where avian flu most prevalent
• www.hpa.org.uk/infections/topics_az/influenza/avia
  n/avianflufaq.htm
• Current outbreak
• Since 2003 157 human cases confirmed (as at
  10/1/06)
• 77 deaths
• H5N1 influenza A subtype

4
Human cases by country since 2003(Financial
Times 10/1/06)
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Current threat level

• No evidence yet of sustained human-to-human
  transmission
• Epidemiological and virological investigation
  underway Turkey cluster
• Cases of avian flu all over Europe. None yet
  detected in UK
• WHO
• Pandemic alert level
• No, or very limited human-to-human
  transmission
• Same since Nov 2005
• Experts at WHO and elsewhere believe that the
  world is now closer to another influenza pandemic
  than at any time since 1968
• www.who.int/csr/disease/avian_influenza/phase/en/i
  ndex.html

6
Control measures

• Travel
• No current travel restrictions www.fco.gov.uk
• NHS March 2006
• If you are travelling to an area affected by
  bird flu
• Do not visit bird or poultry farms or markets
• Avoid close contact with live or dead poultry
• Do not eat raw or poorly cooked poultry or
  poultry products
• Wash your hands frequently with soap and water

7
Surveillance

• HPA algorithm for management of travellers with
  febrile respiratory illness returning from avian
  flu affected areas
• www.hpa.org.uk/infections/topics_az/influenza/avia
  n/algorithm.htm

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Pandemic projections

• UK Influenza Pandemic Contingency Plan
• (UK Health Departments October 2005)
• The impact of a flu pandemic on health and
  social services is likely to be intense,
  sustained and nationwide
• Pandemic likely to occur in 2-3 major waves over
  6-9 months
• Estimate 25 of population ill with flu over this
  period
• But more may be affected FT /HSBC 10 January
  planning for 50

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Impact on health and social services

• Services may quickly become overwhelmed
• Patients with flu and its direct complications
  about 40,000 anticipated in Bournemouth (range up
  to 80,000 worst case scenario)
• Needs for high dependency care, infection control
  facilities and equipment
• Secondary burden anxiety and bereavement
• Depletion of workforce, numbers of informal
  carers own illness, or that of their families
• School closures may be recommended
• Logistical problems disrupted supplies,
  utilities and transport
• Pressure on mortuary facilities

10
Impact continued

• Absence from work will depend on age-specific
  attack rate
• All organisations particularly those providing
  essential services need to have robust
  contingency plans
• Recognition as high priority corporate risk

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Contingency Planning

• UK Influenza Pandemic Contingency Plan
• Bournemouth and Poole Multiagency Pandemic Flu
  Planning Group
• Bournemouth Borough Council Corporate Management
  Team 11 January
• Bournemouth Practices Evening 19 January
• Bournemouth and Poole Resilience Group 26 January
• Health Scrutiny Panel Workshop 7 February
• PCT Staff briefing sessions
• HPA / DH interactive learning package
• Letter to all doctors January 2006
• www.Doctors.net.uk/pandemicflu