Transcript Slide 1

Low Pathogenic Strains vs. Highly Pathogenic Strains
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.
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:
•Egypt
Iraq
For additional information about these reports, visit the
World Health Organization Web Site.
Updated January 2007
Cumulative Number of Confirmed Human Cases of Avian Influenza
A/(H5N1) Reported to WHO March 14, 2007
2003
Country
2004
2005
2006
cases
deaths
cases
deaths
cases
deaths
cases
deaths
Azerbaijan
0
0
0
0
0
0
8
5
Cambodia
0
0
0
0
4
4
2
China
1
1
0
0
8
5
Djibouti
0
0
0
0
0
Egypt
0
0
0
0
Indonesia
0
0
0
Iraq
0
0
Nigeria
0
Thailand
2007
cases
Total
deaths
cases
deaths
0
0
8
5
2
0
0
6
6
13
8
0
0
23
14
0
1
0
0
0
1
0
0
0
18
10
1
1
24
13
0
19
12
56
46
7
6
83
65
0
0
0
0
3
2
0
0
3
2
0
0
0
0
0
0
0
1
1
1
1
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
Responding to the Avian Influenza
Pandemic Threat
Recommended Strategic Actions
World Health Organization 2005
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
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
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
Current WHO phase of pandemic alert
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
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
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
>900,000 additional deaths
Close schools (including universities) for up to 3
months, avoid gatherings and encourage people to
work from home
“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
http://pandemicflu.gov
http://www.pandemicflu.state.pa.us
http://pandemicflu.gov/plan/pdf/CIKRpandemicInfluenzaGuide.pdf
http://www.pandemicflu.gov
HMC PANDEMIC PLAN
http://emergencyhomepreparation.org/
http://www.influenzareport.com/influenzareport2006.pdf
Birdflubook.com
“We’re 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