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Immunization Newsletter, June 2009, Vol XXXI, Number 3
IN THIS ISSUE: Current Situation of Influenza A(H1N1); WHO Pandemic Alert Phases; Glossary and Definitions; Pandemics and Pandemic Threats; Facts About Influenza; Questions and Answers Related to Vaccines for the New Influenza A(H1N1); References; Advice for Individuals 
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Risk and Outbreak Communication: Resources / Guidelines and Best Practices
: The resource section of a website that brings together information on Risk and Outbreak Communication. Maintained by the Special Advisor for Social and Media Communication, this site will continue to grow as more activities are implemented and resources become available. 
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Risk and Outbreak Communication: Resources / Communication Materials
Communication Materials: Posters, Fact Sheets, Messages, Campaigns, and more. The resource section of a website that brings together information on Risk and Outbreak Communication. Maintained by the Special Advisor for Social and Media Communication, this site will continue to grow as more activities are implemented and resources become available.  
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Risk and Outbreak Communication: Resources / National Preparedness Plans
National Preparedness Plans The resource section of a website that brings together information on Risk and Outbreak Communication. Maintained by the Special Advisor for Social and Media Communication, this site will continue to grow as more activities are implemented and resources become available. 
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Risk and Outbreak Communication: Resources / Links to Sites
Links to other important risk and outbreak communication Web sites: The resource section of a website that brings together information on Risk and Outbreak Communication. Maintained by the Special Advisor for Social and Media Communication, this site will continue to grow as more activities are implemented and resources become available.  
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Risk and Outbreak Communication: Workshops
Workshops  
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Risk and Outbreak Communication: Resources / PAHO Documents
PAHO Documents: The resource section of a website that brings together information on Risk and Outbreak Communication. Maintained by the Special Advisor for Social and Media Communication, this site will continue to grow as more activities are implemented and resources become available. 
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The Global Influenza Surveillance Network
Every year more than 250 million doses of influenza vaccine are produced that help to protect the world's population against influenza infections. For over 50 years the process by which an effective vaccine is developed and manufactured has relied on the international cooperation of a wide range of public health partners brought together under the coordination of the World Health Organization (WHO) in the Global Influenza Surveillance Network. This fact sheet provides more details. 
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Infection Control Strategies for Specific Procedures in Health-Care Facilities: Epidemic-prone and pandemic-prone acute respiratory diseases, A Quick Reference Guide
This document is addressed to infection control professionals, occupational health specialists and other professionals involved in patient care in health-care facilities. It is designed to provide quick reference guidance on infection prevention and control to help prevent the transmission of acute infectious respiratory diseases during health care. 
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Risk and Outbreak Communication Workshop for Pandemic Preparedness - Cuba
 
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CD48/INF/3 - Avian Influenza and Influenza Pandemic Preparedness
CD48/INF/3 - Avian Influenza and Influenza Pandemic Preparedness  
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International Health Regulations (IHR)
The International Health Regulations are an international legal instrument that covers measures for preventing the transnational spread of infectious diseases. The newly adopted IHR (2005) has as purpose and scope “to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade”. This page provides a detailed description and information on progress of its implementation, plus relevant links. 
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Health Surveillance and Disease Prevention and Control at PAHO
This page describes the PAHO Technical Area for Health Surveillance and Disease Prevention and Control(HSD), its mission and objectives, what it does in terms of projects and activities. It contains links to the four technical groups and the Pan American Center under its umbrella. Note: Prior to June 2006, the Area was named Disease Prevention and Control. 
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Third Interagency Meeting on Strategic Communication for Avian/Pandemic Influenza.
3rd Interagency Meeting on Strategic Communication for Avian/Pandemic Influenza. Washington DC, February 2008 
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National Pandemic Contingency Plan Self-Assessment Template
PAHO has developed this Excel template for use in the countries for them to evaluate their own capacity to face a pandemic: the National Influenza Pandemic Preparedness: Self-Assessment, Second Round, National Influenza Pandemic Preparedness Plans / NIPPPs. Excel

Recommendations and Laboratory Procedures for Detection of Avian Influenza A (H5N1) Virus in Specimens from Suspected Human Cases
Procedures proposed in this document are intended for testing specimens from patients with suspected avian influenza A(H5N1) infection. It is intended for use by National Influenza Centers (NICs; members of the WHO Global Influenza Surveillance Network) during phases of interpandemic and pandemic alert. Recommendations and Laboratory Procedures - WHO

HOMEPAGE: Risk and Outbreak Communication
A website that brings together information and resources on Risk and Outbreak Communication. Maintained by the Special Advisor for Social and Media Communication, this site will continue to grow as more activities are implemented and resources become available. 
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Risk and Outbreak Communication - Contact Page
An introductory page to the Risk and Outbreak Communications Homepage that details the purpose and objectives of the site. It also lists the contact information for the special advisor for social and media communication.  
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Subegional Risk and Outbreak Communication for Avian Influenza and Pandemic Preparedness, Subregional Workshop
A Website detailing the objectives, outcomes, recources and presentations stemming from Subegional Risk and Outbreak Communication for Avian Influenza and Pandemic Preparedness Workshop. 
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Caribbean Workshops - Avian and Pandemic Risk Communication
A Website detailing the objectives, outcomes, recources and presentations stemming from the Caribbean Workshops - Avian and Pandemic Risk Communication.  
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Sub-regional Workshop on Communication for the National Preparedness Plans for an Influenza Pandemic - Andean Region
A Website detailing the objectives, outcomes, recources and presentations stemming from the A Website detailing the objectives, outcomes, recources and presentations stemming from Training of Trainers Workshop for Outbreak and Crisis Communication. 
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Risk And Outbreak Communication for Avian Influenza and Pandemic Preparedness Workshop - Central America
A Website detailing the objectives, outcomes, recources and presentations stemming from the Risk And Outbreak Communication for Avian Influenza and Pandemic Preparedness Workshop - Central America. 
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CSP27/8--Avian Flu and Pandemic Influenza: Progress Report
Item 4.4 on the Agenda of the 27th Pan American Sanitary Conference, Washington D.C., 1-5 October 2007.  
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Disasters: Preparedness and Mitigation in the Americas-June 2007, No. 107
When a disaster strikes, why is it so difficult to find reliable information? This is the topic of this issue's editorial. In addition, Safe Hospitals has become a common subject in the disaster community. There are several articles that touch on this very important issue. HTML 
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Epidemic-prone & pandemic-prone acute respiratory diseases: Infection prevention & control in health-care facilities, Summary guidance
This 44-page handbook provides advice for health-care workers on infection control of acute respiratory diseases (ARDs): reporting and isolating suspected cases; applying standard precautions, standard and droplet precautions, contact and droplet precautions, airborne precautions, and ventilating with regard to influenza-like illness (ILI) and viral, bacterial, and novel ARDs (e.g. SARS). 
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Infection Prevention and Control of Epidemic- and Pandemic-Prone Acute Respiratory Diseases in Health Care: WHO Interim Guidelines
The purpose of this document is to provide infection control guidance to help prevent the transmission of acute infectious respiratory diseases during health care, with emphasis on acute respiratory diseases that may constitute a public health emergency of international concern as defined in the International Health Regulations (2005; Annex 1). Managers of health-care facilities may also consider using this guidance to assist them in preparation for epidemics and pandemics. It is intended for use by government planners, healthcare facility administrators, infection control professionals, occupational health specialists, other professionals involved in patient care, and direct care providers. WHO

PAHO Regional Program on Epidemic Alert and Response: Working to Deal with Outbreaks in the Americas
This page describes the mission and areas of work of the PAHO Regional Program on Epidemic Alert and Response, mainly responsible for emerging and reemerging infectious diseases, disease outbreak management, implementation of the revised International Health Regulations (IHR [2005]), assessment of national surveillance capacity, and related issues. 
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The Role of National Influenza Centres (NICs) during Interpandemic, Pandemic Alert and Pandemic Periods
National Influenza Centres (NICs) are the backbone of the WHO Global Influenza Surveillance Network (GISN), working to protect global public health by updating seasonal influenza vaccine compositions and functioning as a global alert mechanism for the emergence of influenza viruses with pandemic potential. As a result, it has contributed greatly to the understanding of influenza epidemiology and supporting WHO recommendations for surveillance and vaccine preparation. The Role of National Influenza Centres (NICs)-WHO

CE140/9 - Avian Flu and Pandemic Influenza: Progress Report
Item 4.4 on the Agenda of the 140th session of the Executive Committee of PAHO, Washington D.C., 25-29 June 2007. 
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WHA60.28--Pandemic Influenza Preparedness: Sharing of Influenza Viruses and Access to Vaccines and Other Benefits
This resolution of the 60th World Health Assembly en 2007 constitutes the WHO global mandate for pandemic and avian influenza, which has been adopted by PAHO for the Americas. WHA60.28

Disasters: Preparedness and Mitigation in the Americas-October 2006, No. 105
Why are post-disaster needs assessments important?. They can make a difference in a disaster-affected country, making sure that urgent needs are addressed. This is the subject of the editorial of this issue. Other articles include methanol poisoning in Nicaragua, disaster preparedness in PAHO/WHO Member States, and preparations for pandemic influenza. HTML 
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Communicable Disease Prevention and Control at PAHO: Aims, Strategies and Lines of Action
This page summarizes the mission, objectives, strategies and lines of action of the PAHO Communicable Disease Unit and describes what it hopes to accomplish through technical cooperation. 
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Veterinary Public Health at PAHO
This page provides general information on PAHO's activities in the area of veterinary public health and its strategies to face current issues and challenges involving zoonoses, foodborne diseases and food safety. It also provides information and links for the Veterinary Public Health Unit, newly relocated to its regional center in Brazil, and to international partners. 
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CE138/INF/2 - Influenza Pandemic: Progress Report
Agenda item 7.4 for the 138th session of the Executive Committee of PAHO, Washington D.C., 19-23 June 2006. 
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GF-TADs: Global Framework for the Progressive Control of Transboundary Diseases
The GF-TADs is a joint initiative of the Food and Agriculture Organization of the United Nations (FAO) and of the World Organisation for Animal Health (OIE) which combines the strengths of both organisations in the fight against transboundary animal diseases (TADs) worldwide. It is composed of a global component at the OIE and FAO Headquarters level and of regional and sub-regional components. The ultimate aim of the Programme is to control and eradicate the most significant animal diseases including those transmissible to humans.  OIE

Pandemic Influenza
This page offers an organized listing of everything on the PAHO web on the topic of pandemic influenza, as well as links to other related sites, mainly at WHO and in the Region of the Americas. 
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Travelers' Health
This information published by the Centers for Disease Control and Prevention of the United States (CDC, a PAHO/WHO Collaborating Center), helps orient travelers on anything they should know and precautions they should take when travelling to a given country.  CDC

International Travel and Health
This page links to WHO information related to international travel, helping to orient travellers as to the situation regarding disease prevalence or outbreaks in a given country and what precautions they should take. It provides an index by country, related links, and information on relevant publications. WHO

Advice on Use of Oseltamivir
The antiviral drug Oseltamivir(Tamiflu®) is recommended for use for both treatment and prophylaxis (prevention) of influenza. This document offers WHO's recommendations on its use. WHO

SPP40/5 Influenza Pandemic: Progress Report
Agenda item 14 for the 40th Session of the Subcommittee on Planning and Programming, Washington, DC, March 2006 
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Portal Avian Influenza, Virtual Health Library (VHL)
This special portal from the Virtual Health Library (VHL) at the PAHO Regional Center for Health Information at BIREME constitutes a major information resource site for avian influenza, not only for virtual library materials but for other more general information, events, links to national and international sites of interest to the topic, etc. VHL

WHO's Flu Strike Force Plans for the Worst Case
WHO's Global Outbreak Alert and Response Network (GOARN), over the next three months, plans to assemble a medical strike force that could be sent on six hours' notice to anyplace a potential pandemic emerges. No flu pandemic has ever been stopped or even controlled. GOARN's attempt would be the first, it being a "global fire brigade [whose] primary advice to countries is to prepare for this eventuality: emergence, silent or otherwise, of a pandemic virus that spreads worldwide more quickly than we have the capacity to contain, in a series of waves, with a very high attack rate on the population."  Washington Post

Brasilia Declaration
The ministers and the representatives of ministers of agriculture and health, the presidents and the representatives of producer associations, industry, and other entities representing the poultry production chain, and the representatives of international organizations in attendance at the Hemispheric Conference on Avian Influenza, expressed their commitment in this multilateral agreement at the Hemispheric Conference on the Surveillance and Prevention of Avian Influenza in Brasilia, Brazil, on 2 December 2005. Full conference proceedings PANAFTOSA

Hemispheric Conference on the Surveillance and Prevention of Avian Influenza (Brasília, Brazil, 30 November– 2 December 2005)
The objectives of this conference, co-sponsored by PANAFTOSA and the Ministry of Agriculture of Brazil, are as follows: Review, analysis, and dissemination of the global and Hemispheric knowledge of Avian Influenza (AI) and the risk of pandemic for humans, in order to forge a regional alliance and to discuss the bases of a public multisectoral and private plan, for surveillance and prevention of Influenza Avian in the Americas. This page is Portuguese but offers a link by which to register and the complete conference program in English. PANAFTOSA

Ten things you need to know about pandemic influenza
This page from the Communicable Disease Surveillance and Response section of the World Health Organization (WHO) provides answers to common questions about a flu pandemic, including how pandemic influenza is different from avian influenza. WHO/CSR

Avian Influenza: Frequently Asked Questions (Weekly Epidemiological Record 80:44, pp. 377-384)
This list of over 20 of the most common questions on avian influenza (bird flu) has been issued by the World Health Organization's weekly epidemiogical report. WHO/WER

Influenza: Technical Module (Peru)
This technical document in Spanish, put together by the General Office of Epidemiology of the Ministry of Health of Peru and the National Institute of Health of Peru offers up-to-date information in the form of a manual on influenza for doctors and laboratory technicians working in the country. Handbook in Spanish

PAHO Strategic and Operational Plan for Responding to Pandemic Influenza (draft, September 23, 2005)
WHO has planned a strategic plan describing activities for influenza preparedness planning to prepare the world for the next influenza pandemic and mitigate its impact once international spread has begun. The PAHO Strategic Plan operates within this framework to direct technical-cooperation activities to be carried out to prepare the countries of the Region for an influenza pandemic. 
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National Influenza Pandemic Plans
This WHO site provides access to the national influenza pandemic plans of many WHO Member States, in downloadable PDF files. WHO/CSR

CE137/5-Contingency Plan for an Influenza Pandemic
Agenda item 5.2 for the 137th session of the Executive Committee, Washington, DC, September 2005. 
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Pandemic Influenza Resource Sites
This page provides links to resources dealing with the topic of pandemic influenza, organized into coherent categories (surveillance, emergency preparedness and response, prevention and control, toolkits, press releases, major partner sites).  
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WHO Global Influenza Preparedness Plan: The Role of WHO and Recommendations for National Measures before and during Pandemics
The WHO global influenza preparedness plan has been prepared to assist WHO Member States and those responsible for public health, medical and emergency preparedness to respond to threats and occurrences of pandemic influenza, thus updating and significantly revising the 1999 Plan. It redefines phases of increasing public-health risk, recommends actions for national authorities, and outlines measures to be taken by WHO. This WHO link provides an abstract with table of contents and access to the 53-page plan in PDF (the first chapter of which contains the executive summary). WHO

WHO Checklist for Influenza Pandemic Preparedness Planning
The objective of pandemic planning is to enable countries to be better prepared to recognize and manage an influenza pandemic. Planning may help to reduce transmission of the pandemic virus, to decrease cases, hospitalizations and deaths, to maintain essential services and to reduce the economic and social impact of an influenza pandemic. The checklist, prepared by WHO for the benefit of its Member States worldwide, reflects international expert opinion on the subject of influenza pandemic preparedness planning. The WHO link below provides an abstract and table of contents with access to the 39-page checklist.  WHO

PAHO/WHO Collaborating Centers and WHO Reference Laboratory for Influenza in the Americas
This resource page links to the PAHO/WHO Collaborating Center for Surveillance, Epidemiology and Control of Influenza (located at the CDC in Atlanta), to the PAHO/WHO Collaborating Center for Studies on the Ecology of Influenza in Animals (located at St. Jude Children's Hospital in Memphis), and to the WHO Reference Library for Influenza at the Division of Viral Products, Center for Biologics Evaluation and Research (part of the US Food and Drug Administration /FDA). It also links to the National Influenza Centers in the countries and to other influenza resources at CDC, PAHO and WHO. 
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WHO Guidelines on the Use of Vaccines and Antivirals during Influenza Pandemics
This document provides guidance to health policy-makers and national authorities on planning principles and options for the prioritization of vaccine and antiviral use during an influenza pandemic. It includes recommendations on actions that can improve future supply for the many countries that currently have no national vaccine or antiviral production. The link below provides access to the WHO abstract and full text. WHO/CSR

A58/62: Seventh Report of Committee A
This report from the 58th World Health Assembly in 2005 deals with (1) antimicrobial resistance as a threat to global health security, and its containment; and (2) Strengthening pandemic influenza preparedness and response, and enhancing laboratory biosafety. It set forth the WHO global mandate in this regard and has been adopted by PAHO for the Americas. A58/62

Workshop on the Epidemiology and Surveillance of Influenza and Other Respiratory Diseases (Decatur, Georgia, USA, 9–13 May 2005)
The objectives of this meeting were (1) to discuss activities on the epidemiological and virological surveillance of influenza and analyze the subject of pandemic influenza, as well as present basic and advanced methods of influenza prevention and control; and (2) to find out the degree of progress made in the countries and coordinate development of National Preparedness Plans for a possible influenza pandemic, and to provide tools to assist in the planning process and discuss vaccines and antivirals as prevention and control methods, with a view to a possible pandemic. This page offers the executive summary and access to other conference documentation in Spanish.  
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EB115.R16: Strengthening Pandemic-Influenza Preparedness and Response
This report makes recommendations that led to the resolutions made in the 2005 World Health Assembly, which set forth the WHO global mandate for pandemic influenza preparedness and response and was subsequently adopted by PAHO for the Americas. EB115.R16

CD45.R8: Disaster Preparedness and Response
This report from the PAHO Directing Council lays forth the Organization's mandate for emergency and disaster preparedness and response in hospitals, clinics, and primary-care facilities in the Americas. CD45.R8

Informal Consultation on Influenza Pandemic Preparedness in Countries with Limited Resources (Kuala Lumpur, Malaysia, 23–25 June 2004)
The objective of this informal consultation was to get feedback on key elements of a draft influenza pandemic preparedness checklist prepared by WHO. Specific objectives were to: (1) raise awareness of the need and potential benefits of pandemic preparedness; (2) understand the processes involved in planning influenza pandemic preparedness; (3) reach some consensus on the priority components of a pandemic plan; (4) develop specific recommendations relevant to the high-priority areas of pandemic planning; (5) identify the way forward for Member States as they develop their pandemic plans; and (6) identify whether WHO assistance is needed and, if so, what form it should take. This page contains a summary and access to the full text. 
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Frequently Asked Questions on the Proposed Revision of the International Health Regulations (IHRs)
These 21 questions have been made available to the countries for the revision process of the International Health Regulations (IHRs) currently in progress. The revisions will be discussed and ratified during the upcoming World Health Assembly in May 2005. WHO: IHR FAQs

WHO Consultation on Priority Public Health Interventions before and during an Influenza Pandemic (Geneva, 27 April 2004)
The purpose of this technical consultation meeting was to approach the topic of preparedness for a flu epidemic. More than 100 experts from 33 countries participated, discussing a broad spectrum of measures to be carried out by WHO and national authorities before and during a pandemic. The three main objectives were to prevent potential pandemics as they appear, reduce transmission at national and international levels, and reduce high levels of morbidity, mortality and social impact. WHO link listed below provides access to the opening address, executive summary and to the full text, as well as other useful links related to this topic. WHO/CSR

EID Weekly Updates: Emerging and Reemerging Infectious Diseases, Region of the Americas, Vol. 2, No. 14—8 April 2004
This issue provides information on two events: a workshop in Lima, Peru, on the Epidemiology and Diagnostics of Influenza in the Andean Subregion; and the I International Course on Viral Hemorrhagic Fevers and Hantavirus at the INVEH in Pergamino, Argentina. 
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CD44.R8--Influenza Pandemic: Preparation in the Hemisphere
This resolution of the 44th PAHO Directing Council sets forth the PAHO mandate for dealing with the possibility of an influenza pandemic. CD44.R8

Guidelines for the Preparation of a Subregional Plan of Southern Cone Countries for an Influenza Pandemic (Santiago, Chile, 15-19 December 2002)
Influenza derives its importance from its rapid dissemination and high morbidity and mortality in certain risk groups. This is a cause for concern throughout the world, reflected in WHO Resolution EB.111R6, in which Member States are urged to intensify efforts to prevent and control influenza. A group of experts from Argentina, Brazil, Chile and Uruguay was convened to develop recommendations (contained in this report) for the formulation of guidelines applicable to an influenza pandemic. 
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