Pandemic Flu? It May Not Be a Question of IF, but WHEN by Barb Kay, Absolute EA There is no doubt about it a chill is in the air. After a very sobering but enlightening luncheon seminar hosted recently by the Chamber, members were educated on the background, risk exposure, consequences and actions being taken by the Halton Region to mitigate the effects of a worldwide outbreak of Influenza A in our community. Karen Stanley, a Public Health Nurse, and Justine Hartley, a Public Health Inspector, presented an overview of these matters on behalf of The Halton Region Health Department and distributed Halton Region Pandemic Influenza Response Plan, A "Tool Kit" for Business Continuity. This Tool Kit may be downloaded from their website. The following is information gathered from the workshop and other sources: Background: There are three strains of influenza viruses, Influenza A, B and C. A "pandemic," which involves the whole world (versus a local "epidemic") is possible with Influenza A. Influenza A is divided into subtypes: Hemagglutinin (H) and Neuraminidase (N). When Influenza A mutates, it acquires a new H or H+N, resulting in a new virus. Because these are new viruses, almost no one will have immunity. Symptoms include headache, chills, dry cough, high fever, muscle aches, fatigue and loss of appetite. Influenza A enters a community in waves, moving in, moving out and reemerging to infect people not previously infected. With a pandemic, we could have a possible third wave, affecting us for several months, possibly a year or more. Influenza A affects wild birds and also pigs, horses and people. The avian flu virus, although most often infecting only birds, has shown some ability to infect humans, jumping the species barrier to move directly from chickens to humans and cause disease. Spread of a worldwide pandemic can possibly reach all continents in less than three months because of the speed and volume of international air travel today. Worldwide, WHO conservatively estimates from 2 million to 7.4 million deaths. The 1918-1919 Spanish Flu, which killed 40-60 million worldwide, was recently identified as an Asian-based avian flu type (H1N1), transmitted directly from birds to humans. Influenza A(H5N1), a mutation of the 1918 virus, first appeared in 1997, with infections linked to exposure to poultry markets. Concern has increased in recent years as avian H5N1 infections have killed large numbers of poultry flocks and other birds in Asia and Europe. Since January 2004, WHO reports a cumulative total of 122 confirmed human cases of H5N1 infection worldwide, with 62 deaths (a 50+% death rate), detected in people with close exposure to poultry in Thailand, Vietnam, Cambodia and Indonesia. In Canada in 2004, H7N3 was reported for the first time in humans which caused illness in two poultry workers in Canada. However, so far, this virus has failed to mutate in such A pigeon is collected from a coop by Turkish a way as it did in 1918. "It is not veterinary officials in protective suits in the possible to know whether the current eastern Turkish town of Dogubayazit January H5N1 is capable of adapting to 6, 2006. A third Turkish child from the same humans through aerosol transmission family, died of bird flu on Friday as the virus to initiate an influenza pandemic," which has killed 74 people in east Asia reached the threshhold of Europe. reports The New England Journal of REUTERS/Umit Bektas Medicine on Nov. 24/05.