Pandemic Influenza: Domestic Preparedness Efforts
Summary
In 1997, a new avian influenza virus (H5N1 avian flu) emerged in Hong Kong,killing six people. This was the first time that an avian influenza virus was shownto be transmitted directly from birds to humans. The virus persisted in the region,and has since spread to a number of Asian and European countries, where it hasinfected more than 120 people, killing more than 60. The severity of this strain issimilar to that of the deadly 1918 Spanish flu, which caused a global pandemic thatmay have killed up to 2% of the world’s population. Though influenza pandemicsoccur with some regularity, and the United States has been involved in specificplanning efforts since the early 1990s, the H5N1 situation has created a sense of urgency among the world’s public health officials.Global pandemic preparedness and response efforts are coordinated by theWorld Health Organization (WHO). The U.S. Department of Health and HumanServices (HHS) released a draft pandemic flu preparedness and response plan inAugust 2004, and a final plan in November 2005. President Bush announced anational strategy to coordinate pandemic preparedness and response activities acrossfederal agencies. Domestic response activities will be carried out under the broad,all-hazards blueprint for a coordinated federal, state and local response laid out in theNational Response Plan, released by the Department of Homeland Security (DHS)in 2004.Even in light of the plans discussed above, if a flu pandemic were to occur inthe next several years, the U.S. response would be affected by the limited availabilityof a vaccine (the best preventive measure for flu), as well as by limited availabilityof certain drugs used to treat severe flu infections, and by the general lack of surgecapacity within our healthcare system. The U.S. healthcare system is largely private,while the public health system is largely based in state, rather than federal, authority.This structure creates numerous challenges in assuring the needed response capacity,and coordinating the various response elements. Planning is further complicated bythe fact that while periodic influenza pandemics have been seen over the years, theirtiming and severity have been unpredictable. This report will be updated to reflectchanging circumstances.
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