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Health: Influenza Pandemic Country Preparedness Plans
by Inés DeRomaña
The World Health Organization (WHO) strongly recommends that all countries prepare in advance multidisciplinary pandemic plans to prevent and control the next influenza pandemic. Advice on doing so is contained in the recently revised WHO global influenza preparedness plan (116kb
) and a new WHO checklist (152kb ) for influenza pandemic preparedness planning.WHO recommends that countries should stockpile enough antiviral drugs to cope with a pandemic, which it estimates would affect 25 percent of the population, but warns that developing countries in particular are likely to fall well short.
Speculative Models and Tabletop Exercises for Preparing for Pandemic Influenza
Encourage people to begin to plan mentally for what might happen, as well as to build relationships before a crisis arises.
Australia
Contingency Plan?Australian Management Plan for Pandemic Influenza
Brazil
Contingency Plan?Brazil's Contingency Plan to Confront an Influenza Pandemic (2.5m
)Canada
Contingency Plan?Canadian Pandemic Influenza Plan
Chile
Contingency Plan?Plan de Preparación para una Pandemia de Influenza, Chile 2005
China
Contingency plan?The plan outlines the structure of the national pandemic influenza preparedness system, as well as expected emergency reaction responses and goals. The Ministry of Health urged all localities to also draft their own contingency plans, while taking into account local conditions so as to be better prepared for a possible flu pandemic.
The national plan will have four levels of alert—red, orange, yellow, and blue—that will indicate the seriousness of the outbreak. The most serious level—"red"—will be announced in case of the consistent and rapid spread of new subtype flu virus or if the World Health Organization (WHO) announces the outbreak of a flu pandemic. If a "red alert" is issued, health authorities above the county level must mobilize all medical resources and set up temporary clinics, while the Ministry of Health will issue daily reports on the surveillance and control of the pandemic. The plan also says that the Ministry of Health is responsible for organizing and coordinating epidemic preparedness work and, if needed, suggesting to the State Council the establishment of a national public health contingency headquarters.
In addition, the China Center for Disease Control and Prevention (CDC) will administer the national avian influenza surveillance system and require health authorities above the county level to ensure the collection, registration, and delivery of flu virus samples for testing.
Vaccine research?
China says it has produced a vaccine to prevent bird flu in humans, after four years of research.
Antiviral stocks?
Bird flu patients are being treated with Tamiflu, Amantadine, and Rimantadine according to their symptoms. China is trying to stockpile drugs, but the number of doses is not available.
Other information?
Closer links between health and agriculture ministries established, to fight bird flu.
Costa Rica
Contingency plan?In addition to restricting imports from affected areas, Costa Rica has stepped up scrutiny of importers who lack up-to-date import permits and reinforced its quarantine posts, where birds and poultry products are subjected to rigorous inspections and laboratory testing. On the borders, vehicles transporting poultry are disinfected.
Plan de preparación y respuesta en situación de Pandemia de Influenza
Czech Republic
Contingency Plan?The National Pandemic Plan of the Czech Republic (344kb
)Denmark
In preparation.France
Contingency plan?A revised bird-flu plan is being prepared and a simulation of an outbreak among animals is to be held. France has asked for 40 million vaccine doses in the event of a human pandemic.
Plan Gouvernemental de Lutte Contre la Pandémie Grippale D’origine Aviaire (140kb
)Ministère de la Santé et des Solidarités (Ministry of Health)
Vaccine research?
Clinical trials under way into a "prepandemic" vaccine, with an 82m euro order in place.
Antiviral stocks?
Nine million antiviral doses are already available, rising to 14 million by the end of the year.
Other information?
Fifty million masks have been sent to hospitals. By early 2006, 200 million will be available.
FluWiki lists additional information for France.
Germany
Contingency plan?Bavaria has banned poultry markets until the end of the year. Other German states are preparing detailed plans.
Influenzapandemieplanung
Vaccine research?
Each German state is responsible for ordering vaccine. The government is supporting the pharmaceutical industry with 20 million euros to develop a prototype vaccine, which is expected to be available within weeks.
Antiviral stocks?
A human flu pandemic is expected to infect a third of the German population. There are currently antiviral stocks for one in 10 people.
Hong Kong
Contingency plan?The government’s plan (192kb
) includes a three-level response system (Alert Response Level, Serious Response Level, and Emergency Response Level). These levels are based on different risk-graded epidemiological scenarios relevant to Hong Kong, and each of them prescribes a given set of public health actions required. They are designed to match with the World Health Organization (WHO)’s guideline for pandemic influenza planning.Antiviral stocks?
Antiviral agents are being stockpiled.
Hungary
Contingency Plan?Hungarian National Plan for the pandemic preparedness to influenza (28kb
)Ireland
Contingency plan?A Model Plan for Influenza Pandemic Preparedness (300kb
)Italy
Contingency plan?Compulsory labeling of Italian poultry to include where chicken was raised and the date and place of slaughter. Poultry in various areas already vaccinated. Any imported poultry to be labeled with country of origin and date of entry. Extra vets and animal disease prevention experts recruited. Police units to enforce border controls.
Vaccine research?
No information on research available. The Italian Health Ministry says 36 million doses will be available within three to four months of an outbreak.
Antiviral stocks?
100m euros allocated to buy antiviral drugs to cover 10 percent of the population, with more than 30 million doses ordered.
Other information?
No plans to ban hunting of wild birds.
Japan
Contingency plan?1997 Report on New Influenza Strain Preparedness Measures Part 1 (1.2m
)1997 Report on New Influenza Strain Preparedness Measures Part 2 (1.4m
)Mexico
Contingency plan?Plan Nacional de Preparación y Respuesta a una Pandemia de Influenza
Netherlands
Contingency plan?National pandemic plan in place.
Scenario analysis of the expected number of hospitalisations and deaths due to pandemic influenza in the Netherlands (228kb
)Figures related to the scenario analysis (104kb
)Vaccine research?
The Netherlands proposes EU-wide research. Negotiations to deliver vaccines under way with pharmaceutical companies.
Antiviral stocks?
Stocks of 220,000 are in place, with a further 2.4 million doses to be delivered by the end of the year. Another 2.4 million doses will be bought by early 2007.
New Zealand
Contingency plan?Influenza Pandemic Action Plan
The Philippines
The Preparedness and Response Plan for Avian Influenza consists of four stages withcorresponding specific actions:
- Stage 1, Avian influenza-free Philippines;
- Stage 2, Avian influenza in domestic fowl in the Philippines;
- Stage 3, Confirmation of avian influenza from poultry to humans in the Philippines; and
- Stage 4, Avian Influenza with human-to-human transmission of pandemic influenza causing outbreaks in the country.
FluWiki lists additional information on the Philippines.
Russia
Contingency plan?Avian flu plan adopted in August 2005 after first cases in Siberia. Protective suits and training in recognizing symptoms recommended for people working with birds. In the future, there will be no chicken farm workers over age 60, or with chronic cardiac and lung conditions.
Vaccine research?
Research into vaccines is taking place, but details are a secret under Russian laws.
Antiviral stocks?
Sufficient stocks for each of its 150 million citizens. Drugs for treating people against ordinary flu are also being stockpiled.
Other information?
Only trained doctors and biologists may work with birds showing avian flu symptoms. They must wear full protection suits. Ordinary people are discouraged from approaching places where there has been bird flu.
Singapore
Contingency plan?Influenza Pandemic Readiness and Response Plan
More information?
Information from Singapore's Ministry of Information, Communication, and the Arts
South Africa
Contingency plan?South Africa Preparedness Plan (112kb
)Spain
Contingency plan?The country is preparing for the worst. There is a close watch and daily tests on hundreds of migratory birds because Spain is on the migratory path.
Documento Sobre la Gripe Aviar (Information on Avian Flu) (88kb
)Plan Nacional de Preparación y Respuesta ante una Pandemia de Gripe (396kb
)Ministerio de Sanidad y Consumo (Ministry of Health)
Vaccine research?
There are plans to build a factory to manufacture antiviral in 2011.
Antiviral stocks?
Spain has enough stocks for 5 percent of the population.
Sweden
In preparation.Taiwan
Contingency plan?Taiwan Preparedness Information Web Site
Thailand
Contingency plan?Thailand National Strategic Plan for Influenza Pandemic Preparedness (2005-2007) (432kb
)People have been advised to cook chicken properly and to avoid any meat with dark, bloody, or bruised spots. Eggs should be clean. Poultry farmers must watch for signs of disease in chickens and clean cages and equipment frequently. Poultry farmers should also wear protective clothing.
Vaccine research?
Trials for a human vaccine could begin in 2006 or 2007.
Antiviral stocks?
An order has been placed for 1 million Tamiflu, with 660,000 in stock.
Other information?
There have been 13 confirmed human deaths from bird flu.
Turkey
Contingency plan?National bird-flu action plan drawn up in 2001. Spot-checks have focused on birds in the Manyas area, where an outbreak was discovered in October 2005.
Checks also planned on poultry and at all wetland areas across the country. By law, suspicious deaths or illness among poultry must be reported, and teams from the agriculture ministry must take action within 24 hours.
Imports of birds and poultry products from Greece, Iran, and Romania have been banned.
Vaccine research?
No vaccine being developed in Turkey, which imports up to 300,000 ordinary flu vaccines a year.
Antiviral stocks?
55,000 boxes of Tamiflu at the time of the country's outbreak. The health ministry says it has another 25,000 in stock and has recently ordered another 1m.
Other information?
No restrictions on free-range poultry planned. Most people keep a few chickens in their backyards, making it virtually impossible to police hygiene standards.
Vietnam
FluWiki lists information for Vietnam.United Kingdom
Contingency plan?It remains a remote possibility that bird flu could be introduced to poultry through the migration of wild birds, the illegal importation of dead chickens for consumption, the illegal importation of live birds, or the entry into the UK of a person who has acquired the illness in an infected area. Measures to prevent a bird flu outbreak are under review, and it updated its pandemic contingency plan on October 19, 2005. Bird fairs, markets, and shows are already banned unless declared safe.
As a precautionary measure, the UK has banned imports of live chickens from the following countries (due to bird flu outbreaks in these countries): Croatia, Turkey, Romania, Russia, Kazakhstan, Thailand, Cambodia, China, Hong Kong, Laos, Indonesia, Vietnam, Pakistan, Malaysia, South Africa, and North Korea. A register of commercial poultry producers is to be set up. GPs have been advised on what to do in the event of a human pandemic.
U.K. Influenza Pandemic Preparedness Plan (572kb
) Vaccine research?
Enough vaccine to cover the UK population—120 million doses—will be developed once a human pandemic starts. Manufacturers have been asked to tender for the contract.
Antivirals stocks?
A stockpile of 14.6 million courses of antiviral drugs is being built up. So far, the UK has 2.5 million doses, with 800,000 per month arriving.
Other information?
Fifteen consignments of birds are being monitored after two parrots in quarantine died from the H5N1 strain of bird flu. Consumers have been told that poultry and eggs should be thoroughly cooked to avoid any risk of bird flu.
United States
Contingency plan?Draft Pandemic Influenza Response and Preparedness Plan
