swine flu briefing 30 apr 2009 (2)

8/14/2019 Swine Flu Briefing 30 Apr 2009 (2)

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Dr Armid AzadehPandemic Specialist

International SOS

Swine Flu Briefing


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Agenda for today

Evolution of the ThreatSwine Flu How it all Started

Is this a PANDEMIC?

What can you do now?


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Evolution of the Threat

Thursday,April 23rd

Mexico: 120 / 20

Mexico City 115 / 203 other regions 5

USA: 2

2 California


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Mexico: 850 / 59

Schools Close Airport Screening

USA: 6

4 California, 2 Texas


Friday,April 24th


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Mexico: 1324 / 59

No public gatherings Closed libraries

USA: 8 - add 2 Kansas

Suspect NYC (8)


Saturday,April 25th


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A Fast Moving Target: Where We are Now


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Country Cases What Else?

Mexico Many Most severely impacted (33 confirmed)

Suspect 1,600+ cases and 150 deaths

US 91 New York, Texas, California, Kansas, Massachusetts,Michigan, Arizona, Indiana, Nevada, Ohio.

Canada 13 Two provinces: Nova Scotia (4), British Columbia (2)

Costa Rica 2 San Jose, Heredia

Austria 1 Vienna

New Zealand 3 Another 11 likely to be confirmed from group of 25 students

Israel 2 Both traveled to Mexico

UK 5 Scottish honeymooners

Spain 10 Travel partners

Germany 3 Bavaria, Hamburg

Peru 1 Lima

As of April 30th


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S-OIV (Swine-Origin Influenza Virus) flu:

Symptoms similar to seasonal human influenza.

o Mild to severe.o 1-4 days after exposure to get sick on AVERAGE

o EARLY: Sore throat, Runny nose (clear) and Itchy eyes

o PROGRESSION: Fever, Muscle Aches, Fatigue, Joint Aches, Cough

S-OIV Outside Mexico Most cases presented as mild.

Few cases required hospitalization

Only one death to date in Texas, so far, low % death

S-OIV in Mexico Mild to severe

Some resulting in death but likely a much highernumber of infections, so % deaths unknown



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Influenza: How it is spread

Mainly by droplet spread drops to ground

o Droplets containing the virus produced when coughing, sneezing and talking

o Deposited in mouth, nose, eyes, or via common surfaces

Possible by Aerosol spread floats in air (1 meter rule)o Unusual

o Possible in very crowded conditionso Subways, Planes

Why Influenzas can spread quickly:

May be contagious BEFORE developing symptoms (1 to 2 days) Contagious for 7-10 days AFTER symptoms develop; children can be longer

Some cases are mild and undetectable

Virus can survive on hard surfaces for many hours (i.e. door handles, etc.)

According to the CDC and WHO this virus is unlikely to be contained



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WHO

Low risk of human cases 1

Higher risk of human cases 2

3

4

5

6

Pandemic alertNo or very limited human-to-humantransmission

Evidence of increasedhuman-to-human transmissionNew virus causes

human cases Evidence of significanthuman-to-human transmission

PandemicEfficient and sustained significanthuman-to-human transmission

Inter-pandemic phase

New virus in animals,

no human cases



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WHO

Low risk of human cases 1

Higher risk of human cases 2

3

4

5

6

Pandemic alertNo or very limited human-to-humantransmission

Evidence of increasedhuman-to-human transmissionNew virus causes

human cases Evidence of significanthuman-to-human transmission

PandemicEfficient and sustained significanthuman-to-human transmission

Inter-pandemic phase

New virus in animals,

no human cases



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Swine Flu How it all Started

Usually infects pigs

Infections in Humans uncommon2005-2009: 12 cases in the USA

1988 (Sept.): 1 fatal case in Wisconsin

1976: 200 cases (1 fatal) in an outbreak in New Jersey

S-OIV is a new strain


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Pig farm and Mexican child?

Probably started end of March

April 22nd

CDC and WHO find cases in Californiaand Texas to be linked to Mexico, days before furthercases in North America, EU, and Middle East.

Prior to S-OIV: Close pig contact

This virus: Human to Human spread


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Source: http://www.sciencemag.org/cgi/content/full/299/5612/1502

S-OIV (Swine-originInfluenza Virus)

H1N1


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Edgar Marcus

University of Washington School of Medicine

The Pandemic Clock istickingwe just dont know whattime it is.

Is this a PANDEMIC ?


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1957: Asian Flu

1-4 milliondeaths

1968: Hong Kong Flu

1-4 milliondeaths

1918: Spanish Flu

50 million deaths

Credit: US National Museum of Health and Medicine



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Pandemic Severity Index (PSI)

The substantial difference inthe severity of the illnessassociated with infections from

the same virus, the relativelylow number of cases detectedin the United States, and

insufficient epidemiologic andclinical data to ascribe a PSI

CDC Apr 09



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Number 1 threat to Business Continuity Today

The threat is increasing

Possibly 60-100 million dead (HIV has 40 million)

Significant disruption to global economy (ADB

postulates a decrease in global GDP of 800Billion $)

Business is Darwinian Survival of the Fittest


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What can you do NOW?

Protect yourself: Non Pharmaceutical Interventions

Hygiene, Hygiene, Hygiene

Hand washing can decrease respiratory infections by

35%Hand sanitizers can kill 95% of germs on your hands

Stay away from crowded areas

Wh d NOW?


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Protect yourself: Personal Protective Equipment

Surgical masks can prevent droplet spread Ideal for crowded areas

N95 masks, gloves, gowns?

Avoid contact rather

Wh d NOW?


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Protect yourself: Seasonal Vaccination

Does not seem to protect against S-OIV Diagnostic benefits

Continue normal best practice use

6 months before S-OIV specific vaccine

Wh t d NOW?


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Protect yourself: Antiviral medication

Tamiflu (oseltamivir) and Relenza (zanamivir)

Roches priorities

1) WHO

2) Pending Government and other orders

3) New Government orders

Wh t d NOW?


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Protect your business: Pandemic Consulting

Implement existing Pandemic PreparednessPlans (PPP) or

Develop a customized PPP

Provides a Crisis Management Tool

Complements Business Continuity Initiatives

Pre-emptive measure, development is notsuitable for Phases 4-6

Wh t d NOW?


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Stay Informed: Keeping your finger on the pulse

http://urgent.internationalsos.com

Pandemic Information Services (PIS)

Wh t d NOW?


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Take home message


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Take home message

1) Pandemic is a real risk (yesterday birds,today pigs, tomorrow - ?)

2) Hygiene, Hygiene, Hygiene!3) Secure, trusted information source


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PIS screenshots

swine flu briefing 30 apr 2009 (2)

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