In the last century, three influenza pandemics have swept the globe. In 1918, the first pandemic (sometimes referred to as the “Spanish Flu”) killed over 500,000 Americans and more than 20 million people worldwide. One-third of the U.S. population was infected, and average life expectancy was reduced by 13 years. Pandemics in 1957 and 1968 killed tens of thousands of Americans and millions across the world. Scientists believe that viruses from birds played a role in each of those outbreaks.

Today, we face a new threat. A new influenza strain — influenza A (H5N1) — is spreading through bird populations across Asia, Africa, and Europe, infecting domesticated birds, including ducks and chickens, and long-range migratory birds. The first recorded appearance of H5N1 in humans occurred in Hong Kong in 1997. Since then, the virus has infected over 200 people in the Eastern Hemisphere, with a mortality rate of over 50 percent.

At this time, avian influenza is primarily an animal disease. Human infections are generally limited to individuals who come into direct contact with infected birds. If the virus develops the capacity for sustained, efficient, human-to-human transmission, however, it could spread quickly around the globe. In response to this threat, the President issued the National Strategy for Pandemic Influenza on November 1, 2005. The Strategy outlines the coordinated Federal Government effort to prepare for pandemic influenza. Of equal importance, the Strategy underscores the critical roles that State, local, and tribal authorities, the private sector, and communities must play to address the threat of a pandemic, and the concrete steps that individuals can and should take to protect themselves and their families.

• Chapters 2 and 3 (U.S. Government Planning and Response) describe the unique threat posed by a pandemic that would spread across the globe over a period of many months; the specific and coordinated actions to be taken by the Federal Government as well as its capabilities and limitations in responding to the sustained and distributed burden of a pandemic; and the central importance of comprehensive preparation at the State, local, and community levels to address medical and nonmedical impacts with available resources.

• Chapters 4 and 5 (International Efforts and Transportation and Borders) outline steps we will take to work with our international partners to prevent, slow, or limit the spread of infection globally and in the United States, and describe proposed measures for effective management of our borders and the transportation sector during a pandemic.

• Chapter 6 (Protecting Human Health) details the critical actions that public health authorities, nongovernmental organizations, the private sector, and individuals should take to protect human health and reduce the morbidity and mortality caused by a pandemic.

• Chapter 7 (Protecting Animal Health) highlights the actions necessary to prevent and contain outbreaks in animals with the aim of reducing human exposure and the opportunity for viral mutation that could result in efficient human-to-human transmission.

• Chapter 8 (Law Enforcement, Public Safety, and Security) outlines the support that State and local law enforcement and public safety agencies must provide, with appropriate Federal assistance, to public health efforts and essential public safety services, and to maintain public order.

• Chapter 9 (Institutional Considerations) provides guidance for the preparation of essential pandemic plans by Federal, State, local, and tribal authorities, businesses, schools, and non-governmental organizations to ensure continuity of operations and maintenance of critical infrastructure. It also provides guidance for families and individuals to ensure appropriate personal protection. To address the threat of pandemic influenza, it is essential that such plans be put in place as soon as possible.

The Implementation Plan represents a comprehensive effort by the Federal Government to identify the critical steps that must be taken immediately and over the coming months and years to address the threat of an influenza pandemic. It assigns specific responsibilities to Departments and Agencies across the Federal Government, and includes measures of progress and timelines for implementation to ensure that we meet our preparedness objectives.

This Plan will be revised over time. The pandemic threat is constantly evolving, as is our level of preparedness. The actions, priorities, timelines and measures of progress will be reviewed on a continuous basis and revised as appropriate to reflect changes in our understanding of the threat and the state of relevant response capabilities and technologies. Additional details regarding the implementation of this Plan are included at the conclusion of Chapter 1.

The active engagement and full involvement of all levels of government and all segments of society, including at the community level, are critical for an effective response. Ultimately, however, the actions of individuals will be the key to our response. (Preface)

Download National Strategy for Pandemic Influenza: Implementation Plan

PDF format, 4.11MB, 233Pages.

Homeland Security Council, May 2006.

The Pandemic Threat

Influenza viruses have threatened the health of animal and human populations for centuries. Their diversity and propensity for mutation have thwarted our efforts to develop both a universal vaccine and highly effective antiviral drugs. A pandemic occurs when a novel strain of influenza virus emerges that has the ability to infect and be passed between humans. Because humans have little immunity to the new virus, a worldwide epidemic, or pandemic, can ensue. Three human influenza pandemics occurred in the 20th century, each resulting in illness in approximately 30 percent of the world population and death in 0.2 percent to 2 percent of those infected. Using this historical information and current models of disease transmission, it is projected that a modern pandemic could lead to the deaths of 200,000 to 2 million people in the United States alone.

The animal population serves as a reservoir for new influenza viruses. Scientists believe that avian, or bird, viruses played a role in the last three pandemics. The current concern for a pandemic arises from an unprecedented outbreak of H5N1 influenza in birds that began in 1997 and has spread across bird populations in Asia, Europe, and Africa. The virus has shown the ability to infect multiple species, including long-range migratory birds, pigs, cats, and humans. It is impossible to predict whether the H5N1 virus will lead to a pandemic, but history suggests that if it does not, another novel influenza virus will emerge at some point in the future and threaten an unprotected human population.

The economic and societal disruption of an influenza pandemic could be significant. Absenteeism across multiple sectors related to personal illness, illness in family members, fear of contagion, or public health measures to limit contact with others could threaten the functioning of critical infrastructure, the movement of goods and services, and operation of institutions such as schools and universities. A pandemic would thus have significant implications for the economy, national security, and the basic functioning of society.

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