Download Influenza Outbreaks and Cruise Ships

Influenza Outbreaks and Cruise Ships
Laura Martin
25 April 2002
General Information
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Influenza is an acute respiratory illness caused by a
virus and transmitted by respiratory secretions
through sneezing or coughing.
Symptoms:
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Abrupt onset of fever
Headaches
Muscle aches
Soar throat
Non-productive cough
Congestion
Extreme Fatigue
General Information
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Change in the virus
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“Antigenic Drift”
o Small changes that occur continuously over time.
o Produces new virus strains in both influenza A and B
“Antigenic Shift”
o An abrupt and major change in the influenza A viruses.
o Results in a new subtype of influenza A.
Why is this significant?
o Whenever a new subtype or strain is introduced, the
body’s immune system will not recognize it.
Type C causes a mild respiratory illness and is thought not
to cause epidemics.
General Information
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Groups at Risk for severe infection
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People over the age of 65.
Residents of nursing homes or chronic care facilities.
Those with chronic disorders of the pulmonary or
cardiovascular systems.
Patients who have required medication follow-up or
hospitalization during the past year because of chronic
metabolic diseases, renal dysfunction, or
immunosuppression.
Children or teens who are receiving long-term aspirin
therapy.
General Information
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Prevention
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Vaccine
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Administered yearly because of the genetic changes in
the virus and decreased immunity over time.
o Also consider vaccination before traveling to the
tropics or into the Southern Hemisphere.
Side effects:
o malaise (a feeling of illness or depression),
o myalgia (muscular pain),
o fever,
o or an allergic reaction.
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General Information
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Treatment
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Bed rest
Fluid consumption
Symptom relief with over the counter drugs such as pain
relievers, decongestants, and cough medicines.
The use of anti-viral drugs
o Two are available.
o Can prevent infection during continued exposure to the
virus.
o Can also reduce the severity and duration of the illness
if administered shortly after the appearance of
symptoms.
Cruise Ships
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September and October 1997 – Two Cruise Ships
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Majority of passengers 65 and older and at risk for flurelated complications.
Majority of passengers and crew also unvaccinated.
Action taken:
o Active surveillance
o Vaccination of crew members
o Use of antivirals
The steps taken to control this outbreak were successful.
However, the overall level of influenza activity is typically
low for this time of year, so this situation demonstrates
how travel and large groupings of people can increase the
likelihood of a problem occurring.
Cruise Ships
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Another possible
influenza outbreak
was reported by the
CDC Morbidity and
Mortality Weekly
Report after June of
2000 when an
outbreak of
respiratory illnesses
occurred on the MS
Rotterdam.
Outbreaks and Pandemics
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1918 – The Spanish Flu
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20-50 million people died worldwide.
Many died a few days after infection and
some died of complications later.
This pandemic was unique because almost
half the people that died were young,
healthy adults.
This is an
image from
an
emergency
hospital in
Camp
Funston,
Kansas
during the
1918
influenza
epidemic.
Outbreaks and Pandemics
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Other Pandemics include:
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The 1957 Asian Flu which killed approximately 70,000
people in the United States.
The 1968 Hong Kong Flu that caused nearly 35,000
deaths in the US.
Other outbreaks include:
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The 1976 Swine Flu that infected soldiers
at Fort Dix, New Jersey. Over 40 million
Americans were vaccinated as a result to
Swine Flu
prevent a pandemic.
The 1997 Avian Flu in which 18 people in Hong Kong were
infected with a flu strain previously only seen in birds.