Pandemic Influenza Preparedness

Phase II

Situation Report

Incident Name: Pandemic Influenza Preparedness Phase II

Operational period: 0900/02 JAN 08 to 0900/09 JAN 08

Date/Time Prepared: 08 JAN 08 / 1000

Prepared by: Sarah Sanderlin

1. World

a.  World Health Organization (WHO) Pandemic Phase; Phase 3- human infection with new (current concern is the Asian H5N1) virus; virus does not spread efficiently and is not sustained among humans.

Inter-pandemic Phase
New virus in animals, no human cases / Low risk of human cases / 1
Higher risk of human cases / 2
Pandemic Alert
New virus causes human cases / No or very limited human-to-human transmission / 3
Evidence of increased human-to-human transmission / 4
Evidence of significant human-to-human transmission / 5
Pandemic / Efficient and sustained human-to-human transmission / 6

b. As of January 3, 2008, WHO is reporting a total of 348 human cases (No increase since last report.) of Asian H5N1 infection, including 216 deaths (An increase of 1 since last report) in 14 countries since January 2003. The table includes only WHO laboratory confirmed cases.

c. The Ministry of Health and Population of Egypt has announced the death of a previously confirmed case of H5N1 infection. The 50 years old female from Domiatt governorate died on 31 December.

Of the 43 cases confirmed to date in Egypt, 19 have been fatal.

Country / 2003 / 2004 / 2005 / 2006 / 2007 / Total
cases / deaths / cases / deaths / cases / deaths / cases / deaths / cases / deaths / cases / deaths
Azerbaijan / 0 / 0 / 0 / 0 / 0 / 0 / 8 / 5 / 0 / 0 / 8 / 5
Cambodia / 0 / 0 / 0 / 0 / 4 / 4 / 2 / 2 / 1 / 1 / 7 / 7
China / 1 / 1 / 0 / 0 / 8 / 5 / 13 / 8 / 5 / 3 / 27 / 17
Djibouti / 0 / 0 / 0 / 0 / 0 / 0 / 1 / 0 / 0 / 0 / 1 / 0
Egypt / 0 / 0 / 0 / 0 / 0 / 0 / 18 / 10 / 25 / 9 / 43 / 19
Indonesia / 0 / 0 / 0 / 0 / 20 / 13 / 55 / 45 / 41 / 36 / 116 / 94
Iraq / 0 / 0 / 0 / 0 / 0 / 0 / 3 / 2 / 0 / 0 / 3 / 2
Lao People's Democratic Republic / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 2 / 2 / 2 / 2
Myanmar / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1 / 0 / 1 / 0
Nigeria / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1
Pakistan / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1
Thailand / 0 / 0 / 17 / 12 / 5 / 2 / 3 / 3 / 0 / 0 / 25 / 17
Turkey / 0 / 0 / 0 / 0 / 0 / 0 / 12 / 4 / 0 / 0 / 12 / 4
Viet Nam / 3 / 3 / 29 / 20 / 61 / 19 / 0 / 0 / 8 / 5 / 101 / 47
Total / 4 / 4 / 46 / 32 / 98 / 43 / 115 / 79 / 85 / 58 / 348 / 216

Timeline of major events for World Health Organization H5N1 avian influenza (02 January 08)

http://www.who.int/csr/disease/avian_influenza/ai_timeline/en/index.html

Seasonal Influenza:

From the Alaska State Virology Laboratory (ASVL) for the week ending 1/3/2008:

Since December 1, ASVL has isolated the following: 6 influenza A (H1) and 1 influenza B from Anchorage, and 2 influenza A (H1) from Elmondorf.

From the Alaska Section of Epidemiology:

Nationally, patient visits to sentinel providers for influenza-like illness (ILI) for the week ending December 1, 2007, was 1.6%, which is below the national baseline of 2.2%. In Alaska, the proportion of ILI visits to sentinel providers for the week ending December 8, 2007 was 1.15%.

From the Centers for Disease Control and Prevention (CDC):

During week 52 (December 23-29, 2007), influenza activity continued to increase in the United States. One hundred eight (3.2%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories were positive for influenza. The proportion of deaths attributed to pneumonia and influenza was below the epidemic threshold. The proportion of outpatient visits for influenza-like illness (ILI) and acute respiratory illness (ARI) was above national baseline levels. The East North Central, East South Central, Mountain, New England, South Atlantic, and West South Central regions reported ILI equal to or above their region-specific baselines, and the East North Central, Pacific, and West South Central regions reported ARI equal to or above their region-specific baselines. Five states (including Alaska) reported regional influenza activity; nine states reported local influenza activity; 33 states, the District of Columbia, and Puerto Rico reported sporadic influenza activity; and three states reported no influenza activity.

2. United States:

There are no reported cases of high pathogenic avian or human Asian H5N1 influenza infection in the United States or its territories. The Centers for Disease Control and Prevention does not publish a Pandemic Phase level separate from the WHO report.

3. Alaska:

There are no reported cases of avian or human Asian H5N1 influenza infection in Alaska.

World Bird Situation

Animal Cases: Summary of Current Situation Since December 2003, avian influenza A (Asian H5N1) infections in poultry or wild birds have been reported in the following countries:
Africa Burkina Faso, Cameroon, Cote d’Ivoire, Ghana, Nigeria, Niger, Sudan, Togo / Near East Afghanistan, Egypt, Iraq, Iran, Israel, Jordan, Kuwait, Gaza Saudi Arabia, and West Bank, Palestinian Autonomous Territories*
East Asia & the Pacific Cambodia, China, Hong Kong, Indonesia, Japan, Laos, Malaysia, Mongolia, Myanmar (Burma), South Korea, Thailand, Vietnam / South Asia Afghanistan, Bangladesh, India, Kazakhstan, Pakistan
Europe & Eurasia Albania, Austria, Azerbaijan, Bosnia & Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, France, Georgia, Germany, Greece, Hungary, Italy, Poland, Romania, Russia, Serbia & Montenegro, Slovak Republic, Slovenia, Sweden, Switzerland, Turkey, Togo, Ukraine, United Kingdom /

Countries added this Operational Period

Benin
* Palestinian Autonomous Territories reported by World Organization for Animal Health, but not CDC.

Surveillance activities – Wild Birds

United States

Planning and Coordination – Wildlife agencies nationwide continue to implement plans for early detection of Highly Pathogenic Avian Influenza (HPAI) H5N1 in wild birds. Plans at the national, Pacific Flyway, and state level are found at:

·  National: http://www.nwhc.usgs.gov/disease_information/avian_influenza/

·  Pacific Flyway: http://www.pacificflyway.gov/Documents.asp

·  Alaska: http://alaska.fws.gov/media/avian_influenza/index.htm

These plans describe priority bird species for surveillance; sampling methods, locations, and time periods; sampling and analytical protocols; and coordination guidelines. The 2007 surveillance effort has been similar to last year, but sampling will be reduced on some bird species and more effort will go into morbidity/mortality monitoring (detecting sick or dead birds).

Alaska Bird Surveillance

US Fish and Wildlife Service (USFWS) has conducted 29 bird surveillance projects in Alaska this summer, primarily in the Yukon-Delta, Seward Peninsula and North Slope areas of the state. The goal is to collect 11,000 swab samples this year, 4,000 less that the goal for 2006. The Service has primarily targeted waterfowl for sampling, and has reduced sampling of shorebirds and song birds. The USFWS and USGS have collected >5,000 samples from live birds and 2,100 samples from hunters, mostly spring harvest by subsistence hunters. Of samples tested at the National Wildlife Health Center in Madison, WI to date, 18 have tested positive for AI matrix, but none have been highly pathogenic.

The Alaska Department of Fish and Game has sampled >1,000 live ducks at Minto Lakes and Susitna Flats, 74 sandhill cranes in Fairbanks, and >200 hunter shot birds from Cook Inlet and Juneau areas. Samples for USDA were tested at the ADEC Environmental Health Lab in Anchorage and samples for USFWS were tested at the National Wildlife Health Center in Madison, WI. To date, about 3% of ADFG samples were positive for AI matrix, but none have tested positive for highly pathogenic strains.

US Department of Agriculture - Wildlife Services has a goal to collect about 2,000 swabs from live birds and fecal samples statewide, including remote areas such as the Aleutian Chain and Pribilof Islands.

The Alaska Interagency Bird Disease hotline (1-866-527-3358) was fully operational to receive public reports of sick or dead birds. Reporting activity has been very low this spring and summer. Federal and state agencies that deal with wild and domestic birds have response plans and teams in place to investigate bird disease or mortality events.

Status of Wild Birds in Alaska – Most migratory birds have left Alaska to wintering grounds as far south as Mexico; some geese and late ducks remain until full winter sets in. Currently, sea ducks and other birds are aggregating along Alaska’s coastal waters from the southern Bering Sea to Southeast where they will winter until April. Migratory bird hunting seasons will continue until December 16 in most of the state, and through January 22 in Kodiak and the Aleutian Islands.

Public information about avian influenza in migratory birds, and advice to hunters and the public is posted on the state website at: www.avianflu.alaska.gov. Status of the wild bird sampling effort in Alaska is found at: http://alaska.fws.gov/media/avian_influenza/index.htm and a national summary is found at: http://wildlifedisease.nbii.gov/ai/

Next report to be issued: 1600/16 January 2008

Incident Action Plan

Incident Name: Pandemic Influenza Preparedness Phase

Operational period: 0830/02 JAN 08 – 0830/09 JAN 08

Overall Phase II Objectives:

1.  Conduct Outreach activities; include the private sector

2.  Develop updated community and agency outreach strategy.

3.  Develop and publish Public Information and Education campaign materials; include the private sector

4.  Conduct a MAC/IMT pandemic influenza response capability exercise.

5.  Develop a plan to transition from preparedness activities to response activities.

6.  Conduct training exercises for new MAC Group members to cover policy orientation, MAC response organization, and command and control.

Short Term Tasks

1.  Develop outreach materials and public information messaging for the State to distribute when the World Health Organization (WHO) increases the WHO Pandemic Phase to Phase 4- “Evidence of increased human-to-human transmission.” Ensure the private sector is included.

2.  Public Information Officers to compile PIO contacts list, media outlet distribution list, and official spokesperson list (avian and pandemic events).

3.  Draft transition plan for the IMT to go from planning to response phase when WHO goes to phase IV.

4.  Encourage senior leadership participation in MAC Group meetings.

5.  Prepare historical document for tracking of current and past MAC Group directed tasks and policies. (COMPLETE/ON-GOING)

6.  Identify IMT deputies for IC, OPS, and PIO.

7.  Conduct MAC Group Command and Control Tabletop exercise on 04 MAR 08.

8.  Conduct MAC/IMT pandemic influenza response functional exercise NLT 06 MAY 08.

9.  Invite a Department of Administration ETS/IT Technical Specialist to participate in the IMT.

10.  Encourage MAC Group participation in agency preparedness briefings conducted by preparedness staff.

11.  Develop interagency distribution/dispensing plan for pharmaceuticals and personal protective equipment.

Prepared by: Sarah Sanderlin 08 JAN 08 / 1000

Plans Section Chief: David Kang

Approved by: Bryan Fisher, Incident Commander

ORGANIZATION ASSIGNMENT LIST

/ DATE PREPARED
01/08/09 / TIME PREPARED
1600 hrs / OPERATIONAL PERIOD
0830 02 January 2008 to
0830 09 January 2008
INCIDENT NAME Pandemic Influenza Phase II
COMMAND/MANAGEMENT
INCIDENT COMMANDER / DHS&EM (Bryan Fisher) / PUBLIC INFORMATION OFFICERS / DHS&EM (McHugh Pierre)
DHSS (Greg Wilkinson)
LEGAL OFFICER / DMVA (Mike Mitchell)
SAFETY OFFICER / DOLWD / LIAISON OFFICER / DHS&EM ( TBD)
OPERATIONS
OPERATIONS CHIEF / DPH (Jim Mackin) / MEDICAL Branch dIRECTOR / DPH (Barb Smith)
COMMUNITY RELATIONS
BRANCH DIRECTOR / DPH (Kerre Fisher) / CIP / COOP Branch dIRECTOR / DHS&EM (Eric Benson)
- OUTREACH GROUP / DHS&EM (Kathy Dawson) / SECURITY Branch DIRECTOR / AST (Barry Wilson)
- OUTREACH GROUP / ANTHC (Pete Petram, Barb Spriggs)
- PUBLIC EDUCATION GROUP SUPERVISOR / DHSS (Jamie Littrell)
- TRAINING & EXERCISE
GROUP SUPERVISOR / DHS&EM (Mike Sutton)
PLANNING/INTELLIGENCE
INTELLIGENCE CHIEF / DHS&EM (David Kang) / TECHNICAL SPECIALIST (AI) / USFWS (Deborah Rocque)
DEPUTY INTELLIGENCE CHIEF / HSS
(Ted Smith) / TECHNICAL SPECIALIST (AI) / DEC (Bob Gerlach)
SITUATION UNIT LEADER / DPH (Sarah Sanderlin)
DPH(Susan O’Toole) / TECHNICAL SPECIALIST (AI) / AKDFG (Doug Larsen)
DOCUMENTATION UNIT LEADER / DHS&EM (Wanice Cowles) / TECHNICAL SPECIALIST (MOA) / MOA/DHHS (Nathan Johnson, Bruce Gazaway)
TECHNICAL SPECIALIST (MAPPING & CHARTING) / Danny Anctil / TECHNICAL SPECIALIST (Commo) / DHS&EM (Woody Sanders)
TECHNICAL SPECIALIST
(Alaska Railroad) / AKRR (Marc Peterson) / TECHNICAL SPECIALIST (Human Resources) / DOA (Nicki Neal)
TECHNICAL SPECIALIST (Education) / TECHNICAL SPECIALIST (DNR) / DNR (Martin Maricle)
TECHNICAL SPECIALIST
( ALCOM/JTF-AK) / (Lin Lenahan) / TECHNICAL SPECIALIST (Behavioral Health) / DBH (Rick Calcote)
LOGISTICS
LOGISTICS CHIEF / SECC MANAGER (Vacant) / SUPPORT DISPATCHER / SECC Staff
COMMUNICATIONS UNIT LEADER / DMVA (Mark Merchant)
SUPPORT DISPATCHER / SECC Staff / SUPPORT DISPATCHER / SECC Staff
FINANCE/ADMINISTRATION
FINANCE SECTION CHIEF / DHS & EM (Dale Crum)
DEPUTY FINANCE SECTON CHIEF / HSS (Sonya Young)

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