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Q. What is pandemic flu?
Flu that spreads rapidly causing widespread epidemics around the world. Pandemic influenza occurs when a new, highly infectious and dangerous strain of the influenza virus appears.
In contrast to the 'ordinary' or 'seasonal', flu outbreaks which we see every winter, flu pandemics occur infrequently - usually every few decades. There were three in the last century. The most serious was in 1918, killing millions of people worldwide. Smaller pandemics happened in 1957 and 1968.
Q. What is the difference between an epidemic and a pandemic?
A pandemic occurs over large geographical areas (usually worldwide) and affects a high proportion of the population; an epidemic, although it may be serious, usually refers to what is happening in one country or region.
Q. Is another pandemic of influenza is likely?
Flu viruses are constantly changing and adapting, so it is likely that viruses sufficiently different from 'ordinary' flu strains to cause a pandemic will emerge from time to time. International disease experts are saying that the world is overdue for the next pandemic.
Q. When is the next pandemic due?
We do not know - it can't be predicted. The gaps between previous pandemics have varied widely. Intervals between previous pandemics have varied from 11 to 42 years with no recognisable pattern. Three influenza pandemics occurred in the last century - 1918/19 (Spanish flu), 1957/58 (Asian flu) and 1968/69 (Hong Kong flu). All affected large numbers of the population, causing many deaths and huge economic and social disruption.
Q. Where is the new virus likely to come from?
Past experience suggests that it will first appear in Asia, but it could be anywhere.
Q. Will it arrive in winter like normal flu?
Not necessarily. A new virus may not follow the usual seasonal pattern of ordinary influenza. It could occur at any time of the year.
Q. How long will it take to spread around the world?
Probably less than six months and possibly just a few weeks. The increasing speed and volume of modern travel means infectious diseases can travel very rapidly round the globe.
Q. How is the virus spread?
The virus is easily passed from person to person by breathing in air containing the virus produced when an infected person talks, coughs or sneezes. It can also spread through hand/face contact after touching a person or surface contaminated with the virus.
Q. How will a new virus be detected?
Scientists in an international network of laboratories, co-ordinated by the World Health Organization (WHO) are watching for it all the time. This network provides a mechanism for monitoring flu viruses and avian flu information around the world, detecting the emergence of influenza viruses with pandemic potential, and alerting other countries.
Q. How will we know when a pandemic is possible?
When a new strain of influenza virus has not only been identified but also causing illness and has started spreading from one person to another.
Q. Can't it be prevented at this stage?
International effort will be put to trying to control a pandemic at this early stage. However, influenza is highly infectious and because whole populations will be susceptible to the new virus, despite people's best efforts it is likely to continue to spread.
Q. What will make a pandemic more likely to happen?
A pandemic will be considered imminent when a new virus has shown it can spread easily between people. In practice, this means when a new strain of the virus has been identified as the cause of chains of illness passed from one person to another or illness in more than one country, with no obvious links.
Q. What can we expect to happen?
Once the pandemic reaches your Country it will take a few weeks to take hold, but it will then cause widespread illness across the country over a period of 2-3 months. There may be a second wave of illness a few weeks or months later. Previous experience suggests around a quarter of the population will develop flu during this time.
Q. How many people are likely to catch flu during the pandemic?
From past experience, up to a quarter of the population are likely to develop flu, although it could be more. More than this may be infected without getting symptoms (sub-clinical infection).
Q. Could everyone become ill?
Everyone will be susceptible, but in the past as many people as become ill shake off the infection without developing illness (asymptomatic infection).
Q. How predictable will the effects of a pandemic be?
Every pandemic is different so we cannot be sure how a new pandemic will behave. But we can make sensible plans for what we think is most likely, based on previous experience and our knowledge of how the world has changes since the last pandemic in 1968.
Q. How will this impact on health services?
A flu pandemic will, therefore, place considerable pressure on health and social services due to the greatly increased number of patients with influenza who will require treatment together with depletion of the workforce due to illness.
Q. How will this impact on business?
Each pandemic is different and the impact on business cannot be fully established until more is known about how a pandemic is evolving. Absences from work will depend largely on the age group most affected by the virus. Previous pandemics suggest that up to 10% or more of the population may have to take days of work. Absence may be compounded by the need for some workers to care for family members, and any disruption to transport services.
Q. Will schools be affected?
Pandemic flu is likely to spread rapidly in schools, so they may have to close. Some may also have to close for short periods because of staff shortages. This, in turn, will affect working parents who may need to stay at home to care for their children. Closing schools will, therefore, have an impact on business continuity and the maintenance of essential services. Decisions such as whether to close schools as a measure to try to slow the spread of the pandemic will be taken at the time.
Q. Will other sectors of the community be affected?
Pandemic flu will impact on al services including health, police, fire, the military, fuel supply, food preparation, distribution and transport, prisons, education and business. Al are likely to be affected by staff sickness, travel restrictions and other potentially restrictive countermeasures, and by the knock-on effects of reduced transport, deliveries etc.
Q. Will people be prevented from travelling?
At the start of a pandemic people are likely to be advised not to travel to affected areas or attend international gatherings such as large conferences and sports events. Later, depending on how the disease develops, measures may have to be taken to restrict people's movements to prevent or delay further spread of the disease.
Q. Will the health services be able to cope with so many patients all at once?
There will certainly be greatly increased pressure on the health services, which is used to planning for such emergencies. A flu pandemic is one of the more serious crises which the health services plan for.
Q. Who is at risk?
Everyone is at risk during a flu pandemic, as no one will have immunity to the virus. Older people and those with chronic health problems may be at greater risk of severe complication like pneumonia but until the virus starts circulating it is not possible to know for sure who is at greatest risk.
Q. What are the differences between pandemic flu and ordinary flu?
Ordinary flu is the flu that circulates in the human population al the time and produces the winter flu we see every year. Ordinary flu viruses are monitored closely. The strains likely to be circulating each year can be fairly reliably predicted so that appropriate vaccines can be prepared each year.
Pandemic flu is caused by a new or novel strain of influenza virus. One way that this could happen is as a result of an avian flu virus and ordinary flu virus mixing their genes to produce a "human bird flu" virus that can spread between people. Because it is new, no one has any protection against it and until it is identified, a vaccine cannot be developed against it. It can therefore spread very rapidly and cause high rates of illness and death. See the table on page 7 for a summary of many of the differences between ordinary and pandemic flu.
Q. How many people are likely to die?
This will depend on factors such as how virulent the virus proves to be, which age groups are mainly affected, and how much vaccine is available. According to recent estimates, 25% of the population could fall ill. It is estimated that a pandemic could lead to several million deaths worldwide.
Q. How long will the pandemic last?
It is estimated that pandemic flu will be widespread within about ten weeks of its first arriving in a Country, and will last for about three months. There may be a second wave of infection a few months later. These times are estimates, and may change.
Nigel Thomas is a veteran business continuity professional. He is also the operator of Bird Flu Manual Online, a reference and resource mine designed to help you get your business prepared for Bird Flu. Learn how to conduct a Risk Assessment and a People Risk Analysis, Process Risk Analysis, Suppliers Risk Analysis and Utilities Risk Analysis so you know which are critical to you operations and which are not, saving you time and money. No login required.
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