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St. Vincent Clay preparing for pandemic

Thursday, January 19, 2006

State health officials and Indiana hospitals are working to finish up their plans for isolating and treating flu victims in case a deadly strain of bird flu that's spread from Asia to Turkey causes a global outbreak.

Indiana hospitals must complete their plans for combatting a flu pandemic, or global outbreak, by August, but state health officials hope to see something from them by March.

The Indiana Department of Health is planning a flu pandemic summit in April, although no date or location has been determined, said spokeswoman Jennifer Dunlap.

St. Vincent Clay Hospital, Brazil, has been working on what might be termed the interpandemic phase that includes education and awareness Plans to educate community leaders and others who need to know about the pandemic began in October. Lori Mayle and Andrea Baysinger of the local hospital have been working together.

Janet Archer, a nurse with the Indiana State Department of Health (ISDH), presented a program four times in Brazil on pandemics and what might happen if the bird flu begins spreading from person to person. Through Archer, the hospital reached about 130 associates with the information, as well as 40 community leaders, including school officials, Mayor Tom Arthur, emergency personnel, funeral home personnel, veterinarians, dentists and nursing home personnel. A separate presentation was made to department heads in the mayor's administration.

As they work on their preparations, officials are mindful of the 1918 Spanish flu pandemic, which killed about 11,000 Hoosiers, 500,000 Americans and 50 million people worldwide.

If avian flu in Asia and, most recently, Turkey leads to a global outbreak, state officials estimate that nearly 6,000 Hoosiers would die if the virus were to spread to 35 percent of the population.

Federal officials have estimated that 1.8 million Americans could die.

The 1918 flu passed through the U.S. in about a month, Lori Mayle told The Brazil Times. "And that was before air travel."

Other pandemics have struck Americans as well.

The Asian flu killed 60,000 Americans in 1957-'58 and the Hong Kong flu killed 40,000 in 1968-'69.

The reason 20,000 fewer Americans died in 1968-'69 was because the virus hadn't mutated very much and antibodies or "soldiers" from the flu pandemic a decade before helped protect Americans, as Mayle explained.

The bad news is the bird flu is an entirely new strain and humans will have no immunity against it.

"The flu shot you get will not be effective against the bird flu," Mayle said.

The Brazil hospital's next steps will include the development of a hospital specific plan that will include preparation for a large influx of patients and the supplies needed to care for them.

The ISDH estimates hospitals will need to be prepared with supplies to serve their communities for a month while the flu takes its toll, Mayle said.

The cost may be staggering.

By illustration, Mayle said bird flu is spread by droplets transmitted in a 3-foot space through coughing and sneezing. Therefore, nurses will have to wear masks for protection while treating bird flu patients. Masks will have to be changed every 30 minutes, meaning thousands of masks will have to be ordered .

"It's important to remember this flu pandemic will be widespread," said Andrea Baysinger during the telephone interview on Wednesday.

"So, we won't be able to rely on other areas for help. Those people will also be dealing with the pandemic."

"All we can do is be better prepared today than yesterday and better prepared tomorrow than today," James Howell, a veterinary epidemiologist and co-chairman of the Indiana committee developing the flu pandemic plan told The Associated Press.

St. Vincent Clay is working with the Clay County Health Department, meeting on a bi-monthly basis.

State health officials have been working for months on details of Indiana's plan, which, among other issues, will determine at what point to order the cancellation of public events and how best to isolate the sick.

It would also ensure that lines of communication remain open between health care officials and the public, and determine who gets vaccinations or medications if supplies are limited.

"I think we realize this is likely to happen in the next several years, so now's the time to get this planned," said Dr. Douglas Webb, medical director for infection control at Methodist and Indiana University hospitals in Indianapolis.

During the 1918 flu outbreak, entire families perished and Indiana cities and towns were forced to cancel all public gatherings, schools and religious services for weeks at a time to control the outbreak.

It may become necessary to cancel non-essential gatherings if a bird flu pandemic hits Indiana, Mayle said.

Everyone from the head of the Centers for Disease Control and Prevention to local hospital officials agrees that the nation is not ready for a similar outbreak. There is no vaccine and only a limited supply of anti-viral drugs whose effectiveness is in question.

For now, people can contract the avian flu virus, called H5N1, only through contact with an infected bird.

However, if the virus mutates into a form that permits it to spread from person to person it could have disastrous effects, both in terms of human deaths and the global economy.

The avian virus, which first appeared in Asia in 2003, has killed about half of the estimated 150 people who have contracted it, mostly in Southeast Asia and, more recently in Turkey, the doorstep of Europe.

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