NCSL Influenza Report
February 2007
Overview
A global emergence of avian influenza has made state and local authorities mindful of the potential impact a pandemic of any origin may have on our daily lives. Even the most common forms of influenza will hospitalize on average more than 200,000 people every year. According to the Centers for Disease Control and Prevention (CDC), infections caused by influenza virus A or B have resulted in 36,000 deaths in the United States between 1990 and 1999. Over the last three years avian influenza has claimed the lives of 241 people in 10 countries as well as adversely affecting the poultry industry worldwide. Many scientists believe it is only a matter of time until the next influenza pandemic occurs. Shortages of the influenza vaccine supply in three of the last five flu seasons and the possibility of an outbreak of more serious strains of influenza have called into question the nations ability to endure a pandemic outbreak.
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New Developments
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February 14, 2007--Researchers at the St. Jude Children's Research Hospital in Memphis, Tennessee have found some evidence to support a theory that the seasonal influenza vaccine may provide some cross protection against the H5N1 virus. Findings through research on mice who were immunized for a contemporary strain of the seasonal flu or H1N1 revealed that some immunity was provided by the endemic human virus. They found that a protein produced in the body after vaccination causes the body to produce antibodies effective for cross protection against H5N1. However, Richard Webby, Ph.D. of the St. Jude's team says the jury is still out as to whether this is a reliable way to offer protection. The team also tested sera from 38 human volunteers which demonstrated that some individuals have individuals have antibodies that are high enough to react against H5N1 according to Dr. Webby. A final report of their findings may be viewed online at www.plosmedicine.org.
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February 6, 2007--The Department of Labor's, Occupational Safety and Health Administration (OSHA) has just released a document providing guidance for employers in preparing for a pandemic outbreak. The "Guidance on Preparing Workplaces for an Influenza Pandemic" provides employers with information on how to best prepare and maintain operations during a pandemic. OSHA specifically encourages any employer offering those services which are classified as part of the critical infrastructure, whose failure to be able to operate would result in a number of other failures in the community. Approximately 85 percent of all of the nation's critical infrastructure is owned and or controlled by the private sector.
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February 2007-- The CDC published a document meant to provide interim planning guidance to state, territorial and local governments which focuses on nonpharmaceutical interventions (NPI) which may be deployed in the time of a influenza pandemic. This interim guidance introduces a Pandemic Severity Index to based primarily on case fatality ratio which is a measurement useful in estimating the severity of a pandemic on a population level. By early determination of pandemic severity public health officials will be able to match requirements for community interventions to the severity of a pandemic. The "Interim Pre-pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States," provides communities a framework of NPIs for early use in the first phase of pandemic. Since it is unlikely that a vaccine will be available during the first phase of a pandemic and may not be available for approximately six months into the pandemic, the interventions employed in the early phases and consistently throughout a pandemic to maintain some form of infection control. The NPIs addressed in this document include voluntary isolation of ill persons; voluntary quarantine of household members of ill persons; child social distancing, and; adult social distancing. The community mitigation strategy emphasizes that preparations must be made not only by individuals but also families and by employers. It emphasizes the potential for impact on the workplace, and interruptions of school meal and social programs. Planning guides are provided for development of each NPI and will be updated periodically.
- January 16, 2007--National Infrastructure Advisory Counsel (NAIC) Makes Recommendations on Critical Infrastructure Priorities in an Influenza Pandemic In May of 2006 the Secretaries of the Department of Homeland Security and Health and Human Services requested that the NAIC provide them and President Bush with recommendations regarding the prioritization and distribution of pandemic countermeasures to essential works in the nation's critical infrastructure and key resource sectors. The council was asked to address six specific issues key to protecting the nation's economy and social stability including;
- Identifying and defining "critical services" that must be maintained in a pandemic,
- Establishing criteria and principles for critical; service prioritization,
- Defining critical services priority (with principles for variation, if needed),
- Identifying critical employee group(s) in each priority critical service,
- Building a structure for communication and dissemination of resources, and
- Identifying principles for effective implementation by DHS and HHS.
This final report and recommendations includes specifics in the areas of communication, dissemination, surveillance and detection, and response and containment.
- January 3, 2007--The National Institute of Allergy and Infectious Diseases (NIAID) announced that the first human trial of a DNA vaccine designed to prevent H5N1 avian influenza began December 21, 2006. Unlike the traditional means of vaccine development by growing the influenza virus in a hen's egg, DNA-based vaccines contain only a portion of the virus' genetic material which once inside the body prompts the production of proteins which act as a vaccine against the virus.
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