Low Pathogenic Strains vs. Highly Pathogenic Strains

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Low Pathogenic Strains vs. Highly Pathogenic
Strains
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H5N1 Infection in Cats
Study looked at 500 blood samples taken from
stray cats taken from poultry markets in Java.
Of these cats, 20 had antibodies to H5N1.
Unusually high numbers of dead cats have been
found near many of the outbreaks. Unlike humans,
cats shed virus in high titers and pass it to
each other.
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Human H5N1 Cases
Human Cases Summary of Current Situation
Since January, 2004 WHO has reported human cases of avian influenza A (H5N1) in the following countries East Asia and the Pacific Cambodia China Indonesia Thailand Vietnam Europe Eurasia Azerbaijan Turkey Near East EgyptIraq   For additional information about these reports, visit theWorld Health Organization Web Site.Updated January 2007
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Cumulative Number of Confirmed Human Cases of
Avian Influenza A/(H5N1) Reported to WHO March
14, 2007
Country   2003 2003 2004 2004 2005 2005 2006 2006 2007 Total Total
Country   cases deaths cases deaths cases deaths cases deaths cases deaths cases deaths
Azerbaijan 0 0 0 0 0 0 8 5 0 0 8 5
Cambodia 0 0 0 0 4 4 2 2 0 0 6 6
China 1 1 0 0 8 5 13 8 0 0 23 14
Djibouti 0 0 0 0 0 0 1 0 0 0 1 0
Egypt 0 0 0 0 0 0 18 10 1 1 24 13
Indonesia 0 0 0 0 19 12 56 46 7 6 83 65
Iraq 0 0 0 0 0 0 3 2 0 0 3 2
Nigeria 0 0 0 0 0 0 0 0 1 1 1 1
Thailand 0 0 17 12 5 2 3 3 0 0 25 17
Turkey 0 0 0 0 0 0 12 4 0 0 12 4
Viet Nam 3 3 29 20 61 19 0 0 0 0 93 42
Total 4 4 46 32 97 42 116 80 8 7 280 170

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Responding to the Avian Influenza Pandemic
Threat Recommended Strategic Actions
World Health Organization 2005
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WHO Proposals 1. Reduce opportunities for
human infection - education 2. Strengthen the
early warning system 3. Contain or delay spread
at source - drugs, quarantine 4. Reduce
morbidity, mortality and social disruption 5.
Conduct research to guide response measures
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Problems With Early Warning Systems most
outbreaks are occurring in poor countries no
funds to pay farmers for culled flocks (10
billion to date) no funds for information
systems or labs home slaughter of sick
chickens poor or no health care services
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New WHO Pandemic Phases
Interpandemic Period Phase 1 No new influenza
subtypes in humans, subtype that has
caused human infection may be present in
animals Phase 2 As above, but circulating
animal subtype poses substantial risk of
human disease Pandemic Alert Period Phase 3
Human infection with new subtype, no
human-to-human (HTH) spread Phase 4
Small clusters with limited HTH transmission,
highly localized spread, suggesting the
virus is not well adapted to humans Phase
5 Larger clusters, but HTH spread is still
localized, virus is increasingly better
adapted to humans, but not yet fully
transmissible Pandemic Period Increased and
sustained transmission in general
population
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Current WHO phase of pandemic alert
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Pandemic Vaccine Supply
Assumptions Imported vaccine will not be
available Two doses will be needed for
protection 4-8 months until first vaccine
doses are available U.S Manufacturing
Capacity Only Sanofi has a completely domestic
supply chain Estimated production sufficient
to deliver 5 million monovalent doses per
week Implication less than 1 of the
population may be protected per week
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Health Care and Emergency Response
Address hospital surge capacity issues Address
roles of triage centers, volunteers, home
care Develop hospital employee health
guidance Develop infection control
guidelines Address mass mortality issues Develop
system for tracking hospital resources
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CDC PANDEMIC RANKING February 1, 2007
Category 1 Pandemic 90,000 additional
deaths Isolate the sick at home, reduce
visitors Category 3 Pandemic 90,000 450,000
additional deaths consider closing schools for
no more than a month Category 5
Pandemic gt900,000 additional deaths Close
schools (including universities) for up to 3
months, avoid gatherings and encourage people to
work from home
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What we all learned from Katrina is that
sometimes we have to think very clearly about the
unthinkable, because the unthinkable often
happens. Michael Leavitt Health and Human
Services Secretary
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http//pandemicflu.gov
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http//www.pandemicflu.state.pa.us
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http//pandemicflu.gov/plan/pdf/CIKRpandemicInflue
nzaGuide.pdf
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http//www.pandemicflu.gov
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HMC PANDEMIC PLAN
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http//emergencyhomepreparation.org/
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http//www.influenzareport.com/influenzareport2006
.pdf
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Birdflubook.com
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Were all holding our breaths. H5N1 is the
most important threat the world is
facing. People who fail to prepare for a flu
pandemic are going to be tragically mistaken.
Julie Gerberding, Head of the CDC
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