Pandemic Influenza Preparedness All Indian Pueblo Council Pueblo Health Committee New Mexico Dept of Health Epidemiology and Response Division Office of Health Emergency Management June, 2006

Overview  Avian or “Bird” Flu  Pandemic Preparedness Planning in NM  Point of Dispensing Sites

What is Avian Influenza?  Avian or bird flu is a type of influenza that infects birds.  Influenza viruses occur naturally among birds  Avian flu is very contagious among birds and can make domestic birds e.g. chickens, turkeys, and ducks sick, and even kill them  H5N1 avian influenza or “bird flu” (now in the news) is NOT pandemic flu

What is pandemic influenza?  A pandemic occurs when there is a widespread or world wide outbreak of disease  An influenza pandemic or “pandemic flu” is caused when a new virus appears that people have not been exposed to before

Seasonal vs. Pandemic influenza  Caused by existing flu virus  Healthy adults usually not at risk  Modest impact to society  Approximately 36,000 deaths in US each year  Caused by a new flu virus  Healthy adults at increased risk due to little or no immunity  Could lead to high levels of illness, death, social disruption and economic loss

Why should we prepare?  Influenza outbreaks among humans are annual events  A pandemic could occur if a new strain of influenza is introduced  A new strain of influenza could pass easily from person to person  Local community preparedness can mitigate some of the severe effects of a pandemic on individuals, families & communities

“The pandemic clock is ticking, we just don’t know what time it is” E. Marcuse

Where are we now?  Human cases of H5N1 avian flu are very rare, occurring mainly in Asia where people live close to domestic poultry  Human to human transmission of bird flu is rare, where it may have occurred, did not spread beyond immediate family  Currently, there is no H5N1 virus in the United States  New Mexico is on the Central Flyway for migrating waterfowl  World Health Organization (WHO) and Centers for Disease Control (CDC) are closely monitoring the avian flu  US Fish and Wildlife is monitoring migratory birds in Alaska  NM Game and Fish is monitoring the Sandhill Cranes

Eagles and Turkeys  Eagles and turkeys are not migratory but susceptible to the avian flu virus  Caution should be taken when gathering eagles from the wild  US Fish & Wildlife repository tests eagles for flu before sending them to Native Americans

Pandemic Preparedness in NM  NMDOH received $956,824 from CDC to engage in statewide pandemic preparedness planning  Tribes will each receive $8,000 for planning  Tribes must sign an MOA with the State to receive funds  Tribes must be listed as a current vendor with the State

Pandemic Preparedness in NM  County Emergency Managers are the leads for pandemic preparedness planning in each county  Tribes must identify who will coordinate tribal pandemic response planning with County Emergency Managers  Counties will sign an MOA with the State that obligates them to work closely with the Tribes  Tribal emergency managers & IHS are partners in State- level Unified Command of agencies coordinating pandemic planning (others NM DPS/OEM, NMDOH, & NM Emergency Managers Association)

Point of Dispensing Sites  Point of Dispensing Sites or PODS can be used for giving mass vaccinations in the event of public health emergencies  PODS are not permanent locations and must be separate from hospitals  It is the State’s responsibility to establish PODS in consultation with the tribes  Currently, the State has established 87 POD sites  Tribes have the option to set up PODs on tribal land

Requirements for PODS  Building that is accessible to the public with:  adequate parking  phone lines  Internet access (preferred)  Assurance of security for medication, facility & personnel  Design & plan for service flow throughout facility  Operated primarily by members of your community

Factors to consider  States and Tribes largely will be on their own to prepare for and respond if a pandemic occurs  Indian Health Service will be overwhelmed with the demand for services in their own facilities  There may be very high levels of illness and death  Vaccine may not be available for up to 6 months after initial outbreak  There will not be enough vaccine for everyone

Additional Resources NM Dept Health, Infec. Disease & Epi: NM Game & Fish: Joe Baca, Native American Planner NMDOH, Epidemiology & Response Division Office of Health Emergency Management