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Volume 9, Number 12—December 2003

Commentary

Influenza Pandemic Preparedness

Kathleen F. Gensheimer*, Martin I. Meltzer†Comments to Author , Alicia S. Postema†, and Raymond A. Strikas†
Author affiliations: *Department of Human Services, Augusta, Maine, USA; †Centers for Disease Control and Prevention, Atlanta, Georgia, USA

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Table

Planning for pandemic influenza and bioterrorism: similarities and differencesa,b

Issue Bioterrorist event Pandemic influenza
Likelihood
High
High
Warning
None to days
Days to months
Occurrence
Focal or multifocal
Nationwide
Transmission/duration of exposure
Point source; limited; person-to-person
Person-to-person, 6–8 wks
Casualties
Hundreds to thousands
Hundreds of thousands to millions
First responders susceptible?
Yes
Yes
Disaster medical team support/response
Yes
No (too widespread)
Main site for preparedness, response, recovery, and mitigation
State and local areas
State and local areas
Essential preparedness components
Surveillance
Yes
Yes
Law enforcement intelligence
Yes
No
Investigation
Yes
Yes
Research
Yes
Yes
Liability programs
Yes
Yes
Communication systems
Yes
Yes
Medical triage and treatment plans
Yes
Yes
Vaccine supply issues
Yes (for most likely threats)
Yes
Drug supply issues
Yes
Yes
Training/tabletop exercises
Yes
Yes
Maintenance of essential community services
Yes
Yes
Essential response components
Rapid deployment teams
Yes
No
Effective communications/media relations strategy
Yes
Yes
Vaccine delivery
Yes (for some)
Yes
Drug delivery
Yes (for most)
Yes
Hospital/public health coordination
Yes
Yes
Global assistance
Possibly
Yes
Medical care
Yes
Yes
Mental health support
Yes
Yes
Mortuary services
Yes
Yes
Supplies and equipment
Yes
Yes
Essential mitigation components
Enhanced surveillance
Yes
Yes
Enhanced law enforcement intelligence
Yes
No
Vaccine stockpile
Yes (selected agents)
Prototype vaccines only
Drug stockpile
Yes
Yes
Pre-event vaccination Vaccination of selected groupsc Vaccination of groups at medical high risk with pneumococcal vaccined

aDuring a catastrophic infectious disease event, such as an influenza pandemic, there may be critical shortages of vaccines and drugs. Thus, clinics set up to administer vaccines and distribute antimicrobial drugs may require the services of a range of personnel whose fields of expertise are nonclinical. Examples of additional personnel that may be needed include law enforcement, translators, social workers, psychologists, and legal experts.
bSource: Adapted from: National Vaccine Program Office. Pandemic influenza: a planning guide for state and local officials (Draft 2.1). Atlanta: Centers for Disease Control and Prevention; 2000.
cAt the time of writing, the smallpox vaccination program was just beginning. For other bioterrorist agents for which vaccines are available (e.g., anthrax), limited supplies and concerns about safety profiles have, up to this point, effectively prevented the widespread use of these vaccines.
dIt may eventually be possible to vaccinate high-priority groups and the general population with a yet-to-be-developed “common epitope” vaccine, which might provide for a broader spectrum of protection against a variety of influenza A subtypes.

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1A complete copy of each questionnaire and a complete set of the results are available from the corresponding author.

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