**PANDEMIC INFLUENZA ALERT SYSTEM**

**SIX PHASES ESTABLISHED BY THE WORLD HEALTH ORGANIZATION**

+----------------------+---------------------------------------+-------+
| **Inter-pandemic     | **Low risk of human cases**           | **1** |
| Phase**              |                                       |       |
|                      |                                       |       |
| **New virus in       |                                       |       |
| animals, no human    |                                       |       |
| cases**              |                                       |       |
+----------------------+---------------------------------------+-------+
|                      | **Higher risk of human cases**        | **2** |
+----------------------+---------------------------------------+-------+
| **Pandemic Alert**   | **No, or very limited, human-to-human | **3** |
|                      | transmission**                        |       |
| **New virus, causes  |                                       |       |
| human cases**        |                                       |       |
+----------------------+---------------------------------------+-------+
|                      | **Evidence of increased               | **4** |
|                      | human-to-human transmission**         |       |
+----------------------+---------------------------------------+-------+
|                      | **Evidence of significant             | **5** |
|                      | human-to-human transmission**         |       |
+----------------------+---------------------------------------+-------+
| **PANDEMIC**         | **Efficient and sustained             | **6** |
|                      | human-to-human transmission**         |       |
+----------------------+---------------------------------------+-------+

**PANDEMIC INFLUENZA ALERT SYSTEM**

Almost daily we hear about the outbreak of avian flu and how it is
spreading to countries around the world. While the avian flu is not yet
in the United States, it may arrive here in the near future. Experts at
the World Health Organization and elsewhere believe that the world is
now closer to another influenza pandemic than at any time since 1968,
when the last of the previous century\'s three pandemics occurred. It is
impossible to anticipate when the next pandemic might happen or how
severe its consequences might be.

Local education agencies play an integral role in protecting the health
and safety of the districts' staff, students and their families. Because
of the complicated issues that schools would face should a true pandemic
occur, it is imperative that we plan and prepare now. It is only a
matter of time before the next pandemic arises, so by developing a
strong response plan now, we are prepared for what will inevitably
happen in the future.

The World Health Organization uses a series of six phases of pandemic
alert as a system for informing the world of the seriousness of the
threat and of the need to launch progressively more intense preparedness
activities. The designation of phases, including decisions on when to
move from one phase to another, is made by the Director-General of the
World Health Organization.

Changes from one phase to another are triggered by several factors,
which include the epidemiological behavior of the disease and the
characteristics of circulating viruses. It is important for school
officials to designate someone to monitor influenza surveillance systems
and help gather and disseminate information as needed to staff,
students, and parents.

To help school officials address the different phases of this alert
system, the Orange County Department of Education has developed the
following set of guidelines for schools. These are general actions for
schools to take that coincide with each color-coded pandemic phase
level. In the event that the World Health Organization changes from one
phase to another, school districts may or may not need to take specific
protective actions. These are general guidelines and you can add or
delete as you feel appropriate.

**PHASES OF PANDEMIC INFLUENZA AND RECOMMENDATIONS FOR SCHOOLS**

Each of the following pandemic influenza phases represents an increasing
risk to the general population. **Each school district is responsible
for developing and implementing appropriate and specific pandemic
response plans.**

This phase is declared when there is a low risk of human cases. The
following actions should be considered:

-   Implement a sound health and hygiene program for all staff and
    students to follow.

-   Develop specific pandemic response procedures and add to existing
    emergency plans.

-   Conduct routine inventories of first aid and medical supplies.

-   Verify that illnesses are properly monitored at each school site.

-   Increase pandemic influenza awareness and strengthen training for
    school staff.

This phase is declared when there is a higher risk of human cases. The
following actions should be considered:

-   Review and update school emergency plans; include pandemic response
    procedures.

-   Review current communication plan to notify parents in times of
    emergency.

-   Provide staff members and parents/guardians with any information
    that would strengthen a schools ability to respond to a pandemic.

-   Promote the importance of reducing the spread of illness; remind
    parents to keep sick children at home and remind staff members to
    stay home when they are sick.

This phase is declared when there is no, or very limited transmission
among humans, but the virus continues to spread rapidly among animals.
The following actions should be considered in addition to any specific
plans that are developed and implemented:

-   Communicate the current phase level to all staff members and train
    them in pandemic response plans as they are developed.

-   Identify a person in your agency who will monitor government sources
    for warnings.

-   Gather and disseminate pertinent information as it becomes
    available.

-   Establish an internal planning team and develop specific pandemic
    response procedures.

-   Identify who will make the decision to close schools and at what
    point that decision will be made.

-   Begin to consider the possibility of school closures and that staff
    members may not be able to report to work.

-   Continue to make sure that proper health and hygiene procedures are
    being followed by staff and students.

-   Review whether the precise characteristics of the pandemic threat
    require the refinement of any current emergency plans.

This phase is declared when there is evidence of an increased number of
human to human transmissions. The following actions should be
considered:

-   Communicate the increase in phase level to all staff members.

-   Monitor influenza surveillance systems for the current
    characterization of the virus.

-   Identify the need to implement any recommended social distancing
    measures.

-   Encourage students and staff members who become ill after traveling
    to affected countries to see their health care provider.

-   Report an increase in student and staff illness to the Orange County
    Health Care Agency Epidemiology Department at (714) 834-8180.

This phase is declared when there is significant transmission among
humans. The following actions should be considered in addition to any
specific recommendations from local and state health officials:

-   Communicate the increase in phase level to all staff members and
    parents.

-   Monitor influenza surveillance systems for the current
    characterization of the virus.

-   Identify the need to implement any additional social distancing
    measures.

-   Evaluate your chain of command and identify key decision makers.

-   Assess school events and take additional precautions, if necessary.

-   Consider assigning mental health counselors for students and staff
    members, if needed.

-   Discuss student's fears concerning a pandemic and offer available
    resources.

This phase indicates the presence of a true pandemic. In conjunction
with local and state health officials, determine the appropriate
response with these considerations in mind:

-   Communicate the increase in phase level to all staff members.

-   Review the districts chain of command ensuring that a decision maker
    is available at all times.

-   Gather and provide pertinent information to students, staff and
    parents.

-   Assess the pandemic condition on a regular basis and evaluate
    whether any further protective measures are needed.

-   Evaluate recommendations from health officials for social distancing
    and quarantine and be prepared to respond accordingly.

-   Consider canceling special events.

-   Mobilize Crisis Response Teams to meet the mental health needs of
    students and staff members, if needed.

> **ADDITIONAL LINKS AND RESOURCES**
>
> **\
> Orange County Health Care Agency**
>
> **[www.ochealthinfo.com/epi/af/]{.underline}**
>
> **Official US Government Website\
> [www.pandemicflu.gov](http://www.pandemicflu.gov/)\
> \
> Centers for Disease Control & Prevention\
> [www.cdc.gov/flu/avian/gen-info/index.htm](http://www.cdc.gov/flu/avian/gen-info/index.htm)**
>
> **Center for Disease Control - Respiratory Hygiene Etiquette**
>
> **[www.cdc.gov/flu/professionals/pdf/resphygiene.pdf]{.underline}**
>
> **School District (K-12) Pandemic Influenza Planning Checklist**
>
> **[www.pandemicflu.gov/plan/pdf/schoolchecklist.pdf]{.underline}\
> \
> World Health Organization -- Avian Influenza Information\
> [www.who.int/csr/disease/avian_influenza/en](http://www.who.int/csr/disease/avian_influenza/en)\
> \
> World Health Organization's Human Case Count\
> [www.who.int/csr/disease/avian_influenza/country/en](http://www.who.int/csr/disease/avian_influenza/country/en)\
> \
> Precautions for Travel to Countries Reporting H5N1
> [www.cdc.gov/travel/other/avian_influenza_se_asia_2005.htm](http://www.cdc.gov/travel/other/avian_influenza_se_asia_2005.htm)**
>
> You can find this document and other helpful pandemic influenza
> information on our website at
>
> http://emergency.ocde.us/