1. What is influenza?

Influenza (flu) is a contagious respiratory illness caused by an influenza virus. It can cause mild to severe illness and, at times, lead to death. Every year in the United States, an average of five to
20 percent of the population gets the flu. Some influenza viruses can also infect birds, pigs, horses, seals, whales and other animals. 

2. What is avian influenza (or bird flu) and is that the same as H5N1?

Avian influenza, or bird flu, is caused by an influenza virus that occurs naturally in birds. Wild birds can carry the virus and may not get sick from it; however, domestic birds can get infected from the virus and often die from it.

H5N1 is the scientific name for a specific subtype of the avian influenza virus that has spread from birds to humans in Asia and Turkey. The scientific names for these subtypes are classified by different proteins on the virus. New subtypes naturally occur when the proteins on the virus change through a process called antigenic shift.

3. Where does pandemic flu come from?

Viruses are constantly changing, producing new strains. A new pandemic virus may be the result of viruses exchanged between animals and humans that produce a new strain. This is why avian (bird) flu is such a concern even though there has been no sustained human to human transmission.  Pandemics occur when a new strain is so different from previous strains that few people, if any, are immune to it. This allows the new strain to spread widely and rapidly, affecting many hundreds of thousands of people worldwide. 
 

12. How will this impact my community?

Because most people will be fully susceptible to a pandemic influenza virus, local rates of illness could peak fairly rapidly. This could cause large numbers of people seeking medical or hospital treatment, temporarily overwhelming health services.  High rates of worker absenteeism can also interrupt other essential services, such as law enforcement, transportation and communications. This means that local social and economic disruptions may be temporary. They may, however, be amplified in today’s closely interrelated and interdependent systems of trade and commerce.  Based on past experience, a second wave of global spread should be anticipated within a year.

Vaccines

13. Is there a vaccine, or something, that I can take now to protect myself and those I care about from pandemic influenza?

Unlike seasonal flu, there is no vaccine for pandemic flu until researchers and pharmaceutical companies are able to create one, which takes time. Even if a vaccine is developed for pandemic flu, manufacturing and dispensing the vaccine to everyone in a timely manner will be a challenge.

The best way to protect yourself and others is to practice healthy hygiene in order to keep yourself well now and during a flu pandemic. Practicing these actions now will make them easier to do later. These actions include washing your hands, covering your mouth when you cough and staying home when you are sick. These actions will help slow the spread of illness.

14. Why won’t the seasonal flu vaccine protect people against pandemic influenza?

Seasonal flu viruses are different from the virus likely to cause pandemic flu.  Vaccines are designed to protect against a specific virus, so a vaccine cannot be produced until a new influenza virus emerges and is identified.

15. How much time does it take to develop and produce an influenza vaccine?

The influenza vaccine production process is long and complicated. Traditional influenza vaccine production for the U.S. relies on the use of chicken eggs, which is labor-intensive and takes nine months from start to finish.

The flu vaccine production process is further complicated by the fact that influenza virus strains continually change. Thus, seasonal flu vaccines must be modified each year to match the strains of the virus that are known to be in circulation among humans around the world.  As a result of this constant viral evolution, seasonal influenza vaccines cannot be stockpiled year to year.

Large amounts of vaccine cannot be made before knowing exactly which virus will cause the pandemic. It could then take up to six months before a vaccine is available, and then only in limited amounts at first.

16. What is the difference between a vaccine and an antiviral?

Vaccines are usually given as a preventive measure. Currently available viral vaccines are usually made from either killed virus or weakened versions of the live virus or pieces of the virus that stimulate an immune response to the virus. When immunized, the body is then poised to fight or prevent infection more effectively.

Antivirals are drugs that may be given to help prevent viral infections or to treat people who have been infected by a virus. When given to treat people who have been infected, antiviral medications may help limit the impact of some symptoms and reduce the potential for serious complications, especially for people who are in high risk groups.

Expectations During a Pandemic

17. How long will an influenza pandemic last?

Influenza pandemics may come in two or more waves several months apart, and each wave will last six to eight weeks in a particular location. It is difficult to predict how far apart the pandemic waves will occur. In the 1957 pandemic, the second wave began three months after the first wave, but in the 1968 pandemic, the second wave began 12 months after the first wave. 

18. How would pandemic flu affect communities and businesses?

If an influenza pandemic occurs, many people could become sick at the same time and would be unable to go to work. Many would stay at home to care for sick family members. Schools and businesses might close to try to prevent disease spread. Large group gatherings might be canceled. Public transportation might be scarce. These are examples of challenges on which local communities, schools, civic organizations and businesses need to work together to prepare for a pandemic response.

19. Will I be expected to shelter-in-place?

Shelter-in-place is a short term action to protect you from exposure to hazardous materials, like a chemical gas. Sheltering-in-place won’t protect you and your household from pandemic flu because pandemic flu is passed from person to person. You may be asked to stay at home or limit contact with others to help prevent the spread of the flu.  

20. What should I do to protect myself and those I care about?

The best way to protect yourself and others is to practice healthy hygiene to keep you well during a flu pandemic.  Beginning these actions now will make them easier to do later.  These actions include washing your hands, covering your mouth and nose when you sneeze or cough and staying home when you are sick to slow the spread of a pandemic.

Knowing that the flu is spread through contaminated droplets that exit the mouth and nose during coughing or sneezing can help make the difference between staying healthy and getting sick. Acting responsibly to prevent the spread of germs during a flu pandemic will help you protect yourself and those you care about.

21. Should I avoid cooking and eating chicken, or any other animals?

No, though certain precautions should be followed in countries currently experiencing outbreaks.  In areas free of the disease, poultry and poultry products can be prepared and consumed as usual with no fear of being infected with the influenza virus.

Cooking destroys germs, including the influenza virus. In areas experiencing outbreaks, poultry and poultry products can also be safely consumed provided these items are properly cooked and properly handled during food preparation. Consumers need to be sure that all parts of the poultry are fully cooked (no “pink” parts) and that eggs, too, are properly cooked (no “runny” yolks). For example, cook a whole chicken to 180°F (82°C) in an oven set to a minimum of 325°F (162°C). More information about how to properly cook poultry can be found at www.usda.gov/birdflu.

To date, no evidence indicates that anyone has become infected following the consumption of properly cooked poultry or poultry products, even when these foods were contaminated with the influenza virus.

Updating Your Family Disaster Plan

22. Should I keep extra food and water in my home?

Stocking extra food, water and supplies at home will reduce the need to go out during a local flu pandemic, thereby reducing the potential for exposure to the virus. If a person does get sick and has extra supplies on hand, he or she will help reduce the spread of pandemic flu by staying home.

23. Should I plan to go to work during a pandemic?

Learn now about the plans in your workplace for employees who get sick during a pandemic.  This information will have an important impact on your plans and decisions during an influenza pandemic.

Ask your employer about sick-leave plans to have staff stay home when sick and the
employer’s plans to keep the business functioning if key staff can’t come to work. 

Ask if there are any special considerations regarding sick leave, benefits and wages when there is a pandemic in the community and employees are asked to remain at home. 

24. Should I plan for my children to go to school or day care during a pandemic?

Find out now about the plans at your child’s school or day care during an influenza pandemic. 

Ask how the school plans to encourage parents to keep children who are sick at home to reduce the spread of the disease. 

Ask if the school would close if a pandemic were to occur in the community. 

Discussing these questions now with school administrators, teachers and other parents will significantly affect your plans, decisions and peace of mind during an influenza pandemic.

25. Who will care for me if I get the pandemic flu?

Plan now for care for yourself or loved ones if you get the flu.  Gathering the supplies ahead of time will allow you to provide care at home.  Decide how your family members will be cared for, including whether or not someone else in the household will need to stay home from work, school or other activities.

26. What can I expect from my health care provider?  I’ve heard in the news that they will be overwhelmed.

If you or your family members get sick, help may not be available from the usual sources.  Healthcare services are likely to be overwhelmed during a flu pandemic.  Find out what other sources of help may be available locally.  Contact your health care provider, local health department or other local government agencies now to find out about your role and their role during a flu pandemic.  Ask for the location of the nearest clinic that is available to provide treatment.

27. What makes a pandemic different from other natural disasters? What are the similarities?

Unlike other disasters, a flu pandemic is an infectious disease that does not damage homes, utilities, buildings and other structures.  However, if the workforce which keeps those structures running is unable to work, daily life will be disrupted.

A flu pandemic is similar to other disasters because it will disrupt your daily routines and you will be asked to take personal action to reduce the spread of the flu pandemic virus.

Preparing your business or workplace.

28. If I let my employees stay home during a pandemic, how will the work get done?

Allowing employees to stay home when they are sick may stop the spread of pandemic flu in the workplace. Flexible programs that meet both employee and business needs, maintain productivity, and promote a healthier workplace during the challenging time of a pandemic flu event could include:

• Allowing employees to make up lost hours;

• Telecommuting;

• Allowing alternative hours.

29. What can I do to encourage healthy behaviors in my business?

Provide a healthier workplace by reducing the spread of pandemic flu. Post signs to remind employees to clean their hands frequently and keep bathroom soap dispensers stocked. Supply alcohol-based sanitizers wherever employees gather.

Space as a barrier; slowing the spread of the flu.

30. What should I do if I cough or sneeze?

Covering your mouth and nose when you sneeze or cough is courteous and will help to reduce the spread of pandemic flu.  Use a tissue when possible, and wash your hands or use hand sanitizer immediately afterwards.  If you do not have a tissue, cough into your arm or elbow.

31. How can I greet someone politely and still avoid contact?

The way we greet others often includes touching or standing close to one another, which could spread pandemic flu. Thinking about other ways to show our care and interest — while limiting contact — may help keep you well. 

For example, waving, making eye contact or nodding your head instead of shaking hands could prevent the spread of disease.

32. How can I talk to someone without spreading the flu?

Standing farther away from others when talking is one way to reduce the spread of pandemic flu. This may feel awkward, yet it helps to let others know that you are trying to keep both of you as healthy as possible. You may also choose to avoid groups when you have heard that lots of people are said to be sick.

33. Are there restrictions on my daily routine that I should plan for in a pandemic?

If pandemic flu occurs in the United States, you may be asked to limit your travel and daily activities. Restrictions could be placed on you as an individual, or as part of larger public health precautions taken for the whole community.

Quarantine is not a bad word…or idea.  It protects everyone.

34. What is the purpose of a quarantine?

Quarantine protects people from the spread of highly contagious and dangerous diseases like pandemic flu.  If you have been exposed to pandemic flu you may be quarantined or separated from others who have not been exposed.  Quarantine benefits everyone, and works best when you and everyone who is asked to quarantine cooperates.  This collective action may keep pandemic flu from spreading.

35. How would quarantine look in my community?

Quarantine includes a range of approaches that may be used separately or in combinations to control the spread of pandemic flu. Examples are —

• People volunteering to stay home for short periods of time;

• Restrictions on people gathering, such as school or community events;

• Cancellation of public gatherings and public events;

• Closing public places, such as theatres and libraries;

• Closing mass transit;

• Closing schools and business according to severe weather plans;

• Restricting travel into and out of an area.

36. Why would I be quarantined?

There are different ways quarantine may occur. You may have been in close contact with someone who has pandemic flu and decide to stay at home. You also may be asked to stay home even when you feel fine and aren’t aware of any exposure to disease. People asked to quarantine may receive special care, like food delivery and monitoring for early signs of illness. 

37. How long should I expect to be quarantined?

Adults under mandatory quarantine would most likely be restricted for about 10 days. For children under the age of 12, quarantine is likely to last up to 14 days. It is important to remember that you may not show any signs of flu, yet can still pass it to other people. The actual length of a quarantine may vary based on a number of factors related to the specific circumstances of a flu pandemic.

When a Pandemic Spreads Home

38. Can I do something ahead of time to keep my household safe?

Learn the signs of flu and decide when to limit contact with others. Learn how to keep track of the symptoms and make yourself or the person in your care comfortable. Learn how to determine when medical attention is needed.

39. Where can I get help during a pandemic?

You, your family and friends need to be able to rely on each other when you cannot depend on the services you normally use. It is important to check with services you rely on to determine what their plans are should a pandemic occur.

Coping with a Pandemic

40. I don’t see others around me concerned about a pandemic.

Some people may not be concerned at all about a flu pandemic, which may be an initial reaction.  It’s okay to be concerned and take steps to protect you and your family before it happens.

As you recognize the threat of a pandemic occurring sometime in the future, you may feel scared or not want to think about this at all. This is normal. Getting ready for such an event may help you cope with the threat.

41. How can I prepare mentally and emotionally for a pandemic?

Thinking about how you handle stress and knowing your strengths will help you plan for, get through and recover from a flu pandemic.

During a flu pandemic, there will be many unknowns and the situation will change quickly. This will cause frustration for some people. You may need to make decisions based on incomplete information. 

42. How can I be social and stay in touch with people during a pandemic without the risk of spreading the flu?

During a flu pandemic, limit your face-to-face contact with people but continue to communicate with friends and family using other means such as the telephone, mail and the Internet.