Influenza Outbreaks and Cruise Ships

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Influenza Outbreaks and Cruise Ships

• Laura Martin
• 25 April 2002

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General Information

• Influenza is an acute respiratory illness caused
  by a virus and transmitted by respiratory
  secretions through sneezing or coughing.
• Symptoms
• Abrupt onset of fever
• Headaches
• Muscle aches
• Soar throat
• Non-productive cough
• Congestion
• Extreme Fatigue

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General Information

• Change in the virus
• Antigenic Drift
• Small changes that occur continuously over time.
• Produces new virus strains in both influenza A
  and B
• Antigenic Shift
• An abrupt and major change in the influenza A
  viruses.
• Results in a new subtype of influenza A.
• Why is this significant?
• Whenever a new subtype or strain is introduced,
  the bodys immune system will not recognize it.
• Type C causes a mild respiratory illness and is
  thought not to cause epidemics.

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Cross Section
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General Information

• Groups at Risk for severe infection
• People over the age of 65.
• Residents of nursing homes or chronic care
  facilities.
• Those with chronic disorders of the pulmonary or
  cardiovascular systems.
• Patients who have required medication follow-up
  or hospitalization during the past year because
  of chronic metabolic diseases, renal dysfunction,
  or immunosuppression.
• Children or teens who are receiving long-term
  aspirin therapy.

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General Information

• Prevention
• Vaccine
• Administered yearly because of the genetic
  changes in the virus and decreased immunity over
  time.
• Also consider vaccination before traveling to the
  tropics or into the Southern Hemisphere.
• Side effects
• malaise (a feeling of illness or depression),
• myalgia (muscular pain),
• fever,
• or an allergic reaction.

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General Information

• Treatment
• Bed rest
• Fluid consumption
• Symptom relief with over the counter drugs such
  as pain relievers, decongestants, and cough
  medicines.
• The use of anti-viral drugs
• Two are available.
• Can prevent infection during continued exposure
  to the virus.
• Can also reduce the severity and duration of the
  illness if administered shortly after the
  appearance of symptoms.

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Cruise Ships

• September and October 1997 Two Cruise Ships
• Majority of passengers 65 and older and at risk
  for flu-related complications.
• Majority of passengers and crew also
  unvaccinated.
• Action taken
• Active surveillance
• Vaccination of crew members
• Use of antivirals
• The steps taken to control this outbreak were
  successful.
• However, the overall level of influenza activity
  is typically low for this time of year, so this
  situation demonstrates how travel and large
  groupings of people can increase the likelihood
  of a problem occurring.

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Cruise Ships

• Another possible influenza outbreak was reported
  by the CDC Morbidity and Mortality Weekly Report
  after June of 2000 when an outbreak of
  respiratory illnesses occurred on the MS
  Rotterdam.

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Outbreaks and Pandemics

• 1918 The Spanish Flu
• 20-50 million people died worldwide.
• Many died a few days after infection and some
  died of complications later.
• This pandemic was unique because almost half the
  people that died were young, healthy adults.

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This is an image from an emergency hospital in
Camp Funston, Kansas during the 1918 influenza
epidemic.
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Outbreaks and Pandemics

• Other Pandemics include
• The 1957 Asian Flu which killed approximately
  70,000 people in the United States.
• The 1968 Hong Kong Flu that caused nearly 35,000
  deaths in the US.
• Other outbreaks include
• The 1976 Swine Flu that infected soldiers
• at Fort Dix, New Jersey. Over 40 million
• Americans were vaccinated as a result to
• prevent a pandemic.
• The 1997 Avian Flu in which 18 people in Hong
  Kong were infected with a flu strain previously
  only seen in birds.

Swine Flu