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Pandemic Flu
Frequently Asked Questions

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What's pandemic flu?

A pandemic occurs when a disease spreads rapidly, affecting most countries and regions of the world.  Flu pandemics have occurred periodically throughout human history – including a major pandemic in 1918, and smaller pandemics in 1957 and 1968. The symptoms of pandemic flu are similar to those of seasonal flu but are usually more severe.

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What’s the difference between “pandemic flu” and “bird flu?”

Pandemic flu is a global outbreak of a new flu virus that few, if any people will have immunity.

Bird flu or H5N1 is a flu virus circulating in Southeast Asia, Europe and now Africa, that usually affects birds but also has infected people.  Those people became extremely sick or died.

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How does a flu pandemic start?

Flu viruses are constantly changing, producing new strains. Flu pandemics occur when a virus emerges that is so different from previous strains that few, if any people have immunity. This allows it to spread widely and rapidly, potentially affecting millions of people worldwide. The new virus may be the result of an animal virus, usually from a bird, mixing with a human virus to produce a new strain.

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How common are flu pandemics?

During the 20th century, there were three pandemics, all of which spread around the world within one year of being detected.

  • 1918-19, "Spanish flu," caused the highest number of known flu deaths: more than 500,000 people died in the United States, and up to 50 million people may have died worldwide. Many people died within the first few days after infection, and others died of complications later. Nearly half of those who died were young, healthy adults.
  • 1957-58, "Asian flu," caused about 70,000 deaths in the United States. First identified in China in late February 1957, the Asian flu spread to the United States by June 1957.
  • 1968-69, "Hong Kong flu," caused about 34,000 deaths in the United States. This virus was first detected in Hong Kong in early 1968 and spread to the United States later that year.

Flu viruses can jump from animals to humans.  The ability for the virus to infect both can create new and unusual viruses that could cause a pandemic.

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What's the difference between pandemic flu and seasonal flu?

Seasonal Flu
  • Occurs every year during the winter
  • Affects up to 10% of the population
  • For most people it is an unpleasant but not life-threatening infection
  • The very young, the very old, and people with certain chronic illnesses are most at risk of serious illness
  • Annual vaccination is available
  • Antiviral drugs are available to treat those at risk
  • View our seasonal flu page
Pandemic Flu
  • Has occurred three times in the last 90 years
  • Can occur any time of the year
  • It is a more serious infection for everyone
  • People of every age may be at risk of serious illness
  • A vaccine is currently not available
  • Antiviral drugs are likely to be in limited supply

Vaccine against seasonal flu will not protect against pandemic flu. However, getting your annual flu shot is one of several things you can do to keep yourself healthy, and that may help you fight off a pandemic flu virus.

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How likely is a flu pandemic?

Three pandemics have occurred in the last 90 years, in 1918, 1957 and 1968. Scientists predict that another pandemic will happen, although they can't say exactly when.

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Why does the current bird flu outbreak pose a risk for becoming a pandemic flu outbreak in humans?

New human flu viruses can arise from bird flu viruses that then change to a form that can infect humans and spread readily from person to person.  Current bird flu outbreaks in Asia, Europe and Africa are caused by a type of flu virus called "H5N1." Human infections and deaths due to the H5N1 virus have occurred, although the virus has at this time not developed the ability to pass easily from person to person and cause outbreaks in humans.

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How likely is it that pandemic flu will spread to the U.S. and Nebraska?

The World Health Organization, Centers for Disease Control and Prevention, the Nebraska Health & Human Services System and local health departments are watching for the first signs of an emerging pandemic.

In 1918, pandemic flu spread across the country in less than a month. Now, in the era of international air travel, experts say a pandemic will probably spread even faster. As a result:

  • Many people will get sick with pandemic flu
  • There will be a high demand for healthcare
  • Many aspects of daily life will be disrupted
  • There will be many deaths

Nebraska is working with many different partners to prepare for a possible pandemic.

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How likely am I to catch pandemic flu?

During a pandemic you're more likely to catch it than seasonal flu because it spreads rapidly and very few people will have immunity. Everyone will be at risk. Some groups of people may be more at risk than others, but every pandemic is different, so until the virus starts spreading it is very difficult to predict who these groups might be. With seasonal flu the groups of people more likely to become seriously ill include:

  • The very young
  • People over 65 years of age
  • People with existing medical conditions such as lung diseases, diabetes, cancer, kidney, or heart problems
  • People who have immune system problems because of certain medical treatments, or illnesses like HIV/AIDS

The groups most likely to get sick will probably be different during a pandemic.

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How will I know if pandemic flu has reached the U.S. or Nebraska?

The World Health Organization has an international system in place for tracking the emergence of a new pandemic. The Centers for Disease Control and Prevention, the U.S. Department of Health & Human Services, and the Nebraska Health & Human Services System will also be monitoring the situation.

If it looks like a pandemic is going to reach the U.S., the government will issue warnings and work with the media to advise people on the best course of action. If it looks likely a pandemic will reach Nebraska, health officials will use the media and this Website to advise people on what they should do.

PDF Learn more about Nebraska's flu surveillance system

Are there protective steps that can help lessen the spread of pandemic flu?

Protective steps include:  staying home if you're sick, cancelling public events and closing schools.  Protective steps buy time during a pandemic… give us more time to produce vaccine and vaccinate people… if vaccine exists.  Reduce illness and death rates which equals saving lives.   Decrease the surge of sick people… helps lessen burden on critical infrastructure, hospitals and health care providers.  However, these steps aren’t a magic bullet.  They can’t prevent a community from being affected; they can’t stop some people from getting sick and dying.

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Vaccine and Antivirals

Can a vaccine be made to protect against pandemic flu?

Vaccines against bird flu are already being made and tested.  Experts are also testing new ways of making vaccine quickly.  If pandemic flu occurs, we’ll need a vaccine for the specific virus causing the pandemic.   Flu viruses change constantly so there’s little time to prepare a vaccine in advance.   This new virus would be different from the current bird flu virus.  So although it's possible we may have a bird flu vaccine, it's also possible it may not work on the pandemic flu virus.  It’s also difficult to make large amounts of vaccine without knowing the exact pandemic flu virus.

How long will it take to make enough pandemic flu vaccine for everyone?

The long-term goal is to have enough vaccine for everyone.  However, if there's a vaccine, it will likely be in short supply during the early stages of a pandemic.   Today, it could take a year to produce enough vaccine for everyone in the U.S.  Current techniques require months to make and test vaccines, and there are only two U.S. producers of flu vaccine.

Who decides who gets vaccine first and how will they decide?

Medical and public groups made recommendations about who will get vaccine first in a pandemic.  Medical experts used their knowledge and experience to make recommendations then people across the country reviewed those recommendations and were also asked for input.  Nebraska has gone through a similar process for the state plan.  Our recommendations will be passed on to the Governor.  Vaccine will be used where it can effectively prevent illness and death.  People who perform essential services, like healthcare providers, will be vaccinated first.  Other groups will be identified for vaccination based on the pandemic.

How will vaccine be distributed if there’s a pandemic?

Most likely, the federal government will direct shipments of vaccines to states.  Flu vaccine makers already distribute millions of doses of vaccine every year.  Nebraska has a plan to distribute vaccine quickly.  Informing people where to go for vaccine is part of that plan.  Other systems are also in place such as the Strategic National Stockpile (SNS).

The SNS is a national resource of medicine and medical supplies and equipment.   These “stockpiles” are located around the country so states can get access to them quickly.

Is there medicine that can prevent or treat pandemic flu?  How effective is it?

There are medicines, called antivirals, approved for use in the U.S. to prevent and treat flu.  These “antiviral” medicines fight many kinds of flu.  Health experts think antivirals could provide some protection against pandemic flu but it will depend on the virus.  Antivirals are most effective when used as soon as possible after symptoms appear.  The federal government has a national stockpile of antiviral medicines.  Despite the stockpiling effort, there may not be enough for everyone.

Should I buy my own supply of antiviral medication?

No.  Health officials say in a pandemic flu outbreak, antivirals need to be available to those who need them most so public health employees and healthcare providers must be able to manage available supplies.  That’s not possible if people are hoarding antivirals.  Also, personal stockpiling may reduce supplies making it harder to treat seasonal flu in the elderly and others who are at risk of serious illness or death from complications of “seasonal” flu.

How about antibiotics or the pneumonia vaccine?

Antibiotics won’t help against a pandemic flu virus, but they may help if someone got a secondary infection caused by bacteria.  According to experts, most of the people who died from bird flu, the virus was the cause of death.  However, during the 1918 flu pandemic, many people died from pneumonia and other bacterial illnesses.  There are vaccines that protect against infections like pneumonia.

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Links to more information about pandemic flu

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Contact:
If you have bird flu or pandemic flu questions or would like additional information, email birdflu@dhhs.ne.gov or call the DHHS Disease Surveillance area at 471-2937.

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