PUBLIC HEALTH IN ACTION Responding to Pandemic Influenza A Local Perspective

Objective: To assess, via a tabletop exercise, the ability of a rural health unit to manage an influenza pandemic. Participants: The exercise brought together community stakeholders including representation from public health, hospitals, long-term care, social services, first responders, morticians, local government and the media. Setting: Leeds, Grenville and Lanark, a rural region of Ontario. Intervention: In June 2002, exercise participants were presented with a scenario involving the local response to pandemic influenza. Facilitators prepared a framework for the mock emergency in advance. However, the scenario was guided by decisions made by participants and the probable consequences of those decisions. Following the exercise, a debriefing session identified recommendations to be included in future plan development. Outcomes: The exercise identified critical issues, including communication, emergency decision-making, vaccination priorization, local surge capacity, and disease containment. Both participants and observers deemed the exercise successful. Conclusion: Improvements in the local contingency plan for pandemic influenza were identified. The exercise was an opportunity to familiarize participants with the contingency plan, practice working collectively and identify areas for further planning. The principles and lessons generated from the exercise can be used to guide the response to other large-scale infectious disease outbreaks. Influenza pandemics cause global devas-tation through unprecedented propor-tions of morbidity and mortality. The influenza virus periodically undergoes a major antigenic shift resulting in a ‘new’ virus to which the population has no immunity. Pandemic influenza is a global outbreak resulting from these major anti-genic changes. Although experts are certain that another influenza pandemic will occur, the timing and pattern is unpre-dictable. In the last century, three pan