Modules:
1.	Introduction
2.	Influenza Viruses
3.	Seasonal, Avian, and Pandemic Influenza
4.	Influenza: the disease
5.	New Zealand pandemic planning
6.	Primary Health Care preparedness
7.	Community preparedness
8.	Anti-viral Drugs
9.	Vaccines
10.	Common Questions
11.	Resources
12.	Course Conclusion

Common Questions

Seasonal influenza causes illness in ~5% of adults and ~20% of children each year
Seasonal influenza is usually a self-limiting illness, albeit debilitating, but can lead to complications especially in older people (>65 yrs), the very young and those with certain medical conditions
A pandemic arises from a new influenza virus that spreads globally as there is no pre-existing immunity in humans
The next pandemic virus does not exist yet and impossible to predict its impact
All people will be susceptible to a pandemic virus and may have a higher complication rate than seasonal influenza

A bird disease commonly called 'bird flu'
One strain of Influenza A (H5N1) has been causing a large bird influenza outbreak since 2003
It rarely causes human disease: only 168 confirmed infections (to February 2006)

Avian influenza viruses have been the origin of pandemic viruses in the past
If H5N1 adapts to people with effective human-to-human spread there will be a pandemic!
H5N1 has killed over half the confirmed cases to date(but, if adapts to people, mortality will almost certainly be much lower)
H5N1 outbreaks continue in poultry and may be further spread by both migratory birds and the global poultry trade

An antiviral drug used to treat influenza since the 1990s that:
- reduces illness by at least one day
- halves hospitalisation rate
Tamiflu^® must be given within 48 hours of symptoms starting to be effective
Its effectiveness for pandemic influenza is currently unknown as the virus does not exist yet
Tamiflu^® also prevents influenza; but only works while taking it (it is licensed for up to 6 weeks use); efficacy for pandemic virus unknown, until it emerges

A vaccine cannot be developed until pandemic virus emerges; New Zealand is likely to receive pandemic vaccine no earlier than 15-27 weeks after a pandemic virus is identified.
A vaccine for H5N1 (avian influenza) is being developed but its effectiveness against pandemic virus is unknown as a pandemic virus does not currently exist.
Two doses, by injection, are likely to be needed, separated by a 2-4 week interval

Potentially, many people could be ill at same time, it could interrupt essential services; and there may be many deaths if virus is virulent
Health services are likely to be too stretched to provide hospital services for many pandemic influenza cases or elective services.
A major danger could be from fear and panic

Yes, because it may lead to emergence of a virus that will cause a severe pandemic, and awareness helps to prevent and prepare for a pandemic
However, at present it remains a bird disease; and when the virus changes enough to cause a human pandemic, it may not be much more virulent than seasonal influenza

Control the virus in poultry internationally (there is none in NZ poultry)
Prevent contact between infected birds and humans to avoid infections
- Every human infection is an opportunity for the avian virus to adapt to humans
- Contact includes touching as well as exposure to bird droppings
- The H5N1 virus is also found in birds killed by infection; eating improperly cooked poultry (ducks, chicken and other birds) in these countries can lead to infection
- Encourage annual vaccine for seasonal influenza

Probably; it depends on how the virus changes to become transmissible in people
- Good surveillance is vital for early warning
- Early warning may allow pandemic to be stopped before it develops