By Michael-Ann Miller

he streets are deathly quiet and towns are painted black

with mourning. You shudder’knowing your next breathe

could infect you. It’s 1918 during the Spanish flu
pandemic and you wonder if you will survive...

Even as a nursing student, I find it strange to learn of
death from influenza because of its prevalence and associated
low risk. However, the reality is that influenza is one of the
most deadly viruses that we have come into contact with in
the last thousand years. In 1918 the Spanish flu was estimated
to have killed more than 40 million people and quickly
spread across continents. Nowadays, we view the “flu” as
commonplace and only problematic with populations at the end
of the immunity spectrum, like children and the elderly. But
that was until bird flu and swine flu made an appearance and
we know we will survive, but we wonder, are we prepared?

Zoonoses (zoo-uh-NO-see) are described by the World
Health Organization (WHO) as infections and diseases that are
transmitted between other vertebrates and humans. Influenza is
one of these diseases particularly the HSN1 (bird) and HIN1
(swine) subtypes. According, to Dr. David Waltner-Toews,
epidemiologist, veterinarian, and author of the book The
Chickens Fight Back, diseases and infections play a useful role
in society by helping to maintain a balanced ecosystem within
the populations they infect. However, current changes in our
social-ecological world have highlighted the dangers associated
with tampering with this balance. The dangers are zoonotic
forms of influenza like the bird and swine flu that threaten to
reach pandemic proportions. So what is a pandemic?

A pandemic is a global epidemic and an epidemic
is a large scale outbreak (peak in incidence) of a disease.
Things like climate change and globalization all influence
the likelihood of a pandemic. In 2006, the world was
producing more than 88 million tonnes of chicken every
year. Coincidently, it was between 2005 and 2006 that we
experienced the avian “bird” flu pandemic that reached B.C.,
and hundreds and thousands of chickens and turkeys were
killed in the name of public safety.

Dr. Waltner-Toews’ theory is that globalization of big
farms creates an increase in infectious diseases. Trends in
agriculture reflect a need for farmers to become larger and
more efficient. One method used to achieve this is to co-farm
animals of different species, like waterfowl with chickens or
chickens with pigs, which further contributes to an increase
in the chances that an organism will jump across species.

He further states that mass killing of animals infected with a
zoonotic virus is potentially problematic. Because the viruses
cannot go back to their preferred animal host if that host is
extinct, leading them to seek shelter inside a human body and
mutate to adapt and stay longer. This results in the emergence
of different strains of influenza that can be passed from
animals like chickens to humans. Due to the adaptive nature
of influenza we need to be aware that even though we have
antiviral medications and vaccines, we might not have the

right type, or there is the possibility that the virus could change

 

(Prue

faster than we could manufacture. So we better starting getting
prepared.

What is pandemic preparedness? Currently on the Public
Health Canada website there is a link to a swine flu update
page, which educates Canadians on signs and symptoms,
transmission, and prevention—this is part of a pandemic plan.
Once an incident is reported in Canada, typically three to four
months after a charted epidemic in another part of the world,
the action plan is put into place. The goal of pandemic planning
is to minimize death, disease and social disruption.

The pandemic plan consists of phases and progresses from
public education to mass immunizations and the administration
of antiviral medications. Health systems according to the
WHO are needed to be able to prevent, detect, treat, and
mitigate causes of illness associated with the pandemic virus.
Transmission is what is to be controlled and as the pandemic
progresses the need to quarantine and close down sectors of
society becomes more apparent.

Universities and colleges have unique issues to consider
during a pandemic. Do they shut down dormitories, cancel
classes, or engage in voluntary or involuntary quarantine?
Students too are faced with challenges and risks. The sharing
of computers, textbooks, seats, and washrooms, creates
potential for transmission. According to the British Columbia
Pandemic Influenza Preparedness Plan, in an advanced
pandemic, universities and colleges could be used as a
place to train additional health care professionals to provide
immunizations. It is important to keep in mind that many post-
secondary institutions offer heath care-related programmes and
health care workers are incidentally most at risk for contracting
influenza during a pandemic. Therefore, communication
and education is important between University and College
faculties and their students.

In addition, everyone has a responsibility to promote
their health during a pandemic and here are few suggestions:
wash your hands, eat healthy and get enough sleep. This will
help to support your immune system while it fights off the flu.
Know the signs and symptoms of the flu, and reflect on how a
pandemic would affect your life. Talk about pandemics—the
B.C. Government has both a Facebook and Twitter page
dedicated to communicating information on the current swine
flu outbreak. Be aware of the evidence. Epidemiologists around
the world have made connections between the globalization of
farming and incidences of zoonoses. By advocating for safer
farming practices transmission could be avoided.

Currently, the WHO rates the swine flu pandemic as
a moderate level of concern. However, there is no vaccine
and this type of influenza is resistant to all but one antiviral.
Despite having a pandemic plan and medications to fight the
virus we are still in a vulnerable position.

One weakness with a pandemic plan is that is does not
address what causes the pandemic in the first place. We have
come a long way from the Spanish flu of 1918 but we still have
a long ways to go, and pandemic preparedness will only crisis

manage us through our changing social-ecosystem for so long.

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