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City of Santa Ana Emergency Operations Plan
<br />Part I Basic Plan
<br />Human flu viruses spread easily from person to person, primarily through coughing or sneezing or contact with
<br />recently infected surfaces.
<br />A flu pandemic occurs when a new or mutated influenza virus that humans have not encountered before, and
<br />therefore have no immunity to, begins circulating and spreads quickly from person to person, causing substantial
<br />morbidity and mortality across geographic areas. Orange County HCA routinely does surveillance for seasonal
<br />influenza as well as enhanced surveillance for novel strains and human infections with bird (avian) or pig (swine)
<br />influenza strains that are circulating in other parts of the country and the world. In 2009, an H1N1 influenza
<br />pandemic spread quickly and led to over 200 severe influenza cases and 50 deaths in Orange County. The H1N1
<br />influenza virus (a mutated form of swine flu) quickly established itself as a seasonal influenza strain and was the
<br />predominant virus in the 2013-14 influenza season. Although the mortality rate from H1N1 influenza during this
<br />pandemic was low, other strains may cause more severe illness with case fatality rates as high as 6%.
<br />An influenza pandemic is likely to occur in waves of infection, each lasting approximately 8 to 12 weeks and
<br />separated by weeks of inactivity. In total, it could last from 18 months to several years. An example is the Spanish
<br />Flu outbreak occurring at the end of World War I, which progressed through successively greater waves in 1918,
<br />1919 and 1920. It is reported that more U.S. service members serving in the war died of flu than died in combat.
<br />While flu diagnosis, medical treatment and medical records were much less advanced during this time, it is
<br />estimated that Spanish flu (a mutated bird flu virus) killed more than 50 million people, or possibly more than 3%
<br />of the world's population at that time. Even with the limited and slower transportation methods available at that
<br />time, Spanish flu still spread throughout the world and killed persons on all six continents (excluding Antarctica).
<br />With today's ability to travel from continent to continent within hours, a flu pandemic could spread exponentially
<br />faster.
<br />An influenza pandemic is likely to affect everyone in Orange County at some point and can greatly affect all
<br />sectors of society and government. A pandemic will place great strain on existing health care resources and may
<br />exceed available resources. Personnel, supplies, equipment, and pharmaceutical responses (e.g., vaccination and
<br />antivirals) may be in short supply and/or unavailable. All public and private sector services rely on staff and
<br />employees to function, and as more people become sick, more sectors will be unable to sustain operations. Health
<br />care services, food production, transportation systems, utilities and emergency services may be compromised or
<br />unavailable. Pandemics would occur simultaneously throughout much of the County and State, and possibly other
<br />states as well, which would severely limit the availability of mutual aid assistance and resources from other areas.
<br />Childhood Vaccine -Preventable Diseases, such as Measles and Pertussis
<br />Before the middle of the last century, life -threatening diseases such as Haemophilus influenzae, diphtheria, polio,
<br />measles and rubella affected hundreds of thousands of infants, children, and adults in the United States, with
<br />thousands dying every year. Since the advent and widespread use of vaccines, these diseases have declined
<br />dramatically and nationally, vaccine -preventable disease levels are at or near record lows. Vaccinations for
<br />chickenpox, diphtheria, Haemophilus influenzae type B, hepatitis A, hepatitis B, influenza, measles, mumps,
<br />pertussis, polio, pneumococcus, rotavirus, and rubella are now routinely available for infants and children.
<br />However, this is not the case throughout the world and outbreaks of diseases such as polio and measles still occur
<br />regularly in other regions. Even though most children in the U.S. have received the recommended vaccines by age
<br />2 years, many under -immunized children remain, leaving the community vulnerable to outbreaks of these diseases.
<br />Measles — Measles is one of the most contagious of all infectious diseases with over 90% of exposed people
<br />developing infection if they are not already immune, either by previous infection or by immunization. In the pre -
<br />vaccination era, there were on average over 500,000 cases in the U.S. and almost 500 deaths reported annually.
<br />Cases dropped dramatically after vaccination against measles was introduced in the 1960's and a second dose of
<br />vaccine was routinely recommended in 1989. In 2000, measles was declared eliminated in the U.S., meaning there
<br />was no ongoing transmission, but cases and outbreaks continue to occur from visitors or returning travelers from
<br />countries where measles is still common, thereby introducing the virus into unvaccinated or under -vaccinated
<br />communities. In the U.S. there have been between 37 to 644 cases of measles reported each year, with multiple
<br />outbreaks reported in 2013, 2014, and 2015. In Orange County, 0-1 cases of measles were reported annually
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