U.S. Health Officials Unveil Flu Pandemic Plan

Outbreaks would be tackled based on a 'severity index' of transmission, they say

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HealthDay Reporter

THURSDAY, Feb. 1, 2007 (HealthDay News) -- U.S. health officials on Thursday outlined an early-warning system similar to that employed for hurricanes to protect and mobilize the country against a flu pandemic.

The community-based response system would categorize flu pandemics on a scale of 1 to 5, with 5 being the deadliest. Each level of the "Pandemic Severity Index" (PSI) carries a set of recommendations, ranging from hand washing to closing schools, which are intended to slow the spread of the virus while a vaccine is being prepared.

"One important and new concept is that not all pandemics are equally severe, and we have used what we know about epidemiology to devise a severity index," Dr. Julie Gerberding, director of the U.S. Centers for Disease Control and Prevention (CDC), told a press teleconference.

"One that does not move very fast from person to person would likely be a fairly mild pandemic. On the other hand, we know from 1918 that we had a pandemic that not only moved with extraordinary speed but also had an unusually high mortality rate. We would categorize that as a category 5 pandemic," she added.

The teleconference took place a day after the CDC's first "full functional" avian flu exercise, in which all personnel at the Atlanta headquarters participated.

Health officials have worried that the bird flu virus currently circulating around the globe might mutate, unleashing a new type of flu virus that could prove even more deadly because people's immune systems would not be able to fend off the disease.

The existing H5N1 bird flu strain has generated more fear than normal because of its virulence and ease of transmission among flocks of domestic birds. So far, bird flu has infected 270 people around the world and killed 164.

Human casualties remain largely confined to Asia and to people who have had close and prolonged contact with infected birds, such as poultry farm workers. And, so far, the H5N1 virus has not demonstrated the ability to jump easily from person to person.

But despite recent reports that a pandemic may not be close-at-hand, U.S. health officials are still concerned.

"The media buzz may have died down, but the H5N1 virus has not," Department of Health and Human Services Secretary Mike Leavitt told the teleconference. "The disease is highly pathogenic and continues to spread. We can't be certain that H5N1 will be the spark of the next pandemic, but we can be sure there will be another pandemic."

"Pandemic influenza is not necessarily imminent, but we believe it is inevitable," Gerberding added.

The new initiative consists of two components.

The first is a "community mitigation guide," which outlines specific steps for communities to take depending on the severity of the pandemic. Recommendations include asking ill persons to stay at home until they are no longer contagious in the case of a level 1 situation; closing schools and child-care programs for up to three months in the case of a more severe pandemic; canceling public meetings; and asking people to work from home.

Such measures admittedly have a downside, officials stated. For instance, adults may have to stay home from work to tend to children who can no longer go to school. And communities will need to take these into account. "We've got some real tough decisions here," Gerberding said. "There are a lot of dilemmas."

A recent Harvard study found that one in four adults said they had no one to care for them at home if they did fall ill. Another one in four said they could not afford to miss work for one week.

Not all communities are expected to implement all the guidelines.

"This is a complete list," Gerberding said. "What an individual or community does depends on local circumstance."

But the earlier the plans are implemented, the better, Gerberding added.

The second component of the initiative is a public service announcement (PSA) campaign that will direct people to a government web site.

"This guidance is interim," Gerberding said. "This was our best effort right now, but we fully expect that as we learn more, we're going to need to update this planning tool."

More information

For more on the new pandemic efforts, visit pandemicflu.gov.

SOURCES: Feb. 1, 2007, teleconference with Secretary Mike Leavitt, U.S. Department of Health and Human Services, and Julie Gerberding, M.D., director, U.S. Centers for Disease Control and Prevention, Atlanta

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