Pandemic Influenza

PREPARING FOR PANDEMIC FLU

LEARN – PLAN – PROTECT

By now you probably know quite a lot about pandemic influenza, also known as pandemic flu. You may be frightened by what you have heard and read. You may not think that it is a big deal, or you might not know what to think. As we have seen in the past, if this happens, many people around the world could get sick with, and even die from, a new kind of flu virus. It could affect you, your family, and your community.

This information is a way to help educate and prepare you and all Missourians for pandemic flu. This guide will help you LEARN more about influenza, PLAN how to respond to the next major flu pandemic and find the best ways to PROTECT yourself against this serious health threat.

A flu pandemic could start anywhere in the world with little warning. Because modern technology makes it easier for people to travel around the world, diseases like the flu can be quickly carried from country to country. Once it begins, pandemic flu may also come in waves over a period of time, affecting different communities in different ways.

During the 20th century, there were three serious influenza pandemics, killing millions of people.

  • 1918 – The Spanish Flu killed tens of millions of people around the world, including at least 500,000 people in the United States.
  • 1957 – The Asian Flu killed about 2 million people worldwide, including 70,000 people in the United States.
  • 1968 – The Hong Kong Flu killed up to 1 million people, including approximately 34,000 people in the United States.

We urge you to read this information, put what you learn into action, and take an active role in getting ready. The more prepared we are now, the more lives can be saved in the future. The best way to prepare is to learn, plan, and protect. 

LEARN ABOUT PANDEMIC FLU

What is the difference between seasonal flu and pandemic flu?

Seasonal flu is a contagious respiratory disease that is caused by influenza viruses. Occurring every year, the flu typically is found in the fall and winter. Health problems from the flu can include pneumonia and the worsening of chronic illnesses. Seasonal flu can cause serious illness and even death, and it poses a risk for people with weak immune systems. However, seasonal flu is usually not severe in most people, because they are already partly protected by having had a similar flu virus before. Annual flu shots also play a key role in protecting people from getting seasonal flu.

Pandemic flu is different and can be much worse. Pandemic flu can cause a worldwide outbreak of a new form of flu virus, which spreads easily from person to person because they have no immunity.

Pandemic flu occurs when a flu virus goes through changes (called "mutations") that create a new virus that the body has never encountered. This means that the person has no immunity to the new virus and is not prepared to fight it. There also would be no flu shots available (at first) to help stop the spread of this new flu virus.

Because the new pandemic flu virus would be able to travel easily from person to person, it could spread quickly over long distances to millions of people worldwide. The result would be a flu pandemic.

What are the symptoms of seasonal flu? Are they different if it is pandemic flu?

Seasonal flu symptoms include:

  • Coughing
  • Fever
  • Fatigue
  • Headache
  • Sore throat
  • Stuffy or runny nose
  • Muscle aches

Pandemic flu symptoms may be more severe versions of seasonal flu symptoms and may include symptoms not usually seen with the flu, such as diarrhea or fluid-filled lungs. If pandemic flu does occur, officials will alert the public of any new or different symptoms of the new flu and provide advice on how best to deal with them.

How is the flu virus spread?

The flu virus spreads when infected people cough or sneeze; they spray infectious respiratory droplets into the air, then into the eyes, mouth, or nose of people nearby. These droplets can also fall onto surfaces that people touch before touching their nose, mouth, or eyes, allowing the flu to spread. People infected with the flu can also leave the virus on objects they touch if they have flu germs on their hands. This is why frequent hand-washing is an important way to lower a person's risk of getting the flu, along with avoiding close contact with people who have flu-like illness.

How do you treat pandemic flu?

The treatment for pandemic flu usually is similar to that for seasonal flu, including:

  • Staying home to avoid spreading it to others.
  • Drinking lots of fluids.
  • Getting plenty of rest.
  • Taking pain relievers like acetaminophen (Tylenol) to relieve fever and muscle aches.  Never give aspirin to children or teenagers who have flu-like symptoms, especially fever.
  • Taking medication if a doctor feels it is necessary, especially if symptoms are severe and if medication is available and effective.

What is avian flu, and should we be concerned?

Avian flu, also known as "bird flu," is caused by certain flu viruses normally found in wild migratory birds, like ducks and geese, and domestic birds, like chickens. There has been concern recently about H5 avian flu. The current type has affected birds, dairy cattle, and even a few people in multiple states in the U.S. Highly Pathogenic Avian Influenza (HPAI) is zoonotic, meaning it can spread to humans. HPAI is highly contagious however nearly each case involved people who worked in close contact with livestock also positive for avian influenza. There has been no spread from person to person. You can see more information regarding avian flu at Missouri Department of Agriculture.  https://agriculture.mo.gov/avian-influenza.php

Because there are many types of bird flu viruses in the world, and because one of them could change into a new type of flu virus that easily spreads from person to person, these viruses are being closely watched.  Disease experts are looking for signs that any of these viruses might be changing into a new type of virus that could cause pandemic flu in people.

What is the potential impact of pandemic flu?

The impact of a flu pandemic, or worldwide flu epidemic, is difficult to predict and would depend on many factors.  However, based on past experience, the effects of a pandemic could be severe and felt in almost every part of the world. About one-third of the population could fall sick, and many more people would have to stay home to take care of them.

Having such a large part of the population not working could cause harmful effects, such as:

  • Stopping critical services like public transportation, communications, schools, banks, stores, restaurants, utilities, medical care, and police, fi re fighting, and emergency medical services.
  • Creating a serious, negative impact on the world economy.
  • Overwhelming hospitals, whose staff may also be sick or caring for sick family members. As a result, hospitals may be unable to care for all patients needing medical attention.
  • Keeping stores from being resupplied with food, medications, and many other important items.

    • Although the thought of pandemic flu may make us uncomfortable, each of us can take important steps to protect ourselves, our families, and our communities.

    PLAN FOR PANDEMIC FLU

    What are federal, state, and local governments, including Missouri, doing to prepare for pandemic flu?

    Government agencies worldwide (including the Missouri Department of Health and Senior Services and local public health departments) and many Missouri businesses, organizations and groups are preparing for pandemic flu.

    In the United States, the federal government is:

    • Storing supplies and working on new vaccines.
    • Producing public health guidelines and strategies to help protect our country from pandemic flu.
    • Watching for outbreaks of different flu viruses and standing ready to quickly respond to them.
    • Helping state, local, and tribal leaders develop response plans for pandemic flu, and creating better ways to share health information.

    Missouri and other states also have health emergency plans in place, including:

    • Plans for getting flu shots to many people quickly when the flu vaccine becomes available.
    • Finding ways to help communities provide important services, like public safety and health, to their citizens during a flu pandemic.
    • Bringing different government agencies, social service groups, and community leaders together to plan how they can respond to pandemic flu.

    What can you do to prepare for pandemic flu?

      Step 1 in Planning: Create a Plan

      If pandemic flu does strike, it could make many of us sick very quickly. We all need to know what to do if pandemic flu affects us. It is important to have a plan in place so that the whole family knows how to respond. For example, if pandemic flu does strike, sick family members will need care, so it is important to plan for how that can be done.

      If you have a child in school, you will need to:

      • Know the school's response plan for pandemic flu.
      • Make sure that the school has up-to-date contact information for you and another family member.
      • Know what steps will be taken to protect students, faculty, and staff from the flu, such as the school's plan to isolate those students who have flu symptoms.
      • Ask the school to encourage students, faculty, and staff to wash their hands with soap and water during the day and to practice other good hygiene, such as covering their nose and mouth when they sneeze or cough.

      What to do about your job:

      Employers across Missouri are working on plans to make sure that their businesses continue in the event of a flu pandemic. Depending on your job, you may need to make special arrangements for your family. Be sure to talk with your employer and understand your workplace's plans. You will need to know:

      • If your workplace has a pandemic flu plan and what your role is. 
      • If you will be able to work from home, and how to get ready for that option. 
      • That people in some jobs, such as health care workers or utility workers, may not be able to work from home.If this is the case for you, then make sure to plan for your child care needs.
      • That schools or traditional child care facilities may be closed during the worst part of the pandemic. In that case, you may need someone to care for your children at home.

      If you are a person with special needs living at a special-care facility, or you are a caregiver of a person with special needs:

      • Review the special-care facility's emergency plans.
      • Know where necessary medication is stored.
      • Have your medical equipment clearly labeled with your identifying information.

      If you are a person with special needs living at home, or you are the caregiver of a person with special needs:

      • Identify people who can help you in case of a disease outbreak or other emergency.
      • Give someone you trust a key to your house or apartment, and let that person know where emergency supplies are located.
      • Wear a medical-alert tag or bracelet to identify existing medical conditions, allergies, or other medical needs.

      Step 2 in Planning: Prepare Supplies

      To be better prepared for emergencies, such as a flu pandemic, gather and store at least a two-week supply of basic items. These should include a variety of supplies that will help you survive at home with little or no outside help. While not all of these items will be needed during a flu pandemic, it is a good idea to have them on hand for other emergencies.

      Basic supplies include:

      • Water — at least one gallon per person per day
      • Canned or dried food (including high-protein sources)
      • Household-cleaning supplies (bleach, disinfectant sprays)
      • Battery-powered radio
      • Manual can opener
      • Flashlight
      • Extra batteries
      • Thermometer
      • Over-the-counter pain relievers such as acetaminophen or ibuprofen.  
      • Paper and pencil to keep a record of symptoms and to jot down questions
      • Prescription medication and first-aid kits
      • Extra bath and hand soap

      Personal supplies include:

      • Important family documents
      • Feminine hygiene products
      • Vision aids, such as glasses or contact solution
      • Dental supplies
      • Entertainment (videos/DVDs, books, magazines, music)
      • Baby supplies
      • Pet supplies

      If you have special needs, your supplies should include:

      • A list of prescription and nonprescription medicines, including dosages, and keep extra doses on hand if possible
      • A list of allergies and other medical conditions
      • Extra eyeglasses and hearing-aid batteries, if necessary
      • Extra wheelchair batteries or other special equipment, if necessary
      • A list of the brand/style and serial numbers of medical devices
      • Copies of medical insurance and Medicare and Medicaid cards
      • A list of doctors
      • A list of emergency contacts and family members
      • Phone numbers of close neighbors who can help

      Step 3 in Planning:  Be Active in Preparing Your Neighborhood and Community

      Continue learning about pandemic flu. Be a leader in your neighborhood in making plans. Talk to neighbors who may be elderly or disabled to see what you can do to help. Think about how your neighborhood could help meet their needs, such as supplying food or medicine, in case pandemic flu disrupts services. Be active in your church, school, or social groups by leading discussions about planning for pandemic flu or by inviting speakers from the local health department or hospital. Talk to your co-workers and friends about their plans and share ideas.

    PROTECT AGAINST PANDEMIC FLU

    While state and local governments and many other organizations are working hard to prepare for pandemic flu, you must also be responsible for your own safety. There are simple steps that you and your family can take to help protect yourselves against the spread of flu, whether seasonal or pandemic.

    Practice Good Hand-Washing

    Washing your hands is a simple and very good way to stop spreading germs, including those that cause flu. You should always wash your hands:

    • After coughing, sneezing, or blowing your nose.
    • Before and after helping a sick person.
    • Before and after handling or cooking food.
    • Before serving or eating food.
    • After using the restroom.
    • After changing diapers.
    • After touching animals or cleaning up their waste.
    • After doing unsanitary chores, like cleaning the bathroom or handling trash.

    How to wash your hands well:

    • Wet hands with warm water.
    • Lather both hands with soap and make lots of suds.
    • Scrub hands together well for at least 20 seconds. An easy way to make sure you wash your hands long enough is to say your ABCs while washing your hands. Rinse when you get to Z.
    • Rinse hands thoroughly and dry them completely with a clean towel.
    • In public restrooms, use a paper towel, if available, to turn off the faucet and to open and close doors.
    • Alcohol-based hand-cleaning gels can also be effective if soap and water are unavailable, or in addition to soap and water. To kill germs this way, simply apply gel over both hands and rub them together until dry. However, soap and warm water should always be used, when possible.

    Practice Cough and Sneeze Protection

    When coughing or sneezing:

    • Move and/or turn away from others.
    • Cover your mouth and nose with a tissue, paper towel, or other barrier, then throw it away.
    • If you do not have a tissue, use the crook of your elbow or your sleeve; do not use your hand.
    • After coughing or sneezing, always wash your hands with soap and warm water.

    Cleaning and Disinfecting

    You can also prevent spreading germs by cleaning and disinfecting areas used by many different people. Countertops, sinks, doorknobs, tables, and telephones are all surfaces that should be disinfected on a regular basis. Examples of disinfectants include:

    • Disinfectant sprays
    • Sanitizing wipes
    • Liquid disinfectants

    Personal items, such as toothbrushes, drinking cups, straws, cosmetics, eating utensils, washcloths, or any other items that have been near a person's mouth or nose, including cell phones, should not be shared.

    Listen for Information

    Public health and other authorities will spread the word of an oncoming flu pandemic through your local media. You will receive important details on current events and services available to you, symptoms you should look for, necessary actions to help reduce the impact of a major outbreak, and other useful information.

    Examples of steps that authorities may ask the public to follow include:

    • Practice good hygiene, such as hand-washing and covering sneezes and coughs.
    • Stay home from work or school if you become ill with the flu.
    • Avoid public gatherings and cancel large events.
    • Listen for instructions on where to go for vaccine when it becomes available.

    Public health authorities are reliable sources of information. They will post up-to-date information on their web sites and work closely with the news media to send important information to the public. In case of an outbreak, hotlines will also be opened to answer questions about the outbreak.

    Vaccines for Pandemic Flu

    Flu vaccinations (shots) are a safe and effective way to ward off seasonal flu, the kind of flu that occurs every year. The flu shot helps the body fight off seasonal flu, so it helps keep a person from getting sick if he or she comes into contact with seasonal flu viruses. You cannot get the flu from flu shots.

    Current shots for seasonal flu will not protect against pandemic flu viruses, because pandemic flu viruses will be brand new with no effective vaccine available to provide protection at first. Once the virus makes itself known, scientists can begin creating a matching vaccine, but this process will take months. And as the new vaccine becomes available, the first doses will be used only for certain groups of people, such as emergency workers, health care workers, and people at high risk of serious flu complications.

    Caution with Animals

    Contact with animals is normally not a concern for human flu infection in the United States; however, animals can be a source of germs in general. People who own or work with animals should always take basic safety precautions to stop the spread of germs by:

    • Washing hands after handling animals or contaminated items.
    • Keeping pets out of areas where food is prepared.
    • Limiting close contact between animals and young children as well as people with weak immune systems, since these people may be more at risk of infection. Children should avoid areas where animals relieve themselves.
    • Being careful when handling ducks, geese and other wild game birds.
    • Avoiding handling and/or eating sick game animals. Always handle healthy game with rubber gloves.

    Because of the possible risk of avian flu, people who raise or work with poultry, such as chickens, ducks, and turkeys should:

    • Keep domestic poultry and wild birds separate.
    • Follow cleaning and disinfection guidelines for buildings, equipment and vehicles, when notified to do so by agriculture authorities.
    • Follow other infection-control guidelines when necessary or when notified to do so by agriculture authorities.
    • Report to the Missouri Department of Agriculture birds that are showing major changes in their health or behavior.
    • Wear personal protective equipment, such as a respirator, when directed to do so by the employer and/or public health officials.

    Call to Action

    History shows us that our communities pull together and grow stronger during difficult times. We all can find strength by drawing closer to our friends and neighbors, being informed, and staying prepared for emergencies. You can play a very important part in getting yourself, your family, and your community ready for the next flu pandemic. Since nobody knows when the next pandemic will strike, now is the best time to learn, plan, and protect.

    Public Health Response Resources

    Other Influenza Information