Media coverage of avian influenza has increased as scientists, public health officials and government officials have expressed heightened concern over the threat of a pandemic.

Pandemics have occurred throughout history including three that occurred in the last
century in 1918, 1957 and 1968. Although, scientists cannot predict when the next
pandemic will occur, it is likely that we will experience a pandemic at some time in the
future and should therefore, be prepared.

This bulletin is designed to provide a basic overview of the issue and outline our efforts to prepare for a public health event that could threaten the health and safety of our campus. We would encourage you to access the World Health Organization (WHO) and Centers for Disease Control (CDC) websites listed below if you would like to know more about the topic.

What is avian influenza?

Avian influenza, or “bird flu”, is a contagious and deadly viral disease that normally
infects only birds and on occasion, pigs. This highly pathogenic strain, H5N1, has been persistent and tenacious in the bird population despite the fact that over 150 million birds have died or been destroyed. The virus is now being spread by migratory birds.

Which countries have been affected?

Outbreaks in wild and domestic birds have been reported in over 14 countries including: the Republic of Korea, Vietnam, Japan, Thailand, Cambodia, Loa Peoples Democratic Republic, Indonesia, China, Malaysia, Mongolia, Russia, Kazakhstan, Turkey and Romania.

What are the implications for human health?

Widespread persistence of H5N1 in poultry populations poses two main risks for human health. The first is the direct infection from poultry to humans. The second threat is the emergence of a mutant strain that spreads easily from person to person.
Confirmed cases of bird-to-human transmission or very limited human-to-human
transmission have occurred in ten countries as of July 2006.

How is the virus transmitted?

The bird-to-human transmission occurs from direct contact with infected poultry or
surfaces and objects contaminated by their feces. Exposure to the virus is most likely
during slaughter, defeathering, butchering and preparing poultry for cooking. Currently, there is no evidence that properly cooked poultry or eggs are a source of infection. What changes are needed for the H5N1 virus to affect humans and become
pandemic? The virus can become transmissible among humans by either a “reassortment” event or by a more gradual process of adaptive mutation.

In “reassortment” genetic material is exchanged between human and avian viruses when there is coinfection in a human or pig. This results in a new potent strain that is fully transmissible to humans. The process of adaptive mutation is a more gradual process by which the virus becomes more efficient at binding to human cells.

A pandemic can start when three conditions have been met: a new virus subtype
emerges; it infects humans; and it spreads easily and is sustained among humans.
The first two conditions have been met in that a new subtype has emerged and humans have been infected through contact with infected birds.

Are vaccines and antivirals available for prevention and treatment?

Some vaccine clinical trials are currently underway. Because the antigen needs to closely match the pandemic virus, large scale production will not start until the virus has emerged. Even when an effective vaccine is available, current vaccine production
capacity will not be able to meet the demands.

Tamiflu and Relenza are oral antivirals that are currently available and are effective for
reducing the severity and duration of the illness. These medications can also be used
prophylactically to decrease the number of new cases when an exposure has occurred. Again, production capacity for antivirals is limited.

How is Carnegie Mellon preparing to respond to a pandemic threat?

The following activities have been initiated by Environmental Health and Safety and the Student Health Service and are ongoing:

• Following the latest developments by monitoring WHO and CDC websites.
• Developing and rehearsing an emergency response plan with various groups on
  campus.
• Benchmarking the preparedness activities of other colleges and universities.
• Maintaining an open line of communication with Allegheny County Health
  Department and local universities.
• Ensuring that on campus health care providers and first responders are prepared to respond by providing ongoing education about influenza, rehearsing emergency drills and having medical supplies and equipment readily available.

How can I prepare myself and my family for a pandemic?

Everyone is encouraged to have a personal/family plan that can be used in the event of any emergency or disaster. There are some special considerations that need to be
addressed in the event of a pandemic. We have prepared a general guide to assist you in the development of your personal plan. You can access this guide at:

http://www.pandemicflu.gov/planguide/checklist.html

How can I learn more about avian influenza and the pandemic threat?

The WHO, CDC and DHHS (Department of Health and Human Services) update their websites regularly and have extensive information on these topics:

http://www.who.int/csr/disease/avian_influenza/en/index.html
http://www.cdc.gov/flu/avian/
http://pandemicflu.gov/