PAPER: MIDTERM IUB NATURAL DISASTER RISK ASSESSMENT AND RISK MANAGEMENT Alex Wong There are a few kind of flu, includes seasonal, epidemic and pandemic. The Pandemic is the most deadly one. An influenza pandemic is an epidemic of the influenza virus that spreads over large area like the world and infects a huge proportion of the human population. Pandemic flu is so much more deadly than seasonal flu. It spreads irregularly and could strike mankind without much notice. There have been about 3 main influenza pandemics in each century for the last 300 years, the Spanish Flu, Asian Flu and Hong Kong Flu. Influenza pandemics occur when a new strain of the influenza virus is transmitted to humans, which is originated from another non-human animal species. Species that are thought to be important in the emergence of new human strains are pigs, cows, chickens and ducks. These strains are not protected against any immunity people may have to older strains of human influenza and can therefore spread extremely quickly and infect a very large numbers of people. Influenza viruses can occasionally be transmitted from wild birds to other species mentioned above causing outbreaks in domestic poultry and may mutate and trigger human influenza pandemics. The "Bird Flu", H5N1, is one of the most recent, which happened in 2000 and is still happening, and dangerous flu. With the increasing cases of human getting this disease suggested there maybe a risk that this virus to changing from spreading animalto-human to human-to-human. Health professionals are concerned that the continued
spread of a dangerously high pathogenic avian H5N1 virus across eastern Asia and other countries shows a significant danger to human health. The H5N1 virus has raised concerns about a potential human pandemic because it is powerful, being spread by traveling birds, can be transmitted from birds to mammals including humans, and continues to evolve without any prediction. This can happen anywhere, including Indiana. The virus damages animals, humans' health, and society. So far it has killed 234 people, which totally 369 people got infected. The death rate is very high. At this moment, as this H5N1 virus was recently introduced, there is no highly effective treatment for H5N1 flu that can sometimes restrain the influenza virus from spreading inside the user's body. Even experts and companies are doing a lot of researches and experiments on making new medicines and vaccines, they are fear that the virus would mutate and become not effective towards the drugs. Few years ago, H5N1 first appeared and it was successfully delayed and being extinct. Then it mutated into a totally different species and contained new structures. A vaccine probably would not be available in the initial stages of population infection. Once a potential virus is identified at the beginning of the outbreak, it normally takes at least several months or even years before a vaccine becomes widely available, as it must be developed, tested and authorized. At this time, lots of people would get infected and die. The capability to produce vaccines varies widely from country to country; in fact, only 15 countries are listed as "Influenza vaccine manufacturers" according to the World Health Organization. It is estimated that, in a best scenario situation, 750 million doses could be produced each year, whereas it is likely that each individual would need two doses of the vaccine in order to become totally immune to that
H5N1. Distribution to and inside countries would probably be problematic. Even the virus is so far only discovered outside of the US, as there are lots of traffic of goods and human by planes and ships, it can be introduced to the US. Because of the likely initial lack of vaccine and limited supply of medications, infection control measures will be the most effective means of controlling the spread of the pandemic influenza virus. As this Pandemic Influenza Plan is being revised, the focus of infection control measures is on the use of droplet precautions. Influenza viruses are spread by droplet transmission. Droplets, which are human fluid, are generated primarily by coughing, sneezing, or talking. Several countries well-developed have plans for producing large quantities of vaccine. This virus doesn't just make people sick or kill people, it damages the economy and society. H5N1 has had a huge effect on human society, especially the financial, political, social, and personal responses to both actual and predicted deaths in birds, humans, and other animals. Billions of U.S. dollars are spent to research H5N1 and prepare for a potential avian influenza pandemic. Over ten billion dollars have been lost and over two hundred million birds have been killed to try to contain H5N1. People have reacted by buying less chicken causing poultry sales and prices to fall. Many individuals have stockpiled supplies for a possible flu pandemic. This year in IUB there are 99122 students and also probably a few thousands of faculties, visitors and staffs working in IUB. When H5N1 breaks out, disease can be spread by airborne, from animals to human, or human to human. As Indiana University of Bloomington is a pretty dense living and working area full of people, the virus could infect a lot of people at a fast pace through human-to-human transmission. There are a
few medical institutes nearby, for example the Bloomington Hospital, the Indiana University Health Center, and some other clinics. Doctors and nurses in these facilities can provide professional medical advice and information, and also provide services of drugs and vaccination. Alternate care sites are non-traditional care sites important in providing mass care during a pandemic. An alternate care site is a site that is currently not an established health care site or is an established health care site that usually offers a different type or level of care. Protective gears need to be used, for example, face masks. And according to the World Health Organization, only the N95 face mask is suitable for the outbreak of this virus from entering a human body. As clinically proven, it avoid the virus from infecting a human through air into the human respiratory system. It also avoid people from touching their face. This could reduce the virus spread through air and other body fluid. Education in personal hygiene needs to be promoted in IUB. Also people should reduce the contact with other people as much as possible. When pandemic occurs there are few procedures need to be followed, isolating infected persons from those who are not infected, limiting contact with visitors and other non-health care personnel, promoting spatial separation in common areas, and people have to wash hands frequently to destroy the virus. As birds are the source of the transmission of this virus, sudden death of large amounts of birds should be monitors and reported to the government immediately. This could state that the virus is getting very serious. And when case of human infection from close contacts with birds or from human-to-human transmission should be investigated and the patients shall be isolated in order to avoid virus from spreading to others.
Although there may not be lots of farms that have chickens or ducks, birds flying around in this area could be the host of spreading H5N1. As the death rate of this disease is 64%, if this incident wasn't prepared earlier with sufficient preparation, in the worst case scenario, approximately 65000 people would be killed. And more people would get infected and soon become very sick. This natural disaster could be very disastrous as it causes damage with no limitation of physical boundary. Even Indiana is located in the mainland of the US and is not very close to any ocean or geographical unstable area, which would not have big chance of being attacked by hurricanes, earthquakes, or volcanoes, birds are common animals in this area. In conclusion, the spreading of this virus is a serious situation. It would cost huge amount of losses in a society, including death of population, decline of economy and affect the harmony of a society. All the procedures of preventing and fighting this deadly virus need to be started now. Vaccine has to be produced, food supplies have to be stockpiled and medical equipment and evacuation plan have to be prepared.
Sources: Encyclopedia, Wikipedia, www.in.gov, World Health Organization, SEMA