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Student group work on Swine Flu Pandemic 26/03/2012 Dr. Mary Rose Sweeney What are the six stages of pandemic alert? • What is an Influenza Pandemic? • What are the six stages of pandemic alert? • What strategies should any public health service employ when a pandemic is announced? • Critically discuss the roll-out of the vaccination strategy for HINI in Ireland considering any risks and/or benefits? • Did any of you hear the recent coverage of narcolepsy increased risk among those who received the swine flu vaccination What is an Influenza Pandemic? • An influenza pandemic is a worldwide flu epidemic. It can start when three conditions have been met: • 1. A new influenza virus subtype appears • 2. It infects humans, causing serious illness • 3. It spreads easily between humans. • A new virus may be a re-emerging human virus subtype which has not been in circulation for some time, • or a virus originating in birds which has changed into a form that is highly infectious for humans. • A pandemic can cause serious illness and death and can give rise to enormous social and economic disruption worldwide. What are the six stages of pandemic alert? • The World Health Organization (WHO) uses six phases of pandemic alert as a system for informing the world of the seriousness of the threat. These phases reflect the progression of an influenza pandemic from the first appearance of a new flu virus to wide international spread. • Phase 1 No new influenza virus subtypes have been detected in humans. An influenza virus subtype that has caused human infection may be present in animals. If present in animals, the risk of human infection or disease is considered to be low. • Least threatening, nothing new, no infections in animals or humans • Phase 2 No new influenza virus subtypes have been detected in humans. However, a circulating animal influenza subtype poses a substantial risk of human disease. • Basically the same except infection has been found in animals but none in humans • Phase 3 Human infection(s) with a new subtype, but no human to human spread (or, at most, rare instances of spread to a close contact). • Found in humans who have been in close contact with infected animals only • Phase 4 Small cluster(s) with limited human to human transmission, suggesting that the virus is not well adapted to humans. • Miminal human to human transmission, not a certainty that it will spread between humans • Phase 5 Large cluster(s) but human to human spread still localised, suggesting that the virusis becoming better adapted to humans, but may not yet be fully transmissible. At this stage, there is a substantial risk of a pandemic. • Large spread between humans, but localized • Phase 6 Pandemic phase: increased and sustained transmission in human population. • New cases being reported daily and the spread is world wide human to human. What strategies should any public health service employ when a pandemic is announced? • Communication strategy – leaflets, website, press briefings, advertising, telephone hotlines, TV, radio updates • Hotline – medical support, advise • Personal responsibilities – through the communication channels • Survellance – WHO, ECDC, DoHC • Anti-viral medicines – • Vaccinations – • Re-deploying of health care staff, • Essential supplies needed by Gov – masks, gloves, medicines Critically discuss the roll-out of the vaccination strategy for HINI in Ireland considering any risks and/or benefits? • Group 1. At risk individuals between 6 months and 65years of age – chronic health issues, CHD, renal disease, RTI – asthma, COPD, Liver disease, neurological, morbid obese, • Pregnant women in 2nd and 3rd trimesters, and up to six weeks post pregnancy • Women in 1st trimester with a health risk such as RTI. • Immunocompromised – and their household contacts • Residents of ID services • Physical disabilities and general ID living in their own home • • Group 2 • All Health care staff • Group 3 • Children under 6months (+ contacts in home) to • 6 months to 18 years Group 4 • Adults aged 65 and over • Gen pop Benefits? • Reduce spread • Reduce costs both economic and social • Such as hospital, medicines, losses to employment, production down Risks ? • Unknown risks – pregnant women and their unborn children , children • Financial burden – wastage Inform the group about the recent coverage of narcolepsy increased risk among those who received the swine flu vaccination • Sleeping disorder – teens, • 47 countries had vaccination programme and 12 have reported increased risk of his in children between 4 and 19 years old. • Genetic/drug interaction ? • 1 case per 12,000 post vaccination • This is 9 times greater than pre vaccination