Articles
9 February 2012

Spreading the Word

by Larry Warren

09 February 2012—

It’s hard to imagine a severe viral bug could develop and spread, challenging today's medical resources and potentially taking down businesses and entire communities before doctors could develop a vaccine for it.

After all, fewer people (33,800) died during the last pandemic outbreak of the 1968 Hong Kong Flu than the current national average (36,000) of those who succumb to the seasonal flu, in part because of improved medical care and antibiotics that victims of the 1918 and 1957 pandemics didn’t have.
But state officials are saying that we cannot rely on past pandemic trends to guide our expectations about the impact it could have in the future. “From what I’m hearing, it depends on how serious the strain is," says Charla Haley, public information officer for Utah's Department of Health. "If it’s a particularly virulent strain we could be in big trouble if you consider how much more we travel now than we used to."
What flu officials are watching for is a novel subtype of influenza A, the virus that causes the most severe disease in humans. Although only two influenza A subtypes currently co-circulate globally in humans, at least 16 distinct antigenic subtypes have been identified in wild aquatic birds. A minor change in these antigens would create a new “hybrid” virus. If it contained the right mix of genes, causing severe disease and allowing easy and sustainable human-to-human transmission, it could ignite a pandemic.
And since it would be a new viral strain, Haley says it would take at least six months until a vaccine could be produced, which would only be effective if people act quickly after being exposed.  
State officials say some people are tempted to not look very closely at pandemic flu because they think the disease has the same patterns as the seasonal winter flu. However, Dr. Robert Rolfs, state epidemiologist for the Utah Department of Health, says a pandemic virus might cause outbreaks outside of the usual influenza season, and the young and old aren’t typically the most susceptible. “Usually, the most healthy, middle-aged people are the high risk group with pandemic,” says Haley. “It’s as if it attacks healthy immune systems.”   
Officials don’t want people to react in fear, but rather respond equipped for an inevitable event. That’s because death rates are determined not only by the virulence of the virus, but on the number of people who become infected. “Don’t panic, especially about pandemic flu,” says Scott Duncan, Utah’s Public Safety Commissioner, who co-chairs the Governor's Public Health Emergency Preparedness Advisory Committee. “When it gets here, the information will be non-stop and there will be plenty of guidance if people will listen to it."
In the meantime, Utah Governor Jon Huntsman has established the Governor’s Task Force for Pandemic Influenza Preparedness to produce recommendations to help Utahns prepare for the crisis. The task force includes a larger representation of the people that will be affected, including businesspeople and doctors.
Using mathematical modeling studies of hypothetical pandemics, the state has drafted a community mitigation plan aimed to curb the affects of any viral outbreak:
*Voluntary isolation of infected persons who do not require hospitalization for seven to 10 days, including home quarantine for healthy persons in the household.
*Closure of childcare facilities, schools and universities.
*Excluding ill employees from the workplace through telecommuting, teleconferencing, staggering shifts and canceling large meetings and conferences.   
*Canceling large public gatherings (concerts, sporting events, worship services, etc.), and limiting the number of people in public places such as malls and parks.  
*Infection control measures in the home, community and non-health care workplaces, including hand washing, cough etiquette, use of face masks and respirators and environmental cleaning and disinfection.  
The plan has been posted on the Website http://pandemicflu.utah.gov to get public feedback. As Haley says, “Success depends on the public’s cooperation.”


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