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• Nonpharmaceutical Interventions for Pandemic Influenza, International Measures

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  "Since global availability of vaccine and antiviral agents against influenza caused by novel human subtypes is insufficient, the World Health Organization (WHO) recommends nonpharmaceutical public health interventions to contain infection, delay spread, and reduce the impact of pandemic disease. Virus transmission characteristics will not be completely known in advance, but difficulties in influenza control typically include peak infectivity early in illness, a short interval between cases, and to a lesser extent, transmission from persons with incubating or asymptomatic infection. Screening and quarantining entering travelers at international borders did not substantially delay virus introduction in past pandemics, except in some island countries, and will likely be even less effective in the modern era. Instead, WHO recommends providing information to international travelers and possibly screening travelers departing countries with transmissible human infection. The principal focus of interventions against pandemic influenza spread should be at national and community levels rather than international borders."

  Emerging Infectious Diseases

  2006-01
• Guidance for Employers on Returning to Work After Influenza Illness

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  This document provides employers with guidance on setting criteria for their employees who are returning to work after being sick with the season flu. It also presents important qualifications that should be considered in the event of a pandemic flu outbreak.

  Public Health Seattle & King County

  Teeter, Dorothy F.

  2006-01-01?
• Funding Needs for Pandemic Influenza Preparedness, Hearing Before a Subcommittee of the Committee on Appropriations, United States Senate, One Hundred Ninth Congress, First Session, Special Hearing, November 2, 2005

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  From the opening statement of Arlen Specter. "We have a hearing of unusual importance in a subcommittee which characteristically has hearings of very great importance, but this tops the list of any in recent times. We are looking at a very substantial appropriation to meet the imminent threat of a pandemic flu. I had the opportunity to hear the President's speech yesterday at the National Institutes of Health, and the President really laid it on the line with the potential problems, which are enormous. Last week, when we had full Senate consideration of the appropriations bill, Senator Harkin took the lead, having spotted this problem some substantial time ago, and we worked through a very substantial add-on to our appropriations bill, in the amount of $7,975,000,000. We carefully fenced the money so that the expenditures would be at the discretion of the President and his very able team, many of whom are assembled here this morning. But we did not want to face a situation where Congress adjourned and then the program came forward. We will be looking, perhaps in late November, at a supplemental with the Congress out of session. Supplemental appropriation bills are extraordinarily difficult. They become what we call Christmas trees for many, many other items, so that if we can appropriate for it in due course, which we are moving ahead on, that's the way to handle it." Statements, letters, and materials submitted for the record include those of the following: Arlen Spector, Tom Harkin, Thad Cochran, Patty Murray, Michael O. Leavitt, Anthony Fauci, Bruce Gellin, Julie Gerberding, William Raub, and John M. Barry.

  United States. Government Printing Office

  2006
• Biodefense and Pandemic Influenza: Hearing Before a Subcommittee of the Committee on Appropriations, United States Senate, One Hundred Ninth Congress, Second Session, Special Hearing, May 23, 2006

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  From the opening statement of Judd Gregg: "As a society, I think we recognize and as a culture I think we recognize that there are certain elements of threat which the government has a responsibility to prepare for even though we hope that they will never impact us. Number one on that list, of course, is the use of a biological or nuclear or weapon of mass destruction used by an enemy of America, terrorists specifically, against us, and our preparation for that has been a major focus of this committee, myself and Senator Byrd. We have reoriented funds to address that. Number two-not in that sense; they are equal in status-is the potential of a major outbreak of influenza along the lines of what happened in the early part of the last century, which would potentially harm and kill millions, potentially hundreds of thousands, of citizens across the world and in the United States and would obviously disrupt the entire world and the economy of the world, especially America, if it were not prepared for adequately. There has been a lot of talk about that because of the issues of bird flu and the possible mutation of that virus into a form that can be conveyed to humans and human-to-human conveyance from there. So these are big issues that need to be constantly focused on and that we as a government need to be constantly addressing and talking about and making sure that the agencies in our government which are responsible are on top of these issues." Statements, letters, and materials submitted for the record include those of the following: Judd Gregg, Larry Craig, Robert C. Byrd, Paul A. Offit, John M. Clerici, Scott R. Lillibridge, Frank J. Cilluffo, and Steven D. Rice.

  United States. Government Printing Office

  2006
• Information on Influenza Viruses; Differences Between Human, Avian, and Pandemic Flu and Issues to Consider

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  "What is a pandemic anyway? Basically, this is an event that defines the progression/spread of disease (mortality and morbidity) related to an infectious agent (in this case its influenza). What is the difference between the H5N1 avian influenza 'bird flu' and pandemic influenza? Avian influenza typically infects birds and not people. A pandemic virus is one that emerges (and is transmitted human to human) as a new version or 'strain' of influenza that has never been circulated (or has not been circulated for a long time) among people. If the H5N1 bird flu undergoes enough changes to where it can be readily transmitted from human to human, then it could be considered a pandemic influenza virus. The same holds true for other strains e.g. swine, bird, and human. What are the chances of that happening? Influenza viruses possess the ability to undergo major and/or subtle changes in their outer structural proteins. These major and/or subtle changes are the basis for either the emergence of a pandemic virus or one that is similar to the previous years strain, respectively."

  University of South Florida. Center for Biological Defense

  Sweat, J. Mark

  2006-01
• Vaccines for Pandemic Influenza

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  "Recent outbreaks of highly pathogenic avian influenza in Asia and associated human infections have led to a heightened level of awareness and preparation for a possible influenza pandemic. Vaccination is the best option by which spread of a pandemic virus could be prevented and severity of disease reduced. Production of live attenuated and inactivated vaccine seed viruses against avian influenza viruses, which have the potential to cause pandemics, and their testing in preclinical studies and clinical trials will establish the principles and ensure manufacturing experience that will be critical in the event of the emergence of such a virus into the human population. Studies of such vaccines will also add to our understanding of the biology of avian influenza viruses and their behavior in mammalian hosts."

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

  Luke, Catherine J.; Subbarao, Kanta

  2006-01
• President's Statement on Signing of H.R. 2863, the 'Department of Defense, Emergency Supplemental Appropriations to Address Hurricanes in the Gulf of Mexico, and Pandemic Influenza Act, 2006' [December 30, 2005]

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  From the Document: "Today, I have signed into law H.R. 2863, the 'Department of Defense, Emergency Supplemental Appropriations to Address Hurricanes in the Gulf of Mexico, and Pandemic Influenza Act, 2006.' The Act provides resources needed to fight the war on terror, help citizens of the Gulf States recover from devastating hurricanes, and protect Americans from a potential influenza pandemic. Sections 8007, 8011, and 8093 of the Act prohibit the use of funds to initiate a special access program, a new overseas installation, or a new start program, unless the congressional defense committees receive advance notice. The Supreme Court of the United States has stated that the President's authority to classify and control access to information bearing on the national security flows from the Constitution and does not depend upon a legislative grant of authority. Although the advance notice contemplated by sections 8007, 8011, and 8093 can be provided in most situations as a matter of comity, situations may arise, especially in wartime, in which the President must act promptly under his constitutional grants of executive power and authority as Commander in Chief of the Armed Forces while protecting certain extraordinarily sensitive national security information. The executive branch shall construe these sections in a manner consistent with the constitutional authority of the President."

  United States. Office of the White House Press Secretary

  2005-12-30
• Metropolitan Medical Response System Program (MMRS) and Pandemic Flu Preparedness [presentation]

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  This presentation covers the Metropolitan Medical Response System Program and pandemic flu preparedness options for the U.S. House of Representatives Committee on Homeland Security staff.

  United States. Department of Homeland Security

  2005-12-29
• Local Mitigation Strategies for Pandemic Influenza

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  "Local, open-outbreak mitigation strategies for pandemic influenza that target zones of high infectious contact within a community's social network may be very effective. A networked agent-based model was used to instantiate the contact network within a stylized small town and vary the behavior of targeted groups. Simulations show that until sufficient vaccine becomes available, influenza could be halted solely through social distancing whereby children and teenagers stay home while the rest of the population continues normal day-to-day activities. Subsequent vaccinations that start with children and teenagers return the community to normalcy most rapidly, with the least illness, death, and vaccine."

  Sandia National Laboratories

  Glass, Robert J.

  2005-12-21
• Pandemic Flu Emergency Response Plan: Summary Report to Governor Donald L. Carcieri

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  This report, based on the December 2005 version of Rhode Island's pandemic flu plan, summarizes the major strategies for a statewide response to a pandemic flu event.

  Rhode Island

  Rhode Island. Pandemic Flu Working Group

  2005-12-20
• Rhode Island Pandemic Flu Emergency Response Plan

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  This document analyzes pandemic flu and the possible reactions to an outbreak in the state of Rhode Island. It details plans for action currently in place and makes suggestions for improving them.

  Rhode Island Emergency Management Agency

  2005-12-20
• Jefferson County Avian Influenza Workshop: December 14, 2005 [Colorado]

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  From the Executive Summary: "Avian Flu-H5N1 (AI) is a rapidly spreading disease that endangers both domestic and wild bird population. In its current form, it does not pose a significant threat to the general population. People who come in close contact with birds are at greater risk of contracting a life threatening infection that requires significant amounts of medical care and resources for successful treatment. The arrival of AI in Colorado will require an aggressive and coordinated multi-disciplinary response which will bring a large number of our response personnel into potentially dangerous contact with infected birds. It will also increase concerns about public health, environmental impacts, and possible infections of other domestic and wild species. AI is not currently rapidly transmissible among human beings. However, there is concern it may contribute to the emergence of a flu strain similar to the 1918 pandemic which killed millions of people globally. The probability, timing and nature of the emergence of pandemic flu are topics of significant debate within the public health community. This concern and the general public's lack of understanding of the differences between the current AI and the potential pandemic flu further complicate this issue. […] In support of this goal, the Jefferson County Division of Emergency Management and the Jefferson County Department of Public Health and Environment co-hosted a multi-disciplined workshop to discuss seven 'focus questions' to determine our current level of preparedness for AI, identify gaps, and facilitate an on-going effort to improve our readiness for AI. Although our current all-hazards efforts provide a solid basis for response to AI, there are several areas requiring additional enphasis. The following is a summary of this initial workshop."

  Jefferson County (Co.). Division of Emergency Management

  Moser, Greg

  2005-12-14
• Pandemic Influenza Planning in Minnesota: Presentation by the Minnesota Commissioner of Health

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  This presentation was given during the Minnesota Pandemic Response and Emergency Planning Summit. It discusses the State's influenza planning efforts and identifies the State's public awareness efforts and overall response capabilties improvements to date.

  Minnesota. Department of Health

  2005-12-14?
• Avian Flu Pandemic Response Plan Template

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  This Template was created as a GUIDE to help plan for business or government continuity during a Pandemic. LLIS Core Capability: Community Preparedness; Public Health; Private Sector; Private Sector; Private Sector; Private Sector

  eBRP Solutions

  2005-12-13?
• Federal and State Quarantine and Isolation Authority [December 12, 2005]

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  From the Summary: "In the wake of recent terrorist attacks and increasing fears about the spread of highly contagious diseases, such as severe acute respiratory syndrome (SARS) and pandemic influenza, federal, state, and local governments have become increasingly aware of the need for a comprehensive public health response to such events. An effective response could include the quarantine of persons exposed to infectious biological agents that are naturally occurring or released during a terrorist attack, the isolation of infected persons, and the quarantine of certain cities or neighborhoods. [...] This report provides an overview of federal and state public health laws as they relate to the quarantine and isolation of individuals, a discussion of constitutional issues that may be raised should individual liberties be restricted in a quarantine situation, and federalism questions that may arise where federal and state authorities overlap. In addition, the possible role of the armed forces in enforcing public health measures is discussed, specifically whether the Posse Comitatus Act would constrain any military role, and other statutory authorities that may be used for the military enforcement of health measures."

  Library of Congress. Congressional Research Service

  Elsea, Jennifer; Swendiman, Kathleen

  2005-12-12
• Pandemic Flu: For Servicemembers and their Families

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  "Pandemic flu is a global outbreak of flu that occurs when a new flu virus appears in people, causes serious illness, and spreads easily from person to person. A pandemic is a global outbreak of disease, while an epidemic is a widespread or regional outbreak. During the 20th Century, new influenza viruses caused three pandemics, the most recent in 1968. The most severe was the 1918-1919 'Spanish Flu', which caused more than 500,000 deaths in the United States and 20-40 million deaths worldwide. Nearly half of those who died were young, healthy adults. The first documented human cases of H5N1 avian flu were found in 1997 when six people were infected and died in Hong Kong during a large outbreak of influenza among poultry. Beginning in late 2003, outbreaks among poultry were reported throughout Southeast Asia with extension into Central Asia, Russia, and Eastern Europe. Scattered human cases of H5N1 avian flu have occurred among people who had direct contact with sick poultry or who ate undercooked poultry infected with the virus. So far, spread of H5N1 avian flu virus has been rare and has not continued beyond one person."

  United States. Department of Defense; United States. Air Force Institute for Operational Health

  2005-12-07
• Influenza 2005: The Laboratory's Role in Pandemic Preparedness and Response [presentation]

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  PowerPoint presentation from the Wisconsin State Laboratory of Hygiene that presents information on influenza antigenic characteristics, laboratory diagnostic methods, surveillance for new strains of influenza viruses, and the overall laboratory role in preparedness. LLIS Core Capability: Public Health; Community Preparedness

  Wisconsin State Laboratory of Hygiene

  Shult, Pete A.; Kirk, Carol

  2005-12-06?
• Business Pandemic Influenza Planning Checklist

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  "In the event of pandemic influenza, businesses will play a key role in protecting employees health and safety as well as limiting the negative impact to the economy and society. Planning for pandemic influenza is critical. To assist you in your efforts, the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) have developed the following checklist for large businesses. It identifies important, specific activities large businesses can do now to prepare, many of which will also help you in other emergencies. Further information can be found at www.pandemicflu.gov and www.cdc.gov/business."

  United States. Department of Health and Human Services

  2005-12-06
• State and Local Pandemic Influenza Planning Checklist

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  "Planning for pandemic influenza is critical. To assist you in your efforts, the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) have developed the following checklist. It identifies important, specific activities you can do now to prepare. Many are specific to pandemic influenza, but a number also pertain to any public health emergency. This checklist is based on the HHS Pandemic Influenza Plan, Public Health Guidance for State and Local Partners, but is not intended to set forth mandatory requirements. Each state and local jurisdiction should determine for itself whether it is adequately prepared for disease outbreaks in accordance with its own laws and procedures."

  United States. Department of Health and Human Services

  2005-12-02
• Department of Health and Human Services State and Local Pandemic Influenza Planning Checklist

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  This checklist, released by HHS [Health and Human Services] and the CDC [Centers for Disease Control and Prevention], identifies important activities that state and local agencies and organizations should undertake to prepare for a pandemic flu outbreak. The checklist is based on the HHS Pandemic Influenza Plan, Public Health Guidance for State and Local Partners. LLIS Core Capability: Community Preparedness

  United States. Department of Health and Human Services

  2005-12-02?
• Citizen Voices on Pandemic Flu Choices: A Report of the Public Engagement Pilot Project on Pandemic Influenza

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  From the Executive Summary: "This Public Engagement Pilot Project on Pandemic Influenza (PEPPPI) was initiated in July 2005 to discuss and rank goals for a pandemic influenza vaccination program and to pilot test a new model for engaging citizens on vaccine related policy decisions (The Vaccine Policy Analysis CollaborativE, VPACE). The Pilot Project was sponsored by a network of interested organizations listed on the cover of this report. To conduct this public consultation, the sponsors engaged stakeholders from various organizations with an interest in pandemic influenza (the National Stakeholder Group), and individual citizens-at-large from the four principal regions of the United States. The anticipated major benefits from this public consultation were the development of an improved plan to combat pandemic influenza and one more likely to gain public support, and a demonstration that citizens can be productively engaged in informing vaccine related policy decisions."

  University of Nebraska Public Policy Center

  2005-12
• Health Care Planning for Pandemic Influenza [presentation]

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  This presentation was given by Dr. Debra E. Berg, of the Department's Bioterrorism Hospital Preparedness Program, at a November 30, 2005 meeting of the Greater New York Hospital Association. It discusses the contents of the U.S. Department of Health and Human Services Pandemic Preparedness Plan, the recommendations of the citywide pandemic tabletop exercise after-action report, and how the Department's intitiatives involve New York area healthcare facilities. LLIS Core Capability: Healthcare; Public Health; State and Local Executive Offices

  New York (N.Y.). Department of Health and Mental Hygiene

  Berg, Debra E.

  2005-11-30
• Systematic Analytic Approach to Pandemic Influenza Preparedness Planning

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  "An analytic approach for traffic safety injury epidemiology and prevention was developed by Dr. William Haddon, Jr. in the 1960s, and has since been termed 'the Haddon matrix.' This matrix provides a multidimensional approach to understanding the contributing factors to injury before, during, and after an event. Although the Haddon matrix may seem unfamiliar to some infectious disease scientists, it incorporates familiar analytic elements in a systematic way. The four columns represent the classical epidemiologic triad of host, agent, and environment (physical and sociocultural). The three rows are equivalent to primary, secondary, and tertiary prevention of disease outbreaks. Indeed, Haddon himself used his analytic matrix to describe an outbreak of polio, and this matrix has been recently applied to other public-health emergency preparedness challenges such as SARS. Comprehensive public health emergency preparedness and response efforts require effective pre-event (preventive), event (mitigation), and post-event (consequence management) strategies. By identifying the factors that may modify the outcome in each of these phases, one can prescribe the appropriate measures necessary to tackle each factor. To this end, we specifically applied the Haddon matrix to pandemic influenza planning and response, systematically identifying relevant factors in each phase (pre-event, event, post-event) and on each axis (human, agent/vector, physical environment, sociocultural environment). We then identified factors that may be associated with opportunities for public health intervention, and marked these factors in bold within the matrix."

  Public Library of Science

  Barnett, Daniel J.; Balicer, Ran D.; Lucey, Daniel R.

  2005-12
• SEMP Biot #302: Emergency Departments and Epidemics: The 2003 Toronto SARS Experience

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  This document addresses the medical unfolding of the SARS [Severe Acute Respiratory Syndrome] epidemic in Toronto in 2003. The health epidemic disaster highly stressed the medical and public health systems, exposing hidden weaknesses, which were related to medical, economic and political practices. LLIS Core Capability: 2003: SARS Outbreak

  Suburban Emergency Management Project (U.S.)

  2005-11-27
• Pandemic Influenza Continuity of Operations Plan (COOP) for Massachusetts Hospitals

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  "This plan outlines a comprehensive approach to ensure the continuity of essential services during an influenza pandemic while ensuring the safety and well being of employees, the emergency delegation of authority, the safekeeping of records vital to the agency and its clients, emergency acquisition of resources necessary for business resumption, and the capabilities to work at alternative work sites until normal operations can be resumed."

  Massachusetts. Executive Office of Public Safety and Security

  2005-11-18
• Pandemic Influenza Exercises in Canada

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  This document contains an overview of pandemic influenza exercises in Canada. The document includes the specific details necessary to effectively conduct a pandemic flu exercise.

  Public Health Agency of Canada

  Macey, Jeannette; Tam, Theresa; King, Arlene

  2005-11-16?
• Pandemic Influenza: Domestic Preparedness Efforts [November 10, 2005]

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  "Global pandemic preparedness and response efforts are coordinated by the World Health Organization (WHO). The U.S. Department of Health and Human Services (HHS) released a draft pandemic flu preparedness and response plan in August 2004, and a final plan in November 2005. President Bush announced a national strategy to coordinate pandemic preparedness and response activities across federal 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 the National 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 in the next several years, the U.S. response would be affected by the limited availability of a vaccine (the best preventive measure for flu), as well as by limited availability of certain drugs used to treat severe flu infections, and by the general lack of surge capacity 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 by the fact that while periodic influenza pandemics have been seen over the years, their timing and severity have been unpredictable."

  Library of Congress. Congressional Research Service

  Lister, Sarah A.

  2005-11-10
• Remarks on the National Strategy for Pandemic Influenza Preparedness and Response in Bethesda, Maryland, November 1, 2005

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  This document presents the text of a speech given by President George W. Bush in Bethesda, Maryland on November 1, 2005. In this speech the President discusses the pandemic influenza and offers commentary on the need for the United States to continue taking the offensive in the fighting this epidemic. Finally, President Bush describes what actions the United States has taken combat the spread of pandemic influenza.

  United States. Government Printing Office

  2005-11-07
• Letter to the Speaker of the House of Representatives on Funding for the National Strategy for Pandemic Influenza Preparedness and Response

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  This document contains the text of a letter sent by President Bush to the Speaker of the House asking Congress to consider his request to allocate $7.1 billion to the Departments of Health and Human Services, Defense, Homeland Security, the Interior, State, and Veterans Affairs so these departments could prepare the country to combat the threat of avian and pandemic influenza.

  United States. Government Printing Office

  2005-11-07
• Iowa Pandemic Influenza Annex Executive Summary

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  This Executive Summary of Iowa's Pandemic Influenza Annex provides an overview of the annex's objectives and of the various responsibilities to be delegated to the Iowa Department of Public Health during a pandemic influenza outbreak.

  Iowa. Department of Public Health

  2005-11-04