Inside the ER during a pandemic: What you don’t see on TV

Ever been to the emergency room or had family or friends who've rushed to the hospital only to sit and wait –- sometimes for hours and hours -– before seeing a doctor? If so, then it should come as no surprise that overcrowding in emergency departments is a huge problem.

According to the Institute of Medicine, which released a series of reports this summer on the state of our country's emergency departments, emergency room visits grew by 26 percent between 1993 and 2003. During the same period, the number of emergency departments dropped by 425 and the number of hospital beds fell by 198,000. Every minute of the day, an ambulance is diverted from a crowded emergency department to one that is further away, and some people have to regularly wait as long as two days before getting needed care.

So what does the extra wait in the emergency room have to do with pandemic flu? Well, if today's routine emergencies are filling ERs to capacity, how can we cope with an additional 10 million hospitalizations that are predicted by the Department of Health and Human Services to occur during a severe pandemic flu outbreak? Everyday emergencies won't go away during a flu pandemic. Instead, our system will be more overburdened than ever before.

What can hospitals do? When preparing for the worst, it helps to have a bit of wiggle room. In the health care world, that idea is called surge capacity –- the ability of the health system to expand and adapt to the growing number of patients that can be expected during an influenza pandemic.

Just as we buy extra supplies and develop plans for home, hospitals, too, need additional resources to be able to expand their capacity to operate during a flu pandemic or other times of peak demand.

So where do you come in? You can help hospitals improve their surge capacity by contacting your elected officials and let them know you are concerned. Reach out to your local, state or congressional lawmakers and tell them that hospitals, along with the state and local health departments, need increased preparedness funding, staff and training so that they can be ready to handle the worst. Because in the end, it could be you or your family in need of that hospital bed.

This week in pandemic flu, emerging infectious disease news

Computers and computer networks are playing a key role in helping predict and analyze infectious disease transmission, according to recent news reports. Among the computer-related headlines and research reported this week by APHA's Get Ready News Twitter:

*Online gamers rehearse real-world epidemics
*Scientists launch global computing effort to find cures for dengue, West Nile virus, hepatitis C
*Visualizing the molecules that cause infectious disease: Seeing with supercomputers
*Models of Infectious Disease Agent Study at NIH develops computational models of infectious disease

For links to dozens of news stories and resources on emerging infectious diseases, visit the Get Ready News Twitter. New information is posted each weekday, so check back often for updates.

How to have an itch-free, disease-free summer: Avoiding West Nile virus and Lyme disease

Before you head out to your garden, lace up your hiking shoes or hop on your bike this summer, keep this in mind: Cases of infectious diseases spread by mosquitoes and ticks peak during the warmest months of the year.

Besides being an itchy nuisance, mosquitoes can transmit a number of diseases to humans, including West Nile virus. West Nile virus has spread across the United States in recent years, causing almost 4,300 cases of illness and 177 deaths last year alone. So far this year, more than 570 cases of West Nile virus have been reported to the Centers for Disease Control and Prevention, including 19 deaths. Symptoms of West Nile virus include high fever, headache, neck stiffness, coma, tremors, numbness and paralysis.

Also of growing concern in the United States is Lyme disease, which is transmitted by ticks and is the most common vector-borne disease in the United States. Infected ticks can cause illness in humans and pets. Lyme disease symptoms include cognitive impairment, lethargy, joint pain, severe headaches, fever and fatigue. If that doesn't hit home, get this: President Bush, a frequent biker, was diagnosed with Lyme disease this year after he developed the characteristic bull's-eye rash.

But all this doesn't mean you should stay locked up indoors. Luckily, neither West Nile virus nor Lyme disease can be transmitted person-to-person. Following a few simple precautions can reduce your risk of contracting mosquito- and tick-borne infectious diseases while enjoying nature.

To prevent mosquito-borne diseases:
* Use insect repellent every time you go outdoors. The CDC reports that repellents containing DEET and Picaridin typically provide longer-lasting protection than others. Always follow the warning labels on repellents.
* Avoid the outdoors at dusk and dawn (when mosquitoes are most active), and wear long pants and long sleeved shirts if you must go outside.
* Get rid of mosquito breeding sites by emptying standing water from flowerpots, bucket and barrels, and by changing the water in pet dishes and replacing the water in bird baths weekly.
* Keep mosquitoes out with good screens on your windows and doors.

To prevent exposure to ticks and tick-borne diseases:
* Steer clear of wooded areas with lots of leaf litter, bushes or tall grasses, and wear long-sleeved shirts, long pants and long socks if you're headed to such areas.
* Tuck in shirts into pants and pant legs into socks to prevent ticks from getting inside your clothing.
* Wear light-colored clothing to help spot ticks easily.
* Check your outer clothing frequently and thoroughly while you are outdoors and when you come inside.
* Use duct tape or lint rollers to remove ticks from clothing.

If you find a tick on your body, remove it promptly with fine tipped tweezers. Lyme disease-causing ticks may be small, but they require 24 hours to 48 hours of attachment to transmit the infection.

By taking a few precautions, you can ensure that you stay itch- and disease-free during the summer season!

Photo by Chiya Li, courtesy iStockphoto

This week in pandemic flu, emerging infectious disease

Given the high percentage of infectious diseases that make the jump from animals to humans, scientists and health workers are always on alert for new cases of illnesses among poultry, livestock and other animals. Among the animal-related emerging infectious disease news reported this week via APHA's Get Ready News Twitter are these headlines:

* Agriculture experts call for separating wild, domestic birds in markets
* Virus strikes China's pigs, stirring fears of global outbreak
* Bird flu's spread around the globe
* Influenza: Fear triggers renewed interest in interspecies transmission
* Trappers target deadly rabid raccoons on U.S.-Canadian border
*Bulgarian woman infected with rare animal disease

For links to dozens of news stories and resources on emerging infectious diseases, visit the Get Ready Twitter. New information is posted each weekday, so check back often for updates.

Photo by Scott Bauer, courtesy USDA Agricultural Research Service

Get Your Headphones Out- We Have Added A New Get Ready Podcast!

Episode 5: "Preparedness Across the Nation: Massachusetts Public Health Association Addresses Pandemic Flu"

The first of a series of podcasts seeking to examine the different ways that states and localities are preparing across the nation, Geoff Wilkinson, executive director of the Massachusetts Public Health Association, discusses the organization's work on pandemic preparedness, noting that vulnerable populations will pay the greatest price for a lack of preparedness in the event of a flu pandemic.

*Listen to the podcast
*Download the podcast
*Read the full transcript

Click here to check out our expanding podcast series

Give a listen, and send us your ideas on what topics you'd like to see covered in future podcasts using the comments feature on the blog below.

This week in pandemic flu, emerging infectious disease: Aug 7-14

Seasonal flu time has arrived for some of the world, including Australia, which is experiencing an outbreak that has claimed the lives of six children and caused widespread concern. Among the seasonal flu news reported this week via APHA's Get Ready News Twitter are these headlines:

* Seasonal flu killed 68 U.S. children this season
* Sanofi ships its first flu vaccine of season
* Sixth child dies of seasonal flu in Australia
* Outbreak of seasonal flu in Australia prompts call for more Tamiflu
* CDC TIPS: Six habits to help prevent seasonal flu

For links to dozens of news stories and resources on emerging infectious diseases, visit the Get Ready Twitter. New information is posted each weekday, so check back often for updates.

Practice makes perfect when preparing for a pandemic

Hawaii is one state that is on the right track for preparing for a potential flu pandemic.

In July, report of a plane crash on Midway Island sent more than 200 medical and emergency officials scrambling to respond. Fortunately for passengers and crew, the "crash" was staged as part of a response drill designed to test coordination among agencies within the state. And as if the mock mishap wasn't enough, the simulation reported that all passengers had also been "exposed" to avian flu.

Federal, military, state and county specialists mobilized to respond during the drill. Planes transported medical specialists to Midway to treat the passengers -– some of whom had already developed flu-like symptoms. Officials quickly set up a quarantine site, decontamination station and mobile hospital at a location that was predetermined for triage during the drill. U.S. Customs and Border Patrol agents worked to secure the triage area and identified 10 patients and 50 medical specialists for quarantine or medical care. The agents followed procedures and reported all cases of flu.

Pandemic flu drills such as the one held in Hawaii are becoming more commonplace in communities and states around the country -– and even at the federal level. If there's truth to the adage that "practice makes perfect," they should serve as examples for the rest of us in our efforts to prepare all Americans for a flu pandemic.

Has your state or community held a pandemic flu drill? Share your experiences in the comments section of this blog.

This week in pandemic flu, emerging infectious disease

Infectious diseases spread by mosquitoes and ticks are a continuing concern for health workers, especially during warm, wet weather, according to news headlines reported this week by APHA's Get Ready News Twitter:

Among this week’s highlights:
* CDC: 122 West Nile cases, three deaths so far in 2007
* Dengue on rise in Asia; WHO issues warning
* Lyme disease cases double in Vermont
* Mosquito control tips: No need to get fancy
* Eastern equine encephalitis virus confirmed in North Carolina County

For links dozens of news stories and resources, visit the Get Ready Twitter. New information is posted each weekday, so check back often for updates.

Photo by James Gathany, courtesy CDC/PHIL

Get Ready Trivia: Boiling water during an emergency

Suppose your water supply has been contaminated, and your local health department issues a "boil-water notice." How long must you boil water to ensure that it's safe to drink?

a) 20 minutes
b) 10 minutes
c) 1 minute

Click on the comments section of this blog entry to read the answer!