Pandemic Influenza Plan - Questar III

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Section 8: Travel-Related Disease Control and Community Prevention I. Overview The initial response to a novel strain of influenza will aim at containing the virus at its source. Thorough case isolation and quarantine of contacts in the area where the novel strain emerges may slow the spread of a pandemic. Travel restrictions to and from areas of viral transmission may help slow viral spread to other parts of the world. When the virus moves beyond its initial range and is introduced into the United States, early efforts will likely include isolation and quarantine of newly arrived cases and their contacts. But as transmission becomes more widespread in the United States, quarantine becomes less effective and may not be used as a primary public health intervention. Slowing initial viral spread will allow greater time to manufacture and distribute influenza antiviral medications and to develop, manufacture, distribute, and administer influenza vaccine. Epidemiologic investigation of early influenza cases may reveal features of the novel strain that will be relevant to what efforts have the greatest potential in slowing viral spread. The goal of Travel-Related Disease Control and Community Prevention is to slow the initial spread of pandemic influenza and to describe steps that individuals can take (to reduce their risk of becoming infected and their risk of spreading infection to others) and steps that the community as a whole can take. II. Objectives The objectives of the Travel-Related Disease Control and Community Prevention Section address: • Travel-related considerations and strategies that include distribution of travel health alert notices and restriction or cancellation of non-essential travel. • Isolation of cases and quarantine of contacts, including times when they may be warranted. • Community containment measures to prevent or decrease transmission. • Local community resources needed to support persons caring for themselves and family members at home or in special isolation and quarantine facilities. <strong>III</strong>. Components of Travel-Related Disease Control and Community Prevention A. Travel-Related Disease Control The overall travel-related strategy aims at protecting travelers and decreasing entry of pandemic influenza into New York State. International health and travel organizations will be expected to implement exit screening for ill persons and to identify persons with influenza-like illness during transit and implementing protocols to limit potential transmission to other passengers. February 7, 2006 8-2
Section 8: Travel-Related Disease Control and Community Prevention In-state activity will include: • Promoting awareness of CDC and WHO travel advisories and information on how travelers can reduce their risk of acquiring pandemic influenza when traveling outside New York State; • Implementing point-of-entry interventions to rapidly identify persons who may have or have been exposed to pandemic influenza; • Isolating persons and identifying and quarantining contacts, at home or in isolation and quarantine facilities. Persons living in areas where a novel influenza strain is circulating and who develop influenza-like illness and their contacts, should defer travel to unaffected areas. Persons experiencing influenza-like symptoms should report their illness to health authorities. Travelers from affected areas should undergo exit screening for influenza symptoms before departing for areas currently free of influenza. Non-essential travel to areas where a novel influenza strain is circulating should be postponed. Travelers can learn where a novel influenza strain is present from CDC’s Travel Health Precautions and Warnings web site (http://www.cdc.gov/travel) and WHO’s Disease Outbreak News web site (http://www.who.int/csr/don/en/). Effective management of travelers will require public health resources at entry points. Persons traveling from an affected area who become ill in transit should be separated from fellow travelers (if possible) on board. Illness among travelers should be reported to health authorities in the countries of embarkation, destination, and transit (if any). Upon arrival, newly ill persons should be referred for medical care and influenza testing. Ill travelers arriving in an area where influenza has not begun to circulate should be isolated for a minimum of 5 days, and contacts to the ill traveler should be quarantined for 10 days. Isolation and quarantine facilities for non-resident travelers should be identified in advance and will be needed during the late pandemic alert period and early in the pandemic phase. Local and state health department personnel may be needed to support federal quarantine station personnel at land, water, and air ports of entry. An assessment checklist for isolation or quarantine in the home or community-based facility is contained in Appendix 8-A. Two features of influenza will limit the usefulness of isolation and quarantine during an influenza pandemic: • <strong>Influenza</strong>’s short incubation period makes it difficult to identify and quarantine contacts of infected persons before they also become ill and have spread infection to others. • A high rate of asymptomatic illness means infected persons will not be identified and their contacts not known and quarantined. Because of the uncertainty of the benefits of quarantine for pandemic influenza, the effectiveness and compliance with such measures and the resources necessary to initiate and enforce compliance should be continually evaluated. February 7, 2006 8-3
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February206 Pandemic Plan NewYorkSt
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Introduction Pandemic influenza occ
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example, at this time, it is realis
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Acronyms (cont.) IND IHANS IRB ISHS
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Section 1: Command and Control I. O
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Section 1: Command and Control pers
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February 7, 2006 Appendix 1-A
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Appendix 1-B The Public Health Law
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Appendix 1-B communicable diseases
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Appendix 1-C Management Office or t
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Appendix 1-E Suspension of Public M
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Appendix 1-G A Guide to New York St
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Appendix 1-G health commissioner. P
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Appendix 1-G 8. State Institutions
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Appendix 1-G b. Governor May Invoke
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Appendix 1-G may direct, pursuant t
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Appendix 1-G c. Commissioner of Gen
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Appendix 1-G Designation of emergen
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Appendix 1-G physician’s assistan
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Appendix 1-H Summary of Public Offi
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Section 2: Surveillance and Laborat
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Appendix 2-A • Surveillance Crite
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Appendix 2-A • In New York City,
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NYSDOH Novel Influenza Case Report
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Appendix 2-C to health care provide
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Virus Detection History NYS Lab Num
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Section 3: Healthcare Planning and
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Section 4: Infection Control I. Ove
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Section 4: Infection Control I. Ove
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Section 4: Infection Control A. Bas
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Section 4: Infection Control Drople
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Section 4: Infection Control o Noti
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Section 4: Infection Control E. Coh
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Section 4: Infection Control If wid
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Section 4: Infection Control should
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Section 4: Infection Control Policy
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Section 4: Infection Control o Staf
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Section 4: Infection Control The ma
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Section 4: Infection Control • Up
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Section 4: Infection Control Health
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Appendix 4-A Soiled linen and laund
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Appendix 4-B Respiratory Hygiene/Co
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Section 5: Clinical Guidelines I. O
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Section 5: Clinical Guidelines incu
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Section 5: Clinical Guidelines 1) N
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Section 5: Clinical Guidelines infe
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Section 5: Clinical Guidelines Alth
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Section 5: Clinical Guidelines Infe
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Section 5: Clinical Guidelines •
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Appendix 5-B Clinical Evaluation of
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Appendix 5-C Special Situations and
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Appendix 5-D handling soiled laundr
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DRAFT Appendix 5-E Footnotes to App
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Appendix 5-F February 7, 2006 1
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Appendix 5-F 7. Guidance on the eva
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Appendix 5-H Source: U.S. Departmen
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February 7, 2006 2 Appendix 5-I
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Appendix 5-J Clinical Presentation
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Appendix 5-J diabetes mellitus), re
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Appendix 5-J resistant S. aureus (M
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Appendix 5-K eight patients—all o
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Appendix 5-L Guidelines for Managem
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Appendix 5-L testing should be perf
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Page 207 and 208: Section 6: Vaccine Procurement, Dis
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Page 277 and 278: Appendix 8-F Definitions: Intervent
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Section 9: Communications • In th
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Appendix 9-A Public Health Risk Com
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Appendix 9-C New York State Departm
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Appendix 9-C PRE-EVENT MESSAGE MAP:
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Appendix 9-C PROTECTIVE MESSAGE MAP
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Appendix 9-C TREATMENT MESSAGE MAP:
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Appendix 9-C BUSINESS CONTINUITY PR
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Section 10: Training and Education
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Appendix 10-A NYSDOH STAFF PRIVATE
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FACILITY- BASED RNs FACILITY- BASED
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Section 11: Workforce Support I. Ov
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Section 12: Highly Pathogenic H5N1
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Section 12: H5N1 in Non-Human Anima
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Section 13: Public Health Preparedn
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Appendix 13-A NYSDOH Roles Notified
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Appendix 13-B Notifications sent by
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Appendix 13-B HAN posting is used a
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Appendix 13-B notification system t
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Appendix 13-C Overview of the Healt
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Appendix 13-C • Ongoing surveilla
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Table 1. Summary of HERDS Use To da
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Appendix 13-D Commerce Access and A
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Appendix 13-D Table 3. Organization
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