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Pandemic Planning

The purpose of this site is to educate the public regarding pandemic and how to prepare for it. This site will also serve as the central point of communication for the ND Department of Public Instruction and the local education agencies regarding pandemic preparations. The site will be updated as new information becomes available - refer to this site as often as you need information. Any site visitor can ask questions in the space provided below; all inquiries will be answered by DPI staff and posted to the Pandemic Frequently Asked Questions (FAQ) section.

This site is designed to provide the following information:

February 1, 2007 Update From CDC

On February 1, the Centers for Disease Control and Prevention (CDC) announced the availability of an essential new resource for communities, schools, and colleges that offers guidance on community strategies that would delay or reduce the impact of a severe pandemic by limiting the spread of disease until a vaccine is available. This guidance document, Interim Pre-pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States (Community Mitigation Guidance), contains important planning information on a variety of subjects, including:

  • Community-based strategies. In the early phase of an influenza pandemic, a pandemic influenza vaccine is unlikely to be available. Therefore, it will be important to implement a variety of community-based interventions to help reduce the spread of disease. These interventions include social distancing, such as staying home when sick and avoiding large crowds, prolonged school closings, and planning for alternative work schedules.
  • Pandemic Severity Index (PSI). This will help communities gauge the potential severity and impact of a pandemic and the appropriate actions communities can take to limit the spread of the disease.
  • Triggers for initiating community interventions. These are based on the level of threat.
  • Consequences of community interventions, such as prolonged school closings. These should be anticipated and addressed in local and state planning efforts.
  • Specific planning guidance. This is tailored for businesses and other employers, child care programs, elementary and secondary schools, colleges and universities, faith-based and community organizations, and individuals and families.

The document is available at
We encourage you to share this link with your staff and colleagues working on emergency response plans for an influenza pandemic.

Pandemic School Closure Exercise -- January 26, 2007

On January 26, 2007, the North Dakota Department of Health in conjunction with local public health units organized a state-wide exercise. The exercise focused on pandemic influenza and school issues focused around that topic, specifically school closure issues. Although this exercise focused on pandemic influenza, school closings can be a result of many different scenarios ranging from natural disasters to terrorism or other violent attacks. As requested, an after-action report has been generated to capture comments and issues discussed during the exercise. Please see the following document. School Closure

If you have any further questions about pandemic influenza planning and planning for other emergencies, please contact your regional emergency preparedness coordinator:

  • Divide, McKenzie, Mountrail, Williams counties:
    Faye Moe
    (701) 774-6407
  • Bottineau, Burke, McHenry, McLean, Renville, Sheridan, Ward counties:
    Dustin Hager
    (701) 852-1376
  • Benson, Cavalier, Eddy, Pierce, Ramsey, Rolette, Towne counties:
    Justin Maddock
    (701) 662-7016
  • Griggs, Grand Forks, Nelson, Pembina, Walsh counties:
    Delbert Streitz
    (701) 787-8111
  • Adams, Billings, Bowman, Dunn, Golden Valley, Hettinger, Slope, Stark counties:
    Joe Wanner
    (701) 483-3765
  • Burleigh, Emmons, Grant, Kidder, Mercer, Morton, Oliver, Sioux counties: Cheryl Underhill
    (701) 222-6525
  • Barnes, Dickey, Foster, LaMoure, Logan, McIntosh, Stutsman, Wells counties:
    Tami Dillman
    (701) 252-8130
  • Cass, Ransom, Richland, Sargent, Steele, Traill counties:
    Kym Overland
    (701) 476-4066

Basic Pandemic Facts and Information

An influenza (flu) pandemic is a widespread outbreak of disease that occurs when a new flu virus appears that people have not been exposed to before. Pandemics are different from seasonal outbreaks of influenza. Seasonal flu outbreaks are caused by viruses that people have already been exposed to; flu shots are available to help prevent widespread illness an impacts on society are less severe. Pandemic flue spreads easily from person to person and can cause serious illness because people do not have immunity to the new virus.

A pandemic may come and go in waves, each of which can last for months at a time. Everyday life could be disrupted due to people in communities across the country becoming ill at the same time. These disruptions could include everything from school and business closings to interruption of basic services such as public transportation and health care. An especially severe influenza pandemic could lead to high levels of illness, death, social disruption and economic loss.

A pandemic is a global disease outbreak - a pandemic is a local crisis worldwide. It can happen in every state and every city and every town at almost the same time. A flu pandemic occurs when a new influenza virus emerges for which people have little or no immunity, and for which there is no vaccine. The disease spreads easily person-to-person, causes serious illness, and can sweep across the country and around the world in very short time.

It is difficult to predict when the next influenza pandemic will occur or how severe it will be. Health professionals are concerned that the continued spread of a highly pathogenic avian H5N1 virus across eastern Asia and other countries represents a significant threat to human health. The H5N1 virus has raised concerns about a potential human pandemic because:

  • It is especially virulent
  • It is being spread by migratory birds
  • It can be transmitted from birds to mammals and in some limited circumstances to humans, and
  • Like other influenza viruses, it continues to evolve.

Since 2003, a growing number of human H5N1 cases have been reported in Azerbaijan, Cambodia, China, Egypt, Indonesia, Iraq, Thailand, Turkey, and Vietnam. More than half of the people infected with the H5N1 virus have died. Most of these cases are all believed to have been caused by exposure to infected poultry. There has been no sustained human-to-human transmission of the disease, but the concern is that H5N1 will evolve into a virus capable of human-to-human transmission. Containing or slowing an influenza pandemic demands that a nascent outbreak anywhere in the world be recognized and confirmed within 1 to 2 weeks.

As of April 2006, H5N1 has spread to 37 nations on three continents; 175 people have been infected and 96 of them have died. To date, most of those people were exposed to infected poultry. Fortunately, there has been no sustained human-to-human transmission of the disease, but the rapid spread of H5N1 is reason for concern.

As the avian infection moves closer to America, the Departments of Agriculture, Interior and Health and Human Services are stepping up the monitoring and testing of migratory birds. This surveillance is essential to provide early warning so the disease does not spread to people, poultry and pets and to insure the safety of the nation’s food supply.

The best defense against influenza is vaccination. It is also the most difficult defense to achieve. A fully effective vaccine cannot be developed until the virus strain it must protect against has evolved and been identified. And once developed, there must be the production capacity to manufacture enough vaccine to protect the population.

There currently is no commercially available vaccine to protect humans against the H5N1 virus that is being seen in Asia, Europe, and Africa. A pandemic vaccine cannot be produced until a new pandemic influenza virus emerges and is identified.

How Does Seasonal Flu Differ From Pandemic Flu?

Seasonal Flu

Pandemic Flu

Outbreaks follow predictable seasonal patterns; occurs annually, usually in winter, in temperate climates

Occurs rarely (three times in 20th century - last in 1968)

Usually some immunity built up from previous exposure

No previous exposure; little or no pre-existing immunity

Healthy adults usually not at risk for serious complications; the very young, the elderly and those with certain underlying health conditions at increased risk for serious complications

Healthy people may be at increased risk for serious complications

Health systems can usually meet public and patient needs

Health systems may be overwhelmed

Vaccine developed based on known flu strains and available for annual flu season

Vaccine probably would not be available in the early stages of a pandemic

Adequate supplies of antivirals are usually available

Effective antivirals may be in limited supply

Average U.S. deaths approximately 36,000/yr

Number of deaths could be quite high (e.g., U.S. 1918 death toll approximately 500,000)

Generally causes modest impact on society (e.g., some school closing, encouragement of people who are sick to stay home)

May cause major impact on society (e.g. widespread restrictions on travel, closings of schools and businesses, cancellation of large public gatherings)

Avian Bird Flu

  • Avian influenza - commonly called "bird flu" - is an infection caused by influenza viruses that occur naturally in birds.
  • Wild birds can carry the viruses, but usually do not get sick from them. However, some domesticated birds, including chickens, ducks, and turkeys, can become infected, often fatally.
  • One strain of avian influenza, the H5N1 virus, is endemic in much of Asia and has recently spread into Europe. Avian H5N1 infections have recently killed poultry and other birds in a number of countries.
  • Strains of avian H5N1 influenza may infect various types of animals, including wild birds, pigs, and tigers.

The Avian H5N1 Flu in humans is currently very limited and not a pandemic.

Flu Definitions
Seasonal (or Common) flu is a respiratory illness that can be transmitted person to person. Most people have some immunity, and a vaccine is available.
Avian (or bird) flu is caused by influenza viruses that occur naturally among wild birds. The H5N1 variant is deadly to domestic fowl and can be transmitted from birds to humans. There is no human immunity and no vaccine available.
Pandemic flu is virulent flu that causes a global out-break, or pandemic, of serious illness. Because there is little immunity, the disease can be spread easily from person to person.
Currently, there is no pandemic flu.

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In the event of a pandemic

Education and outreach are critical to preparing for a pandemic. Understanding what a pandemic is, what needs to be done at all levels to prepare for pandemic influenza, and what could happen during a pandemic helps everyone make informed decisions.

A pandemic may come and go in waves, each of which can last for six to eight weeks. An especially severe influenza pandemic could lead to high levels of illness, death, social disruption, and economic loss. Everyday life would be disrupted because so many people in so many places become seriously ill at the same time. Impacts can range from school and business closings to the interruption of basic services such as public transportation and food delivery. Historically, the 20th century saw three pandemics of influenza:

  • 1918 influenza pandemic caused at least 500,000 U.S. deaths and up to 40 million deaths worldwide
  • 1957 influenza pandemic caused at least 70,000 U.S. deaths and 1-2 million deaths worldwide
  • 1968 influenza pandemic caused about 34,000 U.S. deaths and 700,000 deaths worldwide

Characteristics and challenges of a pandemic
Rapid Worldwide Spread

  • When a pandemic influenza virus emerges, its global spread is considered inevitable.
  • Preparedness activities should assume that the entire world population would be susceptible.
  • Countries might, through measures such as border closures and travel restrictions, delay arrival of the virus, but cannot stop it.

Health Care Systems Overloaded

  • Most people have little or no immunity to a pandemic virus. Infection and illness rates soar. A substantial percentage of the world’s population will require some form of medical care.
  • Nations unlikely to have the staff, facilities, equipment and hospital beds needed to cope with large numbers of people who suddenly fall ill.
  • Death rates are high, largely determined by four factors: the number of people who become infected, the virulence of the virus, the underlying characteristics and vulnerability of affected populations and the effectiveness of preventive measures.
  • Past pandemics have spread globally in two and sometimes three waves.

Inadequate Medical Supplies

  • The need for vaccine is likely to outstrip supply.
  • The need for antiviral drugs is also likely to be inadequate early in a pandemic.
  • A pandemic can create a shortage of hospital beds, ventilators and other supplies. Surge capacity at non-traditional sites such as schools may be created to cope with demand.
  • Difficult decisions will need to be made regarding who gets antiviral drugs and vaccines.

Economic and Social Disruption

  • Travel bans, closings of schools and businesses and cancellations of events could have major impact on communities and citizens.
  • Care for sick family members and fear of exposure can result in significant worker absenteeism.

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What is North Dakota doing about the Pandemic
On March 9, 2006 Health & Human Services (HHS) Secretary Mike Leavitt and Governor John Hoeven signed a Planning Resolution detailing HHS' and North Dakota's shared and independent responsibilities for pandemic planning. North Dakota will receive more than $600,000 from the HHS to use for pandemic planning activities. The State of North Dakota, HHS and other federal agencies held a pandemic planning summit on March 9, 2006 with public health and emergency management and response leaders within the state.

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DPI responsibilities
The ND Department of Public Instruction is one of many participating state agencies working together to prepare for a pandemic outbreak. Mutual goals include detection, response, and slowing down the progression of disease.

In the event of a pandemic, the ND Department of Public Instruction will coordinate support to local and tribal governments for:

  • Emergency feeding;
  • Evacuation and transportation support;
  • Transportation and or facilities for mass inoculation;
  • Facilities for emergency medical treatment; and,
  • Assistance to local schools with displaced students.

DPI will support the ND Governor’s Office and the ND Department of Health and communicate with LEAs regarding:

  • Disease identification and referral;
  • Disease control;
  • Criteria for school closing;
  • Criteria for student re-entry / school re-opening; and,
  • School staff management of disease and services.

DPI will follow their agency crisis management plan. Communication is key among internal staff as well as with the LEAs. Communication with LEAs would be through the existing DPI list serves created for ALL superintendents and building principals – public, private and tribal – in addition to this website.

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LEA responsibilities
Local educational agencies (LEAs) play an integral role in protecting the health and safety of their district's staff, students and their families. The Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) have developed a checklist to assist LEAs in developing and/or improving plans to prepare for and respond to an influenza pandemic. [] Building a strong relationship with the local public health units is critical for schools and communities to develop a meaningful plan. See the ND Department of Health website for local health unit contact information.

Obvious questions involving identification of a pandemic, decision about school closings, guidance about school re-opening, staff, ADM and fiscal payments have been discussed, but no formal decisions have been determined at this time pending continued planning and communication with the Governor’s office and the Department of Health.

In the event of a pandemic, the local schools will play many roles. Among the many roles each school will play in the event of a pandemic, it is likely the school building will serve as central communications and location for community members. Community planning may include the use of school buses for transportation of citizens to/from the school for vaccine inoculations, use of the school facility for mass vaccine inoculations, use of school facilities and stockpiled food for mass meal distribution, medical care and triage, etc. In addition, the school district should evaluate options and develop suggestions for home learning activities.

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Personal responsibilities
In the event of a pandemic, it is a normal reaction to be at home with your family to take care of loved ones and avoid public contact. There is no need to panic or worry – information will be readily available at the appropriate time. However, families can begin preparing now. Information is readily available on the US government pandemic website ( about staying healthy and being prepared. Knowing the facts is the best preparation for your self, your children and your family.

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ND Pandemic Summit webcast

US Government Pandemic website

ND Pandemic State Plan

Pandemic Flu Planning Checklist for Individuals and Families

Pandemic Presentation – Dept of Health and Dept of Public Instruction 9/06

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Frequently Asked Questions

  1. How much truth is the May 9th ABC television network made-for-TV movie titled “Fatal Contact: Bird Flu in America” which follows an outbreak of the H5N1 avian flu virus from its origins in a Hong Kong market through its mutation into a pandemic virus that becomes easily transmittable from human to human and spreads rapidly around the world?

      The ABC Movie “Fatal Contact: Bird Flu in America” is a movie, not a documentary. It is a work of fiction designed to entertain and not a factual accounting of a real world event. Please remember that there is no influenza pandemic in the world at this time. It is important to also remember that H5N1 avian influenza is almost exclusively a disease of birds. The H5N1 virus has not yet appeared in the U.S. Should the H5N1 virus appear in the U.S., it does not mean the start of a pandemic.
  2. Is a pandemic imminent? Will the bird flu cause the next influenza pandemic?
      Many scientists believe it is a matter of time until the next influenza pandemic occurs. However, the timing and severity of the next pandemic cannot be predicted. Influenza pandemics occurred three times in the past century — in 1918-19, 1957-58, and 1968-69. Avian influenza (bird flu) is a disease of wild and farm birds caused by influenza viruses. Bird flu viruses do not usually infect humans, but since 1997, there have been a number of confirmed cases of human infection from bird flu viruses. Most of these resulted from direct or close contact with infected birds. The spread of bird flu viruses from an infected person to another person has been reported very rarely and has not been reported to continue beyond one person. A worldwide pandemic could occur if a bird flu virus were to change so that it could easily be passed from person to person.
  3. Is it safe to eat poultry?
      Yes, it is safe to eat properly cooked poultry. Cooking destroys germs, including the bird flu virus. The US bans imports of poultry and poultry products from countries where bird flu has been found.
  4. Is influenza A (H5N1) virus the only avian influenza virus of concern regarding a pandemic?
    Although H5N1 probably poses the greatest current pandemic threat, other avian influenza A subtypes also have infected people in recent years. For example, in 1999, H9N2 infections were identified in Hong Kong; in 2002; and 2003, H7N7 infections occurred in the Netherlands and H7N3 infections occurred in Canada. These viruses also have the potential to give rise to the next pandemic.
  5. Why won't the annual flu vaccine protect people against pandemic influenza?
      Influenza vaccines are designed to protect against a specific virus, so a pandemic vaccine cannot be produced until a new pandemic influenza virus emerges and is identified. Even after a pandemic influenza virus has been identified, it could take at least six months to develop, test and produce vaccine.
  6. How much time does it take to develop and produce an influenza vaccine?
      The influenza vaccine production process is long and complicated. Traditional influenza vaccine production for the U.S. relies on long-standing technology based on chicken eggs. This production technology is labor-intensive and takes nine months from start to finish.
      The flu vaccine production process is further complicated by the fact that influenza virus strains continually evolve. Thus, seasonal flu vaccines must be modified each year to match the strains of the virus that are known to be in circulation among humans around the world. As a result of this constant viral evolution, seasonal influenza vaccines cannot be stockpiled year to year. The appearance of an influenza pandemic virus would likely be unaffected by currently available flu vaccines. Researchers are making and testing possible H5N1 vaccines now. Large amounts of vaccine cannot be made before knowing exactly which virus will cause the pandemic. It could then take up to six months before a vaccine is available and in only limited amounts at first. Research is underway to make vaccines more quickly.
  7. How will vaccine be distributed if a pandemic breaks out? Who will decide who gets vaccination first and who will have priority?
    Most likely, the federal government will work with manufacturers, distributors and states and the states will develop distribution plans at the local level. States are developing and improving plans to distribute a vaccine rapidly. These plans build on experience gained from other emergencies. The greatest risk of hospitalization and death—as seen during the last two pandemics in 1957 and 1968 pandemics and during annual influenza—will be in infants, the elderly, and those with underlying health conditions. These individuals, along with health care providers, who are critical to maintaining a health care system in a pandemic, would likely be the first individuals to receive the first supplies of vaccine. However, in the 1918 pandemic, most deaths occurred in young adults, highlighting the need to remain flexible on determining priorities for vaccination groups based on the epidemiology of an emerging pandemic.
      As part of planning efforts, two Federal advisory committees—the Advisory Committee on Immunization Practices and the National Vaccine Advisory Committee—have made recommendations for prioritizing critical populations that might receive the first supplies of vaccine. These recommendations can be found in the Health & Human Services Pandemic Plan, which is available at
  8. Is a shortage of Tamiflu (or other anti-virals) anticipated? If so, what is the government doing to prevent such a shortage?

      HHS is stockpiling enough anti-virals to treat 25% of the U.S. population should a pandemic occur in the U.S. This figure is based on historical data from past pandemics indicating that roughly 25% of the population would get sick in a pandemic and would benefit from antiviral treatment if started early in the course of illness. To date, the U.S. government has purchased 26 million antiviral treatment courses and expects to have on hand a total of 81 million treatment courses by the end of 2008.
  9. What strategies will help protect Americans?
      In the event of a pandemic, certain public health measures may be important to help contain or limit the spread of infection as effectively as possible. This could include:
    1. Isolating sick people in hospitals, homes, or other facilities,
    2. Identifying and quarantining exposed people,
    3. Closing schools and workplaces as needed,
    4. Canceling public events, and
    5. Restricting travel.
        In addition, people should protect themselves by:
    6. Getting seasonal flu shots,
    7. Washing hands frequently with soap and water,
    8. Staying away from people who are sick, and
    9. Staying home if sick.
  10. Will wearing a surgical mask protect people from the flu?
      Surgical masks are recommended for health care workers who are subjected to repeated exposure to multiple patients. For health care workers performing certain medical procedures on infected patients, respirators are recommended. Surgical masks are also recommended for patients who are infected to help reduce the potential for spread of virus when these people cough or sneeze.
  11. In addition to coughing and sneezing, can one acquire the virus by handshakes, kissing, sharing drinks, etc.?
      Influenza virus is primarily spread by airborne droplets that reach the eyes, nose or mouth but can also spread by touching contaminated surfaces and then touching one’s face. This highlights the importance of learning and practicing good personal hygiene, including:
    1. Wash hands frequently with soap and water.
    2. Cover your mouth and nose with a tissue when you cough or sneeze.
    3. Put used tissues in a wastebasket.
    4. Cough or sneeze into your upper sleeve if you don't have a tissue.
    5. Clean your hands after coughing or sneezing. Use soap and water or an alcohol-based hand cleaner.
    6. Stay at home if you are sick.
  12. Could terrorists spread the avian influenza viruses to create a worldwide pandemic?
      Experts believe it highly unlikely that a pandemic influenza virus could be created by terrorists. Developing a pandemic influenza virus would require extraordinary scientific skill as well as sophisticated scientific equipment and other resources.
  13. How would pandemic flu affect communities and businesses?
      If an influenza pandemic occurs, many people could become sick at the same time and would be unable to work. Many would stay at home to care for ill family members. Schools and businesses might close to try to prevent disease spread. Large group gatherings might be canceled and public transportation might be scarce. These are examples of challenges that local communities, schools, civic organizations, and businesses will have to work together on to plan for a pandemic response.

February 1, 2007 Update From CDC

To ask a question of DPI staff regarding the pandemic, please use this link.

Please refer to this website for all question responses. Thank you.

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North Dakota Department of Public Instruction
Kirsten Baesler, State Superintendent
600 E. Boulevard Avenue, Dept. 201
Bismarck, North Dakota 58505-0440

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