New CDC Guidelines Aim to Prevent Future Influenza Pandemics

As the 2016-2017 flu season continues to wind down, the Centers for Disease Control and Prevention (CDC) have released a new set of guidelines for pandemic prevention based on health officials’ insights from the 2009 flu pandemic.

According to the CDC’s weekly FluView report, there are now only 7 states reporting widespread flu activity, a continued drop from the 10 states reported in the previous week. While the overall summary of the 2016-2017 flu season won’t be available for some time, and sporadic flu activity is expected to continue for several weeks, factors such as the number of influenza-associated pediatric mortalities show that this season has come in below other flu seasons in recent years. Health officials have reported 82 flu-related pediatric deaths so far this season. The 2009-2010 flu season—marked by pandemic conditions caused by the novel influenza A H1N1—saw 288 pediatric deaths, making it the deadliest flu season of the past decade.

To outline what health officials have learned from the 2009 flu pandemic, the CDC published a new set of guidelines on community mitigation of flu pandemics, in the most recent Morbidity and Mortality Weekly Report. The report emphasizes the importance of nonpharmaceutical interventions (NPIs) that people and communities can take to help control the spread of respiratory virus infections. Such actions are especially important in cases of emerging diseases, many of which do not yet have any widely available vaccines. The CDC’s new guidelines offer recommendations to help state and local health officials with prepandemic planning to mitigate the effects of potential future pandemics.

Such measures include:

• Voluntary home isolation recommends that those with influenza infection stay home for at least 24 hours after fever or signs of fever are gone. The guidelines note that a patient’s temperature should be measured in the absence of any fever-lowering medications. In addition, any household members of individuals infected with influenza who have been exposed are recommended to voluntarily “self-quarantine” for a minimum of 3 days.
• Respiratory etiquette, or covering the mouth and nose with a tissue when coughing or sneezing, is strongly advised. When a tissue is not available, the recommendations suggest coughing or sneezing into a shirt sleeve rather than into a hand. Avoid touching eyes, nose, and mouth.
• Hand hygiene, including regular thorough hand washing with soap and water, or use of an alcohol-based hand sanitizer.
• Use of face masks offers a source control measure during severe, very severe, or extreme influenza pandemics when crowded community settings cannot be avoided.

The recent report emphasizes that while individuals with the flu can become infectious 1 day before the onset of symptoms, and continue to be infectious for 5 to 7 days after becoming sick, infants and immunocompromised patients may shed influenza viruses for up to 21 days.

With the new guidelines, the CDC hopes communities can control the acceleration of the number of flu cases in a pandemic, reduce the peak number of cases, minimize healthcare demands on hospitals and infrastructure, and decrease overall cases and health effects. “Communities, families and individuals, employers, and schools can create plans that use these interventions to help slow the spread of a pandemic and prevent disease and death,” wrote the authors.