HHS Releases Updates to Pandemic Influenza Plan to Guide Prevention and Response

To better prepare the nation for its next potential flu pandemic, the US Department of Health and Human Services (HHS) has released an updated pandemic influenza plan based on lessons learned from the 2009 influenza A (H1N1) pandemic.

The novel H1N1 flu virus that emerged in the United States in 2009 and spread around the world, caused the World Health Organization (WHO) to declare a global pandemic, the first in more than 40 years. The pandemic lasted more than a year, as the unique virus went on to cause an estimated 60.8 million illnesses, 274,304 hospitalizations, and 12,469 deaths across the country from April 12, 2009 to April 10, 2010. What was at the time referred to as the “swine flu” was not related to the circulating human seasonal H1N1, and had a combination of genes related to the North American swine-lineage H1N1 and Eurasian lineage swine-origin H1N1 influenza viruses. With the new virus, countries in the north hemisphere saw a high number of summer flu illnesses, which continued to rise as US temperatures cooled and peaked in October, before dropping back to baseline flu levels by January of 2010.

Health officials have used the takeaways from the 2009 flu pandemic to develop new ways to prevent and respond to future pandemics. In fact, the Centers for Disease Control and Prevention (CDC) recently issued updated preventative guidelines to help communities mitigate the spread of a pandemic flu virus. Now, the HHS has published a 2017 update of its Pandemic Influenza Plan, which it released on June 15. The updated 52-page plan highlights the challenges of containing influenza pandemics, emphasizing the virus’s tendency to change and spread easily. The first pandemic influenza plan, released in 2005, aimed to respond to a very severe pandemic capable of social and economic disruption, which, despite its impact, had a level of severity not seen in the 2009 pandemic.

While the 2005 plan included 4 key pandemic response elements, the updated HHS plan lays out 7 domains for the prevention, control, and mitigation of the next pandemic influenza outbreak based on lessons learned from the 2009 pandemic outbreak. These include:

• Domain 1 — Surveillance, Epidemiology, and Laboratory Activities
• Domain 2 — Community Mitigation Measures
• Domain 3 — Medical Countermeasures: Diagnostic Devices, Vaccines, Therapeutics, and Respiratory Devices
• Domain 4 — Health Care System Preparedness and Response Activities
• Domain 5 — Communications and Public Outreach
• Domain 6 — Scientific Infrastructure and Preparedness
• Domain 7 — Domestic and International Response Policy, Incident Management, and Global Partnerships and Capacity Building

“HHS has made substantial progress in pandemic influenza preparedness since the 2005 Plan was released,” says the updated report. The report also notes that these domains reflect an end-to-end systems approach to improving the way preparedness and response are integrated across sectors and disciplines, while remaining flexible for the conditions surrounding a specific pandemic. “In the current document, HHS reviews that progress, highlighting both the successes and remaining gaps in our preparedness and response activities for pandemic influenza. Most significantly, HHS efforts in pandemic influenza preparedness now are closely aligned with seasonal influenza activities, harnessing expanded surveillance, laboratory, vaccine, and antiviral drug resistance monitoring capacity.”

The progress made in the public health sector since the last plan includes expanded global influenza surveillance and laboratory capacity, which the updated report notes has helped health officials track evolving influenza A viruses and the emergence of novel viruses with pandemic potential. With the new forecasting, modeling and planning tools, health agencies can better estimate the spread, burden and impact of a pandemic virus.

With the scientific advances made in recent years, the updated plan also includes the goal of speeding up the development and production of vaccines and antiviral drugs in response to a novel pandemic virus. While the 2005 plan included a 6-month turnaround for pandemic vaccines, the updated plan sets that goal to 3 months of the emergence of a pandemic strain. “These goals are attainable, but achieving them will require dedication in terms of resources, innovation, education and outreach, and commitment,” says the updated plan. The domains laid out in the updated 2017 HHS plan will guide the agency’s pandemic influenza response for the next decade.