Influenza dominated the news in the winter of 2003-2004 when 10 western
US states reported high rates of influenza activity in October and November.
As the epidemic spread eastwards, it eventually claimed the lives of over
100 children and an unknown number of adults (Centers for Disease Control
[CDC], 2004b). In many parts of the country, nervous citizens stood on
long lines to receive the flu shot until vaccine shortages developed,
and young, healthy people could no longer obtain immunizations.
Once again, a new influenza virus, known as swine influenza A H1N1, or the swine flu, is dominating the news in the spring of 2009. The CDC and the World Health Organization (WHO) have been closely monitoring the situation and have been providing updates on what is being called a Phase 5 pandemic (see Figure 1). The United States Government officially declared a public health emergency.
Figure 1. World Health Organization Phases of a Pandemic Influenza Outbreak, 2008.
Downloaded April 30, 2009 from http://www.who.int/csr/disease/avian_influenza/phase/en/index.html.
For updates on what the Centers for Disease Control and Prevention (CDC, 2009) are recommending for healthcare professionals and the public, please go to http://www.cdc.gov/swineflu.
For specific information related to swine flu cases in New York state please visit http://www.nysna.org/practice/alerts/swine_flu.htm.
Influenza routinely kills an estimated 36,000 Americans every year (CDC,
2003a). “Pneumonia and influenza” ranks as the seventh overall
leading cause of death in the US. Over at least the past four centuries,
influenza has caused epidemics somewhere every one to three years. In
the twentieth century, it was responsible for three major pandemics: the
Spanish flu of 1918-1919; the Asian flu of 1957; and the Hong Kong flu
of 1968. The Asian and Hong Kong flu are estimated to have killed 76,000
and 60,000 Americans, respectively (Simonsen, Schonberger, Stroup, Arden,
& Cox, 1996). In the worst pandemic of all time, the Spanish flu epidemic,
which was driven in part by troop movements across continents, 20 to 40
million people died worldwide, and half a million (or more) perished in
the US. The course of World War I was affected; soldiers on both sides
died in droves (Crosby, 1989).
Thus, influenza has had an enormous impact on human endeavors. But it
is not only during pandemics that flu wields its power. During interpandemic
years, influenza is responsible for premature death, morbidity due to
pulmonary and neurological complications, absenteeism in the work force
and school population, and a financial burden to the healthcare delivery
system.
The flu has received attention from scientists, healthcare providers,
public health workers, and pharmaceutical companies, as well as from the
World Health Organization and the CDC (both of which publish pages of
recommendations annually). Despite four effective medications for treatment
and prophylaxis; and safe, efficacious vaccines, influenza is still not
under control anywhere in the world.
To bring influenza under control, three pathways must be followed: maintaining
surveillance of human and epidemiologically significant animal populations;
improving immunization rates; and expediting treatment. By taking this
course, the learner will gain the knowledge required to understand why
bringing influenza under control is so vital, and learn some ways to achieve
that goal. The purpose of this course is to provide the information nurses
need to become part of the global effort to prevent and control influenza
cases and epidemics.
©2008, NYSNA. All Rights Reserved.
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