Avian Flu:  The Next Pandemic

Penn State Hazleton Students investigate the avian flu.

You can download the PDF file here.

The student essays that follow were produced in November and December 2006 for Jim Manis’s English 015, Rhetoric and Composition, course, a freshman writing course that is a required course for college underclassmen at The Pennsylvania State University. They were selected from two different sections of the course.

These essays were produced in response to the fourth assignment for the course. The students were require to read Tim Appenzeller’s National Geographic article, “Tracking the Next Killer Flu,” from the October 2005 edition of the magazine. Dwayne Hilton, Director of Student Affairs, came to one section of the course and delivered a presentation on the topic; Allen Sabatino, Coordinator of Health Services, delivered a presentation on the topic to the second section. Students were required to find at least one additional source, for a total of three secondary sources at a minimum for the assignment.

The students were told that they should consider themselves “staff writers” for a hypothetical student publication on the topic. They need not be exhaustive in their approach, but each should consider him-/herself as producing an article on the topic for the publication.

The instructor has decided to publish the following essays produced for the assignment, in part in response to sources outside of the university who have expressed an interest in the opportunity to see examples of the kind of writing that freshmen produce within the university.

The essays are published here in both HTML format and as a PDF publication. Readers should keep in mind that the copyright belongs to the writers and the written work cannot be reprinted or otherwise reproduced without the express written permission of the authors.



Influenza:  What to Do When the Winter Months Set In




Stephanie Selleck


“Mommy, I do not feel very well,” a child cried out in the night. As his mother rushed to his bedside, she immediately pressed the back of her hand to his forehead. She knew in an instant that something was wrong when his flesh felt as though it were on fire. Without a moment’s hesitation, she flew to the phone and dialed the local hospital’s number. As soon as she heard a voice on the other end of the line, the young mother began to cry. “My son is sick. I do not know what to do.”


            The receptionist responded calmly. “Just relax. Take a deep breath and clam down. Does he have a fever?” (Roche Laboratories 1).


            “Yes, his skin feels as though it is on fire. He is burning up,” the mother cried.


            “Is he extremely tired?” the nurse continued (Roche Laboratories 1).


            “He did not wake up all day. I think the first time he opened his eyes, for more than a few minutes, in the last twenty-four hours was about an hour ago. I just thought that he needed the rest, but each time I tried to wake him, he simply rolled back over and went to sleep. I am becoming really worried.”


            “Okay, so he has a fever and is excessively tired. Is your son suffering from severe chills?” the nurse then asked (Roche Laboratories 1).


            “Well,” the mother thought for a moment, “he can’t seem to get warm. I have piled numerous blankets on him, but he still cries that he is cold. I then tried wrapping him in an electrical blanket and turned it on high, in addition to the mountain of covers. However, he can’t seem to stop shivering.”


            By this time, the mother was wailing hysterically. “What am I to do?”


            The receptionist took another deep breath, “Ma’am, I need you to calm down. Now, can you tell me about his cough? Is it dry and raspy? And is he sick to his stomach? Is he vomiting, suffering from nausea, or diarrhea?” (Roche Laboratories 1).


            The young woman took a deep breath in an attempt to compose herself. “He has been throwing up for the past hour. I just thought that maybe he had a bug from school, but I am not so sure now. He has had a cough for the past few weeks, but it sounds different now.”


            “It sounds dry and raspy?” the nurse pressed.


            “Yes, I think so.”


            “Okay, it sounds as though he has the flu. Those were all symptoms of the virus. The doctor will be right out to explain what must be done and how he probably became infected.”


*     *     *


Influenza is a virus that is common during the winter months. More commonly known as the flu, this illness is “a contagious respiratory illness caused by viruses” (“Influenza: Influenza Most Deadly for the Very Old, AHRQ Report Finds” 1). Studies have shown that in one year, 20 percent of the population will contract the flu. This is largely due to the fact that it is during this particular season that people spend a majority of their time inside, therefore increasing their risk of catching the virus. “The flu virus is usually spread through droplets that are in the air as a result of coughing, sneezing, and talking. However, you can be infected by touching objects such as a door handle that someone with the flu has touched” (“Influenza” 2). Probably the easiest way to protect one’s self from becoming contaminated with this illness is to remain at home. The less often one is exposed to the bacteria that causes this, the less likely one will catch it. Also, when one is forced to become exposed to the illness, the best thing to do is remember to constantly was one’s hands (“Influenza” 2). When we are not at a location which has immediate access to a sink, we should be sure to keep our hands away from our noses and mouths. This will cause the bacteria to remain on our skin until the can be exterminated.


            Yet another possible way to make an attempt to prevent the nuisance of influenza is to receive a flu shot. This causes the body to “make substances called antibodies, which help protect against viruses” (“Influenza” 2). It is recommended for a small group of individuals to make sure they receive the shot each year, including people over the age of 50, those who live in nursing homes, health care professionals, and people who have chronic lung disease, heart or kidney disease, diabetes, severe anemia, or cancer (“Influenza” 2). Each year new strands of the virus are discovered; therefore, it is necessary for this particular group of individuals to make sure they receive the vaccine annually. Because it takes around two weeks for the vaccine to take affect, it is recommended that people who wish to receive it make sure they have it between October 15 and November 15 (“Influenza” 2). This way, the chemicals in the medication have a chance to make their way throughout the entire immune system before flu season begins. This will greatly reduce the risk of becoming infected with the virus. Although this vaccine is necessary to build the body’s immune system so that it fights against the invader, a small percentage of people do have mild side effects to the medication. One in four people will experience redness and swelling in the area where the shot was injected (“Influenza” 2). A small number will also have a fever, chills, a headache, and body aches for a few days (“Influenza” 2). Although this form of prevention has proven to be extremely effective, there is a small group of individuals who must be extremely cautious when deciding to receive the vaccine. These are people who are allergic to eggs. What most people fail to realize is that the vaccine virus is grown in eggs, which cannot be completely eliminated from the shot (“Influenza” 2). Consequently, anyone with this allergy should consult with a doctor before receiving the shot.


            For most people, influenza is harmless. They catch it, wait it out, and then go about their daily lives. However, what most people fail to realize is that this illness can be fatal, depending on the person who catches it. Between 5 and 20 percent of the United States population typically becomes infected with the virus, and more than 36,000 individuals die from it each year (“Influenza: Influenza Most Deadly for the Very Old, AHRQ Report Finds” 1). In 2004, of the 21,000 people hospitalized for influenza, most were elderly patients. For every 100,000 people admitted, 28 were over the age of 65 (“Influenza: Influenza Most Deadly for the Very Old, AHRQ Report Finds” 1). Once calculated, this rate is figured to be over three times higher than the rate for children. Eight in every 100,000 patients are under the age of eighteen. The final age group hospitalized included people between the ages of eighteen and sixty-five. Two to four of the population of 100,000 was included in this age range (“Influenza: Influenza Most Deadly for the Very Old, AHRQ Report Finds” 1).


*     *     *


After several minutes, the doctor finished his call with the upset mother and her child. With great difficulty, he managed to calm her down to a point where he could explain the situation to her. He said that her son did indeed have the flu. He then continued to clarify that he had more than likely managed to pick the virus up from school, where everyone remained inside. In the past month, he had seen numerous cases that were almost identical to this particular one in the school environment. It did not matter how much the teachers emphasized the importance of washing their hands often; the children continued to cough without covering their mouths to capture the germs and to sneeze all over the toys that they were playing with. This caused the virus to spread rapidly. There is not really any way that parents can be positive that their child is not going to pick something up in their learning environment. The only thing that they can do is to keep their child at home throughout the season. However, this would still not ensure that the child would not catch the virus when he or she went into the public.


            “I know that most children are probably not fond of needles. However, the main way to prevent a child from becoming infected once again after he is cured is to make sure he receives a flu shot,” the doctor instructed. “This will allow his immune system to build a resistance against the particular strand of the virus that is sweeping the country that particular year. However, he cannot be allergic to eggs if he is to receive the shot because the virus is grown inside of them and they cannot be completely eliminated from the vaccine.”


            As the mother hung up the phone, she could still hear the soft cry of her son in the room next to her. “Mommy, I still do not feel very well.”


Works Cited


“Influenza:  Influenza Most Deadly for the Very Old, AHRQ Report Finds.” Respiratory Therapeutics Week. 4 Dec 2006:  ProQuest. Pennsylvania State University Library, Hazleton, PA 4 Dec 2006:  15-16 <http://proquest.umi.com/pqdweb?index=8&did=11696306691&SrchMode=1&sid=4&Fmt=3&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1165300584&clientId=9874>.


“Influenza.” Postgraduate Medicine. Nov 2003: ProQuest. Pennsylvania State University Library, Hazleton, PA 4 Dec 2006:  77-81. <http://proquest.umi.com/pqdweb?index=8&did=474448681&SrchMode=1&sid=3&Fmt=3&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1165293478&clientId=9874>.


Roche Laboratories. Flu Symptoms. 2006. Roche Laboratories Inc. 27 Nov 206 <http://www.flufacts.com/symptoms/default.aspx>.


The Flu:  Not Just the Common Cold




David Hartranft


When most people think of the flu, they think about having a fever and not feeling well for a couple of days. Most people feel that the flu is not a threat, and they do not worry too much about it every year. Most people seem to think that the flu can only kill the elderly or extremely young. What most people do not know is the severity of the flu. In fact, the flu changes every year, so nobody is ever fully immune.


            The influenza virus is transmitted from one person to the other through tiny droplets. The flu is spread so quickly and easily that sixty million Americans catch the flu every single year (Appenzeller 2). The flu kills more victims than one may assume. As stated by Appenzeller, “The influenza virus kills over 35,000 people every year” (2). This may come as a shock to most, who feel the flu is just a nuisance disease. This is why a new vaccine is created every year, to save as many victims as possible.


            There are different specific types of flu viruses in the world. One particularly deadly strand of the flu is known as the avian flu. This is also referred to as the bird flu. The bird flu has been around for thousands of years. It was first spotted in Asia and Africa (DeSeve 1). This avian flu virus usually targets birds and tends to kill them within a few hours of exposure to the virus. Avian flu has also affected humans. It is shocking to state that half of the time, the avian flu kills the infected humans (Appenzeller 2).


            The human body can usually survive the normal flu every year because it has seen something similar to it the previous year (Appenzeller 3). Even though the flu is always changing, the body can remember what it has to do to fight the virus, and the immune system usually wins. The problem when humans contract different forms of the flu, such as the avian flu, is that the body has never seen a flu of that type. The body does not know how to respond, which may result in death.


            Another very deadly type of flu developed in 1918. Known as the Spanish flu because of the eight million people who died in Spain in the month of May alone (Billings 3). When United States troupes returned from fighting in World War I, they brought the flu with them. The flu came into country through Boston, which was an important war shipment port at the time. Twenty-eight percent of Americans contracted the Spanish Flu. By the time the flu dissipated, it took the lives of 675,000 Americans. In fact, the effects of the Spanish flu were so severe that the average American life span was decreased by ten years (Billings 2). This flu ended the victims’ lives by drowning them. As Molly Billings notes, “The influenza patients died struggling to clear their airways of a blood froth that would fill up the lungs of those infected” (2). The Spanish flu killed somewhere between twenty and forty million people world wide (Billings 1). As Billings states, “More people died of influenza in a single year than in four years of the Bubonic Plague” (1). Because so many people had the Spanish flu, even those who were healthy were constantly at risk of being infected. Even President Woodrow Wilson suffered from the flu in early 1919. Fear of increased death caused public health departments to distribute gauze masks that were to be worn in public. Despite the futile attempts to stop the spread of this flu; bodies started to pile up. As Billings states, “There were not enough coffins, morticians, and gravediggers to properly take care of the vast number of bodies” (4). This Spanish flu finally ended in 1919 as scientific and medical personnel developed new theories which aided in the discovery of prevention and treatment of the patients.


            Currently, there are foreseeable problems in the future that many worry about. It is predicted that if a human flu and avian flu infect an animal at the same time, a new type of flu may develop. The forms of flu would have what is the equivalent of sex, create a new flu, and a big problem. This new flu would be able to easily pass from human to human, and also have the deadly effects of the avian flu (Appenzeller 3). There were a total of two million human deaths in those years. The odds of this very thing happening are not too encouraging either. As Lowes states, “Six out of ten physicians think it is somewhat likely that the avian flu virus will mutate and achieve human-to-human transmission within the next five years” (1).


            The government’s worst case scenario for the spread of flu is as follows:  The avian flu mutates and earns human-to-human transmission. Thirty percent of the American population would be infected. This would result in two million Americans dying. Then because of all the dead and sickly Americans, there would not be enough people to run critical infrastructures. These include power plants, hospitals, schools, and even banks (Lowes 1).


            It seems that mankind’s survival is dependent on whether or not the avian flu virus starts spreading from human to human. Some may fear that avian flu could possibly change the world as we know it. I, on the other hand, feel that the world is not in any grave danger. I do not believe that we humans are doomed. I feel that the Bubonic Plague and even the Spanish flu were much more deadly than the avian flu will ever become. As Thompson states, the avian flu may never even become a threat:


Last week, Glaxo Smith reported that it had achieved good results on an experimental human vaccine for [avian flu, and a mass production could be available next year. These clinical trial results represent a significant breakthrough in the development of our pandemic flu vaccine.

(Thompson 1)


As previously stated, most physicians feel that if the avian flu would ever gain human-to-human transmission capabilities it would happen sometime within the next five years. What Thompson is saying is that it is even more likely that we develop and mass produce a vaccine for avian flu sometime within the next year. This means that the odds of us humans being struck with the feared avian flu virus, and not being prepared for it, are very slim. In fact, the vaccine is still in the developmental process and its success rate is already over eighty percent (Thompson 1). What is even more encouraging is the fact that drug maker GlaxoSmithKline is close to creating an avian flu vaccine, which means many other drug companies are trying to create avian flu vaccines just to stay competitive.


            It is certainly good to know about the possible dangers of avian flu, but we should not worry too much about it either. I realize that in the past flu has had devastating effects, which I assume many people still fear. When the Spanish flu finally ended, I think that it left behind more than just dead bodies. I feel that once people have experienced something as catastrophic as Spanish flu they learn from it. If a vaccine is never created and avian flu does break out, I believe that we will be somewhat prepared. We would remember what was done to save people during the Spanish flu and do the same thing. I truly believe that there is a very good chance that avian flu will never become a pandemic. I believe that a vaccine is going to be created and mass produced if needed. I also feel that there is no sense of fearing something that will probably never happen.


Works Cited


Appenzeller, Tim. “Tracking the Next Killer Flu.” ProQuest 208 (2005) 8pp. 20 Nov 06 <http://proquest.umi.com/pqdling?did=924540921&Fmt=3&clientld=9874&RQT=309&VName=PQD> October 2005.


Billings, Molly. “The Influenza Pandemic of 1918.” <http://virus.stanfford.edu/uda/> February 2006 (27 Nov 06).


DeSeve, Karen. “Fly away, Flu.” ProQuest 30 (2006): 2pp. November 2006 <http://proquest.umi.com/thx.i?kje+at3iomczn5749372947=324&9> December 2005.


Thompson, Ericka. “Bird Flu Vaccine May Be Ready Next Year.” ProQuest 111 (2006):  2pp. August 2006 <http://proquest.umi.com/pqw?index=4&20398SrchMode8> (2 Dec 06).


Lowes, Robert. “Avian Flu:  Is your practice ready?” ProQuest 83 (2006): 1p. July 2006 <http://proquest.umi.com/pqdweb?index=5&did=98203990=23049> (2Dec 06).


A Lesson Learned:  The 1918 Flu Pandemic




Ryan Halloran


The 1918 flu would prove to be one of our strongest teachers in our quest to learn how to fight future pandemics. Unfortunately, it taught us our lesson by killing off fifty million people around the world (“Unmasking the 1918 Influenza Virus” 1). In 1918, the First World War was ending, but an even larger problem was emerging (Billings 1). The soldiers had suffered through horrible conditions in the trenches and were ready to go home. “Then, in pockets across the globe, something erupted that seemed as benign as the common cold. The influenza of that season, however, was far more than a cold” (Billings 1). This flu was much different than the ones that people were used to. It infected on-fifth of the population and most of the people killed were between the ages of twenty and forty (Billings 1).


            Half of the American soldiers who died during the war in Europe died of the flu and not from enemy soldiers (Billings 1). “An estimated 675,000 Americans died of influenza during the pandemic, ten times as many as in the world war” (Billings 1). The end of the war was supposed to be a joyful time, but the flu made it unforgettably depressing:


[Nineteen hundred and eighteen] has gone; a year momentous as the termination of the most cruel war in the annals of the human race; a year which marked, the end at least for a time, of man’s destruction of man; unfortunately a year in which developed a most fatal infectious disease causing the death of hundreds of thousands of human beings. Medical science for four and one-half years devoted itself to putting men on the firing line and keeping them there. Now it must turn with its whole might to combating the greatest enemy of all—infectious disease.

(Qtd. Billings 1)


Physicians focused on trying to find a way to fight the pandemic, but it seemed hopeless. “The death rate for 15- to 34-year-olds of influenza and pneumonia were 20 times higher in 1918 than in previous years (Qtd. Billings 1). This flu was unlike all the other diseases that had come before it.


            In the United States there were so many people dying that funerals had time restrictions; there were coffin shortages; and the dead just piled up in the streets (Billings 1). We simply did not have enough medical supplies or health care workers to handle an outbreak of this magnitude. Molly Billings states, “The conditions in 1918 were not so far removed from the Black Death in the era of the bubonic plague of the Middle Ages” (1). In reality, the flu pandemic ended up causing even more deaths around the world than the plague had. One third of the world was infected because there was nothing we could do to stop the influenza from spreading (“Unmasking the 1918 Influenza Virus” 1).


            The large number of people traveling, the horrible living conditions, and the deaths involved in World War I were main reasons for the influenza spreading so quickly. “Outbreaks swept through North America, Europe, Asia, Africa, Brazil and the South Pacific” (Qtd. Billings 1). The pandemic, left unchecked, lasted through 19118 and 1919, ravaging the world’s population and killing more people than all the wars before it.


            Today, there are only theories about the origin of the influenza pandemic (Billings 1). “It is thought to have originated in China in a rare genetic shift of the influenza virus” (Billings 1). Many people believed that it started in Spain since it has also been called the Spanish Flu (Billings 1). “The name of Spanish Flue came from the early affliction and large mortalities in Spain (BMJ, 10/19/1918) where it allegedly killed 8 million in May (BMJ, 7/13/1918)” (Billings 1). What is not widely known is that the flu was in the United States before that (Billings 1). There were small epidemics in military camps around the U. S., but there was almost no response to it because of the ongoing war (Billings 1).


            During the war, the flu was an enemy to both sides. “Just as the war had affected the course of influenza, influenza affected war” (Billings 1). Some were so sick that they could barely fight. “The flu was devastating to both sides, killing more men than their own weapons could” (Billings 1). Unfortunately, it would only grow worse when the fighting finally stopped.


            When the war ended, the soldiers from all over the world came home in the fall of 1918 and brought the flu back with them (Billings 1). “The flu that winter was beyond imagination as millions were infected and thousands died” (Billings 1). With all the wounded soldiers filling up the hospitals, the sick had nowhere to go. As a result of this, there was also an extreme shortage of doctors and nurses. “Since the medical practitioners were away with the troops, only the medical students were left to care for the sick” (Billings 1). The few medical professionals available along with medical students and Red Cross volunteers treated the sick (Billings 1). Unfortunately, there were just too many people infected, and they could not all be helped.


            Now this horrible virus has been brought back to life. “The recreation of the virus, which was driven by an urge to unravel why the 1918 pandemic was so devastating, has raised as many fears as it has hopes” (Sample 1). If the virus were to escape the confines of the U. S. government’s Centers for Disease Control and Prevention we may all be in grave danger (Sample 1). Researchers are studying it to try to find out how this flu came into being, which genes cause symptoms, and how to disarm it (Sample 1). They hope that by doing all this they will be able to prevent or at least prepare for the next flu pandemic.


            The virus is listed as “a select agent” and is being held at an extreme level of security. “It is held in a biosafety level 3 enhanced laboratory, kept at a negative pressure to prevent air escaping” (Sample 1). The scientists, who work in the lab, have to go through a number of security measures. “Workers must wear protective clothing, [use a] breathing apparatus and gain entry via fingerprint and retina scans” (Sample 1). Even with this extremely high security, there is always a minuscule risk that the virus could escape. The average person may wonder if it is really worth the risk.


            The scientists know that the chance to study the deadly flu virus of 1918 has made all their hard work worthwhile. “Scientists collected fragments of the virus from lung tissue taken from victims at the time and preserved them in formalin or, in one case, isolated from the lungs of a woman victim whose body had later become frozen in the Alaskan permafrost” (Sample 1). Then they had to reconstruct the entire genetic code of the virus using these fragments (Sample 1). The scientists tested the newly revived flu virus using mice. “All the mice infected died within a few days; all infected with contemporary strains recovered” (Sample 1). Even the scientists were shocked at how lethal their creation had become.


            The researchers tested each of the eight genes separately to see which ones made it so deadly (Sample 1). “The discovered that rather than being caused by one or two genes, they all played a part, which suggest that the virus had completely adapted to cause disease in humans, something they say could happen again with avian flu strains” (Sample 1). This was a very disturbing discovery, but unfortunately, it would not be the worst report from the scientists. That dreaded report came after they had “analyzed the genetic make-up of the recreated virus” (Sample 1). It had no similarities to any human flu viruses that they had available (Sample 1). This means that the current bird flu could become a pandemic simply by evolving as the 1918 flu had.


            Now the scientists are trying to find out the ways in which the 1918 flu mutated so that they can look for those mutations in current flu strains (Sample 1). It does not seem as if there is really anyway to stop an impending pandemic, but if we know it is coming we can be ready. We, the people, cannot forget about the events of 1918 or pretend it never happened. This is the kind of ignorance that helped it spread and become the most deadly pandemic in human history. Now we are actually learning from our mistakes by using the virus itself to find out how a small flu strain could evolve into a pandemic. The people of this planet will not be caught unprepared, as we were in 1918. When the next pandemic comes, we will be ready.


Works Cited


Billings, Molly. 1918 Flu Pandemic. June 1997, modified February 2005. 26 Nov 06. <http://www.1918flupandemic.net>.


Sample, Ian. “From frozen Alaska to the lab:  a virus 39,000 times more virulent than flu.” The Guardian. 6 October 2005. <http://www.guardian.co.uk/science/story/0,3605,1585976,00.html> 29 Nov 06.


“Unmasking the 1918 Influenza Virus:  An Important Step Toward Pandemic Influenza Preparedness.” National Institute of Allergy and Infectious Disease. 5 Oct 05 <http://www3.niaid.nih.gov/news/newsreleases/2005/0510state.htm> 26 Nov 06.


Pandemics:  Will History Repeat  Itself?




Anthony Luzzi


Throughout history there has been war, famine, and brutality, but none of these compare to the hardships encountered with disease. Since medieval times, there have been accounts of catastrophic plagues, such as the Bubonic or Black Death plagues. None, however, compare to the influenza pandemic of 1918, also known as the Spanish Flu.


            During the closing stages of World War I and the following year, the world was hit with a pandemic, a disease prevalent throughout an entire country, continent, or the whole world. Despite all the lives lost in the “Great War,” almost three times as many, forty million, people lost their lives to this world wide virus (Billings 1). La Grippe, better known as the Spanish Flu, affected a fifth of the world’s population in just two years. This was particularly unusual because the age range of the people most affected was between twenty and forty, the ages when people as a rule have the strongest immune system. In the United States, nearly 675,000 people died (Billings 1).


            In 1918 the age expectancy was still low because of the lack of medical technology, but after World War I and La Grippe, it decreased by an additional ten years. During this dark time, the “plague” swept throughout all of North America, Europe, Asia, Africa, parts of South America, and the Asian Islands. The course of this pandemic was due to human carriers along trade routes, shipping lines, and travelers coming back home from the war. In India the mortality rate was so high that for every one thousand people fifty died from influenza (Billings 2).


            Ironically, this pandemic, with its curious name of “The Spanish Flu” did not start in Spain. Traditionally, influenza outbreaks are known by their place or origin, like the Asian flu of the 1950s and the Hong Kong flu of the late 1960s; however, experts named the 1918 flu after Spain because the first serious cases were reported from there, allegedly killing eight million people (Billings 3). This virus became so interminable that even the U. S. president caught it. President Wilson, while trying to negotiate the treaty of Versailles, suffered from the flu in 1919 (Billings 4). It was reported that children would make up little rhymes about the flu. One example of this occurred when young girls jumped rope to


I had a little bird

Its name was Enza

I opened the window

And in flew



“Influenza.” (Billings 2)


In recent years the world has faced the threat of a new pandemic, the Avian Flu. This flu has been found in Southeast Asia, Cambodia, and Laos, and is threatening to spread to the United States. If we are not careful and take every precaution necessary, America could be the next “victim.”


            Known as “The Avian Flu,” this form of influenza derives its name from the fact that it is transmitted through birds. Even birds that are not sick with the flu can still be carriers and transmit the disease. The affected birds carry the disease along migration paths, potentially spreading the disease world wide; however, at the time of this writing, only one infected bird has been discovered in the United States, in California, the likely place for any outbreak in the U. S. to first occur (Hilton).


            To date, the main victims of this flu have been poultry. More than one hundred million chickens have been killed or have been wounded due to this “virus” (Appenzeller 2). In Hong Kong government officials decided the way to control one outbreak was to kill all of the chickens in the city. They killed half a million chickens, hitting the economy hard, because it is the mainland’s biggest importer of chickens and other poultry items (Appenzeller 5).


            In Vietnam, farmers lost forty million birds and that put them in bankruptcy and out of work (Appenzeller 6). After doing some climate tests scientists found that cooler climates are where the virus best spreads and survives. Also if the disease is dormant, it will “come out of hiding” in these nicer temperatures (Appenzeller 8). Recently researchers found that Tamiflu helps protect us against the Amain Flu. In response to these efforts, nations have been preparing for pandemics and have been stockpiling Tamiflu. The U. K. and France bought enough “vaccines” to save fifteen million of their people. Also he U. S. has bought a hefty amount, but not as much as the U. K. or France.


            The company that makes Tamiflu, Roche, is located in Nutley, N. J. (Appenseller 9). On another positive note, the Avian Flu can only be transmitted to humans by other animals, rather than birds. The most logical way a human can become infected is for a pig to engage it from a duck (at the same farm), and then the pig transfers it to the farmer. This will create a hybrid that will be able to affect humans while still carrying the infected bird gene (Appenzeller 4).


            The Spanish and Avian Flues are both extremely fatal. The two epidemics from the twentieth and twenty-first centuries are almost identical. For example they are both airborne viruses. This means that the disease could only be transmitted through coughing by one person, then another person breathing in the “contaminated air” (Hitlton). Another similarity that these illnesses share is the way they affect the body. In both the Spanish Flu and the Avian Flu, the first symptoms are those of pneumonia. Next the victim will not be able to breathe and will suffocate. In the late stages before death, blood will trickle from the nose and/or mouth (Billings 2). In several reported cases, doctors found the Avian Flu attacks the ribcage. A whitish cloud appeared to form around the ribcage on film taken by doctors in Vietnam, indicating fluid build up in parts of the patient’s lungs. Four days later, after the eighteen-year-old female patient died, film revealed that the white cloud spread throughout her chest and her lung tissue had been destroyed (Appenzeller 4).


            These are the same symptoms of La Grippe during the 1918-19 pandemic. If the symptoms of the Avian Flu are almost identical to the Spanish Flu, who is to say that the drastic number of lives taken almost 100 years ago will not occur again in the near future? We have to take even the slightest threats and warnings seriously and evaluate them, in hope of preventing another dark time in history.


Works Cited


Appenzeller, Tim. “Tracking the Nest Killer Flu.” ProQuest 208 (2005): 8pp. 20 Oct 05 <http://www7.nationalgeographic.com/ngm/0510/feature1/> 9 Nov 06.


Billings, Molly. “The Influenza Pandemic of 1918.” June 1997 <http://virus.stanford.edu.eda/> 11 Nov 06.


Hilton, Dwayne. Evergency Preparedness Lecture.” PSU-Hazleton 14 Nov 06.


Society’s Worst Fear




Christine O’Brien


Who knew that a Nintendo game could provide valuable life lessons? In the video game, Dr. Mario, the objective is to try to come up with the perfect remedy to eliminate those little viruses. Could these simple creatures cause society’s worst fear? A sever case of the sniffles. Sure, it may sound harmless, but is the flu just a simple cough? Seasonal flu has proven itself to be a reoccurring burden on our society. Of course there is always the option of receiving a yearly flu shot. Unfortunately, the RNA genes inside of flu cells are constantly transforming, making it almost ridiculous to be inoculated every single year. Is it ever considered what will happen though, if the flu drastically mutates and becomes a pandemic? Rarely, but within the last century there are few cases where the flu has become so extreme that it has been spread worldwide and has claimed the lives of thousands (Appenzeller).


            There are three potential varieties of influenza (Sabatino). The first and least dangerous strain is Type “C” (Sabatino). Type “C” is quite uncommon, but when the infection does arise, the victims only suffer from a short term, mild illness (Sabatino). Type “B” influenza is a moderate case of the flu (Sabatino). This form can only appear in humans and can cause an epidemic but never a pandemic (Sabatino). In the worst-case scenario Type “A” influenza may turn into an outbreak (Sabatino). It is the most serious type of the flu that may be caught (Sabatino). Type “A” is not only a high concern for scientists, but also for farmers, doctors, and anyone who is a member of the economy (Sabatino).


            Type “A” influenza is often referred to as the avian flu virus or bird flu. What makes this type of flu so treacherous is that it has the ability to jump species (Sabatino). The avian flu originates in the systems of many birds but becomes most feared when migratory birds carry the virus (Sabatino). Being highly pathogenic, the avian flu is often transported to pigs (Appenzeller). The skin of a pig is susceptible to both the human flu and the bird flu (Appenzeller). The conjuring of these two influenzas generates a new “code” to the flu (Sabatino). Over one hundred varieties of the avian flu exist or can exist (Sabatino).


            Since the avian flu is exceedingly contagious, various attempts to end its existence have been performed (Appenzeller). Unfortuantely, the many efforts remain unsuccessful (Appenzeller). Perhaps the most popular procedure to end the avian flu was the culling of every last chicken, duck, and migratory bird in the effected vicinity (Appenzeller). Today we realize this method is unproductive. Scientists remain baffled by the avian flu’s no mercy rule.


            In normal flu circumstances, the patient often feels tired, congested, and irritable (Sabatino). When the avian bird flu hits home, the victim suffers with a fever, piercing headaches, and severe joint pain (Appenzeller). The average victim of the avian flu virus often has a week or less to survive (Appenzeller). Many cases of the bird flu have been explored trying to exploit a loophole for a cure; unfortunately, nothing has been found (Sabatino).


            In 1918 American soldiers contracted the Spanish Flu (Appenzeller). Nurses noticed many of the soldiers suffocated (Appenzeller). When doctors and scientists cut open and explored the chests of the deceased, they found that the lungs were not light and elastic, but the tissue was heavy and clogged with large amounts of blood (Apenzeller). Later that year, in October, twelve thousand people alone died of the bird flu, as many as 759 in one day (Appenzeller).


            In 1968, the year of the Hong Kong flu, an eighteen-year-old woman was examined, who showed signs of the deadly flu (Appenzeller). She was admitted to the nearest hospital, and doctors kept a close watch on her symptoms, keeping rigorous records of x-rays (Appenzeller). As time continued, the x-rays showed a whitish haze developing at the base of the young woman’s ribcage (Appenzeller). In just a four short days it was reported that the flu had completely demolished her lung tissue (Appenzeller). She only survived a week of excruciating pain with the avian flu (Appenzeller).


            Because there is such a vast number of flu “codes,” the disease is difficult to cure, let alone ease the suffering. The rarity of the avian flu outbreaks also makes it complicated to predict just what the next pandemic will bring to civilization (Sabatino). For now, society at least has the comfort of knowing that taking simple measures can prevent the seasonal flu. Vaccine for the seasonal flu is available for all ages but is more commonly directed towards infants and the elderly (Sabatino). Procedures that may be practiced everyday by the concerned are frequent hand washing, using tissues, and having regular doctor’s check-ups (Sabatino).


            Based on history alone, some may feel that the harsh reality of another avian flu pandemic is just out of reach. Just three years ago, in 2003 and again in 2004, the H5N1 virus broke out in much of Vietnam, proving that the virus is just not willing to give up (Appenzeller). Although that case did not turn into a pandemic, it is still dealt with in a way just as serious (Appenzeller). Based on the knowledge of scientists, another harsh pandemic of the avian flu is waiting to attack again (Sabatino).


            Because the possibility of a pandemic is always at hand, the economy is forced to create procedures. In November of 2005, the government spent 7.1 billion dollars on emergency funding (“Pandemic Flu: Preparing and Protecting Against Avian Influenza”). Schools, offices, and state officials were forced to create bird flu plans of their own (“Pandemic Flu: Preparing and Protecting Against Avian Influenza”). If the avian influenza just happens to break out again, a variety of problems will follow; morgues will be overcrowded, hospitals will be filled, and the dead will pile up like leaves (Sabatino).


            If the avian flu has never been taken seriously before, it must be taken seriously in the future. The lives, the economy, and the welfare of our society depend on the possibility of a pandemic. Civilization as a whole could come to an end if proper precautions are not in place. No one knows what will happen with certainty until an outbreak actually occurs. It is better to be prepared than to remain ignorant of this potential problem.



Works Cited


Appenzeller, Tim. “Tracking the Next Killer Flu.” National Geographic October 2005 <http://www7.nationalgeographic.com/ngm/0510/feature1/index.html> 14 Nov 06.


“Pandemic Flu: Preparing and Protecting Against Avian Influenza.” The White House 2006 The White House. 4 Dec 06 <http://www.whitehouse.gov/infocus/pandemicflu>.


Sabatino, Allen, CRNP. “Influenza A.” Classroom Lecture 14 Nov 06.

Sequel to the Spanish Flu




Yaling Yang


The research on Avian influenza viruses has greatly expanded since the 1918 pandemic. Many Americans are familiar with the flu but do not understand its severity. During the 1918-19 pandemic, the subtype H1N1 influenza took the lives of approximately 21 million people. The deaths caused by the 1918 pandemic are greater than the total deaths from World War I or any other disease outbreaks in history (Barry). Researchers are expecting a pandemic outbreak this year by the new subtype H5N1 and are convinced that this pandemic will have a similar death toll, percentage wise, as the 1918 pandemic (Sabatino). The next “wave” is expected to arrive this flu season. The importance of studying the avian influenza viruses is to better prepare mankind against the future pandemic(s).


            To have a better understanding of what mankind is fighting, we must study and learn from our past. Throughout the history of epidemics, the 1918 pandemic, commonly known as the “Spanish flu,” is by far the most devastating. According to Barry, the Spanish flu is


considered one of the deadliest diseases in human history. The death toll for the Spanish flu is recorded as 21 million deaths, but research shows greater numbers:


Epidemiologists and scientists have revised that figure several times since then. Each and every revision has been upward. Frank Macfarlane Burnet, who won his Nobel Prize for immunology but who spent most of his life studying influenza, estimated the death toll as probably 50 million, and possibly as high as 100 million.


Even the two milder pandemics, Asian influenza and the Hong Kong influenza, of the twentieth century killed an estimated two million in 1957 and one million in 1968 (“Ten things you need to know about pandemic influenza”). People are ignorant of how severe the flu really is. “The 1918 influenza pandemic killed more people in 24 weeks than AIDS has killed in the 24 years that disease has been know” (Barry). Ironically, people are more concerned and focused on AIDS than the deadly influenza viruses. Although AIDS does not presently have a cure, it is still less dangerous than the flu because it can be prevented by simply avoiding bodily fluid contact. On the other hand, the flu is highly contagious and even a simple sneeze can transmit the deadly flu virus and stealthily bring the world into a devastating pandemic.


            In 1997, a new strain of influenza virus was discovered in Hong Kong and is suspected to be the sequel to the infamous Spanish Flu. Studies have shown similarities between the H5N1 virus and H1N1 virus, or Spanish flu (Appenzeller). The influenza research team of Scripps Research Institute in California is using a new technology called the Blycan Microarrays to determine whether the H5N1 virus is able to attack human cells (Appenzeller). Flu researchers from the Centers for Disease Control and Prevention (CDC) are also conducting tests on the H5N1 virus. In highly-contained laboratories, researchers are artificially breeding new viruses by mixing genes from H5N1 and human influenza viruses. From the new virus researchers will test to see if it has inherited both the fatality of the avian influenza virus and the human influenza virus’s ability to spread. Results will help identify if the H5N1 virus can lead to a pandemic (Appenzeller).


            Since the discovery of the H5N1 virus, over 100 human cases, mainly in Asian countries, have developed, and over half of the infected people died. It is considered to be the worst outbreak since the Spanish flu. The disease caused by H5N1 virus differs from previous influenza viruses where the primary infected organs are within the respiratory system, H5N1 has the ability to replicate different types of cells and thus infect and destroy many different types of organs (“Avian Influenza”). Doctors were horrified and in disbelief when they first witnessed the aftermath of a H5N1 infection: “The lungs, normally light and elastic, were as heavy as waterlogged sponges, clogged with bloody fluid” (Appenzeller). The catastrophic Spanish flu is a wake-up call to the world.


            Aside from the effects of the flu, we must also understand the structure of what we are fighting against. Avian influenzas are classified as Low Pathogenic Avian Influenzas (LPAI) and High Pathogenic Avian Influenzas (HPAI) based on ability to cause disease and genetic structure (Sabatino). The difference between LPAI and HPAI viruses is describes as


[t]he so-called “low pathogenic” form commonly causes only mild symptoms and may easily go undetected. The highly pathogenic form is far more dramatic. It spreads very rapidly through poultry flocks, causes disease affecting multiple internal organs, and has a mortality that can approach 100%, often within 48 hours.

(“Ten things you need to know about pandemic influenza”)


Although LPAI and HPAI are two different forms of AIV, if it genetically mutates it can change its original form, which is usually low pathogenic. Avian influenza viruses primarily affect avian species, but the viruses are contagious and can transmit cross-species (“Ten things you need to know about pandemic influenza”). According to the United States Department of Agriculture, certain influenza viruses are transmitted from avian to poultry in low pathogenic form but after mutation they become HPAI, meaning they have become more severe and dangerous (“Avian Influenza”). Researchers have been tracking the deadly H5N1 virus and have found that the main avian species that hosts this highly pathogenic influenza virus is the waterloo birds. Knowing the source of the problem in this case does not help because it is hard to track and vaccinate all waterloos (Sabatino). The most dangerous type of flu virus is a new subtype of avian influenza virus because it can be transmitted between humans and change into a human influenza which people do not have immunity against and will ultimately spread and lead to a pandemic (Taubenberger). A pandemic is the spread of a fatal disease on a global scale (Kenyon). A flue pandemic is nearly impossible to prevent or stop if officials do not take immediate action at the first sign of an outbreak.


            Not only are the effects of influenza destructive to the human body, but also it destroys the economy, community, and family. When the 1918 Spanish flu struck, “Schools and businesses were shut down and church services cancelled. Morgues overflowed” (Appenzeller). People stopped leaving their homes because they were either ill or afraid of becoming infected (Sabatino). While the majority stops their lives during a pandemic, the morgues and the hospitals will continue to operate. To prevent another chaotic Spanish flu, World Health Officials have been planning and preparing for the possible H5N1 pandemic outbreak. Not only are countries drafting emergency plans, but also, here in the United States, individual states have been developing emergency pandemic plans, as have even schools and businesses (Sabatino). Countries are stocking up flu vaccines, such as Tamiflu and Relenza. These two medications can reduce the severity and the duration of the seasonal flu, but these vaccines are insufficient to provide a cure (Sabatino). In addition, the supply is limited by the risk and expense of producing the vaccines (Billings). Vaccines are dead virus cells produced by killing virus infected eggs (“New Study Describes Key Protein from Highly Pathogenic Avian Flu Virus and How It Might Mutate”). “At present manufacturing capacity, which has recently quadrupled, it will take a decade to produce enough Tamiflu to treat 20% of the world’s population” (“Ten things you need to know about pandemic influenza”). The influenza vaccine for H5N1 is very time consuming and high maintenance that vaccine engineers will not be able to produce an adequate amount of vaccine for everyone if there is a pandemic outbreak.


            Although the H5N1 pandemic was said to arrive this flu season, present cases of H5N1 infections are only in small clusters because the virus have not yet adapted to the human body. The H5N1 virus is said to be as deadly as the Spanish flu virus and will cause a similar percentage of death toll which will be a much greater number considering how much the world population has increased. “The world population in 1918 was only 28 percent of today’s population. Adjusting for population, a comparable toll today would be 175 to 350 million” (Barry). In 1918, people were not prepared nor informed about the deadly Spanish flu. The majority of the population that was infected neglected and belittled their illness, by the time they realized they were not infected with the common cold but the deadly flu, it was too late for health officials to do anything. It is vital for people to be informed and updated about such a devastating epidemic. Ingorance and negligence will only allow flu pandemic to thrive.


Works Cited


Appenzeller, Tim. “Tracking the Next Killer Flu.” National Geographic October 2005 <http://proquest.umi.com.ezaccess.libraries.psu.edu/pqdweb?index=0&did=924540921&SrchMode=1&sid=16&Fmt=3&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=TS=1165083807&clientId=9874> 28 Nov 06.


“Avian Influenza.” United States Department of Agriculture March 2006 <http://www.usda.gov/wps/portal/usdahome?contentidonly=true&contenid=2005/11/0511.xml>.


Barry, John M. “Distinguished Visiting Scholar.” The Center for Bioenvironmental Research at Tulane and Zavier Universities <http://appropriations.senate.gov/hearmarkups/BarryTestimony.htm> 2 Dec 06.


Billings, Molly. “The Pandemic of 1918.” Stanford University June 1997 <http://virus.stanford.edu/uda/> 30 Nov 06.


Kenyon, Simon. “Avian Influenza.” Extension Disaster Education Network <http://www.eden.1su.edu/Issues_View.aspx?IssueID=A59E222E-12A4-4964-AC7C-42E9E01F846A> 2 Dec 06.


“New Study Describes Key Protein from Highly Pathogenic Avian Flu Virus and How It Might Mutate.” National Institute of Health March 2006 http://www3.niaid.nih.gov/news/newsreleases/2006/H5N1_avail.htm> 30 Nov 06.


Sabatino, Allen. “Influenza Presentation.” PSU-Hazleton 21 Nov 06.


“Ten things you need to know about pandemic influenza.” World Health Organization October 2005 <http://www.who.int/csr/disease/influenza/pandemic10things/en/index.html> 1 Dec 06.


Taubenberger, Jeffery. “Interview.” Public Broadcasting Service January 1998 <http://www.pbs.org/wgbh/amex/influenza/sfeature/drjeffrey.html> 3 Dec 06.


Preparing for Avian Flu




Thomas W. Igo


Today, in our global business world, one of the biggest threats facing corporations, businesses and governments is the fear of the avian flu. The avian flu is projected to be the next big pandemic that could hit us in the United States. Government officials at all levels are at different stages of the planning process to deal with this threat. Health officials here in the U. S. and abroad are keeping an eye on the potential outbreak (“Key Facts about Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus”).


            What is the avian flu? Known as “bird flu” or simply “influenza,” it is a viral infection that is currently found in bird populations located in Asia (Cameron). The strain of the virus is H5N1 (Cameron). In 2004 it alone infected millions of chickens and other birds (Cameron). The strain spread to a small number of humans, resulting in human fatalities (Cameron). There are a few interesting characteristics of the virus that have not been addressed. The first is how the transmission of the flu occurs between the birds and humans (Cameron). The second is that most bird flu does not result in the death of the bird, but in the case of H5N1, it has occurred (Cameron).


            How will one plan for a pandemic of this sort? Federal, state and local governments will be forced to look into the infrastructure of their particular areas regarding capacities of health care facilities, cemeteries, morgues, and health care providers (“Pandemic Influenza Preparedness Plan for Maryland”). Schools will be faced with planning for children’s educational needs during the period of pandemic, and employers will be faced with various questions and concerns (Louisville).


            The state of Maryland has set-up a Preparedness Plan to cover the threat of an influenza pandemic. The “essential components” of responding to a pandemic include command procedures, surveillance, vaccine delivery, anti-viral medication delivery, emergency medical service, and communications (“Pandemic Influenza Preparedness Plan for Maryland”). Their communication plan includes six phases to include all steps of the outbreak. The plan starts with the Novel Alert step, which is defined as the first human being infected with the virus and ends with Pandemic Over, which can be defined as a more typical winter influenza cycle ((“Pandemic Influenza Preparedness Plan for Maryland”).


            Air Products and Chemicals, the company where I am employed, has set up a readiness team to create a readiness plan for the Avian Influenza based on the potential for an epidemic outbreak. The plan includes three parts. These areas include preparing the employees ahead of time on precautions to take, which will prepare them for the Avian Flu and other illness. The second part of the process includes preparing the operating team to operate our facility in a safe mode during the time of a pandemic. The third piece revolves around how we deal with our containers that have spent time in Asia. These same containers were staged around the piers at the ports birds tend to call home.


            Air Products has set up some of the same guidelines passed along by the National Health Department in regards to preparing for the influenza. These include planning to receive a flu shot and regular hand washing with soap and warm water—preferably for 15 to 20 seconds (Cameron). The flu shot will help give some protection but will not fully protect anyone from contracting the Avian Flu (“Key Facts about Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus”). This series of guidelines also suggests staying at home if an employee is sick. Some other tips that are recommended by other health agencies include covering coughs and sneezes with disposable tissues and quickly disposing of the tissues (“Key Facts about Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus”). Another recommendation is to keep a safe distance from people who are sick (Cameron).


            Where the plan breaks down is the recommendations of how to prepare the employees at home. This is where the plan should refer the employees to a government website or some type of forum for this type of information. This would offer valuable information to prepare the employee at home. The time line of a pandemic greatly differs from that of a hurricane or winter storm. A pandemic will distance people from normal everyday life for a time period of four to six weeks based on the fact that no Avian Flu vaccine currently exists (“Preparing you for emergencies: Preparing for Avian Flu”). Stores would lack food since people will panic at the onset of the pandemic (“Preparing you for emergencies: Preparing for Avian Flu”). This will happen even if a vaccine becomes available before the time when the next pandemic. People will be afraid to leave their homes to go to work. This alone will create a shortage of supplies. People will be affected in the same way governments and businesses will be. Will we have power at our homes? Without power, how will folks survive?


            Air Products, a large exporting corporation, has faced the obstacle of dealing with potential exposure to bird dung and feces on the containers that we ship to Asia and other foreign countries. The potential for exposure is great, since 80 percent of the products that we manufacture in Schuylkill County, PA are currently shipped to Asia. The containers that Air Products receives back are covered with bird droppings. We believe this happens at our domestic ports, but also believe that some of the droppings are being transported back from abroad. The solution is still in the development stage. Some of the current strategy review on the problem has to do with where a disinfection of the container should occur. At the port is one option, but who will perform this task? How will the waste be handled? Who will pay for the waste disposal and how should it be treated so the virus can be killed? These potential factors drove this large corporation to write a procedure on how to deal with and dispose of dead birds. The procedure calls for the following steps:


1)      do not touch the bird without wearing gloves;

2)      wear a dust mask and place the bird in plastic trash bag, double bag and tie it shut;

3)      remove the gloves by turning them inside out, and remove dust mask;

4)      wash hands thoroughly with soap and water for 15-20 seconds;

5)      wash any clothing that has been in contact with the bird and clean any contaminated surfaces;

6)      contact the local health department or animal control agency.


This procedure calls for additional personal protective equipment if multiple dead birds are found (Cameron).


            The most difficult piece of the whole readiness plan is looking into how Air Products will operate their facility in a safe mode and if they will receive adequate supplies to maintain our facility. The Hometown Air Products site houses some very dangerous chemicals, and if these chemicals are not kept under ideal conditions, potential exposure to the community at large is a viable concern. Inadequate maintenance or lack of supplies could cause an accident. An occurrence of this nature would be evident for miles.


            The first decision is whether the site will have enough employees to safely operate the facility in an operating mode. If not, will enough employees report to work in order to safely monitor and maintain the plant in the safe mode? Part of the planning detail includes who really needs to be on the facility and who can fill his or her capacity from home or in an on-line function.


            In addition, a decision about how much liquid nitrogen will be received from suppliers. This is the main source of refrigeration, and without this raw material, Air Products has the potential to expose the community to dangerous chemicals. The major challenge is to think of alternatives to liquid nitrogen as a refrigerant. Electricity presents the same challenge. Will PPL, the current power supplier, have the resources they need to operate their facility to supply Air Products with the power that is needed to operate the pollution towers, water pumps and other pieces of equipment to safely maintain the facility?


            Overall, a pandemic in the United States presents a very perplexing situation. Currently, all different levels of government have plans in place to confront the issues, and most major corporations have similar plans in place. Current technology, including that of communications, allows us to be far better prepared than at any time previously in history. Perhaps now, time will be on our side.


Works Cited


Cameron, Mariann. “Avian Flu.” April 2006 <http://webcms.apci.com/Sites/4/globalhealth/AvianFlu2.htm> 19 Nov 06.


“Key Facts about Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus.” June 2006 <http://cdc.gov/flu/avian/gen-info/facts.htm> 16 Nov 06.


“Pandemic Influenza Preparedness Plan for Maryland.” February 2002 <http://edcp.org/html/mpipp.html> 17 Nov 06.


“Preparing you for emergencies: Preparing for Avian Flu.” September 2006 <http://louisville.edu/admin/dehs/preparingyou/avianflu/> 12 Nov 06.


An Influenza Pandemic: Are We Prepared?




Beth Bradbury


Ring! Ring! Ring! The fire alarm is going off in the school. Is it a drill or is it real? Are we prepared? Will the children and staff make it out safely? What if an influenza, flu, pandemic strikes? Is our school district prepared? How can we possibly be completely prepared for a crisis of that magnitude?


Seasonal Flu

Pandemic Flu

Respiratory illness; transmitted from person to person. Most people have some immunity; vaccine available.

Human flu that causes global outbreak of serious illness; little natural immunity; spreads easily from person to person.

Occurs annually during winter.

Occurs approx. three times/century, at any time of year.

Affects approx. 10 % of population.

May affect 25% of population.

Very old and immune deficient most at risk.

People of all ages at risk.

Vaccines available.

Vaccines may not be available immediately.

Fig. 1                                                                           (“Key Facts about Pandemic Flu” 2)


The avian, or bird, flu presents a real possibility of a pandemic. The H5N1 virus has resulted in the deaths of chickens, migratory birds, and 153 humans in the past three years (“Cumulative Number of Confirmed Human Cases of Avian Influenza A (H5N1) Reported to WHO” 1). Fortunately, this problem has remained in Asia. It is thought that eventually the migratory birds will carry it along their migration paths, causing it to spread (Appenzeller 4). This, along with modern transportation, could cause the virus to escalate to a pandemic rather quickly. (See Thomas Igo above—Ed.)


            Over the last century, three pandemics occurred (Hilton). In 1918, the Spanish flu caused over 40 million deaths worldwide; 500,000 of those were American. This started in Europe at the end of World War I. As the war ended, soldiers brought the sickness home with them, thus causing the rapid spread (Hilton). The Asian flu of 1957 and 1958 caused many more deaths: 70,000 Americans and two million people worldwide. The Hong Kong flu killed 34,000 Americans alone. It is probable, when the avian flu pandemic comes, one third of the sick will die (“School officials begin to take steps to plan for bird flu pandemic” 11).


            When a pandemic strikes, all organizations must be prepared, from the international down to the local ones, such as school boards and districts. The United Nations has two such groups. The World Health Organization (WHO) along with its sub-committee, the Epidemic and Pandemic Alert Response (EPR), work on tracking potential pandemic causes, scientific studies of the viruses, international training programs, standardizing preparedness and response plans, and various other programs (“Epidemic and Pandemic Alert and Response” 1).


            The United States government has set up a Website (www.pandemicflu.gov) to help individual states plan. The Department of Health and Human Services (DHHS) has come on board the project too. Michael Leavitt, the secretary of DHHS, along with Pennsylvania’s governor, Gov. Rendell, hosted a statewide Pandemic Influenza Preparedness Planning Summit in March of 2006. One thousand officials attended this event. At the summit, Leavitt pledged $3.5 million for Pennsylvania and Rendell pledged $500,000 toward planning efforts (“Pennsylvania Conducts Pandemic Influenza Preparedness Planning Summit” 8). Money will play a key role in how much a town or state will be able to prepare, plan, and even stockpile items such as non-perishable foods and antiviral medicines. Rendell also unveiled two mobile medical units capable of responding to a biological emergency anywhere in Pennsylvania within three hours (“Pennsylvania Conducts Pandemic Influenza Preparedness Planning Summit” 8).


            When the next flu pandemic strikes, local school districts and boards, being the hubs of their respective communities, need to be prepared. There are many tools available to help districts. Many district personnel will be needed to help formulate and carry out the plan. When it strikes, everyone from the administrators to the janitors will be paramount in the plans working smoothly and effectively. Local school districts should already have an Emergency Procedure Manual, which outlines emergency response procedures. This should cover any emergency from school violence to fire to communicable diseases. The manuals are usually designed and maintained within the help of the local Emergency Management Agency (EMA). In planning for a flu pandemic, there are four basic steps to follow: prevention, preparedness, response, and recovery (Dillon 1).


            Prevention is the first step in the pandemic plan. Districts should actively plan and participate in this. Rapid spreading can occur at schools because of the simple fact that children contract and spread sickness at a faster rate than adults (Dillon 1). Schools’ health service departments, concurred by WHO, have several suggestions for precautions to take. When someone coughs or sneezes, he or she should cover his or her nose and mouth with a tissue or the upper part of his or shirtsleeve. Immediately afterwards, the tissue should be thrown away. Hands should then be washed thoroughly with soap and water or alcohol wipes or gels. Alcohol is very effective in killing the germs. These preventative measures will not only help lessen the spreading of a pandemic but colds and seasonal flu as well. The community should be made aware of these procedures so they can follow them. Schools must actively practice them (Health Services 2). School cleanliness is another important factor. Each night after the children and staff leave, the classrooms, bathrooms, and other heavily used areas should be vigorously cleaned.


            Preparedness comes next. DHHS and the Center for Disease Control and Prevention (CDC) have published a suggested plan and checklist, in a joint effort, to help aid districts (“School officials begin to take steps to plan for bird flu pandemic” 13). Policies and procedures can be created or modified. Some decisions need to be made regarding authority, chain of command, and back-ups. First and foremost, if there is a public health emergency, the authority and responsibility to call it needs to be identified. A designee needs to be identified to notify and co-ordinate with local businesses, emergency personnel, private schools, county intermediate units, boroughs, townships, staff, students, parents, and anyone else deemed necessary. Someone will need to report absenteeism of more than 10 percent, as required by the Pennsylvania Department of Health. If a school unit must shut down for an extended period of time due to the high number of sick people, a back-up plan for home education must be in place, with the possibility that assignments for school work be made available through a designated Website (“PSBA testifies on state, school efforts to prepare for pandemic flu” 14).


            A number of questions need to be answered. What happens when things escalate and local businesses, such as stores, pharmacies, and banks shut down? What can the school do to help the community? Can the cafeteria help with food? Can the bus drivers transport people or supplies? Can the school be used as a makeshift hospital? Where will the money come from if extra costs are incurred? Each district will differ from the next in what they can and cannot do. They must each analyze and plan accordingly. Some other questions that must be answered are 1) If the flu pandemic has struck in a district’s state or local region, do they start stockpiling items such as food, water, and medicine? 2) Who will be responsible for the initial and continuing updates to the public? 3) What type of media will be used? Once all of this and much more have been planned, a district should then educate and train the staff, and test certain aspects of the plan (“PSBA testifies on state, school efforts to prepare for pandemic flu” 15).


            In a pandemic, response would be the next step. Response would basically consist of the implementation of the plan. The key factor in all of this is communications. The more communication between all the involved parties, the smoother and more efficiently things should run.


            The last step is recovery. In a flu pandemic, there is a probability of a high rate of mortality (Hilton). Grief counseling will be much-needed. Students and their families and maybe other community members will be in need of these services. Some temporary modifications in the school day may need to be implemented. For example, students and staff may tire easily; therefore, half days of school may be the best way to ease back into the schedule. The whole experience should be documented. The plan should then be re-evaluated and updated.


            In speaking with the board members of the Mahanoy Area School District, administration, the district’s EMA, and health services personnel, regarding flu pandemic planning, our district has a long way to go to be prepared for a pandemic. We have a solid start with our Emergency Procedure Manual (Cadau). All our policies have just been reviewed and revised recently but should be updated to incorporate a pandemic. We have procedures, but many are not written down. Preventative measures, such as hand washing, are currently taking place. A packet of information was sent home by helath services regarding coughing, sneezing, and hand washing to inform parents (Health Services 2). The facilities director and his staff are meticulous in keeping the school clean. He is also researching special products and procedures to be used for avian flu prevention and cleanup afterwards (Pastucha). Money would be available from the district’s fund balance, if needed (Hurst).


            One of the principals suggested the possibility of having our schools designated a “Pod” or an area to isolate the sick (Golden). The superintendent, along with the crisis intervention specialist, has been attending meetings to form the Safe Schools Coalition. This group will consist of county fire companies, schools, and police. They will look at a countywide response plan for any type of emergency (Mahanoy Area School District 5). These are small steps to reaching our gargantuan goal of a Pandemic Preparedness and Response Plan. Our district, along with many others, has a large task to perform. No matter how much planning and preparation is completed, there will be many other unexpected problems that arise in an actual crisis. We can never be totally prepared, but we can be better prepared.


Works Cited


Appenzeller, Tim. “Tracking the Next Killer Flu.” National Geographic October 2005: 10 ProQuest  <http://proquest.umi.com.ezaccess.libraries.psu.edu/pqdlink?index=5&did=924540921&SrchMode=3&sid=1&Fmt=3&VInst=PROD&RQT=309&VName=PQD&TS=1165326874&clientId=9874&aid=1>.


Cadau, Michael. Personal Interview. 5 Dec 06.


“Cumulative Number of Confirmed Human Cases of Avian Influenza A (H5N1) Reported to Who.” World Health Organization. 20 Nov 06. <http://www.who.int/car/disease/avian_influenza/country/cases_table_2006_11_13/en/print.html>.


Dillion, Naomi. “Education Department highlights effective pandemic plans.” NSBA 11 Nov 06 <http://www.nsba.org/site/doc_sbn.asp?TrackID=&SID=1&DID=39501&CID=1974&VID=58>.


“Epidemic and Pandemic Alert and Response.” World Health Organization 20 Nov 06 <http://www.who.int/csr/disease/avian_influenza/country/cases_table_11_13/en/print.html>.


Golden, Charlotte. “Re: Interview questions.” E-mail to the author. 4 Dec 06.


Health Services. “Re: Healthy Habits That Can Prevent the Flu.” Memo to Mahanoy Area Staff 6 Nov 06.


Hilton, Dwayne. “Emergency Preparedness Lecture.” PSU-Hazleton 14 Nov 06.


Hurst, John. Personal Interview. 4 Dec 06.


“Key Facts about Pandemic Flu.” World Health Organization. 20 Nov 06 <http://www.emro.who.int/iran/media/pdf/WHO-KEY%20FACTS.pdf>.


Mahanoy Area School District. Minutes of the November 20, 2006 Meeting. Mahanoy Area Board of Education 20 Nov 06.


Pastucha, Robert. Personal Interview. 4 Dec 06.


Pennsylvania Conducts Pandemic Influenza Preparedness Planning Summit.” School Leader News. PSBA. 3.13 (2006): 8-10.


“PSBA testifies on state, school efforts to prepare for pandemic flu.” School Leader News. PSBA. 3.21 (2006): 13-17.


“School officials begin to take steps to plan for bird flu pandemic.” School Leader News. PSBA. 3.13 (2006): 10-13.