Sunday, February 19, 2012

H5N1: Now That They’ve Broken The `Species Barrier’

 


# 6157

 

 

When a pandemic did not erupt in 2006-2007 from the H5N1 virus, many scientists (and media pundits) began to question whether there might be some sort of `species barrier’ that would prevent the H5 virus from ever adapting to mammals.

 

Some researchers took comfort in the fact that - in the albeit short history of influenza virology - only H1, H2, and H3 viruses have been known to effectively transmit among humans.

 

Avian H5s, H7s, H9s, and H11s have only been rarely found in humans, do not appear to transmit particularly well – and with the exception of the H5N1 virus – produce usually mild illness.

 

After the relatively mild 2009 H1N1 Swine Flu pandemic, and since bird flu has failed to adapt to humans, the flurry of pandemic preparedness activity we saw 5 or 6 years ago amongst military, government, and corporate entities seems to have disappeared.

 

Last fall we learned that researchers had successfully created ferret transmissible  strains of the H5N1 virus - breaking this supposed `species barrier’ – and that has set off a firestorm of debate in academia.

 

It’s been a huge story that has deeply divided scientists and policy makers, and has consumed the influenza community for months. 

 

Despite strongly suggesting that the H5N1 virus in nature is likely a bigger pandemic threat than many have previously believed – most of the discussion has been directed at what policies should be adopted for conducting, and publishing, of controversial `life sciences’ research.

 

Admittedly, these are thorny problems, requiring much thought and discussion, and over time, will hopefully produce some consensus.

 

But lost in this discussion have been the practical aspects of pandemic preparedness.

 

It’s as if after the `damp squib’ pandemic of 2009, officials are afraid to voice concerns, and talking publicly about pandemic preparedness has fallen out of favor.

 

 

While I advocate a balanced `All Threats approach to disaster preparedness, a severe pandemic represents a huge (and unparalleled) risk to society, the economy, and human health. 

 

It deserves to be talked about - and planned for – every bit as much as do hurricanes, earthquakes, and floods.

 

More so, I would argue, since the kind of preparations recommended for the more likely-to-occur natural disasters (i.e. self-sufficiency for 72hrs) would hardly suffice during a really severe pandemic.

 

 

In 2006-2007, the United State’s government actively urged companies – both large and small - to develop comprehensive pandemic plans. Local communities were told that they should prepare as well - since during a severe pandemic - the timing and availability of Federal assistance would be uncertain at best.

 

If the risk of a severe pandemic has not diminished (and many virologists believe it has not), then we need to seriously revisit and update those preparedness plans that - for the past few years - have been languishing and gathering dust.

 

Rather disappointingly, a number of the preparedness links I’ve highlighted over the years no long work. In some cases documents have been moved to new locations, in others, they appear to have been withdrawn altogether.

 

Undaunted by this, today we’ll take a look back at some of the pandemic planning guidance documents that still remain available for individuals, families, businesses and communities who might wish to prepare.

 

First stop, an OSHA fact sheet from 2009 on protecting employees during a pandemic.

 

 

image

During an influenza pandemic, transmission of the pandemic virus can be anticipated in the workplace, not only from patients to workers in healthcare settings, but also from customers and coworkers in general work settings. Employers can use a set of occupational safety and health controls referred to as the "hierarchy of controls" to reduce exposures to pandemic influenza in their workplaces. The types of control measures, listed from most effective to least effective, that may be used to protect yourself, your workers and your customers are:

  • Engineering controls;
  • Administrative controls;
  • Work practices; and
  • Personal protective equipment (PPE).

 

 

Next a 46-page PDF file from the Department of Labor and the HHS on preparing workplaces for an influenza pandemic.

 

image

 

The CDC provides the following links for Community Mitigation of Pandemic Flu on their Flu.gov website.

 

Mitigation Guide

Community Strategy for Pandemic Influenza Mitigation (PDF - 10.3 MB)
CDC guidelines on actions, designed primarily to reduce contact between people, that community government and health officials can take to try to limit the spread of infection should a pandemic flu develop. Appendixes 5, 6, and 7 contain information for childcare programs, elementary schools, and colleges and universities.

Plan Now to Be Ready for the Next Flu Pandemic (PDF - 213.55 KB); (DOC - 51 KB)


The Next Flu Pandemic: What to Expect (PDF - 226.83 KB); (DOC - 47 KB)

 

And as a last stop today, a terrific video from the Seattle & King County Public Health Department, followed by an extensive list of downloadable resources.

 

Business Not As Usual: Preparing for a Pandemic Flu

Business Not As Usual: Preparing for a Pandemic Flu (video)
Click link to open streaming video:
Business Not As Usual: Preparing for a Pandemic Flu

Downloadable resources from the DVD

General resources:

Business and government preparedness:

Community Based Organization (CBO) preparedness:

Personal preparedness:

 

While the H5N1 virus is getting all of the attention right now, it isn’t the only virus with pandemic potential.  The next pandemic could just as easily arise from the H9N2 virus, or one of the H7’s, or another reassortant swine flu virus.

 

Given the number of warnings we’ve had, there is no excuse for us to be caught flatfooted by the next pandemic virus. 

 

Yet, if one started tomorrow, I suspect we would find ourselves very much in that most difficult of positions.