Planning, knowledge enlisted in fight against potential flu pandemic

"The worst-case scenario for humans is so devastating — a conservative 1.4 million to 7 million deaths worldwide — that people have tuned it out," says James McGlothlin, associate professor of health sciences. "And we don't want to raise fear because we can't be certain how lethal this flu might be if it mutates and spreads human to human.

"Yet, we collectively have seen with Hurricane Katrina how quickly emergency services can be overtaxed. The most important message is that each business, institution, school and individual must plan now. We must take responsibility and not expect the government to do everything for us. It's just not possible."

At Purdue, planning for the possibility of a flu pandemic has been ongoing since November.

A co-chair of the planning committee, James Westman, is the director of the Purdue Student Health Center.

"Right now the most important thing we need to do is educate the public about the difference between the traditional flu and this H5N1 strain of Type A influenza, commonly called bird flu," Westman says. "It is critical that people understand the difference so we not only can keep it from spreading but also so we don't overtax our health services with false alarms."

Should the H5N1 influenza virus infect humans, symptoms will range from those typical of the flu —fever, cough, sore throat and muscle aches — to eye infections, pneumonia, severe respiratory diseases and other serious and life-threatening complications. There may be several strains of the H5N1 virus, so symptoms will vary with the specific virus subtype.

"We do expect that when people contract the disease, they will show no symptoms for 24 hours, yet they will still be contagious during that period," Westman says. "This is why it will be essential that people self-quarantine if they come into close contact with anyone suspected of having the bird flu."

The characteristics of the avian flu caused by the H5N1 virus differ from those associated with a typical seasonal flu in a variety of ways:

Typical seasonal flu is less likely to cause severe illness because many people will have partial immunity. Illness normally lasts one to two weeks and is:

• Usually less virulent — meaning it will make fewer people ill.

• In the United States alone, about 36,000 people die each year.

• Less likely to cause pneumonia early in the illness, if at all.

• Most severe for the youngest and oldest of the population.

• Normally strikes in winter and includes just one wave.

An H5N1 virus attack, on the other hand, is expected to be more severe because humans have little or no immunity to it. Illness is expected to last for several weeks, and it is expected to:

• Strike 15 percent to 30 percent of the population.

• In the United States, it would be expected to cause 108,000 to 252,000 deaths, three to seven times the rate for typical seasonal flu.

• Lead to viral pneumonia in the first two days of the illness.

• Be severe for all ages.

• Strike at any time during the year and have multiple waves.

Unlike typical seasonal flu, the H5N1 influenza is expected to be more resistant to antiviral medicine, such as Tamiflu, which currently is in limited supply. There currently is no commercially available vaccine to protect humans against the H5N1 virus. Some promising vaccine research efforts are under way — including several efforts at Purdue, McGlothlin says, but large commercial production can't begin until the exact flu strain is known.

Still, a little common sense can go far to keep a potential pandemic at bay, Westman says. First and foremost, if you are ill, do not go to work or school.

Proper hand washing and germ control also are especially important in preventing illness, including the flu, from being passed person to person, he says. In order to minimize the spread of germs when sneezing and coughing:

• Cover your mouth and nose with a tissue.

• If you don't have a tissue, cough or sneeze into your upper sleeve, not your hands.

• Put used tissue in the wastebasket.

• Wash with soap and water, or clean with alcohol-based hand cleaner.

• Wash with soap and warm, clean running water for 20 seconds, which is about the time it takes to sing "Happy Birthday" twice to yourself.

• Rinse hands well.

• Dry your hands using a paper towel or air dryer. If possible, use your paper towel to turn off the faucet.

If soap and water are not available, use an alcohol-based hand sanitizer. If using one of these products, apply it the palm of one hand, rub hands together and make sure to rub the product over all surfaces of hands and fingers until hands are dry.

Health-care professionals recommend washing your hands often, especially in the following situations:

• Before preparing or eating food.

• After going to the restroom.

• After changing diapers or cleaning up a child who has gone to the bathroom.

• Before and after tending to someone who is sick.

• After blowing your nose, coughing or sneezing.

• After handling an animal or animal waste.

• After handling garbage.

• Before and after treating a cut or wound.

Keep surfaces clean, especially those used by others, such as counters, doorknobs, telephones and keyboards. Choose liquid over bar soap.

In addition, it is advised that getting adequate exercise (at least 30 minutes most days of the week), getting enough sleep and taking a multivitamin can help boost overall immunity.

Westman adds, "It's also a good idea to get an annual flu shot. Even though the present vaccine is not effective against H5N1, it will protect against the typical seasonal flu. And that, in turn, will help you maintain your health, and that will make you less susceptible to the new variety."

Individuals also should prepare for possible periods of in-home quarantine or shortages of food and other supplies, says Carol Shelby, senior director of environmental health and public safety and the other co-chair of the Purdue planning group:

Good items to have on hand include ready-to-eat canned meats, fruits, vegetables and soups; protein or fruit bars; dry cereal or granola; peanut butter or nuts; dried fruit; crackers; canned juices; bottled water; canned or jarred baby food and formula and pet food.

Also, experts say it is wise to keep a variety of health-related supplies around the house. This includes prescribed medical supplies, such as glucose and blood-pressure monitoring equipment; soap and water, or alcohol-based hand wash; medicines for fever, such as acetaminophen or ibuprofen; a thermometer; anti-diarrhea medication and vitamins.

It's also suggested to maintain a supply of flashlights, batteries, a portable radio, a manual can opener, garbage bags, tissues, toilet paper and disposable diapers.

Knowledge is our most important weapon, McGlothlin says.

"The most contagious thing out there is fear, and it spreads faster than any virus possibly could," McGlothlin says. "Knowledge is the vaccine that stops the spread of fear and will help us meet this challenge."

Information about Purdue planning and other topics related to the potential pandemic is available on the Web. Individuals can register there to receive alerts when the Web site has been updated.

Writer: Jeanne V. Norberg, (765) 494-2084; (765) 491-1460 (c); jnorberg@purdue.edu

Sources:

Carol Shelby, (765) 494-7504, cshelby@purdue.edu

James McGlothlin will be traveling for the next week, (765) 532-2921 (c); (765) 496-6359, jdm3@purdue.edu

James Westman, (765) 494-1720, (765) 743-7499 (home), westman@purdue.edu

Purdue News Service: (765) 494-2096; purduenews@purdue.edu

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