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• El Dorado County Public Health Department Pandemic Influenza Fact Sheet

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  This fact sheet includes a general overview of pandemic influenza and what El Dorado County is doing to prepare.

  El Dorado County (Calif.). Public Health Department

  2008-02-06
• State of Alaska: Division of Public Health: Pandemic Influenza Response Plan [2008]

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  "Influenza pandemics occur when there is a major change in the structure of a strain of influenza virus such that most (or all) of the world's population is vulnerable to infection. These major changes emerge by at least two mechanisms: genetic recombination and adaptive mutation. [...]. At some point in the future, the world will be faced with another pandemic caused by a novel strain of influenza virus that spreads rapidly and causes extraordinarily high rates of illness and death--higher, in fact, than virtually any other natural health threat. Because novel influenza viruses have the potential to spread rapidly, high levels of absenteeism in the workforce can quickly jeopardize essential community services, including health care services throughout affected regions. Furthermore, it is currently estimated that it will only take one to six months from the time the pandemic is identified to the time that the first outbreak will occur in Alaska, provided the pandemic does not start in Alaska. Because no one can predict exactly when or where the next influenza pandemic will occur, and little time will be available to prepare after the pandemic is first identified, it is critically important for us to promptly maximize our ability to respond effectively to this imminent threat."

  Alaska. Division of Public Health

  2008-02
• Iowa State University Emergency Preparedness Pandemic Flu Plan Draft

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  The purpose of this plan is to ensure that faculty, staff, and students at Iowa State University are adequately prepared for an influenza pandemic.

  Iowa State University

  2008-02
• LLIS Practice Note: Protective Actions: Contra Costa County, California, Community Awareness and Emergency Response Group's All School Shelter-In-Place Drill

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  "The Contra Costa County, California, Community Awareness and Emergency Response Group's All School Shelter-In-Place Drill enables schools to evaluate the effectiveness of their emergency preparedness plans in response to a chemical release or a transportation incident involving hazardous materials."

  Lessons Learned Information Sharing (LLIS)

  2008-01-11?
• EMR-ISAC: InfoGram 1-08 [January 10, 2008]

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  The Emergency Management and Response Information Sharing and Analysis Center's (EMR-ISAC) InfoGram is a weekly publication of information concerning the protection of critical infrastructures relevant to members of the Emergency Services Sector. This issue includes the following articles: "2008 CIP [Critical Infrastructure Protection] Resolution"; "Pandemic Flu Preparedness"; "Injury Risks for EMS [Emergency Medical Services] Responders"; and "Examples of Mitigation Measures".

  Emergency Management and Response-Information Sharing and Analysis Center (U.S.)

  2008-01-10
• Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2: Core Document

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  "This is an updated version of the draft guidance document issued by the Centers for Disease Control and Prevention (CDC) on November 3, 2003. CDC revised the draft based on comments received from public health partners, healthcare providers, professional organizations, and others. CDC will continue to update the document as necessary to incorporate additional comments and to reflect increased understanding of SARS-CoVtransmission dynamics and the availability of improved prevention tools. […] Although the United States had a limited SARS outbreak, it is clear that we are susceptible to the more widespread outbreaks experienced in other countries. It is not possible to predict whether SARS-CoV will reappear, but it could from its original animal reservoir, persistent infection in humans, or the laboratory. To achieve the type of swift and decisive response that is required to control a SARS outbreak, we must be prepared. Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) outlines a framework and approach to assist public health and healthcare officials in preparing for and responding rapidly and decisively to the appearance of SARS-CoV in a healthcare facility or a community. The document has its basis in the United States Government Interagency SARS Concept of Operations Plan (CONPLAN), which outlines the Federal government's strategy for a coordinated national response to an outbreak of SARS. The CONPLAN provides planning guidance for a timely, coordinated response by federal agencies to a SARS emergency and serves as a foundation for the development of operational plans and procedures at the national, state, and local levels."

  Centers for Disease Control and Prevention (U.S.)

  2008-01-08
• Privacy and Pandemic Flu Guide

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  The Privacy and Pandemic Flu Guide is designed to aid public, health professionals when privacy concerns are raised about, activities related to pandemic flu planning and response., The guide describes four steps that will walk a public health, professional through an analysis of the activities. The guide, was developed as a result of a May 2007 discussion among, a small group of experts in privacy and preparedness. This, guide is intended to be a dynamic document, and it is hoped, that feedback from the field on its utility will inform future, iterations.

  Association of State and Territorial Health Officials (U.S.)

  2008-01-08?
• Field Evaluation of Whole Airliner Decontamination Technologies for Narrow-Body Aircraft

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  From the Abstract: "The outcome of a field evaluation of AeroClave's thermal decontamination system is discussed. This exercise evaluated the system both as a stand-alone technology and as a means of delivering STERIS vaporized hydrogen peroxide (VHP®)*. The report is submitted in the context of a decontamination technology selection exercise and work conducted on the efficacy of thermal decontamination. The field evaluation, performed on a McDonnell Douglas DC-9 aircraft, determined that the stand-alone thermal decontamination system exhibited reasonable temperature and relative humidity control capabilities. Indeed, the system reproduced the environmental conditions needed to be efficacious as an antiviral process, based on an earlier study. The thermal decontamination system also provided an effective means of providing environmental preconditioning for the use of VHP and for aeration after VHP exposure. The field evaluation did leave a number of unanswered issues which are discussed in the report. Overall, the field evaluation of both the stand-alone thermal decontamination system and the VHP add-in can be described as successful."

  United States. Federal Aviation Administration

  Gale, W. F. (William Francis); Gale, Hyacinth S.; Watson, Jean

  2008-01
• Quarantine Facilities for Arriving Air Travelers: Identification of Planning Needs and Costs

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  "Threats to public health are a concern to the air travel industry for many reasons, not the least of which is the potential for air travelers to be ill with one of nine communicable diseases that could require quarantine at or near an airport. The threat of pandemic flu and the specter of terrorists using pathogens as a weapon have mobilized many government and defense agencies which are addressing how to detect and contain the spread of potentially deadly illnesses to the general public. Since one of the most effective means of controlling communicable diseases is to reduce the exposure of healthy individuals to persons who have the illness, the subject of quarantine has surfaced as a critical tool to be employed when necessary. The Airport Cooperative Research Program sponsored research undertaken by TriData the division of System Planning Corporation into what would be necessary to effectively quarantine up to 200 travelers from an international flight for 2 weeks, and how much it might cost. This study also presents information on the nature of quarantine and the laws that authorize this form of medical surveillance. There are four phases of quarantine: (1) the decision to quarantine, (2) establishing quarantine, (3) quarantine operations, and (4) demobilization (including recovery). For this study, quarantine at an airport facility away from the main terminal was the premise on which a range of costs was estimated. These costs include the price for stand-by readiness, the costs of activating the site, the financial requirements attendant to operating a quarantine for 2 weeks, and recovery or demobilization costs. Each of these is described in terms of the specific services, supplies, and some of the infrastructure that would be needed."

  National Research Council (U.S.). Transportation Research Board

  Stambaugh, Hollis; Sensenig, Daryl; Casagrande, Rocco . . .

  2008
• Lessons Learned From School Crises and Emergencies: Responding to Infectious Disease: Multiple Cases Of Staph Infections in a Rural School District

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  In this issue of Lessons Learned from School Crises and Emergencies: "Studying infectious disease outbreaks in the school context provides important lessons for all-hazards emergency management planning. Infectious diseases may be more easily transmitted and spread more rapidly in school settings than most because students are in proximity to one another and tend to more easily spread infectious diseases than adults. Schools need to be prepared to respond quickly at the first indication of infectious disease to assess the situation and take necessary steps to limit or mitigate disease transmission. This document focuses specifically on an incident involving several cases of Methicillin-resistant Staphylococcus aureus (MRSA) at a rural high school. MRSA is a specific strain of Staphylococcus aureus bacteria--often called staph--that is resistant to antibiotics commonly used to treat staph infections. About one-third of the population is a carrier for staph on the skin or in the nose; however, being a carrier does not equate with infection. Because a MRSA infection is hard to treat and often causes serious infection, it can sicken or even kill those it infects. MRSA infections are not new and have existed in the community for some time."

  Readiness and Emergency Management for Schools Technical Assistance Center (U.S.)

  2008
• Eleventh Futures Forum on the Ethical Governance of Pandemic Influenza Preparedness

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  "The Eleventh Futures Forum reviewed some countries' experience in applying ethical governance approaches to a major contemporary policy concern for WHO and its Member States: preparedness for an influenza pandemic. […].Decision-makers could face a number of key ethical questions in an influenza pandemic, such as how to ensure equitable, fair and cost-effective access to curative drugs, vaccines and medical treatment, how to set priorities for treatment, and how to allocate resources to prevent and treat influenza. The Forum aimed to enable the participants to identify good practices, exchange and learn from experience in ethically governing pandemic influenza preparedness and identify some of the knowledge gaps. This report describes the ethical considerations used in pandemic influenza planning in the WHO European Region, WHO's work on incorporating ethical considerations in the development of such plans, some possible guiding principles for ethical decision-making, the ethical frameworks for pandemic influenza planning in three countries (Norway, Switzerland and the United Kingdom), national decision-making structures for planning and response (with a case study from Belgium), the issue of public participation in ethical questions in pandemic influenza preparedness, and the Forum's conclusions. It is hoped that this publication will contribute to global work on the ethics of pandemic influenza planning, and, through the exchange of experience with the tools countries are using for ethical policy-making, further promote and concretize the policy principles of ethical governance of health systems in the WHO European Region. "

  World Health Organization

  2008
• Community Pan-Flu Preparedness: A Checklist of Key Legal Issues for Healthcare Providers

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  From the Introduction: "This publication will examine the key legal issues that arise in the context of pandemic influenza along the healthcare continuum, and address a broad range of issues faced by pre-hospital providers, physicians, other community health professionals, acute care facilities, and long term care facilities. This publication also will discuss the important relationship between healthcare providers and the public health authority during a pandemic. By identifying the key legal issues in checklist form, this new publication will provide a scalable tool to assist providers and the broader healthcare community to take concrete preparedness steps with respect to a pandemic, and thus translate 'preparedness on paper' into 'preparedness in practice.' [...] This checklist is organized around the traditional Incident Command System (ICS) structure, providing a scalable approach to emergency management that offers a model for the immediate (and hopefully short-term) ad hoc restructuring of an organization around functional, rather than administrative, lines to meet the demands of the emergency situation. ICS identifies key roles within an organization, including responsibilities for each role, and assigns individuals and resources to those roles based on their availability as needed during an emergency."

  American Health Lawyers Association

  Abelman, David; Belmont, Elisabeth; Lax, Joanne R. . . .

  2008
• Bioterrorism Preparedness for Infectious Disease (BTPID) Proposal

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  "Bioterrorism preparedness for infectious disease (BTPID) as part of homeland defense initiatives continues to advance. Significant opportunities exist for new research and development of bioinformatics and telecommunications solutions for BTPlD that can complement ongoing initiatives. With this in mind this funded effort with additional proposal modifications progressed from a planning study identification of problems and potential solutions analyses of potential solutions all resulting in important recommendations and knowledge. This project also helped to establish a Joint Clinical Research Center in Thailand. In addition to the effort described above an additional modification was added to the existing proposal to expand relationships with nations in Southeast Asia (SEA) which will help foster bioterrorism related infectious disease research in Thailand and SEA in general. This modification enabled advanced simulation-based training on-site during the 2005 APMMC held in Vietnam. The project in its entirety represents a strengthening of knowledge and resources related to bioterrorism and infectious disease as well as a strengthening in Asia-Pacific relationships that are beneficial in working future problems related to bioterronsm infectious disease outbreaks and effective exchange of information. Publications resulting from certain efforts in this project also document this knowledge for application wherever it may be needed in the future. This final report summarizes the spectrum of objectives accomplishments and products from work conducted over the entire research period."

  University of Hawaii at Manoa

  Burgess, Lawrence P.

  2008-01
• Pandemic Influenza Prevention and Mitigation in Low Resource Communities

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  This document should act as a guide for public health professionals in a pandemic influenza situation. This guide outlines key principles that should be followed in the event of an outbreak such as distancing oneself from sick individuals and patient management tools. This document offers concrete information about how to care for the sick as well as hygiene and sanitation measures to implement in the event of an outbreak.

  World Health Organization

  2008
• Business Not As Usual: Preparing for a Pandemic Flu [webcast]

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  This 20 minute video covers planning for a Pandemic flu outbreak. It discusses life during a pandemic, the implementation of social distancing, and how to create a plan from what can learned from others. King County Government, Food Lifeline, Harborview Medical Center, Seattle Fire Department, Washington Mutual, and the Chinese Information and Service Center provide advice for preparing a plan which includes: expect a reduced workforce, plan for months not weeks, prioritize critical functions, verify suppliers' pandemic flu plans, understand interdependencies, assume no mutual aid, develop internal and external messages, decide what you will do, reduce, suspend, cross-train employees, prepare for human resource issues, demonstrate leadership, anticipate supply-chain issues, stockpile supplies, educate employees on how to prepare at home, determine how to keep critical functions running, create partnerships, test and revise your plan, communicate plan to employees, emphasize stop germs behaviors, and identify resources to help with planning. The video concludes with benefits of planning and what to expect for the recovery period.

  Seattle and King County Department of Public Health

  2008
• Quarantine and Isolation; Public Health Leadership's Challenge When Enforcement Is Necessary

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  "Quarantine and isolation may seem like antiquated or medieval concepts particularly when you consider the dramatic advances in medicine over the last several decades. However, the spotlight is on public health in recent years as public health 3 departments across the country engage in unprecedented preparedness activities to be able to respond to an ever increasing variety of public health threats. Incidents such as the spread of SARS [Severe Acute Respiratory Syndrome] in 2003, the threat of influenza A (H5N1), the first CDC [Centers for Disease Control] issued federal order of isolation under the Public Health Service Act since 1963 involving an international traveler in 2007 and globalization highlight the need for public health leadership to make sure their agency is ready for anything. High profile incidents such as the international traveler with a drug resistant form of TB [tuberculosis] focus attention on the methods of controlling the spread of diseases. Specifically, cases involving quarantine and isolation raise many legal questions and create a delicate balancing act between protecting the community at large and preserving individual liberties."

  Mid-America Regional Public Health Leadership Institute

  Dames-Schuster, Pat; Gugle, Joseph; Horner, Mark . . .

  2008?
• Local Challenges of Global Proportions: Evaluating Roles, Preparedness for, and Surveillance of Pandemic Influenza: Hearings before the Oversight of Government Management, the Federal Workforce, and the District of Columbia Subcommittee of the Committee on Homeland Security and Governmental Affairs, United States Senate, One Hundred Tenth Congress, First Session: The Role of Federal Executive Boards in Pandemic Preparedness, September 28, 2007; Preparing the National Capital Region for a Pandemic, October 2, 2007; and Forestalling the Coming Pandemic: Infectious Disease Surveillance Overseas, October 4, 2007

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  From the opening statement of Senator Akaka from the hearing: "The Role of Federal Executive Boards in Pandemic Preparedness". "A Government Accountability Office report concluded in the year 2004 that Federal Executive Boards could play a greater role in the coordination of emergency preparedness and response. Their latest report released in May of this year reaches the same conclusion with a particular focus on pandemic influenza preparedness. GAO recommends the development of a strategic plan for FEBs to support emergency operations, including dedicated funding and performance measurements. I understand that OPM has been working on a strategic plan and consulting with the Federal Emergency Management Agency." From the opening statement of Senator Akaka from the hearing: "Preparing the National Capital Region for a Pandemic." "Public health experts believe that the world is overdue for a pandemic influenza outbreak. The Spanish flu pandemic of 1918 and 1919 killed approximately 40 million people around the world. Beyond this tremendous death rate, an estimated 20 to 40 percent of the population fell ill. The Centers for Disease Control and Prevention estimate that a flu pandemic could kill between 2 to 7.4 million people worldwide. In the United States, an estimated 200,000 people could die and another 2 million people could become ill. In short, we must prepare our communities to protect lives. The effect of pandemic in our Nation's Capital, the heart of the Federal Government, would be dramatic. Comprised of 11 local jurisdictions, the District of Columbia, and parts of Maryland and Virginia, the NCR is home to over 5 million people, 340,000 Federal employees, 40 colleges and universities, and 27 hospitals. The NCR has the second-largest rail system in the country and hosts nearly 20 million tourists each year." From the opening statement of Senator Akaka from the hearing: "Forestalling the Coming Pandemic: Infectious Disease Surveillance Overseas." "Today's hearing focuses on efforts to project our defenses beyond our borders. The Government Accountability Office will also be releasing a report today entitled 'Global Health: U.S. Agencies Support Several Programs to Build Overseas Capacity for Infectious Disease Surveillance.' That report reviews several of the programs we will hear about during this hearing.'" Statements, letters, and materials submitted for the record include those of the following: Bernice Steinhardt, Kevin E. Mahoney, Art Cleaves, Ray Morris, Kimberly Ainsworth, Michael Goin, Kevin Yeskey, Christopher T. Geldart, Robert P. Mauskapf, Darrell L. Darnell, David Gootnick, Ray Arthur, Kimothy Smith , Ralph L. Erickson, Kent R. Hill Health, Nathan R. Flesness, Daniel A. Janies, James M. Wilson, Daniel Akaka, Tom Coburn, Joseph Lieberman.

  United States. Government Printing Office

  2008
• Six Years After Anthrax: Are We Better Prepared to Respond to Bioterrorism?, Hearing Before The Committee on Homeland Security and Governmental Affairs, United States Senate, One Hundred Tenth Congress, First Session, October 23, 2007

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  From the opening statement of Joseph Lieberman, "Good morning and welcome to our hearing today where we will assess whether the Federal Government has developed the tools that we need in the post-September 11, 2001, world to respond to bioterrorist attacks on the United States and also to the effects of pandemic events. Six years ago--just one week after the September 11 attacks traumatized America--we were shaken again by a string of anthrax attacks that, over the course of 2 months, killed five people, sickened 22, and drove more than 10,000 others to take powerful antibiotics as a precautionary measure. Postal Service workers were hit the hardest as the attack came in letters through the mail, but I will say, it also hit close to home. In Wallingford, Connecticut, a wonderful woman, Ottilie Lundgren, was one of those who died because she opened a letter containing the deadly substance. I know that we all certainly here in the Capitol remember those days because a mailroom employee of then-Majority Leader Tom Daschle opened a letter containing the deadly white powder. The Hart Building was evacuated, closed for months while environmental HAZMAT teams scoured the building. Regrettably, whoever was responsible for the anthrax attacks, has remained unknown and, therefore, unfortunately, unpunished. But we do know that a catastrophe can strike Americans in their homes or places of work or places of assembly as a result of bioterrorism or naturally occurring diseases such as pandemic flu. And, therefore, we must be ready. So 6 years after those anthrax attacks, are we better prepared to respond to bioterrorism than we were then? My answer, unfortunately, is yes, but not much, and certainly not enough. And I base that on the testimony and the GAO report that we will hear today."

  United States. Government Printing Office

  2008
• Options for the Use of Human H5N1 Influenza Vaccines and the WHO H5N1 Vaccine Stockpile: WHO Scientific Consultation

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  "From 1 to 3 October 2007, WHO [World Health Organization] held a scientific consultation to review the current data on H5N1 vaccine immunogenicity, safety and other characteristics, to consider current general options for the use of such vaccine and to identify options specifically for the use of the WHO H5N1 vaccine stockpile. One of the principal objectives of this consultation was to review the available scientific information as a basis for the possible uses of the WHO H5N1 vaccine stockpile in order to inform the discussions of the WHO Strategic Advisory Group of Experts (SAGE) in November 2007. The participants of the October consultation included researchers, representatives from WHO Influenza Collaborating Centres, selected country representatives, SAGE members, and the pharmaceutical industry. Observers were allowed."

  World Health Organization

  2008
• Plan Now to Be Ready for the Next Flu Pandemic

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  "Use this fact sheet to help you plan how to get ready for the next flu pandemic before it happens. [...]. A new pandemic flu virus will spread easily from person to person, mostly through coughing and sneezing. When a sick person coughs or sneezes near you, you can breathe in droplets that have the virus. The droplets also could land on surfaces you may touch with your hands."

  Centers for Disease Control and Prevention (U.S.)

  2008
• Addressing Ethical Issues in Pandemic Influenza Planning

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  From the Introduction: "In March 2006, the World Health Organization (WHO) convened four working groups to review the literature and develop preliminary conclusions on key ethical issues in pandemic preparedness and response. [...] This volume includes the background papers prepared by the chairpersons in consultation with their working group members. In chapter I, Marcel Verweij of Utrecht University (Netherlands), chairperson of the working group on 'Equitable access to therapeutic and prophylactic measures', explores the challenge of allocating vaccines, antiviral medications, ventilators, and other scarce resources during a pandemic. [...] Chapter II is written by Larry Gostin, chairperson of the working group on 'Isolation, quarantine, border control, and social distancing' and Ben Berkman, both of Georgetown University. [...] In chapter III, Ross Upshur of the University of Toronto (Canada), who served as chairperson of the working group on 'Role and obligations of health-care workers during an influenza pandemic', discusses the importance of ensuring adequate numbers of health-care workers during a pandemic. [...] Finally, in chapter IV, Robert Archer, chairperson of the working group on 'Pandemic influenza planning and response - transnational issues for governments', explores the role of international cooperation in pandemic preparedness and response efforts."

  World Health Organization. Epidemic and Pandemic Alert and Response

  2008
• Hawaii Pandemic Influenza Preparedness & Response Plan

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  Hawaii's Pandemic Influenza Preparedness and Response Plan provides guidance for state agencies and departments to counter the anticipated impact of a pandemic influenza outbreak.

  Hawaii. Department of Health

  2008-01-01?
• Tulalip Tribes Pandemic Flu Response Plan

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  "The primary goal of this plan is to give local decision makers a clear and easy to read guide that defines roles, responsibilities and predetermined decision points that are likely to occur throughout the pandemic. In addition to being a guide to response, the plan should also serve as a lightning rod for the potentially politically charged and complicated questions that need to be asked and answered well before the onset of any pandemic. The Tulalip Tribes' Pandemic Flu Response Plan will be coordinated with local, regional, and state partners. The purpose of the plan is to: Define activities that the Tulalip Tribes and partner agencies may do before a pandemic occurs to prepare for a pandemic flu response; Define the decision-making structure and coordinated response efforts among the Tulalip. Tribes and partner agencies of Snohomish County, and state and federal agencies; Define roles and responsibilities of the Tulalip Tribes and local response partners during a pandemic; and Describe Public Health activities during a pandemic influenza event."

  Northwest Tribal Emergency Management Council

  2008
• Comments from the Center for Biosecurity of UPMC on Draft Guidances for Pandemic Influenza Planning

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  "On May 23, 2008, the U.S. Department of Health and Human Services (HHS) proposed and requested public comment on 3 draft guidances for pandemic influenza planning (73 FR 31690-91): (1) Interim Guidance on the Use and Purchase of Facemasks and Respirators by Individuals and Families for Pandemic Influenza Preparedness; (2) Proposed Guidance on Antiviral Drug Use during an Influenza Pandemic; and (3) Proposed Considerations for Antiviral Drug Stockpiling by Employers in Preparation for an Influenza Pandemic. The documents are part of a series of HHS guidances to assist government agencies, businesses, community organizations, and the public in preparing for a pandemic. The Center for Biosecurity of UPMC reviewed the proposed draft guidances and submitted to HHS the following analyses of the antiviral use and employer stockpiling guidances as its official comments."

  University of Pittsburgh Medical Center. Center for Biosecurity

  2008
• Occupational Health Disaster Expert Network, (OHDEN) Pandemic Influenza Information Site for Workplace and Workforce Planning [website]

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  "This website is intended to provide four types of information: Links to instructive materials and smart reference sites regarding either Avian Influenza H5N1, or to the concepts of Pandemic Influenza; Aspects pertaining to care and prevention of worker issues regarding these topics. This means special workforce situations (eg. poultry and healthworkers); Organizational needs regarding public health aspects or population concerns, including contingency management plans for major absenteeism and illness; and Plans and programs created by other professionals responsible for Occupational & Environmental Health issues. Plans, spreadsheets, flow-charts, essays, ideas, commentary are collected."

  Occupational Health Disaster Expert Network

  2008
• Australian Health Management Plan for Pandemic Influenza: Important Information for All Australians [2008]

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  "The burden of an influenza pandemic could overwhelm a nation's health system. An influenza pandemic also has the capacity to cause economic and societal disruption on a massive scale1. For these reasons, the World Health Organization (WHO) encourages all countries to draw up and implement national preparedness plans for an influenza pandemic2. There is no certainty when the next influenza pandemic will occur but according to the WHO, 'there will be an influenza pandemic, sooner or later'3. In recent history, two to three pandemics have been recorded every century. How rapidly the next pandemic will emerge is unclear but it could emerge very quickly with little warning. Currently there are influenza viruses with pandemic potential circulating widely in animals. These viruses occasionally infect humans. This situation could continue for some time, and while this situation remains, there is a risk that a pandemic may develop. It is also uncertain how severe the next pandemic may be. It could be relatively mild, creating health problems similar to those seen during a very severe influenza season. Alternatively, a highly pathogenic virus could emerge resulting in serious and widespread illness, leading to a large number of deaths and to the disruption of the normal functioning of society for a prolonged period." © Commonwealth of Australia 2008 This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced by any process without prior written permission from the Commonwealth. Requests and inquiries concerning reproduction and rights should be addressed to the Commonwealth Copyright Administration, Attorney General's Department, National Circuit, Barton ACT 2600 or posted at http://www.ag.gov.au/cca

  Australia. Department of Health and Ageing

  2008
• Public Health Pandemic Influenza Response Plan

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  "The purpose of this plan is to provide a guide for the Wyoming Department of Health (WDH) for detecting and responding to an influenza pandemic. This plan must be periodically reviewed and updated to ensure that its assumptions, resources, priorities, and plans are consistent with current knowledge and changing infrastructure. In addition, in the event of a pandemic, the judgments of the public health leadership, based on the epidemiology of the outbreak and the extent of population infection, may alter or override anticipated strategies and plans."

  Wyoming. Department of Health

  2008-01
• Missouri's Pandemic Influenza Response Plan [January 2008]

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  This plan lays out the specific responsibilities of the Missouri Department of Health and Senior Services and coordinated agencies during the phases of a pandemic response.

  Missouri. Department of Health & Senior Services

  2008-01
• Intergovernmental Cooperation in Benchmarking a Local Government Continuity-Of-Operations Exercise

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  From the Document: "This paper describes intergovernmental cooperation in the conduct of a local government continuity-of-operations exercise by the Public Works Division, Bernalillo County, New Mexico. The commitment of Bernalillo County to cooperation included the implementation of national standards and recommended practice. The commitment was based on principle and not on funding. The planning, training, and exercise cycle is considered part of the ongoing responsibility of the agency and is funded within the Public Works Division's operating budget. All levels of government participated in the exercise. The commitment of other agencies to the local government exercise included external evaluation, review of the AfterAction Report and Improvement Plan, the support of continuity of operations, and ongoing cooperation in critical infrastructure protection. The state involvement in the exercise was through the Department of Homeland Security and Emergency Management as well as the Department of Health. Federal agencies supporting the exercise were the U.S. Department of Homeland Security; the Federal Bureau of Investigation; the Office of the U.S. Attorney; the 377th Wing Command, Kirtland Air Force Base; Sandia National Laboratories; and the National Nuclear Security Administration. The exercise was successful. The conduct of the exercise demonstrated that the division was well prepared."

  National Research Council (U.S.). Transportation Research Board

  West, Tim; Miller, Steve; Zdunek, Tom . . .

  2008
• Pandemic Influenza: Progress Made and Challenges Ahead, Hearing Before a Subcommittee on Appropriations, United States Senate, One Hundred Tenth Congress, First Session, Special Hearing, January 24, 2007

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  From the opening statement of senator Arlen Spector. "Good morning, ladies and gentlemen. On a conspiracy, secret conspiracy, which is about to be made public, the chairman and I have been conferring and he handed me the gavel so that we could have a ceremonial shift in gavel. Senator Harkin and I, who have traded positions as the powers have flowed, have always talked about it being a seamless change in the gavel. So I want to express my appreciation to Senator Harkin for handing me the gavel and to announce publicly that I'm not going to give it back. But on a serious level, it doesn't happen too often in the Senate, Tom Harkin and Arlen Specter have worked very closely together for more than two decades, since Senator Harkin was elected in 1984, and I think that has benefited the American people and the health community and the education community and worker safety and labor, where those three departments are under the funding of this subcommittee. In a contentious political climate in Washington, this is we think the way it ought to be operated. So here comes the seamless transfer, Mr. Chairman." Statements, letters, and materials submitted for the record include those of the following: Tom Harkin, Gerald W. Parker, Julie L. Gerberding, Anthony S. Fauci, and John Jay Treanor.

  United States. Government Printing Office

  2008