University of Houston-Victoria

Emergency Management

Situation and Assumptions

Situation

A significant and recurring risk to the university is that of pandemic influenza. Influenza, also known as the flu, is a disease that infects the respiratory tract (nose, throat, and lungs). Influenza usually comes on suddenly and may include fever, headache, dry cough, sore throat, nasal congestion, and body aches. Although the seasonal flu is not usually fatal, complications can arise. The seasonal flu kills an average of 36,000 U.S. citizens every year, sends some 200,000 to the hospital, and causes countless lost days of school and work.

Pandemic influenza occurs when a novel influenza virus appears that causes readily transmissible human illness against which most people lack immunity. During the 20th century, there were three such pandemics, the most notable of which was the 1918 Spanish influenza responsible for 20 million deaths throughout the world. A new strain of influenza, resulting from antigenic drift, is the form of pandemic disease most likely to affect the University of Houston-Victoria.

The impact of an actual pandemic cannot be predicted precisely, as it will depend on the virulence of the virus, how rapidly it spreads, the availability of vaccines and antivirals, and the effectiveness of medical and non-medical containment measures. When pandemic influenza occurs, many people will become ill and may die from the virus or complications. One can only become immune to infection after natural infection or after receiving an effective vaccination. In addition, animals may also be susceptible to the novel influenza virus and may carry, spread, or serve as an intermediate host of the virus. Experts predict that a highly virulent strain of pandemic influenza would disrupt all aspects of society and severely affect the economy.

Seasonal FluPandemic Flu
Happens annually and usually peaks between December and February. Rarely happens (three times in 20th century).
Usually some immunity built up from previous exposure and influenza vaccination. Most people have little or no immunity because they have no previous exposure to the virus or similar viruses.
Certain people are at high-risk for serious complications (infants, elderly, pregnant women, extreme obesity and persons with certain chronic medical conditions). Healthy people may be at increased risk for serious complications.
Health care providers and hospitals can usually meet public and patient needs. Health care providers and hospitals may be overwhelmed. Alternate care sites may be available to meet public and patient needs.
Vaccine available for annual flu season. Usually, one dose of vaccine is needed for most people. Although the US government maintains a limited stockpile of pandemic vaccine, vaccine may not be available in the early stages of a pandemic.Two doses of vaccine may be needed.
Adequate supplies of antivirals are usually available. Antiviral supply may not be adequate to meet demand.
Rates of medical visits, complications, hospitalizations and death can vary from low to high. CDC estimates that flu-related hospitalizations since 2010 ranged from 140,000 to 710,000, while flu-related deaths are estimated to have ranged from 12,000 to 56,000. Rates of medical visits, complications, hospitalizations and death can range from moderate to high. Number of deaths could be much higher than seasonal flu (e.g. The estimated U.S. death toll during the 1918 pandemic was approximately 675,000).
Usually causes minor impact on the general public, some schools may close and sick people are encouraged to stay home. Manageable impact on domestic and world economies. May cause major impact on the general public, such as travel restrictions and school or business closings. Potential for severe impact on domestic and world economies.

CDC Webstie: How Is Pandemic Flu Different from Seasonal Flu?

Assumptions

  1. Seasonal influenza vaccination may or may not offer some level of protection against a novel pandemic influenza strain.
  2. It is highly unlikely that the most effective tool for mitigating a pandemic (a well-matched pandemic strain vaccine) will be available when a pandemic begins.
  3. The time from a candidate vaccine strain to the production of the first vaccine dosage could be six months or more.
  4. Once vaccine is available, it may take five months to produce an adequate supply of vaccine for the entire U.S. population (currently production capacity is approximately five million doses per week).
  5. Two doses of vaccine administered 30 days apart may be required to develop immunity to a novel virus.
  6. There is a limited supply of antiviral medications. Antiviral distribution to states will occur through the Strategic National Stockpile.
  7. Non-medical containment measures will be the principal means of disease control until adequate supplies of vaccines and/or antiviral medications are available.
  8. The novel influenza virus may initially be spread by animals to people in Texas, or by people entering the state and already contagious with the virus.
  9. Multiple waves of illness are likely to occur - each wave may last six to eight weeks.
  10. Pandemic influenza may severely affect even otherwise healthy individuals in all age groups,and will limit or degrade the response capabilities of all levels of government.
  11. Persons who become ill shed virus and may transmit virus up to one day previous to the onset of illness. Persons who are ill may shed virus up to five days after onset of illness.
  12. Systematic application of disease control measures can significantly reduce the disease transmission rates with accompanying reductions in the intensity and velocity of pandemic influenza.
  13. Control and monitoring of pandemic influenza will involve many state and federal agencies,not just those associated with public health activities.
  14. Some individuals may not believe the reality of the threat posed by a pandemic influenza incident, and may take actions counterproductive to the government process to quarantine, control and treat infected people with the disease. Health education will be needed on multiple levels and at multiple points to achieve full cooperation.
  15. Over the course of the pandemic, up to 50 percent of the work force may be absent due to illness, care taking responsibilities, fear of contagion, loss of public transportation, or public health control measures.
  16. The health impact of a pandemic event will be great. Up to 25-35% of persons may become ill in a major pandemic influenza wave. Rates of influenza-related hospitalizations and deaths may vary substantially. Estimates based on past pandemic influenza events indicate that 0.01-8% of the population may be hospitalized and 0.001-1% of the population may die.
  17. There will likely be critical shortages of health care resources such as pharmaceuticals, vaccine(once developed), staffed hospital beds, health care workers, mechanical ventilators, morgue capacity, and temporary refrigerated holding sites.
  18. Pandemic influenza will severely affect local and state economies, as well as intrastate,interstate, and international travel and commerce.
  19. Pandemic influenza may result in long-term and costly emergency response operations.
  20. Pandemic influenza may cause stress and/or emotional trauma.
  21. Disseminating timely, consistent, and accurate information to public and private sector stakeholders, the media, and the general public is one of the most critical facets of pandemicinfluenza preparedness and response.