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Pandemic flu far from forgotten in the rest of the world

July 30, 2009

By Michael Broihier

The H1N1 influenza virus has fallen out of the news since it first entered the US earlier this spring, but local, state and federal governments and agencies continue to work behind the scenes preparing for the possibility that the flu will roar back this fall, more widespread and more virulent. While many rightfully question the media feeding frenzy that accompanied the initial outbreak, it is dangerous to begin thinking the threat has past.

In 1918 the spring pandemic infection rates were high, but death rates were similar to the seasonal flu. When the second wave of infection hit in the fall death rates soared, and that is what all of the health agencies from your local hospital to the World Health Organization have been preparing for. Here in Lincoln County there are two efforts underway to avoid the flu pandemic or mitigate its results.

The Centers for Disease Control and Prevention (CDC) completed final formulation for a vaccine early in June and are working closely with US pharmaceutical manufacturers to ensure an ample supply of the vaccine in the fall. The Lincoln County Health Department has been planning to establish Points of Distribution Sites (PODS) to efficiently administer the flu vaccine when it becomes available. By using PODS, the department hopes to make access to vaccines easier and safer for both the recipient and the care giver. The PODS will allow the vaccinations to be distributed without bringing thousands of people into crowded doctors' offices and hospital waiting rooms, possibly exposing them to the virus they wish to avoid.

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The second effort your health department has been working on is a plan to distribute and administer antiviral drugs like Tamiflu to people who have been exposed to or are suffering from the flu. The federal government has released 25 percent of antiviral drugs in the Strategic National Stockpile (SNS) to state control. The SNS is a federally held reserve of emergency medical supplies that was established to replenish local supplies in a widespread natural or manmade disaster. The supplies are cached around the country, and initial "push packages" of pharmaceuticals, antidotes and medical supplies can be delivered anywhere in the continental United States in 12-hours.

While Tamiflu can be used as a prophylaxis, even its manufacturer says that the best defense against the flu is a vaccine. Tamiflu, at least initially, will be used for health and emergency workers with the highest likelihood of exposure to the virus.

At the state level there has been a great deal of work done preparing for a possible deadly pandemic and next week there will be a commonwealth-wide preparedness exercise. From simple table top discussions at local levels to activation of the state Emergency Operation Center, hundreds of organizations across Kentucky are going to be exercising their pandemic and emergency operation plans from Aug. 3-7.

Elsewhere in the world the H1N1 virus has spread more quickly than it has in the US. In June, the World Health Organization (WHO) declared a global pandemic based on the rapid spread of the novel flu virus to more than 70 countries. In the intervening months the count has reached 123 countries. Of concern to the WHO is the fact that a majority of the cases requiring hospitalization and fatalities are occurring in young people. Like the 1918 Pandemic, it appears that the disease hits those with the best immune systems hardest. Seasonal flu usually takes the greatest toll on those over 65 years old and people with compromised immune systems.

Despite the fact that government and health agencies are working hard to prevent a fatal fall, all need to remember the basics of flu prevention which need mentioning again: wash your hands frequently, cough and sneeze in your sleeve, and if you or your child are sick, stay home.

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