Flu pandemic could hit, local consultant says

Ross Dolan The Daily Republic
Published Friday, July 11, 2008

To the nearly 40 people who attended the Thursday presentation of an areawide pandemic influenza response plan, one thing was clear: any future pandemic won’t be over quickly. Allan Miller, who wrote the strategy with input from committee members from Aurora, Davison and Hanson counties, said that when a pandemic, or worldwide, flu strikes, it will do so in cycles.
“We don’t know how bad it will be or when it will strike,” said Miller, of Miller consulting. “But it will come in waves. It won’t be a case of one shot and it’s done.”
f one occurs, it could be six months to a year before the virulent illness will run its course, he said.The severe respiratory disease will affect all classes and occupations and will infect an estimated 40 percent of the population and workforce. That means healthcare workers and emergency responders also will fall ill.
“There’s no reason to believe it won’t strike,” Miller said. “It’s already done so three times in the past 100 years.”
Miller was talking about the Spanish influenza of 1918 that caused 500,000 deaths in the U.S. and more than 20 million worldwide; the Asian flu of 1957, which caused about 70,000 U.S. deaths; and the Hong Kong flu of 1968, which killed about 34,000.
Community Health Nurse Connie Fergen said that in cases where the H5N1 avian flu, or bird flu, has mutated and jumped to humans in the Far East, the disease has been deadly. A recent outbreak of 135 cases in Indonesia resulted in 110 deaths.
In the Spanish flu outbreak, the 20-to 40-year-old age group was most affected.
“That’s very concerning, because that group makes up the majority of our workforce,” Fergen said.
South Dakota’s location on two major flyways might also be a concern, said Fergen, since hunters might accidentally run across an infected bird. She recommended that hunters wear gloves and take precautions when cleaning birds. That’s just one vector for the disease. A more likely scenario would involve infected air travelers who unknowingly carry the disease from one continent to another.
The flu plan presented Thursday lays out ways in which area communities can rely on their own resources during a pandemic.
“We had to make assumptions during our planning,” said Miller, “and one of them is a pandemic event will happen.”
There’s no stopping a pandemic, said Miller, “but you can slow it.” That may give scientists enough time to develop an effective vaccine. It’s impossible to predict the severity of a pandemic beforehand, he said.
“Until an actual virus emerges, you can’t develop an actual vaccine to stop it,” he explained.
The virus already has made some scary changes. State Epidemiologist Lon Kightlinger, said Miller, has stated that avian influenza is only two mutations from being fully transmissible.
In the event of infection, communities will have to relay on “non-pharmaceutical interventions” that include school closures, shutting down non-critical services and self-isolation. Miller said the South Dakota work ethic won’t work in a flu pandemic. Those who are ill need to stay home a week and recover. Those who are infected with flu are infectious one day before they come down with it and up to seven days afterward.
The flu plan stresses communication, coordination and information management, said Miller. Regarding the latter, he said all information given to the public must be accurate and timely.
The plan makes Avera Queen of Peace Hospital the focus of high-level health care. Other counties may have to send patients to the Mitchell hospital for care, but in a pandemic that aid could be limited and will likely be rationed by using triage stations in each county to determine who is most ill. Many will simply have to deal with the illness at home.
Vicki Lehrman, compliance and safety executive for Avera Queen of Peace, said the hospital is working to expand its “surge” capacity in case a severe pandemic occurs.
Miller said the 131-page plan is available by request through any member of the committee. There are a limited number of CDs and plans are in the works to put a downloadable version on county and city Web sites. No timeline was given on when that will happen.