Pandemic Influenza Frequently Asked Questions

The New York State Department of Health has been working aggressively to develop detailed plans to prepare for and respond to a possible influenza pandemic. The department is encouraged by the comprehensive federal plan and the guidance it has provided us. We are moving forward to finalize our planning efforts, many facets of which are already in place as part of our comprehensive initiatives to protect the public health, which include health systems preparedness, disease surveillance, antiviral medication, and vaccine distribution. The following information highlights the answers to the most frequently asked questions about an influenza pandemic:

General Questions

Q. What is a pandemic?

A. An influenza pandemic is a global outbreak that results from the emergence of a new influenza virus that can cause serious illness in humans, and spreads easily from person to person.

Q. What's the difference between a pandemic and a seasonal outbreak of influenza?

A. Influenza pandemics are caused by the emergence of a virus that is "novel" (brand new) or radically different from flu viruses that circulated previously. Because people have no or little natural resistance to a new virus, and there is no readily-available vaccine, influenza pandemics often result in much more severe illness and death.

"Seasonal" influenza outbreaks are caused by small changes in the common influenza viruses. Even though these viruses may change slightly from one flu season to another, many people have developed some immunity. Because similar viruses have circulated previously, vaccine is more readily available.

Q. When will the next pandemic occur?

A. Influenza pandemics are known to have occurred several times each century since the Middle Ages. There were three influenza pandemics in the 20th century, in 1918, 1957 and 1968. Experts believe we are overdue for the next influenza pandemic.

No one can predict when a pandemic might occur, but many scientists from around the world are watching the H5N1 avian (bird) influenza situation in Asia and Europe very closely. They are preparing for the possibility that the virus in birds may change and become more easily transmissible among people.

H5N1 Avian (Bird) Influenza

Q. Why is there concern about the H5N1 avian influenza outbreak in Asia and other countries?

A. Although it is unpredictable when the next pandemic will occur, and what strain of flu virus will cause it, the continued and expanded spread of a severe form of avian influenza in birds across eastern Asia and into a few countries in Europe represents a significant threat.

This bird flu virus, known as highly pathogenic "H5N1," has raised concerns about a potential human pandemic because:

  • This H5N1 virus is widespread and persistent in poultry in many countries in Asia and has spread to birds in several countries in Europe;
  • The virus has been transmitted from birds to a few species of mammals and in some limited circumstances to humans;
  • Among humans known to have become infected with the avian H5N1 virus, many have developed serious illness and approximately 50 percent have died;
  • Wild birds and domestic ducks have been infected without showing symptoms and have become carriers of viral infection to other domestic poultry species;
  • Although most humans who were infected with the H5N1 virus had close contact with infected birds, a few cases of limited person-to-person transmission have been reported;
  • Genetic studies confirm that this H5N1 influenza virus, like other influenza viruses, is continuing to change; and
  • This H5N1 influenza virus may change in a way that enables it to be easily transmitted from person-to-person.

Q. Is the influenza A (H5N1) virus the only avian influenza virus of concern regarding a pandemic?

A. Although H5N1 probably poses the greatest current pandemic threat, other avian influenzas have also infected people in recent years. For example, in 1999, human H9N2 infections were identified in Hong Kong; in 2002 and 2003, human H7N7 infections occurred in the Netherlands and human H7N3 infections occurred in Canada. These viruses also have the potential to give rise to the next pandemic.

Q. Will H5N1 cause the next influenza pandemic?

A. Scientists cannot predict whether the H5N1 avian influenza virus will cause a pandemic. But federal, state and local health officials are working with their counterparts across the world to track H5N1 as it occurs in birds, and to watch for possible human cases.

Vaccine

Q. Is there a pandemic influenza vaccine?

A. No. Federal officials have contracted with a manufacturer to produce a small supply of human vaccine against H5N1 bird flu, and clinical trials are underway. The vaccine might not be effective if the H5N1 virus changes to a strain that more easily infects humans.

Q. Why isn't there a vaccine available?

A. Large amounts of vaccine cannot be made before knowing exactly which virus is causing a pandemic. Production of a new vaccine takes approximately six months.

Q. Why won't the annual influenza vaccine protect people against pandemic influenza?

A. Influenza vaccines are designed to protect against specific viruses that have already been identified, so a pandemic vaccine cannot be produced until a new influenza virus emerges and starts to cause a significant number of human illnesses. A virus that could cause a pandemic would be very different from the seasonal flu viruses for which there is already vaccine.

Q. Can I get the vaccine once it's developed?

A. Very few people would be able to get vaccinated at first. If a pandemic occurs, federal, state and local governments will work with partner groups to make specific recommendations on the early use of vaccine. Current recommendations are to target limited vaccine supplies to people at high risk and healthcare workers.

Antiviral Medications

Q. What are influenza antiviral medications?

A. These are prescription drugs that can reduce influenza symptoms and shorten the length of time people are sick. The drugs may also make a person less likely to spread influenza to others. To be effective, they must be taken within two days of becoming sick. Some antiviral medications may also be used to prevent influenza if they are taken over a long period of time.

Q. Which antiviral medications would be used in an avian flu pandemic?

A. At this time, Tamiflu® and Relenza® are the most likely antiviral medications to be used in a pandemic caused by the H5N1 virus. The effectiveness of these antivirals would vary depending on the level of resistance an influenza virus may have to one or more of these medications.

Q. Are there enough antiviral medications for everyone if a pandemic occurred now, and if not, who will get them?

A. No. Although the government is stockpiling antiviral medications, there are not enough now for everyone. The federal government has made recommendations about prioritizing who will be the first to receive antiviral medications based on their risk, role in fighting the pandemic, and severity of illness. Discussion continues on the best way to allocate these medications.

Preparing for an Influenza Pandemic

Q. What effect would an influenza pandemic have on our communities?

A. The effects of a pandemic could be severe. Many people could become sick at the same time and be unable to go to work. Many of us might have to stay at home to care for sick family members. Schools and businesses might close for a time to try to reduce the spread of disease. Large group gatherings might be canceled. These are examples of challenges that are being considered as we plan for a pandemic response.

Q. What can I do right now to prepare for a possible pandemic?

A. One of the most important things you can do is to help prevent spread of the disease. Begin now to practice simple but important habits that reduce the spread of germs:

  • Cover your mouth and nose with a tissue when coughing and sneezing. Throw out the tissue in the nearest waste basket and wash your hands.
  • If you don't have a tissue, don't cough or sneeze into your hand. Instead, cough or sneeze into the crook of your arm so you won't get germs on your hands and spread them to others.
  • Wash your hands often with soap and water. When hand washing is not possible, use antiseptic hand gels that contain alcohol.
  • Stay at least three feet from people who are coughing or sneezing.
  • Always practice good hand washing after contact with an ill person or soiled materials, such as tissues.
  • Stay at home when you are sick.
  • Keep your children home from school or daycare when they are sick.
  • If you go to the doctor's office or emergency department when you are sick, ask for a mask.
  • Keep a supply of non-perishable food and other essential household items on hand so you can minimize trips to stores and other crowded places in the event of a pandemic.
  • Learn more about the importance of a good home preparedness plan. You can visit the American Red Cross Web site for guidance in preparing one, or visit the federal government's Pandemic Influenza Web site for planning tools.
  • Stay informed.