Influenza, Pandemic

What is pandemic flu?

Flu that spreads rapidly to affect almost all countries and regions around the world. Flu pandemics occur when a new strain of influenza virus appears, which most people have no immunity to. Flu pandemics generally affect more people, cause more severe illness and result in much more serious disruption to society than the ‘ordinary’ flu seen each winter.

How often do pandemics occur?

Flu pandemics have occurred every few decades. There were three flu pandemics in the last century.

What happened in the previous pandemics?

Previous pandemics affected large numbers of the population, caused many deaths and resulted in severe economic and social disruption.

Previous influenza pandemics

*The first documented cases were in Europe/USA

When is the next pandemic due?

No one knows for sure. Intervals between previous pandemics have varied with no recognisable pattern. Also, a pandemic may not follow the usual seasonal pattern of ‘ordinary’ flu and could occur at any time of the year.

What is the difference between 'ordinary flu' and pandemic flu?

The main differences are summarised in the table below. ‘Ordinary’ flu is the flu that circulates most of the time and produces the outbreaks we every winter. For most people this is an unpleasant though not lifethreatening illness. The strains of virus causing this type of flu change from year to year but can be fairly reliably predicted so that an appropriate vaccine can be prepared each year.

Pandemic flu is caused when a new strain of influenza virus emerges which is markedly different from recently circulating strains. These changes cannot be predicted in the same way as the changes in ‘ordinary’ flu viruses, so a vaccine specifically against the new strain cannot be developed in advance.

Summary of the main differences between ‘ordinary’ and pandemic flu

How will we know a pandemic has started?

The World Health Organization monitors influenza activity around the world and will announce the start of a pandemic and will inform governments.

Can a pandemic be prevented at an early stage?

Efforts will be made internationally to try to control a pandemic at an early stage. However, flu is highly infectious and because whole populations will be susceptible to the new virus, it is likely to continue to spread despite efforts to contain it.

How will it spread to Malta?

 Most likely through people catching the infection in an affected part of the world and developing symptoms after arriving in Malta.

How long will it the pandemic last?

It is estimated that pandemic flu will last for about 2-3 months. There may be a second wave of infection a few weeks or months later. These times are estimates, and may change as more information becomes available.

Who will be at risk during a flu pandemic?

Everyone is potentially at risk of catching flu during a flu pandemic, as few, if anyone, will have immunity to the virus. Certain groups or age groups may be at greater risk than others; we will not know for certain who they will be until the virus starts circulating.

How many people are likely to catch flu during the pandemic?

From past experience, around a quarter (25%) of the population is likely to develop flu, although it could be more.

Are many people are likely to die?

This will depend on several factors such as how virulent the virus proves to be, which age groups are mainly affected, how soon vaccine is available and in what quantity and how effective antiviral drugs are in treating people.

How will a flu pandemic impact on health services?

A flu pandemic will place considerable pressure on health and social services due to the greatly increased number of patients with influenza requiring treatment both in the community and in hospital, a reduced workforce due to illness, and the general disruption that is likely to occur.

How will a flu pandemic impact on business?

Each pandemic is different and the impact on business cannot be fully established until more is known about how a pandemic is evolving. Absences from work will depend largely on the age group most affected by the virus.

A quarter or more of the working population may have to take days off work at some stage during the pandemic. In addition to absence due to illness, some workers may need time off to care for family members or may have difficulty getting to work.

How will other sectors of the community be affected?

A flu pandemic will impact on all sectors of the community through the illness itself and the consequences of staff sickness, travel restrictions, reduced transport and deliveries etc.

What are antiviral drugs?

Antiviral drugs are special medicines for the treatment of certain viral infections and are likely to play an important role in treating pandemic flu. Treatment with antiviral drugs can be expected to shorten the duration of the disease, alleviate symptoms and reduce complications and serious illness. They can also be used to prevent flu, particularly in the early stages of a flu pandemic.

Do antivirals have side effects?

The antivirals which are likely to be of most use in a pandemic are generally well tolerated, but on occasion they can cause nausea and vomiting.

Why don’t we make a vaccine against pandemic flu now?

Because the virus will be new and not predictable in the way that ‘ordinary’ flu viruses are. Preparatory work is being undertaken to be in the best possible position to produce vaccine against a pandemic strain as quickly as possible when the need arises, but development of a vaccine will take time and a vaccine will not be available in the early stages of a pandemic.

How long would a vaccine take to produce?

On current international estimates, the vaccine will take at least four to six months to produce. There may be further delays due to unexpected technical difficulties. Once the virus has been identified and a suitable vaccine developed then large-scale production will begin as quickly as possible.

Are there any other countermeasures available?

Other public health and ‘social distancing’ interventions may help to limit or slow the spread of the disease and reduce its impact, especially at the onset of a flu pandemic. These include measures such as hand washing, limiting non-essential travel and discouraging mass gatherings of people.

How will we know what to do?

There will be regular updates on the television, radio and in the national press, telling people what is happening and what to do. People with mild to moderate symptoms will be advised to stay at home.

How can I reduce my risk and protect myself and my family?

·       Cover your mouth and nose when you sneeze or cough

·       If you blow your nose, carefully throw the tissues away into the rubbish

·       Wash your hands often – especially after coming in from outside

·       Avoid touching your eyes, nose or mouth

·       Avoid mass gatherings as far as you can

·       Stay at home when you are sick – if you have a cough and a fever, it is best to rest at home, take medicines to relieve the symptoms and drink plenty of fluids. This will speed your recovery and help prevent the spread of infection.

 Why are experts concerned about a flu pandemic now?

Experts believe we should be ready for a pandemic to emerge at any time. However, the avian flu (often called ‘bird flu’) currently affecting poultry and some people in Asia has increased their concern.

What is avian flu? click here