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BRACING FOR FLUState Seeks Details of Pandemic plansNebraska and Federal Strategies for Super-Flu Strain Seem to meshFighting Influenza

Posted on: Wednesday, 2 November 2005, 18:01 CST

By Julie Anderson

Federal money could come Nebraska's way to help prepare for a flu pandemic, but state officials don't yet know how much that might be.

The state is anxious to hear more because it's struggling to figure out how to pay for lab testing for flu surveillance, training and public education, Dr. Joann Schaefer, the state's chief medical officer, said today.

The state's plan, for example, calls for working with the Nebraska Game and Parks Commission and the Nebraska Department of Agriculture to screen bird populations should a virus emerge.

The state already has begun its annual surveillance for seasonal flulike illness and school absenteeism, a measure that also could help identify an emerging pandemic bug, should one strike.

Another key question for states is how much they will have to pay for stockpiles of vaccine and anti-viral drugs.

Overall, however, Nebraska's plan appears to be in line with emerging details of President Bush's plan for a national response to a flu pandemic.

"I don't see any gaps," Schaefer said. "I just see more details of a really well-placed skeleton."

Schaefer said she was just skimming the nearly 400-page document -- about the size of Omaha's telephone book -- that the Bush administration released this morning.

The latest details of the federal plan call for $100 million for state preparations, including determining how to deliver stockpiled medicines directly to patients.

Schaefer said she wouldn't say where the state's planning focus would lie until she reads the whole plan. Nebraska is ahead of the curve in flu planning, she said, but the plan will evolve.

Iowa officials were still reviewing the plan this morning and were not prepared to comment.

According to the federal plan, sustained person-to-person spread of the bird flu or any other super-influenza strain anywhere in the world could prompt the United States to implement travel restrictions or other steps to block a brewing pandemic.

If a super-flu begins spreading in the United States, states and cities will have to ration scarce medications and triage panicked patients to prevent them from overwhelming hospitals and spreading infection inside emergency rooms, the federal plan says.

The plan provides longawaited guidance to the frontline local officials, urging them to figure out now how they would prevent that -- and to practice their own plans to make sure they'll work.

Pandemics, or worldwide outbreaks, strike when the easy-tomutate influenza virus shifts to a strain that people have never experienced before, something that happened three times in the last century.

It's impossible to predict when the next pandemic will strike. But concern is rising that the Asian bird flu, called the H5N1 strain, might trigger the next one if it eventually becomes easily spread from person to person.

With a public increasingly jittery about the H5N1 spread among birds and a drumbeat of criticism that the nation is unprepared, President Bush on Tuesday outlined a $7.1 billion strategy to get ready for the next pandemic.

Topping his list is improving systems to detect and contain the next super-flu before it reaches the United States -- and overhauling the vaccine industry so that eventually, scientists could quickly brew enough for everyone within months of a pandemic's appearance.

That vaccine improvement will take years to implement -- and the details released today stress that early on, the public will be depending on scarce supplies of anti-flu drugs and stockpiled vaccines and old-fashioned ways of limiting viral spread.

Stockpiled drugs "are not the equivalent of preparedness," Health and Human Services Secretary Mike Leavitt told a Senate subcommittee today as he unveiled the details.

Indeed, the plan stresses that if a pandemic begins, Americans should limit visits to doctors and hospitals unless absolutely necessary and hospitals should triage those seeking care so that suspected super-flu victims have limited contact with other patients, the federal plan says.

Schaefer said the state has a chain of command set up through its Homeland Security Department and Nebraska Emergency Management.

More drills are required, but the bioterrorism drills the state already has run "fit nicely with the pandemic plan," she said.

The Nebraska Health and Human Services System was involved in a drill that began Tuesday and will wrap up Thursday involving a bioterrorism agent that produced flulike illness.

Dr. Adi Pour, director of the Douglas County Health Department, said quarantines likely would take place at home or such places as long-term care facilities. She would have the authority to impose one in the county, and local police would help enforce it.

World-Herald staff writer Nichole Aksamit contributed to this report, which includes material from the Associated Press.

Fighting influenza

Some assumptions in the national pandemic flu plan:* Everyone will be susceptible to the virus. Forty percent of school-aged children, 20 percent of working adults and 30 percent of all U.S. residents will contract the disease. About half who get sick will seek medical care. Depending on the pandemic's severity, between 865,000 and 9.9 million could require hospitalization and 209,000 to 1.9 million could die. People will be able to transmit the virus before they show symptoms.

*Based on past pandemics in the United States.

Source: U.S. Health and Human Services Pandemic Influenza Plan

Source: Omaha World - Herald

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