NYC Department of Health & Mental Hygiene

• Isaac B. Weisfuse, MD, MPH
• 31 pages
• For Internal Distribution Only
• Not For Public Dissemination
• December 12, 2005

Avian Influenza:
The Next Pandemic?

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Avian Influenza Update
As of December 7, 2005
•135 human cases, 69 deaths (laboratory confirmed)
–Indonesia, Viet Nam, Cambodia, Thailand, China
•Almost all cases with direct contact with poultry, rare human to human cases
•Migratory waterfowl are infected
•Area of infected birds is increasing westward (now in Europe), ? Eventually into North America

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Uncertainties
•We don’t know, if the next pandemic will be due to avian flu or another strain.
•We don’t know when a pandemic will happen.
•We don’t know if the strain will be susceptible to antivirals, what the mortality risk factors are.
•Was 1918 unique?

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Control Measures to Limit Dissemination of Influenza
•Covering mouth/nose with a tissue when coughing
•Post signs that promote respiratory/cough hygiene in common areas
•Hand hygiene after contact with respiratory secretions
•Make hand sanitizers available to your staff
•If feasible, screen personnel for cough or fever before they come on duty
•Ill workers should be advised to stay home

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Tamiflu –Potential Negatives
•Not a cure: decrease duration of symptoms, and viral shedding
•May not be effective against pandemic strain
•Inappropriate use may lead to resistance
•In anthrax, prophylaxis adherence 27%
•Proven efficacy only if given within 48 hrs of symptoms
•5-year shelf life
•Not approved for pregnant women and children < 1
•Adverse effects
•Real impact uncertain

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