UK Health Departments reveal Pandemic Plan

UK public health experts have unveiled their plans to deal with an Avian Flu Pandemic in the face of rising concern over this serious health threat in Asia.

The Government has also announced the purchase of over a million doses of vaccine, which to be used primarily for Key Workers. These steps coincide with increased reports and concern from the World Health Organisation concerning Avian Flu.

Interim advice on the risks of an influenza pandemic

Purpose

This note is to inform emergency and business continuity planning by local authorities, schools and other education establishments, essential services and the business sector for the contingency of a world-wide pandemic of influenza. It highlights key issues to take into account in such planning. Further details are available in the main body of the UK Health Departments’ Influenza Pandemic Plan.

Context

The main source of information for this guidance is the UK Health Departments’ Influenza Pandemic Plan. It also draws on the results from consultation during 2004 by the World Health Organisation on preparedness for an influenza pandemic, which was largely driven by concerns amongst public health experts that the current outbreaks of avian influenza in parts of Asia could give rise to a pandemic .

The Pandemic Plan highlights, among other things, that Health Departments would implement a public education campaign, early on in a pandemic, on the nature of the infection and the measures the public and organisations can take to reduce its spread. Information would be widely available on Health Departments’ websites and in leaflet form. However, a key message to the public would be that the ability of health services to reduce the impacts of a flu pandemic on health are limited, and as a result, infection is likely to be widespread.

This guidance is issued to local responders to provide advice on the likely impacts of an influenza pandemic in order to inform and assist emergency and business continuity planning. The guidance is not intended either to be prescriptive or to be an operations manual, nor does it place any obligations on local authorities or service providers. The guidance is intended to help establish a co-ordinated national framework for effective local contingency planning. The guidance is interim because thinking and planning continue to evolve.

Background

Influenza pandemics have occurred at irregular intervals throughout history, three in the last century: in 1918 (‘Spanish flu’), 1957 (‘Asian’ flu) and 1968 (‘Hong Kong’ flu). Each of these events was associated with illness, deaths and general societal disruption far in excess of that experienced in a ‘normal’ winter. The 1918/19 pandemic, for instance, is estimated to have caused over 20 million deaths world-wide with 150,000 deaths in the UK. A further pandemic is thought to be inevitable. There may not be much warning and therefore advanced planning is essential for a smooth response.

Nature and scale of a flu pandemic

The outbreaks or epidemics of influenza which occur most winters affect some 5 to 10% of the population. The vast majority will have an unpleasant but self-limiting illness or even no symptoms, with less than 0.05% consulting their GP. Those most at risk of serious illness or death (the elderly, and those with chronic underlying diseases) are offered annual vaccination. Death from flu is usually due to complications such as secondary bacterial infections, e.g. pneumonia, or exacerbation of an underlying disease, rather than the direct effects of the influenza virus itself.

An influenza pandemic arises when an entirely new strain of influenza virus emerges to which most people are susceptible. Thus it is able to spread widely. Some important features of influenza pandemics are:

¨ They are unpredictable;
¨ They may occur at any time of year;
¨ They are most likely to start in Asia, or at least outside the UK, and gradually spread; this spread has been divided into phases allowing an escalating response according to the scale and geographic spread of the pandemic;
¨ Spread to the UK may take several months, but may be shorter;
¨ Once established in the UK, the disease is likely to spread rapidly over 2-3 weeks and then gradually decline over the next 4-6 weeks; a second wave of illness may occur 6-9 months later;
¨ some 20 to 30% of the population or even more may be affected over a 1-2 year period, including children and normally fit young adults; and
¨ a far greater proportion of people are likely to require hospitalisation or die than for seasonal flu.

Confirming a Flu Pandemic

The World Health Organisation (WHO) monitors influenza across the world. Once a new influenza virus has been identified and shown to have pandemic potential, the WHO will announce the various phases of a pandemic and inform national Governments (further details in Chapter 3 of main Plan). The UK Government will then put its own plans into action with the Department of Health in the lead working closely with the Health Departments in the Devolved Administrations (DAs) and supported by the Health Protection Agency and its equivalents in the DAs. This will include guidance and advice from Health Departments and/or the Health Protection Agency for the public and for planners across all sectors.

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