The Canadian Pandemic Influenza Plan for the Health Sector

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Vaccination Vaccine Virology Virus Volunteers (Pandemic) WHIMIS Wild type WHO V The act of administering a vaccine. A substance that contains antigenic components from an infectious organism. By stimulating an immune response (but not disease), it protects against subsequent infection by that organism. The study of viruses and viral disease. A group of infectious agents characterized by their inability to reproduce outside of a living host cell. Viruses may subvert the host cells’ normal functions causing the cells to behave in a manner determined by the virus. A volunteer is a person registered with a government agency or government designated agency, who carries out unpaid activities, occasionally or regularly, to help support Canada prepare for and respond to a pandemic influenza outbreak. A volunteer is one who offers their service of their own free will, without promise of financial gain, and without economic or political pressure or coercion. W The Workplace Hazardous Materials Information System (WHMIS) is Canadian legislation covering the use of hazardous materials in the workplace. This includes assessment, signage, labelling, material safety data sheets and worker training. WHMIS closely parallels the U.S. OSHA Hazcom Standard. Most of the content of WHMIS is incorporated into Canada’s Hazardous Products Act and the Hazardous Materials Information Review Act, which are administered by Health Canada. Certain provincial laws may also apply. WHMIS is enforced by the Labour Branch of Human Resources Development Canada or the provincial and territorial agencies and offices of occupational health and safety. A naturally occurring strain of virus that exists in the population. World Health Organization, a special agency of the United Nations generally concerned with health and health care. References 1. Last, John, M. (Editor) A Dictionary of Epidemiology (2 nd edition), 1988. Oxford University Press Inc., New York, New York. 12 The Canadian Pandemic Influenza Plan for the Health Sector
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INFORMATION NOTICE The Canadian Pan
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Organization of Contents Preface Se
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Foreword and Acknowledgements The C
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Alternate Dr. Ross Findlater Chief
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Dr. Anne Roberts Department of Heal
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Past Surveillance Working Group Mem
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With special thanks to the : • Ad
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Preface Influenza A viruses periodi
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Section One INTRODUCTION
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ii The Canadian Pandemic Influenza
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Given that an influenza pandemic is
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The federal government, through Pub
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Table of Contents 1.0 Epidemiology
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Background 1.0 Epidemiology of Pand
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Based on past pandemics, when the p
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historical relationship between sic
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The Pandemic Influenza Committee wi
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4.0 Terminology On April 8, 2005, t
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4.1.2 Pandemic Alert Period Phase D
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4.1.5 Post-Pandemic Period A recove
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public of the risk from a pandemic,
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Section Three PREPAREDNESS
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2.6 Communications . . . . . . . .
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The changes are now resulting in em
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2.1.1 Current Status The national F
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2.2.1 Current Status The annual inf
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At the time of a pandemic, it is as
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The objectives of the antivirals in
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amantadine, which is not currently
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2.4.2 Planning Principles and Assum
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census, high intensive-care unit ce
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2.5.2 Planning Principles and Assum
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iii) Federal Federal communications
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Section Four RESPONSE
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Other unknown factors (e.g. age dis
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However if no other pandemic activi
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Canadian Phase 1.1 No new virus sub
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6.2 Pandemic Alert Period Canadian
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Canadian Phase 3.1 Sporadic human i
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Canadian Phase 3.1 Sporadic human i
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Canadian Phases 4.0 and 5.0 Cluster
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Canadian Phases 4.0 and 5.0 Cluster
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Canadian Phases 4.1 and 5.1 Sporadi
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Canadian Phases 4.2 and 5.2 Localiz
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6.3 Pandemic Period Canadian Phase
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Canadian Phase 6.0 Outside Canada,
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Canadian Phases 6.1 and 6.2 Pandemi
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Canadian Phases 6.1 and 6.2 Pandemi
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Component Focus Actions Response Le
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Table of Contents Annexes
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Annex A Planning Checklists Date of
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Consider how special studies, ident
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Purchase in bulk and stockpile extr
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Develop a list of essential communi
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B Pandemic Influenza Planning Consi
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Clear protocols for on-reserve FNs
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2. FNIHB Regions 2.1 Develop FNIHB
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5. Centre for Emergency Preparednes
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C Pandemic Influenza Laboratory Pre
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The Pandemic Influenza Laboratory P
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The NML currently performs testing
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and manipulation of viral cultures.
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3. Communication Information such a
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as appropriate, and the provision o
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3. Communication As in Phases 1.0 t
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8. Allow the swab to sit in place f
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Disease Surveillance Liaison Jeanne
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Annex D Recommendations for the Pri
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D Recommendations for the Prioritiz
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1. Priorities for Vaccination Prior
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Group 3: Persons at High Risk of Se
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Annex E Planning Recommendations fo
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3.0 Classes of Antiviral (Anti-Infl
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3.2 M2 Ion Channel Inhibitors (Cycl
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There are ethical obligations to pr
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) Neuraminidase inhibitors can be u
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At a national Influenza Research Pr
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F Infection Control and Occupationa
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helpful when transmission has enter
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Glossary of Terms Antiseptic hand r
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Infectious waste Influenza Intermed
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Statement.......
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Part C: Pandemic Influenza in Non-T
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1.1 World Health Organization Phase
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practices are the infection prevent
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3.0 Occupational Health and Infecti
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health care workers (see glossary f
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(b) (c) (ii) they have been immuniz
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(l) the importance of being immuniz
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5. Inform the public to avoid publi
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Part B. Management of Pandemic Infl
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(d) 3. Masks and eye protection, or
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Note: *Immune are those recovered f
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C. Infection Control Practices 1. U
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(e) Sterilization in Health Care 3
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3.0 Management of Pandemic Influenz
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(d) or using tissues; and the impor
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B. Management of Staff 1. Provide e
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to generate splashes or sprays of b
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(b) (c) washing. Antiseptic hand ri
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(f) Patient Care Equipment (Cleanin
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procedures is imperative to minimiz
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(b) Control of Pandemic Influenza 1
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3. Workers and their household memb
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Planning for Pandemic Influenza 1.
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Part C. Infection Control and Occup
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supplies and soap and towel dispens
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c. Gowns vii. Single-use disposable
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d. Laundry (linen) i. When reusable
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C. Infection Control Practices To p
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3. Environmental Control (Housekeep
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3.2 Control of Pandemic Influenza A
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v. before preparing, handling, serv
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c. Gowns i. Gowns are not required
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3. Disinfection a. Reuseable items
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(equipped with exhaust filter) rath
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. Collection and handling i. There
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3. Waste vi. All caregivers and lau
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Appendix I. Guideline Rating System
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Phase 4: Second or later waves of t
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B. Decontaminating Hands with an Al
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Appendix V. Tables Table A. Cleanin
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Reference List 1. Boyce JM, Pittet
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32. Duchini A, Hendry RM, Redfield
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67. Wade JJ, Desai N, Casewell MW.
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100. Orth B, Frei R, Itin PH, Rinal
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133. Korniewicz DM. Barrier protect
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Annex G Health Services: Clinical C
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Chapter 2. Patient Management I 2.1
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Chapter 6. Special circumstances 6.
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Pathogenesis of influenza The major
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dysfunction and less than 80 pg/mL
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influenza viruses supplant all othe
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maternal age 189 . Only four of the
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developed severe infections, one ch
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1.2.3 Cardiovascular Sudden death o
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High-risk conditions: (Co-morbidity
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Chapter 2. Patient Management I 2.1
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Legend: 1) Triage centres may be lo
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Initial influenza illness assessmen
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Microbiologic Diagnostic tests Micr
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2.2 Pediatric Triage This algorithm
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Initial influenza illness assessmen
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Secondary assessment (15% Platelets
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Clinical assessment for evidence of
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Appendix 2.I. Caring For Your Self
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B. Protect Yourself Against Influen
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C. Plan Ahead Spend a little time t
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Read the label to be sure that the
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D. When A Child Is Unwell Older chi
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Attachments A) How To Take A Child
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Squeeze and hold down the button fo
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C) Self-care Algorithms, Adults Sta
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Does Your Infant or Young Child (Bi
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Does Your Older Child (Age Six Year
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Appendix 2.II. Assessment Forms 1.
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Clinical features on history YES NO
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) Children ≤ 18 years: Identifica
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Symptoms (children 18 years) Date a
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Provisional Diagnosis Please Tick a
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Provisional Diagnosis Please Tick a
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Investigations Complementary labora
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If not admitted: Sent to: Home car
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measurements and minimize false ala
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2. Trans cutaneous PO2 monitoring
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3.2. Assessment and management of l
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3.2.2.1 Symptoms consistent with fl
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c) Specific therapy: Specific thera
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Appendix 3.I. Influenza-Like Illnes
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Chapter 5. Patient Management IV Ho
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5.3.3 General management Fluid the
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Appendix 5.I. Admission form 171 Id
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Symptoms Date and time of onset of
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Investigations (Not all tests will
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Provisional Diagnosis Please tick a
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Appendix 5.II. Rapid Virologic Diag
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Appendix 5.III. Antiviral Drugs for
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susceptible Staphylococcus aureus.
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Table 5.7. Antimicrobials for the t
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Chapter 6. Special circumstances 6.
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3. Education of all medical and non
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Legend for Table 6.1.2 1) This algo
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6.1.5 Management of influenza patie
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6.2 Correctional and penal institut
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Legend for Table 6.2.3 1. A special
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) General management: Specific aspe
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15. Barrett MJ, Hurwitz ES, Schonbe
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50. Duchini A, Viernes ME, Nyberg L
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85. Govaert TM, Dinant GJ, Aretz K,
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119. Kim HW, Brandt CD, Arrobio JO,
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152. NACI August 1, 2001, posting d
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182. Ruff RL, and Secrist D. 1982.
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217. Van Caeseele, Macaulay A, Orr
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Annex H Resource Management Guideli
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3.2.4 Consider Insurance and Licens
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1.0 . . . . . . . . . . . . . . . .
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2.0 . . . . . . . . . . . . . . . .
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Various options to increase bed cap
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addition, provinces and territories
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3.2 Human Resource Management Durin
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technicians (laboratory, radiograph
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Clerical skills in terms of patient
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3.2.5 Immunization of Health Care W
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workers, as well as the public will
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Appendix A Evaluation of Bed Capaci
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Inventory of Beds (Work Sheet) Type
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Emergency Ventilatory Capacity Cons
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Annex I Guidelines for the Manageme
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Steps Requirements Limiting Factors
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In order to deal with the increase
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1.6 Capacity of and Access to Vault
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As a result of these special requir
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Annex J Guidelines for Non-Traditio
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Section 2: Human Resource Issues 2.
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Section 1: Non-Traditional Sites 1.
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timely distribution. The NESS shoul
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most likely the local medical offic
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1.6.4 Assess Locations for Potentia
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Security and Safety The safety of b
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intravenous equipment (e.g., needle
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1.7.4 Coordinate Procurement of Sup
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2.2.1 Appoint a Human Resource Mana
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For each site the essential functio
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FUNCTIONS SKILL SETS/PERSONNEL F Mo
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2.2.5 Plan for Salaries or Payments
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c. Develop job descriptions and ski
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Based on the Checklist of Functions
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Malpractice/Liability Insurance of
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c. Volunteer screening Volunteers i
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Annex K Canadian Pandemic Influenza
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Interpandemic Phase - National Comm
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Health Canada Primary Communication
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Primary Communications Roles Primar
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Pandemic Alert Phase - National Goa
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Health Canada Primary Communication
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L Federal Emergency Preparedness an
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1. The Federal System Traditionally
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National Response Structure Nationa
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2. Public Health Agency of Canada a
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Public Health Agency of Canada, Hea
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Technical Response Group Structure:
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M Public Health Measures Table of C
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1.0 Introduction As an influenza pa
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Individuals who recover from illnes
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In March 2004, WHO hosted an intern
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5.1 Recommendations Encourage all
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As previously noted, antiviral trea
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Except when visiting a health care
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aseline data on these indicators sh
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Recommendations for Management of C
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The availability of antiviral drugs
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7.1 Strengthen recommendations to s
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7.3 Restrict indoor public gatherin
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7.5 Implement hand-sanitizing stati
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7.7 Other Measures NOT Recommended
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Increase awareness of the “travel
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initially at Customs, and within 4
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Contact management logistics Althou
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References 1. Department of Communi
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A.2 Community-Based Disease Control
Page 559 and 560: N Pandemic Influenza Surveillance G
Page 561 and 562: Introduction The overall goals of i
Page 563 and 564: Special Studies Protocols for speci
Page 565 and 566: Surveillance Objectives/Roles and R
Page 567 and 568: Pandemic Alert Period Table 2, belo
Page 569 and 570: Surveillance Objectives/Roles and R
Page 571 and 572: Canadian Pandemic Phase 4.1 Single
Page 583 and 584: Table 4: Post-Pandemic Period Canad
Page 585 and 586: Study design Two types of surveys c
Page 587 and 588: Table 2 Sample size of each group (
Page 589 and 590: Household data How many total indiv
Page 591 and 592: Poultry and Other Animal Exposures
Page 593 and 594: Collected environmental swabs from
Page 595 and 596: Appendix 2: National FluWatch Influ
Page 597: Glossary of Terms and List of Acron
Page 600 and 601: Bed (Institutional Bed) Case weight
Page 602 and 603: Health Care Worker (HCW) without cl
Page 604 and 605: LICO (Low income cutoff point) LPN
Page 606 and 607: Pandemic Pandemic Alert Period Pand
Page 608 and 609: R Raw data Measurements and observa
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The Canadian Pandemic Influenza Plan for the Health Sector

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