'Our assumption is that we can't prevent it'
by: David F. Ashton, Jessica Guernsey Camargo, MPH, Project Supervisor for the Pandemic Influenza Community Engagement, was here telling a S.E. Portland group that there is no cure, nor any prevention yet, for the coming Avian Flu. “The fact is, the only real way of managing the pandemic is through citizens taking personal responsibility.”

Those listening to the project supervisor of Multnomah County's Pandemic Influenza Community Engagement center, Jessica Guernsey Camargo, MPH, looked stunned when she said that there is little government can do if Portland is struck with a pandemic of Avain Flu.

Speaking calmly, Camargo was in S.E. Portland on June 6th, sharing information about Avian Flu, the county's preparation, and how people can protect themselves.

The good news: At this time, nowhere in the world, is there an area yet experiencing a epidemic of Avian Influenza - known as H5N1 scientifically, and 'Bird Flu' commonly.

Right now, the H5N1 bird flu strain is commonly carried by wild birds. It does spread to domestic birds like chickens and ducks, Camargo told us. When the virus mutates so it can transfer among humans, we'll have a pandemic. 'There is no H5N1 bird flu in our country; but we do expect it to arrive at some time. We don't know when.'

Currently, bird flu rarely spreads from person to person, she said. 'When it does spread to humans, it is from very close, 'beak to cheek' contact. People who work with birds, or are in close contact with them, have a higher likelihood of infection.'

Thus far, the reported cases of the virus transferring from human to human have centered in Indonesia. 'But, if something changes, there is a potential for a serious pandemic or plague.'

Pandemic defined

Camargo said 'pandemic influenza' is a worldwide epidemic of flu. 'Pandemics result from new flu strains emerging, rapidly spreading around the world, and infecting large populations very quickly. The most severe pandemics have been in 1918, 1957, and 1968.'

The reason the health department takes this so seriously is that, in humans, H5N1 progresses rapidly into organ and respiratory failure. And, the virus mutates as it gets passed person-to-person.

Health Department preparations offer little personal aid

'Our 2006 assumption is that we can't prevent it,' continued Camargo. 'It can't be avoided. Vaccine for the virus is unlikely to be available in adequate supply. Antiviral drugs will have a limited role in easing the epidemic.'

Before and during the pandemic, she added, there will be open, continuous, and uncensored media coverage, because managing a flu pandemic will require broad community involvement.

'Specifically, we're increasing public information--how you can prepare yourself. We're working with hospitals to prepare their facilities for a large increase in seriously ill patients.'

No vaccine available

'We're trying to increase community education and dialog because we don't have a vaccine for H5N1. We will most likely not have one early on in a pandemic. When we do, It will be given to responders, police and health care workers first,' Camargo warned.

Asked about using face masks, she replied, 'We're not endorsing using any kind of mask to prevent illness.'

Watchful waiting

'Right now, we are doing disease surveillance. We work with the state labs in Alaska; they are the entry point for birds on the Pacific flyway through Oregon,' Camargo explained.

'We're also doing emergency response exercises with our community partners and official responders, to prepare for when pandemic strikes.'

How long a notice will we have once such a pandemic arises? 'A few weeks', she predicted. 'Most people will just think they have a cold, and won't realize how ill they truly are. They'll spread the illness.'

Our best hope: Community-level prevention programs

If a pandemic were to strike now, the health department official said, 'Local response would rest, largely, on community-level prevention programs. Individuals will be instructed to:

> Cover your cough;

> Wash your hands;

> Protect others by staying home when sick;

> Use medical prevention and treatments appropriately.

If a pandemic worsens to the level of requiring community-level intervention, Camargo said the officials will begin to 'enforce 'social distancing' such as patient isolation, focused contact notification, quarantine of small groups, cancellation of specific events, closure of specific facilities, communitywide "slow downs" -- stay at home days; as well as broad closure of businesses, schools, events, and transportation; finally, strict communitywide quarantine.'

Be aware and prepare

We asked Camargo for her bottom line on surviving the Avian Flu.

'Multnomah County is helping people prepare for it; we're doing all we can to prepare for it from the governmental side. But people put too much reliance on vaccines and medication. The fact is, the only real way of managing a pandemic is through citizens taking personal responsibility. I urge everyone to set aside an evening with their friends and families to begin to prepare for the possible pandemic.'

For more information, visit the Internet website, or call 503/988-4454 for a recorded message.

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