Frequently Asked Questions and Answers About Pandemic

(From TAHSN Pandemic Influenza Planning Guidelines, May 31, 2006)

 General

Q: What is a pandemic influenza?

A: A pandemic influenza is a worldwide outbreak of a new influenza virus that spreads rapidly around the world. Influenza pandemic occurs when all three of the following occur:

1. A new influenza virus appears against which people have little or no immunity.
2. Human to human transmission happens easily.
3. The new virus causes serious clinical illness and death.

Q: When was the last influenza pandemic?

A: The world experienced influenza pandemics in 1918 (Spanish flu), 1957 (Asian flu) and 1968 (Hong Kong flu). The most deadly, the Spanish Flu of 1918-19, killed an estimated 20 million people worldwide. There were high rates of morbidity and mortality for both high risk and normal children and adults.

Q: Should we be expecting a pandemic in Canada?

A: Infectious disease experts have warned that a global influenza pandemic is overdue. Historically, influenza pandemics have occurred about every 30-40 years. Experts and scientists from the World Health Organization (WHO) are monitoring influenza activity around the world so they can identify and determine circulation of virus strains.

Q: Why do pandemics occur?

A: Influenza viruses often make “mistakes” when they replicate. While most of these mistakes result in ineffective viruses, once in a while a mistake occurs that changes the way the virus looks to your immune system. This happens on a small scale every year which is why we have to get a flu shot every fall. A pandemic virus arises when existing viruses change into a new, more deadly strain.

Influenza

Q: What are the symptoms of influenza?

A: Symptoms from pandemic influenza will look similar to the influenza we deal with every winter, however pandemic influenza is more likely to cause serious illness and death. Symptoms include fever, muscle pain and weakness, headache, tiredness, dry cough, and sore throat.

Q: How is the influenza virus spread?

A: The virus spreads easily from person to person, mainly through large respiratory droplets and to a lesser extent through direct contact with contaminated surfaces and items. Frequently washing your hands has been shown to be an effective way of preventing yourself from becoming sick.

Q: Do we have an influenza vaccine against pandemic influenza?

A: In the event of an influenza pandemic, a completely new virus strain will develop before a vaccine can be made. It will take several months to develop, test, manufacture and distribute a new vaccine containing the pandemic strain.

Q: Does a flu shot protect me from an influenza pandemic?

A: The influenza vaccine or “flu shot” is effective against this year’s known circulating strains of influenza virus. You need a new flu shot every year because the virus is always changing slightly.

A flu shot is a good way to increase your overall immunity against this year's known flu strains. In fact, the more flu shots you've received over time, the greater the protection against different viruses, some of which may have some similarities with an eventual pandemic strain. Getting a flu shot and practicing Infection Prevention and Control should be part of everybody's daily practice - especially if you work in a hospital where you are more exposed to infectious diseases.

Q: What’s the difference between vaccines and antivirals?

A: Vaccines are the primary means to prevent illness and death from regular seasonal influenza. An actual vaccine against a pandemic will not be available at the start of a pandemic. It can take four to five months for a vaccine to be developed against a new flu virus.

Antiviral drugs may be used to help lessen the impact of the pandemic and may be effective in very early treatment. If taken shortly after getting sick (within 48 hours), they can reduce influenza symptoms, shorten the length of illness and reduce the serious complications of influenza.

Both the federal and provincial government are creating antiviral stockpiles that will be directed at treating those at high risks of complications or death due to influenza who present with influenza-like illness within 48 hours of onset of symptoms. Ontario will be adopting priority groups set nationally. These priority groups may change based on age and risk groups most affected by the pandemic; its severity; and other factors.

Impact

Q: What will a pandemic mean for the Greater Toronto Area?

A: A pandemic strain will appear in Toronto within one to three months of it being detected elsewhere in the world. It has the potential to infect up to 35 per cent of the population, causing a large number of individuals to require some level of health services.

Estimated direct health impact of a pandemic on the City of Toronto:

Absenteeism, as a result of influenza, is expected to be 30-35 per cent or higher. There will be a tremendous strain on the healthcare system, business community and city services.

Q: Are health care workers at risk?

A: Influenza is a community-spread organism and is highly contagious. Healthcare workers will be affected equally with the general population.

Q: What can we expect to happen when the pandemic strain is identified?

A: When the pandemic strain arrives in the GTA, self-sufficiency will be required as the situation will be global. We can expect the first wave to last six to eight weeks and be followed several months later by one or two more waves, possibly of stronger severity. Vaccine will not be available for the first wave. Antiviral agents may not be in adequate supply. Large numbers of patients will require triage and current hospital beds and ventilator capacity will be overwhelmed.      

Q: What type of Infection Prevention and Control precautions will be used during a pandemic?

A: Pandemic influenza will not be treated any differently from regular influenza. Flu patients will be placed in droplet precautions until they are no longer symptomatic i.e., health care workers will be required to wear surgical masks and don eye protection when within one metre of influenza patients. Gowns and gloves may be required if your clothing is likely to be soiled. N95 masks, PAPR hoods and other equipment that we used during SARS will not be used at the present time.

Q: What is the city doing to prepare for the possibility of influenza pandemic?

A: Toronto Public Health is the lead agency for the City of Toronto pandemic preparedness and response. Professionals from hospitals, government agencies, emergency services and community organizations have been working together to develop a local pandemic plan. These stakeholders are building relationships, defining responsibilities and coordinating communication between agencies at the national, provincial and local levels.

The Toronto Influenza Planning Steering Committee has been working with community partners to identify key issues and to provide an opportunity for input from all stakeholders. The committee meets regularly and has established a process to focus on specific areas such as health services and emergency measures. Through this consultation, Toronto Public Health will produce a comprehensive influenza pandemic plan that will be widely distributed and promoted throughout the community.

Q: What are hospitals doing to prepare for the possibility of influenza pandemic?

A: Infectious disease experts agree that a pandemic influenza outbreak is just a matter of time. Hospitals are taking this threat seriously. Toronto teaching hospitals are working together to plan by sharing expertise, experience and resources. We are addressing complex operational issues such as staff protecting and safety, impact to services, ethics, and human resources.

We will keep staff informed as we move forward with these complex issues.

Q: How can I protect my family and myself from infection?

A: When a pandemic is declared, pay attention to public health messages about who is at risk. In the meantime:

• Get a flu shot every year
• Wash your hands or use alcohol based hand antiseptic frequently
• Cover your nose and mouth when you cough or sneeze
• If you are sick with flu-like symptoms, don’t go to work or to school
• In the community, try to maintain at least one metre distance from people who are coughing or sneezing
• At work consistently use appropriate personal protective equipment as indicated by infection prevention and control when caring for people with respiratory infections.

Q: Where do I get more information?

A: Pandemic Related Web Sites:

www.health.gov.on.ca

http://www.phac-aspc.gc.ca/publicat/info/panplan_e.html

http://www.hc-sc.gc.ca/english/media/releases/2003/2003.87bk2.htm

http://www.who.int/csr/disease/influenza/WHO_CDS_2005_29.en/

 

 

 

 

 

 

 

 

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