Eastern Ontario Health Unit Bureau de santé de ll’est ’est de ll’Ontario ’Ontario
PANDEMIC WHAT YOU SHOULD KNOW WHAT YOU SHOULD DO
1918 Spanish Flu: 50,000 people killed Greatest human disaster in Canadian history The 1918–19 Spanish Flu caused 50,000 deaths in this country and 40 million deaths worldwide. It is believed to have been spread by World War I servicemen traveling overseas. It is sometimes hard to believe that germs spreading from person to person can cause this much destruction, but infectious diseases are the number one cause of death around the world. The availability and frequency of travel today makes it easy for diseases to rapidly move from country to country. The 2003 SARS outbreak was an example of this. The flu is another example. Every year the world prepares for another flu season. New strains of flu evolve and spread around the world on a regular basis. The flu greatly impacts the elderly and ill, and has a significant economic cost to society. Usually the risk to healthy individuals is relatively low.
Even though the flu is hard to fight, there have been major scientific achievements that can greatly decrease the spread of this disease. Vaccinations, medicine, good personal hygiene and a healthy lifestyle have proven to be the best way to combat illness. Government and community planning for public health emergencies will also help to reduce illness and death caused by the flu. This report provides you with an overview on influenza and the new strains as well as how influenza is spread and can be prevented. It also explains Public Health’s role in helping to protect the communities we serve from influenza and other diseases and how you can prepare for a pandemic.
Based on history, however, scientists expect a deadly new type of flu virus to emerge, which will also attack the young and healthy. When this “pandemic influenza” hits, it is likely to kill many people worldwide, including many Canadians, unless a vaccine to fight it can be developed early enough. Adapted and reprinted with permission of the Thunder Bay District Health Unit
THE
FLU
What is the flu?
Influenza (the flu) is a very contagious respiratory illness caused by a virus. Every flu season in Canada, between November and April, it is estimated that as many as 8 million people get the flu.
How is it spread?
The flu spreads easily through droplets coughed or sneezed into the air by a person infected with the flu virus. You can get the flu if you breathe in the droplets, or if the droplets land directly on your eyes. You can also get the flu virus if you shake hands with infected people, or touch contaminated surfaces, and then touch your nose, mouth or eyes.
How dangerous is the flu? •
Every year, about 500 to 1,500 people in Canada will die from the flu or related complications.
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In Canada it is still the leading cause of hospitalization and death due to an infectious disease because it attacks and weakens the elderly and the ill – people with heart and lung conditions, diabetes, kidney disease, HIV and cancer.
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$1 billion is the estimated cost to Canada – in terms of health care costs and lost productivity.
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The flu can lead to pneumonia, worsen a chronic condition, or cause death.
How is the flu different from a cold?
Unlike a cold, the flu usually starts suddenly and commonly causes a fever, headache, extreme tiredness, coughing, body aches, nausea, vomiting and diarrhea (in children).
Symptom
Flu
Fever Headache General Aches & Pain Fatigue & Weakness Runny, stuffy nose Sore throat Chest discomfort, coughing
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Xx common symptoms x less common symptoms
Cold
XX XX
X
XX
X
XX
XX
X
XX
XX
X
WHAT IS
AVIAN INFLUENZA?
There have been many news reports about influenza in birds and the resulting culls of millions of chickens and ducks. Avian influenza infects birds, as well as horses, pigs, seals and whales. On rare occasions, it can cause disease in humans. Wild migratory birds carry the virus around the world and can spread it through their saliva and feces to domesticated birds.
How can humans get avian flu? Although relatively rare, humans can become infected with avian flu by coming into direct contact with infected birds and pigs, or their droppings. Also, if saliva droplets carrying the virus become airborne from an infected bird or pig, they can land on the mouth, nose or eyes of a person or be inhaled into their lungs. Although some people have been infected with avian flu, scientists believe it is difficult for humans to transmit it to other humans. A particularly deadly strain of avian flu, called “H5N1”, is of current concern to international health authorities. As of December 2005, there have been 141 human cases of this strain, about half of which have died.
Why is avian flu important? Some strains of avian flu can be harmful to farm workers and are, therefore, important in their own right. However, the main reason for the current concern over avian influenza is that a combination of avian and human influenza viruses could result in an easily spread, deadly new virus a pandemic influenza virus.
What is pandemic influenza? Though the flu is a major concern to the ill and elderly, occasionally, a new, deadly and highly infectious strain occurs that can cause serious illness and death in the healthy population. Such a strain is called pandemic influenza.
Pandemic Influenza Pandemics are thought to start with pig-duck farming in Asia. Flu viruses are widespread in both wild and domestic fowl, such as chickens and ducks. A water sample from almost any lake in Ontario is likely to turn up flu viruses.
Most of the time bird flu viruses cannot infect humans. However, they can infect pigs. Pigs can also become infected with human flu viruses. This makes pigs an ideal “mixing vessel” in which human and bird flu viruses can mingle to create a new virus that can infect both pigs and humans. Do you remember the ‘swine flu’? In China, a very intensive and efficient form of agriculture called “integrated pig-duck farming” is practiced in which pigs, ducks, and human farmers are in very close contact. Pandemic strains of influenza seem to arise when bird and human flu viruses mix within the pig to create a very different pandemic flu strain. The new pandemic strain is then passed from the pig to the human farmer, who then passes it onto other humans. Because it is a very different new strain, no one has any immunity to the virus and it spreads quickly. It is believed that the 1918 “Spanish Flu” actually evolved in China through pig-duck farming, and went on to kill at least 40 million people. The current outbreaks of avian influenza in fowl were first identified in Asia and have now been seen in East Europe.
When does flu become a pandemic? > New influenza virus evolves > It can easily be spread from human to human > It can cause serious illness and death > The population has little or no immunity to the virus
Potential Impact of a Flu Pandemic Health officials estimate that 15%–35% of the population will be infected with the pandemic flu. The following table shows estimates of the impact of the flu.
Ontario
Eastern Ontario
Deaths
5 000 - 12 000
140 - 324
Hospitalized
22 000 - 52 000
460 - 1070
Ill and needing out-patient care
1 million - 2.3 million
22 400 - 53 000
Ill but not needing professional care
800 000 - 1.9 million
70 000 - 80 000
Total affected:
1.8 million - 4.2 million
92 400 - 133 000
Predicted community impacts
> Hospitals will not be able to care for all of the ill > Doctors, nurses and other health care staff will also be sick so less professional care will be available > Demand for care will be extremely high > With up to 1/3 of eastern Ontario’s population ill and others staying home to care for them, many stores may be closed and basic services may be strained
What to expect
:
> An influenza pandemic will happen > The timing and pattern of the pandemic is unpredictable (where and when) > A short lead time will exist (about 3–6 months) from the time the pandemic is first identified to the time it becomes global in extent > Outbreaks will occur simultaneously throughout the world, in multiple waves, and with devastating impact on communities > A vaccine will not be immediately available
What is happening to protect us from the
NEXT PANDEMIC? The World Health Organization has a number of laboratories that are watching closely for new pandemic strains coming from Asia. But, it is important for Ontarians to remember that it only takes about 20 hours to fly from Hong Kong to Toronto. With modern travel times, we are no longer protected by distance from diseases evolving in other parts of the world.
Planning for the
PANDEMIC
The Eastern Ontario Health Unit has drafted a pandemic response plan.
This plan outlines how the Health Unit will respond to a
pandemic emergency.
The Health Unit is currently working with
many community agencies to prepare a community wide response to pandemic influenza. Here is a list of some of the agencies involved: > Eastern Ontario Health Unit > City of Cornwall > Local health care and long- term care facilities > Hospitals > Area school boards > Community Care Access Centre > United Counties of Stormont, Dundas & Glengarry and Prescott & Russell > All municipal offices > Social services agencies > Physicians > Local laboratories > Emergency Management Ontario > Ontario Provincial Police/City police, Fire departments and Ambulance services > Private sector industries
All municipalities in the area are working to develop their own local preparedness plans in the event of a flu pandemic.
PREVENTION Get Vaccinated Complications from the flu can be very serious. The flu shot can help reduce the risk of contracting this illness. Adults age 65 and more and individuals with chronic illness should also be encouraged to receive the pneumococcal vaccine. A few people are severely allergic to eggs and shouldn’t get a flu shot. Others admit they’re afraid of needles. Still others believe some unfounded myths about the flu shot. These are some common myths and the real facts.
MYTH #3
MYTH #1
I’m young and healthy, I don’t need a flu shot.
Fact: Even healthy children and young adults can become quite ill, losing time from work, school or vacation. Plus, there’s a chance you might infect others at much greater risk than you.
MYTH #2 Getting a flu shot will give me the flu.
Fact: This is simply not true. The vaccine does not contain a live virus. Many people confuse the flu with a cold, which the flu vaccine will not protect you against. The flu is much worse than a cold.
Flu shots aren’t worth getting because they’re not very effective.
Fact: A flu shot is about 70 to 90 per cent effective in preventing flu in healthy adults and children, when the vaccine is a good match to the strains. Among the elderly, the vaccine can help prevent pneumonia, hospitalization and death. If you do get the flu, it is usually a milder case than it would have been without the shot.
MYTH #4
I don’t need another flu shot, I got one last year.
Fact: A flu shot is needed every year. Each year, the flu changes and each year a new vaccine must be produced that provides protection against the three most common strains predicted for the coming season. (Adapted from Ontario Ministry of Health & Long-Term Care)
Be brave... get your flu shot!
Antibiotics Do not Fight the Flu
WASH YOUR HANDS Hand washing is the #1 way to prevent infections. Follow these simple steps to prevent illness:
Most illnesses that can spread from person to person are caused by germs such as viruses and bacteria.
1
To treat illnesses caused by bacteria, antibiotics may be used. Antibiotics only kill bacteria, not viruses. Given that flu and colds are viruses, antibiotics cannot cure them.
WET HANDS
Unfortunately, antibiotics are often not taken correctly and are sometimes prescribed for illnesses that they cannot fight, like the flu. As a result, some bacteria have become stronger and harder to destroy. When this happens, the bacteria germ is said to be “antibiotic resistant.” Sometimes, this type of germ is called a “superbug” because it is hard to kill.
SOAP/LATHER (20 SECONDS)
Superbugs cause longer hospital stays, increased treatment costs, longer absences from work, prolonged illnesses, and can cause more deaths. Antibiotic resistance is a concern worldwide. Two ways to help solve the problem are: take antibiotics exactly as prescribed by your doctor when they are needed for a bacterial infection, and, don’t take antibiotics for illnesses that are caused by viruses.
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RINSE 5
TOWEL DRY 6
TURN OFF TAP WITH TOWEL
Protect Yourself and Others Because the flu is highly contagious, if you’re sick, it’s better to stay home than risk spreading the flu virus to coworkers, friends and family members. Workers who stay home can help reduce sick leave at work by up to 40%. When you are at work, you can help prevent getting infected with the flu bug by: • Getting a flu shot (workplaces can even hold clinics for their employees);
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Washing your hands often throughout the day;
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Keeping a disinfecting spray or wipes handy for cleaning things like your phone, desktop, mouse and keyboard;
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protects the community from infectious diseases by:
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Providing immunization to school children, people traveling to foreign countries, and community members;
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Holding free flu immunization clinics;
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Investigating reports and outbreaks of infectious disease;
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Leading pandemic influenza planning;
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Working with hospitals, longterm care facilities and other health care agencies by providing consultation, case management, and education;
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Providing education to the community about infectious disease prevention;
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Working with workplaces to promote healthy workers and work environments;
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Working with schools to promote healthy lifestyles and education on infectious diseases.
Cleaning surfaces that are often touched such as door knobs and toilet handles regularly.
More Tips to Stay Healthy 1.
The Eastern Ontario Health Unit
Discourage habits that include touching eyes, nose and mouth without first washing hands. This may reduce the spread of respiratory, eye and ear infections. Practice cough etiquette, that is cover your mouth and nose when you sneeze or cough. Teach your children to do the same. Clean and disinfect surfaces. Ensure that you follow the chemical manufacturer’s recommendations for any product used at home or work. Keep a distance of more than 3 feet between people. This will help reduce the spread of infection.
For more information, call (613) 933-1375 or 1 800 267-7120 and ask for Health Line.
