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Vol. LVIII, No. 23
November 17, 2006
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Pandemic Flu Conference Preps NIH’ers on Continuity of Operations

On the front page...

The Oct. 19 conference on Pandemic Flu Operational Continuity briefed hundreds in Masur Auditorium on NIH’s state of readiness. Led by acting associate director for security and emergency response Dr. Pierre Noel (see NIH Record, Oct. 6) and supported by Colleen Barros, NIH deputy director for management, 10 working group leaders gave status reports and then fielded questions from the audience.

Dr. David Henderson, the Clinical Center’s deputy director for clinical care, put the effort in context. In flu’s 400-year history, he said, the average time between pandemics has been about 24 years. In 1968—38 years ago—“Asian flu” hit. Thus the urgency. “We’re due,” he said. “So we have to be ready.”

Continued...


Dr. Pierre Noel outlines NIH panflu readiness plans.
Dr. Pierre Noel outlines NIH panflu readiness plans.

All stressed how this is a work in progress. Meanwhile, here’s a list of highlights, tips and tools:

  • Summaries, updates and other useful information appear on NIH’s PanFlu web site—the only HHS site yet developed for employees to track PanFlu activities and links—at http://www.nih.gov/employee/pandemicflu/.
  • Seasonal flu vaccine is free for employees (for schedule see NIH Record, Oct. 20).
  • Seasonal flu vaccine does not provide protection against H5N1. There is H5N1 vaccine in the national stockpile; this vaccine may not be specific to the strain associated with a pandemic in the U.S. but will provide some cross-protection and decrease mortality and morbidity. It will take 6-12 months to produce a strain-specific vaccine.
  • Dr. David Henderson says the average time between pandemics has been only 24 years: “We’re due, so we have to be ready.”
    Dr. David Henderson says the average time between pandemics has been only 24 years: “We’re due, so we have to be ready.”
  • Contractors are encouraged to speak with their respective employers and health care providers about vaccination for seasonal flu.
  • 400 NIH nurses and physicians working in non-clinical areas on campus have volunteered to staff the CC in case clinical staff is down. The CC will also partner with Suburban Hospital and the National Naval Medical Center in the event of an emergency.
  • Alcohol-based disinfectants, widely available in “drywash” hand cleaners, are very effective in preventing spread of the virus.
  • Hand-washing, using soap and warm running water, destroys bird flu virus. Wash hands for a minimum of 15 to 20 seconds.
  • In the event that leave-approving officials are down with flu, the ITAS system can centrally approve timecards.
  • Since administrative leave (“excused absence”) is not an entitlement, its widespread use, even in a pandemic, would be the last resort, after sick/annual leave and leave without pay have been exhausted.
  • To prepare for wide-scale work from home, the next telework tests are scheduled for Dec. 7 and a TBA date in March 2007.
  • Acquisitions will participate in telework test days to orient and train employees in remote procurement and contract awards.
  • Dr. David Henderson says the average time between pandemics has been only 24 years: “We’re due, so we have to be ready.”
    Calvin Jackson, chief of the News Branch, Office of Communication and Public Liaison, discusses emergency plans.
  • CIT telework courses, including a basic remote access course, are now available. Online modules will be available by year’s end.
  • NIH’s Office of Research Facilities is planning its staffing to accommodate high-priority needs in the event of a pandemic.
  • Animal care supplies are being stockpiled for intramural research animal facilities.
  • No staff are currently expected to shelter-in-place; this includes animal care staff and CC staff. In the event that normal supply chains are disrupted, cafeteria contractor Eurest has identified vendors outside of the D.C. area so that NIH employees will be fed.
  • The NIH Employee Directory (NED) will soon feature a button for “Red Alert Critical (RAC).” Each IC point of contact will be able to designate authorized staff as RAC by clicking “yes” to activate an employee’s ID badge, allowing access to campus in the event of an emergency.
  • Each IC needs to look at its own personnel and identify who is critical.
  • All staff should educate themselves on county and local government plans and develop their own individual and family plans. A pandemic would likely come in two waves, each lasting 6-8 weeks, with 30-40 percent of employees affected.

Decoding H5N1’s Name

Influenza is caused by a virus, and some viruses are more virulent—better at causing disease—than others. The current strain of bird flu that has caused over 150 deaths, mostly in Asia, is called H5N1. How did it get its name? This has to do with how viruses work.

Viruses can’t reproduce outside a host cell; they must use the host to copy themselves. To do that, they need an effective way to hijack the host cell without getting killed.

Not all proteins are created equal and the ones found in viruses can overwhelm the host’s defenses. Two of these viral proteins appear as abbreviations—the H and the N—in H5N1. The H lets the viruses break into the cell; the N lets them escape.

H stands for hemagglutinin (HA), a protein found on the surface of many germs, including viruses. HA is shaped like a spike and attacks the cell being infected. In the case of the influenza virus, HA binds the virus to a cell in the lining of the lung. Once it gains entry, the virus contents pour into the cell. The virus then uses the host’s “stuff” to make new viruses.

N stands for neuraminidase (NA), the protein that releases the newly formed viruses from the infected host cell, which breaks open and dies. If enough cells die, the whole organism will suffer.

Now for the numbers: N7—type-7 neuraminidase—is not necessarily more virulent than N6—type-6 neuraminidase. Numbers are assigned by scientists tracking the viruses as they evolve.

No one should panic. “It’s not like a bomb,” said Noel, who should know—he is NIH’s advisor on weapons of mass destruction, disaster planning and biodefense while he serves, concurrently, as flight surgeon in the Air Force Special Operations Command.

Even if the virus learns to “jump” efficiently from human to human, “We’ll have time to prepare,” he said. “We’ll have weeks, maybe months to finalize.” Even in faraway rural Indonesia, Henderson noted, one of the H5N1 isolates (which ultimately burned itself out) was completely sequenced within 48 hours. The first U.S. clinical trials of bird flu vaccine are currently in progress. NIH Record Icon

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