Health & Counseling Services
Reed College
Pandemic Response Planning
Working draft: 8/18/06
Avian influenza (subtype H5N1), also known as the "bird flu," continues to demand our attention, both in the popular media, as well as within organizations which, like Reed College, must make preparations to manage the possibility of an eventual outbreak.
Despite the fact that millions of birds, domestic and wild, have been culled, the infection has been persistent in the bird population and continues to spread along the flight paths of migratory birds. Most of the laboratory confirmed cases in humans have resulted from direct contact with infected birds with only a few cases occurring from human-to-human contact. Scientists, public health authorities, and government officials have expressed concern that the virus could spark a pandemic if it mutates in a way that allows for sustainable transmission from person to person. The World Health Organization and U.S. health authorities are making preparations in the event a pandemic occurs, and has urged all communities to follow suit. In accordance with these recommendations, Reed College is making plans to prepare our campus community as well.
In the context of an ongoing campus-wide effort, the Health and Counseling Center (HCC) is currently developing an emergency response plan. We are working to ensure that on-campus health care providers and first responders are prepared to respond by providing ongoing education about avian influenza, rehearsing emergency drills, and having medical supplies and equipment readily available. We are also following the latest developments by monitoring the World Health Organization and Centers for Disease Control and Prevention websites, following the guidelines of the American College Health Association, maintaining an open line of communication with our local health department and hospitals, and benchmarking the activities of other colleges and universities.
Finally, we realize that you may have many questions about avian influenza. To help answer some of those questions, we have prepared the following frequently asked questions and answers. You can also learn more about avian influenza and the pandemic threat at the following websites:
World Health Organization
www.who.int/csr/disease/avian_influenza/
Centers for Disease Control
www.cdc.gov/flu/avian/
Department of Health and Human Services
http://pandemicflu.gov/
If necessary, important updates and announcements will be posted to the Reed College website and distributed via email from Reed's Incident Reponse Team.
Rest assured that we are taking proactive measures to be prepared in case the avian flu or any other pandemic should affect our campus community. Thank you for your attention.
Sincerely,
Michael Brody, PMHNP
Director, Health and Counseling Service
Frequently Asked Questions About Influenza
What is avian influenza?
Avian influenza, or "bird flu," is a contagious viral disease that normally infects only birds and on occasion, pigs. A highly pathogenic strain, H5N1, has been persistent and tenacious. Despite the fact that an estimated 150 million birds have died or been destroyed, the virus has become endemic in some areas and is being spread by migratory birds.
Which countries have been affected?
Outbreaks in wild and domestic birds have been reported in more than 40 countries including: the Republic of Korea, Vietnam, Japan, Thailand, Cambodia, Loa Peoples Democratic Republic, Indonesia, China, Malaysia, Mongolia, Russia, Kazakhstan, Turkey, and Romania.
What are the implications for human health?
Widespread persistence of H5N1 in poultry populations poses two main risks for human health. The first is the direct infection from poultry to humans. The second threat is the emergence of a mutant strain that spreads easily from person to person.
How is the virus transmitted?
The bird to human transmission occurs from direct contact with infected poultry or surfaces and objects contaminated by their feces. Exposure to the virus is most likely during slaughter, de-feathering, butchering, and preparing poultry for cooking. Currently, there is no evidence that properly cooked poultry or eggs are a source of infection.
What changes are needed for the H5N1 virus to affect humans and become pandemic?
The virus can become transmissible among humans by either a "reassortment" event or by a more gradual process of adaptive mutation. In "reassortment" genetic material is exchanged between human and avian viruses when there is co-infection in a human or pig. This results in a new potent strain that is fully transmissible to humans. The process of adaptive mutation is a more gradual process by which the virus becomes more efficient at binding to human cells. A pandemic can start when three conditions have been met: a new virus subtype emerges; it infects humans; and it spreads easily and is sustained among humans. The first two conditions have been met in that a new subtype has emerged and humans have been infected through contact with infected birds.
Are vaccines and antivirals available for prevention and treatment?
Some vaccine clinical trials are currently underway. Because the antigen needs to closely match the pandemic virus, large-scale production will not start until the virus has emerged. Current vaccine production capacity cannot meet demand. Tamiflu and Relenza are oral antivirals that are currently available and are effective for reducing the severity and duration of the illness. These medications can also be used prophylactically to decrease the number of new cases when an exposure has occurred.
References:
World Health Organization
www.who.int/csr/disease/avian_influenza/
Centers for Disease Control
www.cdc.gov/flu/avian/
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