Pandemic influenza is described as a global outbreak, where everyone is susceptible. This type of flu spreads rapidly with an increased risk of death. The 20th century produced three influenza pandemics: 1) the Spanish Flu in 1918-1919, which caused approximately 20-40 million deaths worldwide (500,000 in U.S.); 2) the Asian Flu 1957-1958, which resulted in 1-2 million deaths worldwide (70,000 in U.S); and 3) the Hong Kong Flu in 1968-1969, which caused 750,000 deaths worldwide (34,000 in U.S.).

 

A more recent outbreak of the swine influenza (H1N1) has sparked concern about an influenza pandemic. Information regarding this outbreak is fluid and the most accurate and up-to-date information can be found at Centers for Disease Control website www.cdc.gov/swineflu/ or WHO website at http://www.who.int/csr/disease/swineflu/en/index.html  

 The World Health Organization (WHO) developed a six-phase alert system, with clearly defined roles established for governments, industry, and WHO to follow. Currently, WHO is at phase 3, defined as: “a virus new to humans is causing infections but does not spread easily from person to person.” The WHO urged all countries to develop preparedness plans and to stockpile antiviral drugs nationally for use at the start of an influenza pandemic. Approximately 30 countries are purchasing large quantities of these drugs. However, the manufacturer does not have the capacity to fill these orders immediately. Furthermore, the WHO issued a series of recommended strategic actions for countries to follow for response to an influenza pandemic.

In November 2001, the European Commission commenced a conference on influenza pandemic planning. The Conference identified the key areas for European Member States to focus on regarding pandemic preparedness. The work completed at this Conference resulted in the development of the EU Community Influenza Pandemic Preparedness Plan. The Plan delineates the role of the Commission and Member States regarding pandemic preparedness planning and defines the actions that will take place at pre-determined phases. It also explains the WHO stages of an influenza pandemic and describes the action plan developed by WHO. On November 28, 2005, the Commission adopted a communication on influenza pandemic preparedness, which incorporated new recommendations published by the WHO and recognized the authority of the European Centre for Disease Prevention and Control (ECDC) for influenza pandemic preparedness. The Commission continues to coordinate its efforts with the WHO and the ECDC.

On November 1, 2005, U.S. President George Bush implemented a three-part strategy to address a possible influenza pandemic outbreak. This includes: 1) preparedness and communication; 2) surveillance and detection; and 3) response and containment. Furthermore, the Department of Health and Human Services (HHS) released a more detailed plan, which outlines the federal response to a possible influenza pandemic. The HHS plan provides guidance to state and local governments on what should be accomplished to prepare for an influenza pandemic. Recently, the HHS Secretary reiterated that state governments will take the lead, explaining that final decisions regarding preparedness will be left to state and local officials. Ninety percent of vaccines will be allocated to states and the state authorities will be in charge of distribution.