Anticipated Q&A at Pan Flu Community Forums

Can I stock up on maintenance prescription medications and will insurance cover it?

Check with your medications provider to see if that option is available. Most providers allow for a limited supply of meds on hand. Some plans, if you purchase by mail order through its own resources, will provide a 90-day supply of each prescription medication.

As a school nurse, what do I need to know and what should I be doing?

You can increase your knowledge about pandemic flu, seasonal flu and avian flu by visiting the government Web site www.pandemicflu.gov. Also, you can stress the importance of each family having a home emergency plan to your students, of taking universal respiratory procedures and of staying home when ill.

How will the communities be alerted?

Communities can be alerted by a variety of means, everything from radio and television announcements, reverse 911 calls, newspaper articles to emergency vehicles with loudspeakers traveling through neighborhoods.

How might public service utilities be affected?

Utilities have emergency plans that are periodically exercised which cover most incidents. Public utilities are capable of continuing essential services with reduced manning levels. Some services normally provided but not deemed critical, may be postponed or temporarily disrupted, depending upon the real time situation.

 Who might be at high risk besides the regular groups (very young/old)?   

A flu pandemic would be caused by a new virus strain for which there is no vaccine, therefore all persons would be equally susceptible and at risk until a new vaccine was produced and approved.

How long would it take to “make” a vaccine?

The Centers for Disease Control and Prevention and the National Institutes of Health suggest it could take 4 to 6 months before a vaccine could be available for a new pandemic flu strain.

How much protection can we get from a regular flu shot?

Persons should still get the seasonal flu shot for protection against that strain of flu. But it would offer no or minimal protection against a different strain of pandemic flu.

How is H5N1 being transmitted?

In its current form, it is very difficult to get H5N1. Since 2003, there have been 253 confirmed human cases of H5N1 according to the World Health Organization, resulting in a case fatality ratio of 58 percent. Most of those cases involved patients in developing nations who lived in close contact with their chickens or other birds for extended periods of time.

Does an H5N1 vaccine exist?

The National Institute of Allergy and Infectious Disease (NIAID), part of the National Institutes of Health, is currently evaluating two vaccines for H5N1.       

What is the availability of season flu vaccine expected to be, compared to last year’s shortages?

Last year the shortage was caused by production problems at a facility in England. This year there has been no reported production problems. The federal government is also testing vaccine produced in Canada. If approved, vaccine from all sources will provide more than 100 million doses, capable of meeting all anticipated demands.

Is the County conducting a flu vaccine program.

Every year the CDC conducts its flu education program, encouraging higher risk populations to obtain a seasonal flu shot. More information can be found at www.cdc.gov/flu.

Given the early absence of a vaccine, is there anything extra that can/should be done to protect high risk groups?

High risk individuals can reduce their chances of getting seasonal flu by following universal respiratory procedures, which include frequent washing of hands, covering your mouth with your sleeve if you have a cough, wearing a mask to cover nose and mouth, avoiding crowds and staying home when ill.

Should everyone get a pneumovax shot?

No, only persons 65 years of age and older, persons 2 years of age and older with a long-term health conditions (heart disease, diabetes, lung disease, sickle cell disease, etc.), persons 2 years of age and older with an immunosuppressive condition (HIV, lymphoma, leukemia, kidney failure, etc.).  There are a few other specific categories and people should consult their physician  if they have any questions.

Why not stock up on Tamiflu? (50 Percent protection is better than nothing.)

Health authorities are stockpiling antivirals but there is no recommendation for individuals to do the same.  Supplies of TamiFlu are already limited and in the event of a pandemic it can be allocated more efficiently and appropriately by health authorities.

Does Tamiflu work better for certain population segments?

Tamiflu is for treating adults, adolescents, and pediatric patients 1 year of age and older with the flu whose flu symptoms started within the last day or two.  Tamiflu’s safety and effectiveness have not been determined in people with chronic heart or lung disease, kidney failure, or in people with high-risk underlying medical conditions. 

Can we buy anti-virals over-the-counter?

Since effective vaccines must be custom-made specifically for that type of flu, effective anti-virals will not be available over-the-counter.

What do we do about the stocking of foods and how to keep from having outdated items in your emergency food pantry?

Plan on purchasing a few extra items each week. Keep in a special place. Items should be foods your family normally enjoys. Avoid salty items, as they can create thirst. Avoid items that require a lot of preparation. To insure freshness, rotate your emergency food items with your regular groceries, but remember to replace any items consumed.

How long might the illness last in a person?

It is difficult to say how long a person will be ill during the pandemic flu because this strain will be quite different from the seasonal flu and most likely more virulent.  What we can say is with seasonal influenza, uuncomplicated illness typically resolves after 3-to-7 days for the majority of persons, although cough and malaise can persist for up to two weeks.

What is the predicted “flow” of the disease? (East to West, North to South)

Using seasonal flu as a model, we can expect it to begin in urban areas where there are high concentrations of people within limited space. In today’s age, where air travel is common, it could quickly spread around the country. There is no set flow.

Based on bird migration patterns, can we predict where a flu may be brought into the US?

The government has been testing thousands of birds along the Alaska flyway. There have been no reported cases of H5N1 virus in the birds tested to date.  Geese and other birds have tested positive to other avian viruses, strains of which are not harmful to humans.

Is it possible to acquire the bird flu form lake water in which birds (geese) have been?

One way that H5N1 is spread from bird-to-bird is through water contaminated with bird droppings from birds with the virus. Healthy birds ingest the virus and can become ill after feeding among the grasses and weeds on the lake bottom. To date, there have been no confirmed cases of human H5N1 originating in this manner.

Can I be infected and not get as sick?

Because few people if any people would have immunity to the virus it is likely most persons will experience some type of symptoms.  Although scientists cannot predict the specifics of a pandemic, it is likely that many age groups would be seriously affected.  The greatest risk of hospitalization and death – as seen during the last two pandemics in 1957 and 1968 and during annual influenza – will be infants, the elderly, and those with underlying health conditions.

How might authorities deal with a “panic” response once the pandemic begins (run on stores akin to snow storms)?

Educating the public will be a big task for officials at all levels should a pandemic occur. Public Health and Law and Safety officials at the federal, state and local levels have been preparing for a flu pandemic for the first time ever in our nation’s history. We are better prepared to handle a public health emergency today than at any time in our nation’s history.  Emergency plans have been made and exercised. Due to the nature of a pandemic, while initial reaction may cause a run on the stores, as the public learns more about what officials are doing, the easier it will become to return to a normal routine while still following healthy habits.    

Who recommends quarantine and how will it be enforced?

The Commissioner of the Department of Health and Senior Services can order quarantine anywhere in the state. The Ocean County Public Health Coordinator can order quarantine anywhere within Ocean County. Quarantine is unlikely to be widely used, due to the support required to make it effective. Not only is enforcement a major consideration, especially during a public health emergency when assets will be strained, but the logistics of supplying food and services to the persons within a quarantined zone places additional burdens during the emergency.

How will we know the type of flu being transmitted in the pandemic?

The flu type will be identified by using standard epidemiological protocols.

Are there varieties of the bird flu?

Yes. There are many different subtypes of type A influenza viruses. These subtypes differ because of changes in certain proteins on the surface of the influenza A virus (hemagglutinin [HA] and neuraminidase [NA] proteins). There are 16 known HA subtypes and 9 known NA subtypes of influenza A viruses. Many different combinations of HA and NA proteins are possible. Each combination represents a different subtype. All known subtypes of influenza A viruses can be found in birds. Usually, “avian influenza virus” refers to influenza A viruses found chiefly in birds, but infections with these viruses can occur in humans. The risk from avian influenza is generally low to most people, because the viruses do not usually infect humans. However, confirmed cases of human infection from several subtypes of avian influenza infection have been reported since 1997.

Does rubbing alcohol work as well as hand sanitizer?

Rubbing alcohol may just like a hand sanitizer as the active ingredient is ethyl alcohol, also the active ingredient in hand sanitizer gels.  Ethyl alcohol must be at a concentration at or above 60% to be effective against bacteria, fungi, protozoa, and viruses; it will NOT work on spores.  (There are hand sanitizer gels on the market with only 40% alcohol).

Will antibacterial wipes be of any use on items such as doorknobs?

Commercially available whips pre-moistened with cleaners and disinfectants are effective against bacteria commonly found on surfaces such as doorknobs.  You must read the labels to see whether or not the product is effective on viruses too.

How should we clean areas where people work together in close quarters?

People should keep in mind the flu and colds generally spread person-to-person when an infected person coughs or sneezes.  So, in addition to using a disinfectant to clean work areas, prevention is going to be most successful on an individual level.  There are some basic things to keep in mind: cover your mouth and nose when you sneeze with a tissue, cough into your sleeve, clean your hands often, avoid touching your eyes, nose or mouth and most importantly, stay home when you are sick.