Surviving an Influenza Pandemic

(and the Subsequent Zombie Apocalypse) History

Illness from the 19181919 flu pandemic, also known as the H1N1 Spanish flu, came on quickly. Some people felt fine in the morning, but died by nightfall. People who caught the Spanish Flu, but did not die from it, often died from complications caused by bacteria, such as pneumonia. During the 1918 pandemic:

Approximately 20% to 40% of the worldwide population became ill. An estimated 50 million people worldwide died. Nearly 675,000 people died in the United States.

Most influenza outbreaks disproportionately kill juvenile, elderly, or already weakened patients; in contrast the 1918-1919 flu pandemic killed predominantly previously healthy young adults. Modern research, using virus taken from the bodies of frozen victims, has concluded that the virus kills through a cytokine storm (overreaction of the bodys immune system). The strong immune reactions of young adults ravaged the body, whereas the weaker immune systems of children and middle-aged adults resulted in fewer deaths among those groups. Since then weve had three more flu pandemics:

19571958 with the H2N2Asian flu where about 70,000 people died in the U.S. 19681969 with the H3N2 Hong Kong flu where about 34,000 people died in the U.S. 20092010 with the H1N1 swine flu where about 18,000 people died worldwide.

How the Flu Virus Changes

Flu viruses are constantly changing and mutating. These changes can happen slowly over time or suddenly. Sometimes these mutations result in viruses that move from animals to humans:

Antigenic drift is when these changes happen slowly over time. These changes happen often enough that your immune system cant recognize the flu virus from year to year. That is why you need to get a new flu vaccine each year. The flu vaccine protects you against that seasons three or four most common flu virus strains. Antigenic shift is when changes happen suddenly. This occurs when two different flu strains infect the same cell and combine, which may create a new flu subtype. Because people have little or no immunity to the new subtype, it can cause a very severe flu epidemic or pandemic.

Analyses of the H7N9 and H5N1 bird flu strains found that both viruses are only one mutation away from becoming highly contagious to humans. One Degree of Separation for Avian Flu, Cell, Volume 153, Issue 7, 20 June 2013, Pages 1409,1411.

Preparing Yourself for an Influenza Pandemic

Always get an annual flu shot! There are several flu vaccine options for the 20132014 flu season. Traditional flu vaccines made to protect against three different flu viruses (called trivalent vaccines) are available. In addition this season, flu vaccines made to protect against four different flu viruses (called quadrivalent vaccines) also are available. The trivalent flu vaccine protects against two influenza A viruses and an influenza B virus. The following trivalent flu vaccines are available:

Surviving an Influenza Pandemic

(and the Subsequent Zombie Apocalypse)

Standard dose trivalent shots that are manufactured using virus grown in eggs (if you dont have an egg allergy). These are approved for people ages 6 months and older. There are different brands of this type of vaccine, and each is approved for different ages. However, there is a brand that is approved for children as young as 6 months old and up. A standard dose trivalent shot that is egg-free, approved for people 18 through 49 years of age. A standard dose trivalent shot containing virus grown in cell culture, which is approved for people 18 and older. A high-dose trivalent shot, approved for people 65 and older. A standard dose intradermal trivalent shot, which is injected into the skin instead of the muscle and uses a much smaller needle than the regular flu shot, approved for people 18 through 64 years of age.

The quadrivalent flu vaccine protects against two influenza A viruses and two influenza B viruses. The following quadrivalent flu vaccines are available:

A standard dose quadrivalent shot. A standard dose quadrivalent flu vaccine, given as a nasal spray, approved for healthy people 2 through 49 years of age. (Healthy indicates a person who does not have an underlying medical condition that predisposes them to influenza complications.)

CDC does not recommend one flu vaccine over the other. The important thing is to get a flu vaccine every year.

Preparing Workplaces for an Influenza Pandemic

The best strategy to reduce the risk of becoming infected with influenza during a pandemic is to avoid or, if unavoidable, minimize time in crowded settings and other situations that increase the risk of exposure to someone who may be infected. Basic hygiene and social distancing precautions that can be implemented in every workplace include the following:

If sick, stay at home. Wash hands frequently with soap and water or, if soap or water are not available, with alcohol-based hand sanitizer. Also, avoid touching your face (i.e., nose, mouth, and eyes). Cover your coughs and sneezes with a tissue, or to cough and sneeze into your upper sleeves if tissues are not available. Wash your hands with soap and water, or use an alcohol-based hand sanitizer after you cough, sneeze or blow your nose. Avoid close contact with coworkers and customers (maintain a separation of at least 6 feet). Avoid shaking hands and always wash your hands after contact with others. If wearing gloves, wash your hands upon removal of the gloves; always assume your hands become contaminated during the glove removal process. Provide customers and the public with tissues and trash receptacles, and with a place to wash or disinfect their hands. Keep work surfaces, telephones, computer equipment and other frequently touched surfaces and office equipment clean. Be sure that cleaners are safe and will not harm yourself or your office equipment. Use only disinfectants registered by the U.S. Environmental Protection Agency (EPA), and follow all directions and safety precautions indicated on the label.

Surviving an Influenza Pandemic

(and the Subsequent Zombie Apocalypse)

Discourage others from using your phone, desk, office, or other work tools and equipment. Minimize situations where groups of people are crowded together, such as in a meeting. Use e-mail, phones, and text messages to communicate with each other. When meetings are necessary, avoid close contact by keeping a separation of at least 6 feet, where possible, and assure that there is proper ventilation in the meeting room. Reducing or eliminating unnecessary social interactions can be very effective in controlling the spread of infectious diseases. Promote healthy lifestyles, including good nutrition, exercise, and smoking cessation. A persons overall health impacts their bodys immune system and can affect their ability to fight off, or recover from, an infectious disease.

Preparing Homes for an Influenza Pandemic

Typical of the emergency preparation process for other natural disasters, preparing your home to shelter-in-place for an influenza pandemic involves stockpiling at least a two-week supply of some key essentials for creating a degree of isolation to avoid spreading the virus to yourself or others:

Drinking water (one gallon per person per day) and nonperishable food. Be sure to include a manual can opener! Flashlights, a battery-operated radio, and a supply of batteries. Personal care products soap, toiletries (including toilet paper and tissues), alcohol-based hand sanitizer, extra glasses or contact lenses, prescription and over-the-counter drugs such as pain relievers, cough suppressants, and an antiviral such as Tamiflu (a neuraminidase inhibitor that inhibits virus replication; catechins in green tea do the same thing), tissues, and toilet paper, and any special items for infants or people with special health needs. A well-stocked first aid kit, including a supply of disposable, NIOSH-certified respirators (e.g., the Moldex 2730 and 3M 8233 both are rated to remove 99.97% of airborne particles) and disposable gloves (suggest non-latex to avoid an allergic reaction, e.g., vinyl or nitrile) for wearing in public places and to prevent the spread of infection from sick family members. Safety glasses or goggles are also helpful to prevent the spread of airborne infection through sneeze and/or cough droplet contact with the eyes. Kitchen utensils and dishwashing supplies, and clothes washing supplies. Extra clothing and bedding. Critical miscellaneous items money and credit cards, extra car keys, medical and insurance information, and copies of other important documents. Games, reading material, and other entertainment items for children and adults; you might need to stay home for an extended period during a pandemic.

References
https://www.osha.gov/dsg/topics/pandemicflu/ http://www.flu.gov/ http://www.cdc.gov/flu/pandemic-resources/

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