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Epidemic Flu, Respiratory Illness

This web site is intended to provide an overview and key documents, resources, tools and links to web sites for epidemic and pandemic influenza and respiratory illness preparedness.

Avian influenza viruses occur naturally among birds and may infect humans who live in close proximity with infected birds. The World Health Organization (WHO) tracks the number of cases of avian influenza A (H5N1) on a special web site. Public health officials are closely monitoring for H5N1 and H7N9 avian influenza in humans and other strains capable of being spread efficiently from person to person.

Human infections with a new avian influenza A (H7N9) virus continue to be reported predominately in China and the virus has been detected in poultry in China as well. Many of the people infected with H7N9 are reported to have had contact with poultry and there is no sustained person-to-person spread of the H7N9 virus at this time. While mild illness in human cases has been seen, most patients have had severe respiratory illness and some people have died. The new H7N9 virus has not been detected in people or birds in the United States as of November 2014.

Many of the people infected with H7N9 are reported to have had contact with poultry. However some cases reportedly have not had such contact. Close contacts of confirmed H7N9 patients are being followed to determine whether any human-to-human spread of H7N9 is occurring. No sustained person-to-person spread of the H7N9 virus has been found at this time.

Human infections with avian influenza (A, or “bird flu”) are rare but do occur, most commonly after exposure to infected poultry (Bird-to-human spread). Limited person-to-person spread of bird flu is thought to have occurred rarely in the past, most notably with avian influenza A (H5N1). Based on this previous experience, some limited human-to-human spread of this H7N9 virus would not be surprising. Most important, however, is that this transmission not be sustained (ongoing).

Influenza viruses constantly change and it’s possible that this virus could become able to easily and sustainably spread between people, triggering a pandemic. CDC is following this situation closely and coordinating efforts with domestic and international partners.

Coronaviruses are common around the world and cause a range of illnesses in humans from common cold to SARS. Virus of this family also cause disease in animals. From April 2012 to July 2013, a novel new coronavirus has caused respiratory illness in 81 adults (45 fatal) from four countries in the Middle East(Saudi Arabia, Qatar, Jordan, and the United Arab Emirates) as well as France, Germany, Tunisia and the United Kingdom. (Updated case counts) Symptoms have included fever, cough, and shortness of breath. The new virus has been named the Middle East Respiratory Syndrome Coronavirus or (MERS-CoV). This particular strain of coronavirus has not been previously identified in humans and there is still limited information on transmission, severity and clinical impact. Thus far, all clusters of cases have occurred in a health care setting or among close family contacts. Human-to-human transmission has been documented on several occasions in which secondary cases had not traveled to affected areas and is strongly suspected in others. Transmission does not appear to have extended beyond these clusters into the larger community in any of the events. The mode of transmission has not been defined in any of the clusters.

Middle East Respiratory Syndrome (MERS) is viral respiratory illness first reported in Saudi Arabia in 2012. It is caused by a coronavirus called MERS-CoV. Coronaviruses are common around the world and cause a range of illnesses in humans from common cold to SARS.

Most people who have been confirmed to have MERS-CoV infection developed severe acute respiratory illness. They had fever, cough, and shortness of breath. About 30% of people confirmed to have MERS-CoV infection have died.

So far, all the cases have been linked to countries in and near the Arabian Peninsula. This virus has spread from ill people to others through close contact, such as caring for or living with an infected person. However, there is no evidence of sustained spreading in community settings.

In May 2014, there were two imported cases of MERS in travelers from Saudi Arabia to the US, however the cases were not linked.

One hallmark of influenza viruses is that they are constantly changing. If a non-human (novel) influenza virus gains the ability for efficient and sustained human-to-human transmission and spreads globally, an influenza pandemic occurs. The 2009 H1N1 influenza virus pandemic is one example.

Includes flu activity and surveillance, vaccinations, risk assessment tools, print and audio-visual materials, and H7N9 updates.

  • provides one stop access to U.S. Government H1N1, avian and pandemic flu information.
  • Pandemic Influenza Resources CDC resources to prepare for the next influenza pandemic.
  • Nonpharmaceutical Interventions (NPIs) Information about actions, apart from getting vaccinated or taking medicine, that people and communities can take to help slow the spread of illnesses like influenza (flu). NPIs are also known as community mitigation strategies.

In April 2009, the World Health Organization (WHO) redefined their phase descriptions for an influenza pandemic. This corresponded with the start of the H1N1 flu pandemic, and was intended to make phases easier to understand, more precise, and based upon observable phenomena. On June 11, 2009, the WHO raised the H1N1 virus to Phase 6 – meaning the pandemic was underway. WHO declared the H1N1 pandemic over on August 10, 2010.

  • Phases 1 – 3 correlate with preparedness, including capacity development and response planning activities.
  • Phases 4 – 6 clearly signal the need for response and mitigation efforts.

The Centers for Disease Control and Prevention (CDC), with input from other Federal partners, developed a checklist in 2007 to help hospitals assess and improve their preparedness for responding to pandemic influenza. Because of differences among hospitals (e.g., characteristics of the patient population, size of the hospital/community, scope of services) and need to adapt this checklist to meet its unique needs and circumstances, Premier prepared this checklist as a Word file to save on your computer and complete or update at your own pace. The checklist was updated in April 2013 and retains the HTML format and features.

A novel influenza A virus, detected among people in the spring of 2009, caused the first influenza pandemic in more than 40 years. This virus is now a regular human flu virus and continues to circulate seasonally worldwide.

Please visit the Safety Institute’s section on emergency preparedness for resources on all types of emergency planning. Premier members can access comprehensive disaster and emergency preparedness information and resources here. (Log in required)

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