Pandemic influenza (H5N1)

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I work in Alaska on the Aleutian island occasionally.
Recently a village had a ‘dry run’ to practice giving immunizations incase the pandemic flu strikes here. Alaska is a threat because of migration of birds. It is felt that Alaska will be one of the first hit with the avian flu.
This small village was able to immunize 68 people in 4 hours.
The staff was eight people but they probably could have done it with six because they used two people to evaluate and work on spousal and child abuse issues with the ‘dry run’
One person was an intake at the door of the community center to guide the people through and help fill out forms.
Two people took vital signs and screened to make sure the person receiving the immunization had never been allergic to other flu shots or allergic to eggs.
Two people gave the vaccines; one person helped the person go out of the clinic and answered any other questions.
The village thought this ‘dry run ‘ was a success.

Original Post:
November 29, 2007
If/when a pandemic takes place, clinical nurses will need to use advanced assessment skills to recognize those who have been infected as well as those at risk. The symptoms of H5N1 have been shown to mimic the pandemic flu of 1918. Early symptoms of H5N1 mimic that of regular seasonal flu. However, the disease process of the H5N1 appears to be more inflammatory in nature leading to a mortality rate >50% affecting those with healthy immune systems. There is no rapid method to test for H5N1 and no vaccine. A person with seasonal flu or a regular cold has upper respiratory symptoms and an increased WBC count. A person with H5N1 has upper respiratory symptoms and a low WBC count. Could these clinical markers be used as an effective screening tool to triage and disperse available treatments (anti-virals, ventilators, etc.) in the throws of a full blown pandemic? If/When H5N1 mutates to develop human-to-human transmission initiating the pandemic, could the virulence decrease?

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