A virus can spread fast -- but hopefully, we can spread information even faster. Here are some common questions I've heard today in relation to the swine flu outbreak:
1. What is a “Health Emergency?”
The World Health Organization (WHO) is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters and monitoring and assessing health trends among other things.
In response to the recent cases of swine influenza, the WHO has reviewed available data on the current situation and advised that many questions are still unanswered. Nevertheless, the WHO believes that the current situation constitutes a public health emergency of international concern. This means that the WHO is recommending that all countries intensify their surveillance of unusual outbreaks of influenza-like illness and severe pneumonia.
The Centers for Disease Control and Prevention (CDC) serves as develops and applies disease prevention, control, and health education activities designed to improve the health of the people of the United States.
The Secretary of the Department Homeland Security, Janet Napolitano, (who oversees the CDC) declared a public health emergency in the United States. This is important because this declaration will allow federal funds to be released to support the public health response. In addition this allows, CDC's Division of the Strategic National Stockpile (SNS) to release one-quarter of its antiviral drugs, personal protective equipment, and respiratory protection devices to help states respond to the outbreak.
2. Are the swine flu, avian flu and flu pandemic the same thing?
Simply put, no.
Swine influenza, or “swine flu”, is a highly contagious acute respiratory disease of pigs. Outbreaks in pigs occur year round, with an increased incidence in the fall and winter in temperate zones. Many countries routinely vaccinate swine populations against swine influenza.
Pigs can also be infected with avian influenza viruses and human seasonal influenza viruses as well as swine influenza viruses. Sometimes pigs can be infected with more than one virus type at a time, which can allow the genes from these viruses to mix. This can result in an influenza virus containing genes from a number of sources, called a "reassortant" virus. Although swine influenza viruses are normally species specific and only infect pigs, they do sometimes cross the species barrier to cause disease in humans.
Avian Influenza: commonly known as bird flu, this strain of influenza virus is naturally occurring in birds. Wild birds can carry the virus and may not get sick from it; however, domestic birds may become infected by the virus and often die from it.
Influenza (Flu) Pandemic: a global outbreak of the influenza disease that occurs when a new influenza virus appears in the human population. Because people have little or no immunity to the new strain, serious illness can occur, and the virus can spread easily and rapidly from person to person with no vaccine immediately available.
3. I read we are currently at Pandemic Phase 4. What does that mean?
The World Health Organization (WHO) sets what alert phase in the WHO Global Preparedness Plan. In nature, influenza viruses circulate continuously among animals, especially birds. Even though such viruses might theoretically develop into pandemic viruses, in Phase 1 no viruses circulating among animals have been reported to cause infections in humans.
In Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans, and is therefore considered a potential pandemic threat.
In Phase 3, an animal or human-animal influenza reassortant virus (virus from a number of sources) has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks. Limited human-to-human transmission may occur under some circumstances, for example, when there is close contact between an infected person and an unprotected caregiver. However, limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemic.
Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a foregone conclusion.
Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.
Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.
Nicole Holtgrefe is the director of preparedness and client services for the St. Louis Area Chapter.