Swine Flu Outbreak: What You Need to Know

The H1N1 pandemic occurred despite the years of regularly exercising, developing, and refining mitigation plans at the community, international, local, federal, and state levels. Previously, the H5N1 was believed to have the greatest pandemic threat because it was endemic to areas that keep poultry and had deadly results on humans after infection. Most of the response planning used against the 2009 H1N1 were based on the H5N1. The response by the CDC was long term, complex, multifaceted, and extended for more than a year ( Evans & Roberts, 2017a) . Initially, it was believed that it was spreading among US pig herds, but it was later apparent that it was a human to human transmission. The paper will evaluate the emergency response to the swine flu. 

History 

The influenza A (H1N1) was detected in 2009, and it prompted the 2005 International Health Regulations (IHR) that became effective in 2007. The existence of the IHR was shaped due to the SARS outbreak of 2003. The regulations emphasized the leadership role of the World Health Organization (WHO) in the management and declaration of public health concerns that have global effects. Janet Napolitano, the Secretary of Homeland Security, made the public health emergency announcement and cautioned citizens against panicking. The declaration was a standard procedure that prompted local, federal, and state agencies to free up their resources for the prevention and mitigation of the disease ( Sharma, Arora, & Mahashabde, 2014a) . The virus was a unique blend of influenza virus genes that had not been identified in either animals or humans. It was a blend of the Eurasian and North American swine lineage, and it was the reason the infection became known as swine origin influenza virus. 

Patient zero was a 10-year-old child who lived in California. Further testing at the CDC proved that the infection was new to humans. The second infection was an 8-year-old child who was about 130 miles away from the first case. Further tests indicated that the infection was resistant to the two most important antiviral drugs: rimantadine and amantadine. However, the infection was vulnerable to zanamivir and oseltamivir. The infection of two patients who were about 130 miles apart raised concern that the infection had affected incorporated itself into the human population and was being spread human to human. The CDC began immediate research and investigation with local and state human and animal health officials in the state. The CDC was in continuous communication with the international health community because it was a pandemic under the International Health Regulations (IHR) ( Keim, Driebe, & Engelthaler, 2014a) . The Pan American Health Organization was also informed about the infection as part of the prosperity and security of North America. 

Discussion of the Event 

The first case of the H1N1 was reported in Mexico in February 2009. The first case in the US was detected in late March in California. By April, the disease had various states and countries such as Germany, Canada, Israel, Spain, New Zealand, and the United Kingdom. The pandemic was declared public health emergency that was of global concern by the WHO. In early June, about 73 countries reported about 26000 laboratory confirmed cases ( Keim, Driebe, & Engelthaler, 2014a) . By mid-June, I had met the criteria for phase 6 of a full-fledged pandemic. After extensive research, it was discovered that the influenza was a blend of four different influenza strains. After testing the various virus samples, they appeared to have one source. Further tests indicated that it was different from the 1918 influenza outbreak that was associated with severe diseases. The H1N1 did not have genetic markers that were associated with avian influenza H5N1 that exhibited high death rates on the people it infected. The CDC began reporting both probable and confirmed cases of the 2009 H1N1. Also, about 98% of the probable cases tested positive for the swine flu. The results exhibited the ever growing threat of a full blown outbreak. The CDC deployed over 100 staff to assist in the outbreak response. The staff was vital in analyzing the data and making policy decisions regarding the prevention and control of the influenza. 

About 12.5 million doses of Relenza and Tamiflu were deployed to areas that had reported the cases, and the CDC expected the situation to worsen. By October, it had caused almost 10000 deaths in the country and infected over 50 million people ( Sharma, Arora, & Mahashabde, 2014a) . About one in every six Americans was infected by the swine flu. Over 200000 people were hospitalized. Most of the people who were affected by the disease were young adults who suffered about 7500 deaths. About 80% of the deaths occurred in people between the ages of 20 and 59. Alaska Natives and Native Americans reported the highest number of deaths in comparison to other Americans. The findings may not have come as a surprise because Alaska Natives and Native Americans had higher rates of asthma and diabetes that made them more vulnerable than other people. Moreover, they had higher poverty levels. The influenza hit the country in two waves. The first wave was reported in spring and the second larger wave affected the country in the late summer. By October, 48 states reported cases of influenza. October was the peak of the second wave because, after October, fewer states reported cases of influenza ( Sharma, Arora, & Mahashabde, 2014a) . Various schools were closed due to the swine influenza. 

All cases of H1N1 were immediately reported to the CDC. The CDC worked closely with both human and animal health officials to establish the source of the disease. It was established that the infection was transmitted human to human ( Patavegar, Kamble, & Langara-Patil, 2015a) . The CDC tried to develop a virus that could act as a vaccine. After coming up with the vaccine, the CDC sent it to vaccine manufacturing companies if the government found it necessary to distribute the vaccine ( Keim, Driebe, & Engelthaler, 2014a) . They also activated the Emergency Operations Center to coordinate response to the disease. The response activities were coordinated in relation to the National Incidence management Systems. The vaccines were distributed to pharmacies, health care providers, and all local public health agencies. The government ensured that the public health emergency was available all over the country. The Strategic National Stockpile (SNS) released about a quarter of their supplies for the protection and treating of influenza. Over 10 million regimens of personal protective equipment and antiviral drugs were released. Moreover, about 40 million face shields, respiratory protection devices, gloves, and gowns were allocated to each state depending on their population. The federal government also purchased about 50 million treatment courses of the required antiviral drugs, zanamivir, and oseltamivir. 

Conclusion 

The CDC response to swine flu was regulated by science, and it was dynamic according to the needs of the country. The entire CDC response was based on emergency risk communication principles of transparently, quickly, and proactively offering accurate information to citizens, public, and other partners. The strategy allowed the CDC to state its objectives, what it knew, and what it did not know about the infection. In the early days of the swine flu outbreak, a 24-hour communication cycle was established ( Evans & Roberts, 2017a) . Proper emergency management systems should be maintained to avoid a future outbreak of the H1N1 or other pandemics. 

References 

Evans, M. R., & Roberts, R. J. (2017a). Sting in the tail: swine flu returns. Sign , 1757 (880). 

Keim, P., Driebe, E., & Engelthaler, D. (2014a). U.S. Patent No. 8,808,993 . Washington, DC: U.S. Patent and Trademark Office. 

Patavegar, B. N., Kamble, M., & Langare-Patil, S. (2015a). Awareness and Practices Regarding Swine Flu among Interns and Nursing Staff: A Cross-Sectional Study at Tertiary Care Hospital, Pune. International Journal of Health Sciences and Research (IJHSR) , 5 (12), 1-5. 

Sharma, S., Arora, V. K., & Mahashabde, P. (2014a). Knowledge and behavior regarding swine flu among interns at index Medical College, Hospital & Research Center, Indore (MP). Journal of Evolution of Med and Dent Sci , 3 (10), 2590-2594.