PDF _ RL33145 - Pandemic Influenza: Domestic Preparedness Efforts
20-Feb-2007; Sarah A. Lister; 40 p.

Update: February 20, 2007

Abstract: In 1997, a new avian influenza (“flu”) virus emerged in Asia and jumped directly from birds to humans, killing six people. The virus has since spread to more than 50 countries in Asia, Europe and Africa, where it has killed millions of birds and infected more than 270 people, killing more than 160 of them. The virus bears some similarity to the deadly 1918 Spanish flu, which caused a global pandemic estimated to have killed more than 50 million people worldwide. The current spread of avian flu raises concerns about another human flu pandemic.

Global pandemic preparedness and response efforts are coordinated by the World Health Organization (WHO). Domestic preparedness efforts are led by the White House Homeland Security Council, with the U.S. Department of Health and Human Services (HHS) playing a major role. Domestic response efforts would be carried out under the all-hazards blueprint for a coordinated federal, state and local response laid out in the National Response Plan, overseen by the Department of Homeland Security (DHS). HHS officials would have the lead in the public health and medical aspects of a response. The federal government has released several pandemic flu plans to govern federal, state, local and private preparedness activities.

There are concerns about how a domestic public health and medical response would be managed during a flu pandemic. There is precedent, under the Stafford Act, for the President to declare an infectious disease threat an emergency (which provides a lower level of assistance), but no similar precedent for a major disaster declaration (which provides a higher level of assistance). In any case, many of the needs likely to result from a flu pandemic could not be met with the types of assistance provided pursuant to the Stafford Act, even if a major disaster declaration applied.

Vaccination is the best flu prevention measure. But because of continuous changes in the genes of flu viruses, vaccines must be “matched” to specific strains to provide good protection. A pandemic flu strain would, by definition, be novel. Stockpiled vaccine would not match, so stockpiling in anticipation of a pandemic is of limited value. In addition, global and domestic capacity to produce flu vaccine is limited. The U.S. government, primarily through HHS, has launched an aggressive effort to expand domestic vaccine production capacity, and to develop technologies to support more rapid production of a matched vaccine at the onset of a pandemic.

Since matched vaccine would not be available at the outset of a flu pandemic that occurred within the next several years, planning efforts focus on measures to slow the spread of disease, and mitigate its effects. These include stockpiling of antiviral drugs to prevent or treat flu infection, planning for medical surge capacity, and continuity planning for businesses and utilities.

This report discusses pandemic flu in general, WHO and U.S. preparedness and response plans, and a number of relevant policy issues. The focus of this report is U.S. domestic public health preparedness and response planning, and the projected impacts of an influenza pandemic on Americans. This report will be updated to reflect changing circumstances.

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Topics: Population

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