Influenza Update #10 - Swine Flu

MedPrep Consulting Group LLC Dr. Stuart B. Weiss  IMPORTANT INFLUENZA UPDATE #10 WHO PANDEMIC ALERT LEVEL 5 MAY 1, 2009 Influenza cases continue to rise, but here's the good news The number of confirmed cases in the world increased by about 30% since yesterday but the good news is that for the most part, the virus seems to be causing only mild disease.       CURRENT SITUATION: U.S. is reporting 109 confirmed cases in 11 states. State health departments are reporting slightly more cases that are strongly suspected to be swine flu. That number is 134 cases in 19 states. Except for one death and a report of a critically ill 30 year old woman in the news this morning, the vast majority of people recover uneventfully. The World Health Organization (WHO) is reporting that there are 331 confirmed cases in 11 countries although Mexico itself is reporting many more cases than the WHO lists for Mexico so the numbers don't quite add up (this is to be expected this early in an outbreak). U.S. Government is sending 400,000 treatment courses to Mexico to help fight the outbreak U.S. Government is reportedly purchasing 13 million more anti-viral treatment courses to replace the medications from the National Pharmaceutical Stockpile that have been sent to states New CDC Guidance for School Closures has been posted (this could impact businesses significantly) this morning. Take a look at: http://www.cdc.gov/h1n1flu/K12_dismissal.htm for more information. Highlights include: School closure recommendation if one student in a school has laboratory confirmed case of swine flu Closure of a entire school district if more than one school or daycare center has confirmed cases Closure of neighboring school districts even without a confirmed case Minimum closure recommendation of 14 days (children tend to remain infectious for up to 10 days after becoming ill) Several international agencies suggest changing the name of the virus (see analysis below)   ANALYSIS: This situation is highly fluid as details continue to emerge.    As expected in an outbreak, the number of cases continues to rise. As I mentioned a few days ago, outbreaks such this one tend to follow a bell-shaped curve with the number of cases building to a peak and then dropping off. We are still in the build up phase and normally we would expect the numbers to continue to rise. This may be altered by the fact that influenza tends to not spread so well in the northern hemisphere during the warmer and humid spring and summer seasons. This should become more apparent over the next week or two.   The good news is that the overwhelming majority of cases reported so far are relatively mild. Of course, mild is a relative word if you have ever caught a full blown case of influenza. Having high fever, muscle aches, headache, sore throat, and vomiting or diarrhea for 3 or 4 days is not great but almost everyone has been recovering uneventfully. Only occasionally do people get into trouble and require hospitalization. Some virologists are commenting that this is equal to or less severe than normal seasonal influenza, which by the way kills about 36,000 people in the U.S. each year. The challenging part comes from the fact that this is a new virus so its hard to predict. Things could get worse pretty quickly. If this virus follows the 1918 pattern, we will see it calm down over the summer and then come back stronger and more lethal in the fall. The good news about that would be that by the fall, we should have a vaccine that is available for human testing. Vaccine development is speeding along at full steam but it will still take 6 months for development and production to begin.   What's in a name, apparently everything if you are a pig!! In response to the mistaken belief that this virus circulates in pigs, Egypt began killing all of the pigs in the country. Several countries have banned pork imports from Mexico and the U.S.. This is unnecessary and ridiculous. There is NO evidence that this virus is circulating in pigs and there is no risk of catching this illness from properly cooked pork (I say properly cooked due to other food borne illnesses). In response, three international agencies (UN Food and Agriculture, World Animal Health, WHO) want to change the name of the virus but no one has yet come up with the correct new name. Some publications are calling it S-OIV for Swine-Origin Influenza Virus, some are using the scientific designation A/H1N1 and some are still calling it swine flu. Stay tuned to see what we end up calling this.     ADVICE: Each day, I will focus on issues from a pandemic planning area that we have found during pandemic plan audits that we have performed for our clients. Look closely as your HR policies. As we discussed on the Daily Brief call yesterday and as evidenced in the CDC guidance released this morning, school closures may affect your workforce. If the virus continues to spread as predicted, more and more schools will be closed. Kids that are released from school SHOULD NOT be allowed to congregate in group since this would negate the whole reason for closing schools. So the question is what will your employees do to provide supervision for children that are home. Have these discussions with your employees now. Tighten up your travel policies. Look closely at your company travel policies. All non-essentail travel to MExico should be banned at this point. Some companies have begun to look closely at limiting employee travel temporarily until the situation becomes more apparent (over the next week or so). Large meetings. You should consider postponing any large meetings you are hosting in high outbreak areas. Although we may get a chance to catch our breath in the next few weeks do not relax on your planning efforts. This virus may take a summer break but it could be back in full force this fall.   Let us know if you need help reviewing your plan, designing educational posters or writing FAQ's (frequently asked questions) or policies. We have resources and expertise that you can use.     Not preparing now would be a serious mistake should things worsen quickly.      If you have any questions or concerns that we can help you with, please feel free to reach out to me. My email is: sweiss@MedPrepGroup.com   SUBSCRIBE TO ALERTS by clicking the button below.    Dr. Stuart Weiss is a nationally recognized pandemic planning expert and CEO of MedPrep Consulting Group. MedPrep can assist you with your pandemic planning, training and exercising needs. Drop me a note if you want more information about us.            Stuart Weiss, MD, CBCP MedPrep Consulting Group LLC