Community Mitigation Guidelines to Prevent Pandemic Influenza — United States, 2017

Abstract

SummaryWhen a novel influenza A virus with pandemic potential emerges, nonpharmaceutical interventions (NPIs) often are the most readily available interventions to help slow transmission of the virus in communities, which is especially important before a pandemic vaccine becomes widely available. NPIs, also known as community mitigation measures, are actions that persons and communities can take to help slow the spread of respiratory virus infections, including seasonal and pandemic influenza viruses.These guidelines replace the 2007 Interim Pre-pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States — Early, Targeted, Layered Use of Nonpharmaceutical Interventions (https://stacks.cdc.gov/view/cdc/11425). Several elements remain unchanged from the 2007 guidance, which described recommended NPIs and the supporting rationale and key concepts for the use of these interventions during influenza pandemics. NPIs can be phased in, or layered, on the basis of pandemic severity and local transmission patterns over time. Categories of NPIs include personal protective measures for everyday use (e.g., voluntary home isolation of ill persons, respiratory etiquette, and hand hygiene); personal protective measures reserved for influenza pandemics (e.g., voluntary home quarantine of exposed household members and use of face masks in community settings when ill); community measures aimed at increasing social distancing (e.g., school closures and dismissals, social distancing in workplaces, and postponing or cancelling mass gatherings); and environmental measures (e.g., routine cleaning of frequently touched surfaces).Several new elements have been incorporated into the 2017 guidelines. First, to support updated recommendations on the use of NPIs, the latest scientific evidence available since the influenza A (H1N1)pdm09 pandemic has been added. Second, a summary of lessons learned from the 2009 H1N1 pandemic response is presented to underscore the importance of broad and flexible prepandemic planning. Third, a new section on community engagement has been included to highlight that the timely and effective use of NPIs depends on community acceptance and active participation. Fourth, to provide new or updated pandemic assessment and planning tools, the novel influenza virus pandemic intervals tool, the Influenza Risk Assessment Tool, the Pandemic Severity Assessment Framework, and a set of prepandemic planning scenarios are described. Finally, to facilitate implementation of the updated guidelines and to assist states and localities with prepandemic planning and decision-making, this report links to six supplemental prepandemic NPI planning guides for different community settings that are available online (https://www.cdc.gov/nonpharmaceutical-interventions).

Modeling and Forecasting Influenza-like Illness (ILI) in Houston, Texas Using Three Surveillance Data Capture Mechanisms

“…Though several surveillance systems have been designed to provide warning, few provide reliable data in near-real time, and fewer still have demonstrated the capability to provide advanced forecasting of impending influenza cases [1,18]. Our study recorded varying peak week, peak ILI %, and mean over the period from 2012-2016 with resultant effects on the ILI forecast estimates by data capture mechanisms.…”

“…Effective management of both seasonal and pandemic influenza requires early detection of the outbreak through timely and accurate surveillance linked with a rapid response to mitigate crowding [1]. Several diverse data sources, including historical and real-time, have been used to forecast influenza activity based on predictive models that could facilitate key preparedness actions and improve understanding of the epidemiological dynamics or evaluate potential control strategies [2-6].…”

Update: Public Health Response to the Coronavirus Disease 2019 Outbreak — United States, February 24, 2020

“…Currently, COVID-19 is not recognized to be spreading in U.S. communities. If sustained transmission in U.S. communities is identified, the U.S. response strategy will enhance implementation of actions to slow spread in communities (2,6). Implementation of basic precautions of infection control and prevention, including staying home when ill and practicing respiratory and hand hygiene will become increasingly important.…”

Estimating the Case Fatality Risk of COVID-19 using Cases from Outside China

“…Nevertheless, "most of the estimates in this category [symptomatic cases] fell in the range of 5 to 50 deaths per 100,000 cases." Pandemic influenza in 1957 (US data) 0.2% Calculated using US data from: [20].…”