Strains could spread well beyond hospitals to the community and economic infrastructure EMTs are told
By: David Campbell
The Spanish Flu pandemic of 1918 killed 40 million people worldwide, including 650,000 in the United States. Adjusted for 2006 populations, that would translate into about 100 million deaths worldwide today, with 2 million of them in the U.S.
If an avian influenza pandemic reached the U.S. today, depending on the flu strain and other factors, the results could be as devastating as the 1918 outbreak, or the virus strain might be benign with no symptoms at all, Dr. Stephen Harrison, emergency medicine specialist at University Medical Center at Princeton, said at an avian flu training workshop for area EMTs hosted Monday night by UMCP’s Emergency Department.
A bird flu pandemic, if severe, could place serious strains on hospitals but also on other infrastructure, such as electricity and public services, as workers fall ill or stay home for fear of being infected, and so preparedness and community education are essential, Dr. Harrison said.
"If this ever gets going, there’s going to be a run on the hospitals," he said. "There are a lot of social-economic factors that could be more destructive than the virus itself."
Every year in the U.S., about 5 to 20 percent of the population gets the flu, with the most common variety of influenza caused by influenza virus A. Each year more than 200,000 people are hospitalized from flu complications and about 36,000 people die mostly the elderly but also the very young, Dr. Harrison said.
When public-health officials talk about avian flu, they are referring to influenza A viruses found chiefly in birds. Most cases of avian flu infection in humans have resulted from contact with infected poultry or surfaces contaminated by infected birds. The spread of avian influenza viruses from one person to another has been reported very rarely, and transmission has not been observed to continue beyond one person, according to the federal Centers for Disease Control and Prevention.
Some strains have high virulence like the one that struck Hong Kong in 1997 the first reported transmission of an avian influenza A virus directly from birds to humans which hospitalized 18 people, six of whom died. By contrast, a strain that broke out in Denmark caused only eye infections, Dr. Harrison said.
About 30 EMTs from area municipalities attended the Monday night training workshop, held at the hospital on Witherspoon Street. Presenters at the session also included Dr. Anthony Scardella, specialist in critical-care medicine, internal medicine and pulmonary disease; Nancy Panarella, clinical instructor; and Kathy Hill, infection control coordinator.
Ms. Panarella said that when humans get infected with avian flu they are accidental hosts "It’s not meant to go to humans," she said and that when transmission occurs, it’s typically among people working closely with birds and through food-preparation practices found in some Asian countries.
She said an outbreak in the U.S. potentially could inundate hospitals, cause shortages of antibiotics, and close businesses and schools. "It truly can shut down a community," she said. But she said an outbreak can be contained with proper preparation and measures like vaccinations and quarantine.
Bev Glockler, a member of the EMS squad in Montgomery, said Monday night that she attended the workshop in order to be prepared if such an outbreak ever occurs. "There’s certainly that possibility, and people should be aware," she said.
Dan Hudson, a member of Princeton First Aid & Rescue Squad, said he came to learn more about disaster preparedness by hospitals. "I’m concerned about avian flu being a threat," he said. "Do I see it as an immediate threat? Not necessarily."
Mr. Hudson said he doesn’t foresee avian flu becoming an acute disaster in the immediate future "It’s not going to hit 1,000 people in Princeton next Thursday" but said health-care personnel need to be prepared whether it’s a bird-flu pandemic or any other public-health risk, he said.

