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Kathy Harriman
Minnesota Department of Health
Infectious Disease Prevention and
Control Division
Acute Disease Epidemiology Section
What is influenza?
An acute respiratory illness resulting
from infection with an influenza virus
Highly infectious and can spread
rapidly from person to person
Some strains cause more severe
illness than others
Domestic birds
Humans
and other
animals
Influenza symptoms
Sudden onset
Fever, headache, muscle aches,
severe weakness
Respiratory symptoms, e.g., cough,
sore throat, difficulty breathing
Courtesy of CDC
Seasonal influenza:
minor changes - antigenic drift
Occurs among influenza A viruses
resulting in emergence of new variants
of prevailing strains every year
New variants result in seasonal
influenza each winter
Some years are worse than others
partly related to degree of drift
Pandemic influenza:
major changes - antigenic shift
Major changes occur in the surface antigens
of influenza A viruses by mutation or
reassortment
Changes are more significant than those
associated with antigenic drift
Changes lead to the emergence of potentially
pandemic strains by creating a virus that is
markedly different from recently circulating
strains so that almost all people have no preexisting immunity
History of influenza
412 BC - first
mentioned by
Hippocrates
1580 - first pandemic
described
1580-1900 - 28
pandemics
1918 Spanish Flu 1957 Asian Flu 1968 Hong Kong Flu
20-40 million deaths
1 million deaths
1 million deaths
H2N2
H3N2
H1N1
1920
1940
1960
1980
2000
1918 Pandemic
Pandemic waves
Past experience teaches us that following
the emergence of a new pandemic virus:
More than one wave of influenza is likely
Waves typically last 6-8 weeks
Gaps between the waves may be weeks or
months
A subsequent wave can be worse than the first
Vaccine
Because the virus will be
new, there will be no
vaccine ready to protect
against pandemic influenza
at the start of a pandemic
Specific vaccine cannot be
made until the virus strain
has been identified and will
take at least 4-6 months to
produce
Antiviral drugs
Likely to be the only major
medical countermeasure
available early in a pandemic
Uncertainty about effectiveness
for treatment or prevention
U.S. goal is to stockpile enough
antiviral drugs to treat 25% of
the U.S. population
Summary
The currently circulating avian influenza
strain may or may not cause a pandemic
Global surveillance is essential;
international cooperation is critical
Planning for a possible pandemic is
occurring nationally and internationally
National, state, local, and individual
preparedness are all important
CDC
http://www.cdc.gov/flu/avian/ index.htm
HHS
http://www.pandemicflu.gov/
http://www.hhs.gov/pandemicflu/ plan/
WHO
http://www.who.int/csr/disease/ avian_influenza/en/index.html
Questions?