1. The Vermont Department of Health Update on Pandemic Threat Cort Lohff, MD, MPH State Epidemiologist Guidance Support Prevention Protection

2. The Vermont Department of Health Present Threats The introduction of the H5N1 virus (avian influenza virus – “bird flu”) into North America An influenza pandemic

3. The Vermont Department of Health Avian Influenza Illness in birds Domestic and wild (migratory) Usually with different strains of the virus than what are found in humans High and low-pathogenic strains

4. The Vermont Department of Health Avian Influenza Humans rarely can get infected/ill: Risk associated with close contact to infected birds or their contaminated environments H5N1 one example

5. The Vermont Department of Health H5N1 Update 333 human cases/204 deaths (October 31, 2007) 12 countries Almost all cases had close contact with infected poultry or contaminated environments

6. The Vermont Department of Health H5N1 Update Human infections continue to be rare despite : Increasingly wide geographic range High number of human exposures to infected birds or their contaminated environments Suggests the virus has not adapted itself to be easily transmitted to humans

7. The Vermont Department of Health

8. How Might H5N1 Enter the U.S.? Major risk pathways Illegal movement of poultry Illegal movement of birds, pets Lower risk pathways Migratory birds Ill humans

9. The Vermont Department of Health Pandemic - Definition Global disease outbreak For an influenza pandemic to occur: A new type of the influenza virus must emerge Most or all of the population susceptible Virus easily spread person to person Widespread illness and death [Note the first two conditions are met with H5N1]

10. The Vermont Department of Health 20 th Century Pandemics 1918 Spanish Flu 20-100 million deaths worldwide  500,000 U.S. 1957 Asian Flu 1968 Hong Kong Flu

11. The Vermont Department of Health Potential Impacts Simultaneous and sustained impact across U.S. and globally: Unlike other emergencies Disruptions in essential services Up to 40% workforce out

12. The Vermont Department of Health Potential Impacts Shortages of vaccine and antiviral medications Overwhelming number of ill people, demand for health care resources, and deaths