I. Background

Influenza A viruses have the ability to infect wild and domestic birds including ducks, chickens, and hens, as well as pigs, horses and other animals. Influenza A viruses normally seen in one species can sometimes cross over and cause illness in another species. This creates the possibility that a new virus will develop, either through mutation or mixing of individual viruses. This, in turn, creates the possibility for new viral strains that can be highly infective, readily transmissible and highly lethal in humans. When a pandemic virus strain emerges, more than 35% of the population could develop clinical disease, and a substantial fraction of these individuals could die.

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II. Purpose

This Pandemic Influenza Preparedness Plan has been compiled to help the campus prepare and respond to a pandemic influenza outbreak.  The purpose of the plan is to describe specific actions to be taken by university personnel in the event of an outbreak.  The plan should be implemented in accordance with the John Carroll’s Emergency Operations Plan and used to advise the community about our response to an influenza pandemic.  The plan encompasses the various aspects of communication and education, preparedness, emergency response, and the recovery and maintenance efforts needed in the event of an influenza pandemic.

The development of this document is based on the following assumptions:

    • In the event of an influenza pandemic, the State of Ohio Department of Health will have minimal resources available for onsite local assistance and therefore local authorities and institutions will be responsible for community-specific response action.

    • The federal government has limited resources allocated for the State of Ohio and local plan implementation, and therefore the State will provide supplementary resources in the event of pandemic influenza, which may include the redirection of personnel and monetary resources from other programs.

    • The federal government has assumed the responsibility for developing materials and guidelines, including basic communication materials for the general public on influenza, influenza vaccine, antiviral agents, and other relevant topics in various languages; information and guidelines for health care providers; and training modules.  This information is now available at http://www.pandemicflu.gov.

    • A viral strain of pandemic influenza will likely emerge outside of the United States.  However, pandemic influenza may emerge in Ohio due to its geographic location, proximity to airports, climate, tourist populations, and other factors.

    • It is likely that moderate or severe shortages of vaccine may exist early in the course of a pandemic and it is also possible that no vaccine will be available.

    •The supply of antiviral medication used for prevention and treatment of influenza may be limited.

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III. World Health Organization (WHO) Pandemic Response Alert Phases

The World Health Organization has established six pandemic influenza response alert phases as part of its Global Influenza Preparedness Plan (see Table 1 below).

Table 1 – World Health Organization Pandemic Response Phases

PHASES	PUBLIC HEALTH GOALS
Interpandemic period
Phase 1. No new influenza virus subtypes have been detected in humans.  An influenza virus subtype that has caused human infection may be present in animals.  If present in animals, the risk of human infection or disease is considered to be low.	Strengthen influenza pandemic preparedness at the global, regional, national, and subnational levels.
Phase 2. No new influenza virus subtypes have been detected in humans.  However, a circulation animal influenza virus subtype poses a substantial risk of human disease.	Minimize the risk of transmission to humans; detect and report such transmission rapidly if it occurs.
Pandemic alert period
Phase 3. Human infection(s) by a new subtype, but no human-to-human spread, or at most, rare instances of spreading to a close contact.	Ensure rapid characterization of the new virus subtype and early detection, notification and response to additional cases.
Phase 4. Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.	Contain the new virus within limited foci or delay spread to gain time to implement preparedness measures, including vaccine development.
Phase 5. Larger cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming increasingly better adapted to humans, but may not yet be fully transmissible (substantial pandemic risk).	Maximize efforts to contain or delay spread, to possibly avert a pandemic, and to gain time to implement pandemic response measures.
Pandemic period
Phase 6.  Pandemic: increased and sustained transmission in general population.	Minimize the impact of the pandemic.

The world is presently in Phase 3: a new influenza virus subtype is causing disease in humans, but is not yet spreading efficiently and sustainably among humans.

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IV. JCU Pandemic Influenza Alert Matrix

In response to the WHO Pandemic Response Alert Phases and in consultation with the Ohio Department of Health, JCU has established the following alert matrix for our Pandemic Influenza Preparedness Plan (see Table 2).

TABLE 2 – JCU Pandemic Influenza Alert Matrix

What type of transmission is confirmed?	Where are the cases?	Are there cases in Ohio or neighboring states?	JCU Alert Level
None or sporadic cases (e.g. animal-to-person) only	In the world	No	Preparation
Person-to-person transmission	Anywhere outside North America	No	1
Person-to-person transmission	Anywhere in North America (except Ohio and neighboring states)	No	2
Person-to-person transmission	In Ohio or neighboring states	Yes	3

Specific organizational responsibilities for primary and support agencies are outlined in
the JCU Pandemic Influenza Preparedness Matrix.