U.S. Pandemic preparedness: Health protection or civil liberties violation?

If there is a flu pandemic or other widespread outbreak of infectious disease in the United States, the federal government has plans ready to help contain the spread of disease and keep people safe.

The American Civil Liberties Union, however, says U.S. preparedness plans and laws rely too much on enforcement and security. In a January report, the group concludes that the U.S. plan of action might restrict people's civil liberties during a flu pandemic.

But some public health experts have another take. They say that while increased transparency, communication and community involvement in planning is still needed, such obstacles should not be reasons to abandon proven public health methods to stop the spread of disease.

APHA's Get Ready campaign recently invited experts on both sides of the issue to share their thoughts. Take a look at their commentaries, published online now and post your comments on the issue. What do you think? Is U.S. pandemic preparedness health protection — or civil liberties violation?

Read the guest commentaries now

CDC: States making progress toward preparedness

U.S. states are more prepared for an emergency, but still have a lot of work to do before they receive an "A" grade, according to a report released last week by the Centers for Disease Control and Prevention(CDC).

CDC Director Julie Gerberding, MD, MPH, said the report, Public Health Preparedness: Mobilizing State by State, shows the progress state health departments have made in areas such as disease detection, lab testing and public health planning -- which is great news for all of us.

Many states have developed emergency response plans, the report found, and they are able to identify and confirm public health threats. States are also good at communicating between the many agencies and organizations that respond during public health emergencies. These efforts are just the beginning steps to becoming fully prepared, however.

The CDC report provides important data and reveals areas where work still needs to be done. States need a better system for electronic health records, for example. They need to make sure that emergency volunteers are legally protected in case they are injured when helping out. And even though they've improved, states need to practice regularly for emergencies to stay prepared, which is something we all benefit from.

After all, while it's up to each and every one of us to be personally prepared for an emergency, isn't it great when our states and health systems are as well?

Next wave of infectious diseases likely to emerge from animals, developing countries

Monkeys, chickens, pigs, bats: What do all of these animals have in common? They're all sources of infectious diseases that have proven deadly to humans in recent decades.

A study released last week found that 60 percent of new diseases emerge from animals and progress to humans. Some examples of these diseases are AIDS from chimpanzees and Marburg from bats. Because of large human populations who come into contact with animals, both wild and domesticated, the diseases can be easily spread, according to the study, which was published in Nature. The study analyzed more than 335 diseases that emerged since 1940, finding that more new diseases emerged in the 1980s than in any other decade, most likely due to infections related to HIV/AIDS.

How can the world prevent these killer diseases from spreading even further? Luckily, the research team went the extra mile and tried to predict where the next outbreak would occur. Using computer models, they designed a global map of emerging disease hotspots, finding that developing countries, such as Central America, tropical Africa and south Asia should be the focus of interventions.

"The problem is, most of our resources are focused on the richer countries in the north that can afford surveillance," said Peter Daszak, executive director of the Consortium for Conservation Medicine, who worked on the study. "This is basically a misallocation of global health funding and our priority should be to set up 'smart surveillance' measures in these hotspots, most of which are in developing countries. If we continue to ignore this important preventative measure, then human populations will continue to be at risk from pandemic diseases."

Photo caption: Global distribution of relative risk of an emerging infectious disease event.

Photo Credit: Jones, et al, Nature

Set Your Clocks, Check Your Stocks reminds you to be prepared

When you set your clocks for daylight saving time on March 9, use it as a reminder to make sure your emergency preparedness kit is still stocked. That's the message of Get Ready: Set Your Clocks, Check Your Stocks, a new initiative of APHA's Get Ready campaign.

Set Your Clocks, Check Your Stocks is reminding everyone that they should have at least three days worth of emergency supplies, and to make sure that their stockpile has all the necessary items, including non-perishable food, bottled water and essential medications for each member of their family. Even if you already have a stockpile, it's easy to forget to check expiration dates or to switch out your batteries, so use daylight saving time as a reminder!

Don't have an emergency preparedness stockpile? Set Your Clocks, Check Your Stocks has a great checklist that can help you create one. The clock change is also a perfect time to familiarize yourself with your community's emergency preparedness plan, including evacuation routes, emergency shelters and the location of food banks. And, as always, don't forget to check the batteries in your smoke detector!

The Set Your Clocks, Check Your Stocks Web site includes free fun materials about creating an emergency preparedness stockpile, including recipes, games for kids and a grocery list. When you spring forward this year, be sure that you and your family have a preparedness stockpile to fall back on in the event of an emergency!

Seasonal flu packing a wallop as strains mismatch vaccine

Got the flu? You’re not alone. The Centers for Disease Control and Prevention is reporting this week that seasonal flu is widespread in 44 states. Unfortunately, some of the flu strains that are most prominent right now aren't "well-matched" for this year's seasonal flu formula, according to CDC. That means that even people who had their vaccination this year are getting sick — though their illness may be more mild than those who didn't get their shots at all.

Joe Bresee, branch chief for epidemiology and prevention in CDC's Influenza Division, told reporters during a Feb. 5 news conference that it is not easy to predict which strains are going to be circulating during each flu season. Decisions are made a year in advance so that the vaccines can be produced on time. (In fact, the World Health Organization just released its recommendations for a vaccine formula for next year's flu season.) So even though health officials thought they came up with the winning formula for this season, the flu proved them wrong — which happens occasionally.

Experts from CDC say that even though the vaccine isn't as effective as they had hoped, it still offers some protection. They're recommending that everyone still get their shots, as vaccination can mean the difference between a mild flu and a severe flu. (And it's not too late to get your shot!) Vaccination is especially important for children and the elderly, who have a higher risk of dying from the flu. In fact, 10 deaths from seasonal flu have already been reported among U.S. children this year.

Besides the flu vaccine, there are other tried-and-true prevention measures: Washing your hands, avoiding sick people, staying home from work when you are sick and using antiviral medications all can help. Following these tips can help in the fight against the flu more than ever this season.

Can human behavior be blamed for global pandemic risks?

Guest blog entry: Today's blog entry is authored by Trent Wakenight, MA, consortium coordinator of the Global Nexus of Animal and Human Health Project at Michigan State University.

When it comes to human health and disease, what we do in one part of the world is affecting other places in ways we have yet to appreciate.

AIDS, SARS and avian influenza typify the current "local to global" disease threat confronting human and animal health. Like flu outbreaks before them, each shows how disease can start locally yet have global impact. Unfortunately, blame is shared by civil society’s own progress.

A global human population set to double by 2050 and a rise in urban populations contribute, as do advances in transportation. Travelers can move from African jungles to New York City within eight hours, enabling disease spread.

Disease transfer between species is also a concern. About 75 percent of all human diseases are from animals. Avian influenza H5N1, transmitted easily between birds, could be next. Some birds get sick, while others don't and become carriers. The fear is that the virus could mutate into a human problem, too.

Our world is increasingly interdependent. Pressure placed by more developed and wealthy countries such as the United States, China and India upon poorer developing nations where meat is grown cheaply is one example. Livestock operations in developing nations will grow by 50 percent by 2020 to meet demand. This is occurring in conditions where disease controls may not exist and where the human population is seeing its greatest growth. The result may be a feeding of this convergence of animals, humans and microbes that has pushed us to the verge of the next global outbreak.

This complex challenge in a complex environment requires local and global solutions. During a recent conversation I had with David Nabarro, the U.N. system flu coordinator, he said he believes that a diverse collection of partners must be involved.

"We can't just rely on government," said Nabarro. "We need others to be involved as well. Private agencies, business, voluntary services, those who work at the community level and community groups who are active in civil society and how people go about their lives."

The Global Nexus of Animal and Human Health project at Michigan State University and the University of Minnesota, is working to address global disease drivers and solutions and seeking to create open platforms for dialogue among all of the communities of practice affected by the issue.

This week in pandemic flu, emerging infectious disease: Seasonal flu is here

Seasonal flu cases are mounting across the United States, according to headlines reported by APHA's Get Ready news Twitter. The Centers for Disease Control and Prevention is reporting that flu is currently widespread in more than 30 states. While this year's flu vaccine formula doesn't protect fully against all the strains that are out there right now, it's still your best bet for preventing the flu.

Among the seasonal flu headlines reported recently by the Get Ready news Twitter are:

*Seasonal flu now widespread in 31 states
*Seasonal flu shots target wrong strain but still worth having, says CDC
*Two children in New York state die from seasonal flu
*Hospital offers tips to avoid seasonal flu
*Flu cases on the rise at Tennessee hospitals
*Seasonal flu virus spreading in Arkansas, officials urge prevention
*Seasonal flu cases appear to be increasing in Sacramento
*Flu season is here, and western Pennsylvanians are feeling the effects
*Seasonal flu virus spreading in the mid-South
*Flu season now at peak in Colorado
*Doctors in southwestern Minnesota see more young seasonal flu sufferers

For links to these and dozens of other news stories and resources, visit the Get Ready Twitter.

New information is posted each weekday, so check back regularly for updates, or sign up for our RSS feed. Our Twitter headlines can also be read on the Get Ready for Flu blog.

New test promises to quickly tell if you've got seasonal flu

Have you ever wondered whether your cough, fever or achy head was really caused by the flu? With the help of a new test, doctors will be able to tell more quickly whether you are suffering from the flu or another problem.

The Food and Drug Administration announced in January that it had cleared a new test, called ProFlu+, for marketing. According to the manufacturer, Prodesse Inc. of Milwaukee, the test can detect four strains of the flu virus in less than three hours. It can also detect bronchiolitis, a common respiratory illness that affects children ages 2 and younger.

The quickness of the test means that you can get treated for the flu sooner, and maybe have a better chance of getting well. Respiratory illnesses are best treated within the first two days of feeling sick, according to Daniel Schulz, director of the FDA's Center for Devices and Radiological Health.

About 5 percent to 20 percent of Americans suffer from the flu each year. Unfortunately, about 200,000 are so sick they have to be hospitalized and 36,000 die. Remember: The best way to prevent seasonal flu is to get your annual vaccination. But if you do end up feeling sick, it's best to see your doctor and make sure you are treated the right way.

New Get Ready materials aimed at kids

Even kids need to be ready for pandemic flu. That's the message of new materials from APHA's Get Ready campaign that feature information aimed at helping children prepare for pandemic flu and other emerging infectious diseases.

The Get Ready Kids Fun Site features a kid-friendly, easy-to-understand guide to pandemic flu and preparedness with tips on creating an emergency kit and staying healthy. The site also offers games -- such as brain teasers and word scrambles -- a family preparedness checklist and links to other kid- and parent-friendly Web sites. Visitors are welcome to download, copy and pass out the materials or to link to them from their Web sites and blogs.

"Involving kids in creating an emergency kit can be a fun and easy way to teach them about preparedness, and having those supplies on hand will make a world of difference if a disease outbreak or disaster occurs," said Susan Polan, PhD, APHA's associate executive director.

The new Kids Fun Site is the latest addition to tools available through APHA's Get Ready campaign, which is working to help Americans prepare themselves, their families and their communities for pandemic influenza and emerging infectious diseases. The campaign features a Web site, podcasts, a news Twitter and free downloadable fact sheets, among other resources.

Kid ‘n play

It may not be the most polite conclusion to come to, but most of us think it at one time or another: kids make me sick - literally. They forget to wash their hands, they share sips from each other's cups and bites from each other's forks, give the ol' "wet willy" in the ear, aren't yet too embarrassed to pick their noses in public and could be considered a germ's best friend. Kids just don't understand.

There is some hope, however. If we can make staying healthy fun, we can help kids catch on — which will be especially important if we're faced with a pandemic flu strain. So, lesson one: Prevention is fun!

Health experts agree that handwashing is probably the least expensive but most effective way to not get sick. To get kids in the habit, make handwashing something to look forward to, which isn't too hard since some pretty fun ingredients are already involved: water, soap and bubbles. It's recommended that you wash your hands for at least 20 seconds, so tell kids to sing their favorite song while handwashing, see who can make the most bubbles and who can get the best lather. Encourage kids to cover their mouth when they cough or sneeze by buying pretty tissues, or get crafty and help kids make their own handkerchiefs and tissue holders.

Lesson two: Getting ready can be fun for everybody! Preparing for a possible flu pandemic or any other emergency is key and should involve the whole family. So why not have a little fun along the way? When assembling items for your emergency preparedness kit, hide the items around the house and lawn and create a scavenger hunt. Invite your kids to a family pizza party and talk about creating an emergency communications and meeting place plan. Let the kids decorate your emergency kit containers, pick out fun board games to include in the kits or let them pick one special item — a toy or a stuffed animal — that stays with the kit as well.

So even though kids are particularly vulnerable to spreading germs and getting sick, they're also vulnerable to having fun. And that's one vulnerability we should take advantage of.

Photo by Debi Bishop, courtesy iStockphoto.